5 Most Common Hoof Pathologies

1. 5 Most Common Hoof Pathologies Treatment and Prevention Leslie Taylor

2. 5 Common Hoof Pathologies • 1. Thrush • 2. White Line Disease (Seedy Toe) • 3. Club Foot • 4. Navicular Disease • 5. Laminitis

3. #1 Thrush Thrush is cause by an anaerobic bacterial infection of Fusobacterium Necrophorum . This bacteria is commonly found in the normal flora of the mouth and large intestines. A horse’s stall or pasture normally contains this bacteria due to waste. When dirt or feces become trapped in the hoof, an environment for excessive bacterial growth occurs resulting in thrush.

4. #1 Thrush: Causes • Poor hygiene: Muddy pastures and dirty stalls, lack of daily hoof cleaning • Lack of movement: Decrease circulation in the hoof which causes unhealthy hooves, increasing the risk of infection. • Diet: High carb diet from processed grains and lack of nutrients prevent healthy hoof growth. • Abnormal hoof: Deep collateral grooves/sulcus.

5. #1 Thrush: Signs/Symptoms Noticeable pungent, foul smell when picking the hoof. Thick black substance in or around the frog. Soft frog with unusually deep clefts or groves. Sore and tender heels. Lameness.

6. #1 Thrush: Treatment Hygiene: Keep the hoof clean and remove black debris. Keep pastures clean and dry. Diet: Provide a diet of mixed hays, vegtables, fruits, natural seeds and grains and decrease or eliminate processed grains. Movement: Allow pasture time with buddies to increase movement. Remedies: Daily apply thrush tx or natural remedies such as Apply Cider Vinegar.

7. #1 Thrush: Hoof Debridement In this photo we can see all the black necrotic tissue that needs to be removed due to thrush. Only trim down to healthy tissue. Remove shoe and provide natural trim Remove necrotic sole Debride black necrotic frog and collateral groove tissue

8. #1 Thrush: Treatment Natural Traditional • Decrease processed grains, increase mixed hays, seeds, fruits, vegetables. • Keep environment and hooves clean and dry. • Use a natural trim to promote a healthy, strong, comfortable hoof. • Allow movement for increased hoof circulation • Natural treatments such as Apple Cider Vinegar RESULTS: Strong healthy barefoot hooves that resist bacterial and fungal invasion! • Continue with diet of processed grain • Debride necrotic tissue and replace shoes. • Add shoe pads for “comfort” and to keep hoof clean. • Decrease turnout to prevent dirt in hooves. • Use thrush treatments daily during episode. RESULTS: May eliminate thrush during this cycle but does nothing to build a strong comfortable hoof or prevent future episodes.

9. #1 Thrush: Prevention • Hygiene: Hooves that have a natural barefoot trim are “self cleaning.” This means that dirt and debris naturally fall out of the hoof during movement. Clean hooves daily if debris is accumulating in the hoof. • Environment: Provide dry areas for horses to move around. Keep stalls clean. Moisture and wastes increase bacteria. Movement increases circulation which promote healthy hoof growth. • Diet: Eliminating or decreasing processed grains decreases the work of the pancreas which increase the immune system.

10. #2 White Line Disease (WLD) White Line Disease is caused by fungi alone or with bacteria that infiltrates the hoof and feeds on and destroys the keratin tissue of the hoof wall. This can be found in 1 or all 4 hooves. Also called “Seedy Toe,” Onychomycosis, or “Stall Rot.”

11. #2 White Line Disease: Causes • Horses that are fed processed grain have increased blood glucose levels. The pancreas works overtime to produce insulin to decrease the blood glucose levels. This results in a decreased immune system. • The decreased immune system cannot easily fight off fungi and bacteria that are commonly present in the environment. • The fungi take up residence in the hoof wall, feeding on the keratin. Trauma or cracks provide access. • The fungi and bacteria are anaerobic, therefore they love oxygen- depleted environments and travel further up the hoof to the coronet band. Decreased circulation from lack of movement (stalled horses) also contributes to a decrease in oxygen in the hooves. • Other stressors which decrease the immune system can also contribute to this disease.

12. #2 White Line Disease:Signs and Symptoms • Soft, chalky, crumbly horn tissue in the middle of the wall (Stratum Medium), which can extend from ground to coronet. • Irregular thickening of the white line, more than 1/8th inch. • Hooves chip easily and cannot hold a shoe • Shows up as a large pocket on x-ray. • Dished appearance on one side with a bulge on the other side of hoof. • Laminitis if WLD spread to inner wall

13. #2 White Line Disease: Treatment Provide a proper balanced trim and allow movement to increase the circulation and promote growth of a new healthy hoof. Cut away the crumbling wall to expose anaerobic infection to oxygen. Carbon Dioxide treatment

14. #2 White Line Disease: Treatment • To trim this hoof, the toe needs to be shortened at line A. • The heel at B needs to be shortened to allow the hoof and leg to rotate back to vertical. • At C, the wall flare needs to be filed to allow new hoof to grow straight down. • All of the circumferential wall flare (yellow line) needs to be filed down. B C A

15. #2 White Line Disease: Treatment Natural Traditional • Properly balanced barefoot trim. • Diet consisting of mixed hays, fruits, vegetables, seeds, and grains to promote proper nutrition and hoof growth. • Movement to increase the circulation to the hooves to increase oxygen and promote growth. • Clean, dry environment RESULTS: New healthy hoof will grow out. • Debride areas of hoof wall and repair with an acrylic composite • Shod normally or heartbar shoe for bony column support. • Apply broad-spectrum bacterio-fungicidal agents RESULTS: Infection will be killed by agents, acrylic may trap fungi inside, shoes prevent healthy hoof growth resulting in continuously week hoof.

16. #2 White Line Disease: Prevention • Prevention of White Line Disease is similar to its treatment. Maintain healthy, strong hooves with proper diet and movement. • Keep hooves balanced with barefoot trim to prevent cracks or trauma that allows microorganisms to invade hoof wall. • Maintain a dry, clean environment for the horse.

17. #3 Club Foot • Club foot is usually a hereditary condition in which the hoof has a long heel and a short upright toe. • The angle of the hoof is caused by a shortened Deep Digital Flexor Tendon. The hoof then grows to support this unnatural angle.

18. #3 Club Foot:Grades 1-4 • Grade 1. Feet are mismatched and affected foot is 3 to 5 degrees greater than the opposite foot. Affected foot is slightly smaller in circumference. • Grade 2. Affected foot is 5 to 8 degrees greater than the opposite foot. Growth rings are wider at the heels than at the toe. Sole touches the ground at the toe. Heels will not touch the ground when foot is properly trimmed parallel to the true frog. Walls are straighter than normal at the sides. • Grade 3. Growth rings at the heels are double the width than those at the front of the wall. The wall has a dish (flare) at the front. Coronary band extends over the dorsal surface of the hoof wall. Heels are closer to each other. • Grade 4. Foot is severely dished. Extreme contracture of hoof and heels are pinched together.

19. #3 Club Foot: Signs/Symptoms A club foot has a more upright and contracted appearance. The horse stands with a club foot back and the other foot in the forward position. The horse may stumble more frequently on a club foot. Horse is reluctant to take up lead on affect foot. Other front foot develops long toe/low heel.

20. #3 Club Foot: Signs/Symptoms Normal Hoof Club Hoof Above: Shows the usual “standing back” position of a club foot compared to a normal hoof. Above: Club foot on left front hoof.

21. #3 Club Foot: Causes Hereditary Suprascapular Nerve Damage: decrease range of motion in the scapula so the horse has to compensate by growing and upright hoof. The shoulder muscle on the club side is smaller and a rider may notice the saddle always slipping to that side. Pain: Often horses move in a way to avoid pain, this can result in increase musculature on the club side. Thrush, navicular, or other heel pain causes a horse to want to land toe first. Rider Imbalance: puts extensive pressure on one side of the horse causing imbalanced movement in the horse.

22. #3 Club Foot: Treatment DDFT Trimming a club foot to increase the hoof angle is a gradual process. Above, we can see the steps taken to slowly improve the angle of the hoof as well as the length of the Deep Digital Flexor Tendon.

23. #3 Club Foot: Treatment *The trimming process for this hoof will be progressive over several trimming cycles. *The first trim will be at Line A, with future trims continuing to lower the heel and lengthen the toe. *Care is taken not to cut into live sole during any of the trims. *This horse will also benefit from stretches and massage. Initial Trim A

24. #3 Club Foot: Treatment Natural Traditional • Maintain healthy diet to enhance optimal hoof growth. • Provide a balanced natural trim every 4 weeks to keep long heels in check. • Allow daily movement to promote lengthening of the tendon and to promote healthy hoof growth. • Oxytetracycline will aid in the "relaxation" of the tendons involved • Surgery to transect the inferior check ligament • Frequent trimming programs • Corrective shoes

25. #3 Club Foot: Treatment Natural Traditional • Massage therapy and stretching to increase movement in shoulders and legs. • Improve rider balance • Treat heel pain • RESULTS: As the horse becomes more comfortable, balanced and flexible. • RESULTS: Oxytetracycline requires repeated injections, shoes prevent heel wear and increase contraction of hoof, surgery may or may not have intended results. Additional causes of club foot are not assessed.

26. #4 Navicular Disease • Navicular Disease is defined at “Caudal Heel Pain,” which can include numerous problems associated with the hoof, however only deterioration of the Navicular Bone shown on X-ray proves true Navicular Disease. • This disease is gradual and progressive, taking years and multiple X-rays to diagnose. • The bone, bursa, and/or tendon are involved.

27. #4 Navicular Disease: Causes • Repetitive concussion on the hooves as a result of jumping, eventing, racing, etc. • Improper trimming: long toes and long heels cause Digital Cushion become fatty because frog has no contact with ground. This decreases shock absorption. • Under-run heels, overlaid bars, and contracted heels put pressure on the navicular area instead of behind it. • Confinement: decreases circulation in hoof.

28. #4 Navicular Disease: Signs and Symptoms • Horse stands on toes • Lameness after being work which improves with rest. • Heels become smaller and contracted due to decreased blood flow. • MRI shows inflammation in soft tissue around navicular bone. • Horses refuse work, swish tail, bob head, problems develop with performance. • Affects both front hooves at same time.

29. #4 Navicular Disease: Treatment Provide a proper balanced natural trim. Digital Cushion will begin absorbing shock and become less fatty. Allow horse adequate time for movement in a pasture with a buddy. This increases circulation to the hoof which promotes healing and decreases inflammation. Allow adequate resting from strenuous activities: Jumping, Racing, Eventing.

30. #4 Navicular Disease: Treatment Natural Traditional • Natural balanced trim: increases circulation by decontracting the heel which decreases inflammation, moves shock absorption back to frog and Digital Cushion and off of Navicular Bone, Bursa, and Tendon. • Light to medium work to decrease inflammation and increase circulation. • Heel pads and wedges on rocker-toed shoes to take pressure of Navicular Bone. • Pain medications such as phenylbutazone. • Injecting Corticosteroids into Navicular Bursa. • Light to medium work. • Desotomy (cutting of tendons) and Denerving to relieve pain. • Long-term blood thinners.

31. #4 Navicular Disease: Treatment *This horse is suffering from long toes and under run heels. We can see the hyper extended angle of the fetlock joint in the red lines. *First the shoes need to be removed and a balanced natural trim will follow. *The yellow line depicts where the toe and heel will be trimmed. This is a progressive process and cannot always be corrected in one trim.

32. #5 Laminitis • Laminitis is: • A. Inflammation of the foot inside the hoof capsule • B. Failure of an attachment between P3 and the inner hoof wall • C. A result of metabolic disturbances and consequent compromise of the digit’s biochemical integrity.

33. #5 Laminitis: Stages • Developmental Stage: non-symptomatic inflammation that causes laminitic rings. • Sub Acute Stage: mild period with less severe clinical signs and no mechanical failure (founder). Lasts 72 hours. • Acute Stage: Clinical changes in the hoof occur: pounding Digit Pulse, heat, sensitivity, lameness, camped out stance. • Lasts 72 hours and ends with rotation or sinking P3 • Refractory Stage: When horse no longer responds or minimally responds to treatment within 7-10 days.

34. #5 Laminitis: Causes Excess Carbs from processed grains or lush grass. Excess Weight, GI or Endocrine problems Stress, Shock Renal, Immune, and Respiratory Disorders Mechanical hoof problems Depression, Grief Vaccinations (Lactic Acid response to stress settles in hoof)

35. #5 Laminitis: Signs and Symptoms Lameness Bounding Digit Pulse Heat Sensitivity Camped out stance Sinking or Rotation of Coffin Bone confirmed on X-ray. Pressure ulcers on hips or sides from lying down.

36. #5 Laminitis: Treatment Natural Traditional • Provide a natural and balanced trim • Turn out 24/7 • Free choice mediocre hay • Limit/eliminate all grain for 72 hours. • Anti-inflammatories for no more than 3 days. • Herbs for hoof growth • Homeopathics: Tumeric, more effective than Bute, NSAIDS, or Cortisone Shots • DDFT Tenotomy to relieve chronic pain. • Heel Wedges to relieve strong pull off DDFT. • Rocker: Beveling hoof wall 15-20* to decrease weight bearing force on dorsal hoof. • Decrease or remove grain and rich hay. • Stall the horse • Anti-inflammatories, cortisone injections

37. #5 Laminitis: Treatment Natural Traditional • Provide organic grains, vitamins, and minerals. • Detoxification • No chemicals or processed foods. RESULTS: This path of treatment returns the horse and his hooves to health without causing further damage. Recovery is faster and more comfortable through a natural trimming process. RESULTS: Many of these treatments can harm the horse long term such as NSAIDS, tenotomies, heel wedges, and Rocker trims. And the do not focus on returning the hoof to natural health.

38. #5 Laminitis: Treatment *Trim hoof at red line. *File hoof flare back to yellow line. *Progressively shorten heels with each trim cycle.

39. #5 Laminitis: Prevention • Do not allow horses to graze uncontrollably on lush pastures. • Do not feed sweet feeds or excessive amounts of processed grains. • Supply a hay mixture that is not too rich yet has vital nutrients. Supply fruits, vegetables, seeds, and grains. • Keep horses turned out as much as possible to promote movement. • Monitor for hoof changes during times of stress.

40. Summary • 5 Most Common Hoof Pathologies • Thrush • White Line Disease • Club Foot • Navicular • Laminitis