Reverse shoes......

[Derin Foor]

How much longer do we have to endure the shoeing prescription of "reverse shoes" for laminitis from vets? :mad:

is this a local problem or is it as wide spread as I think it is?.....I have never, nor will I ever, apply a reverse shoe....sure it reduces break-over, I'll give them that....but it does NOTHING to reduce the pull of the DDFT which is creating a large percentage of the pain in the first place for the laminitic horse.....if a reverse shoe works then I would argue that there are far better options available to today's farrier that could do the same thing with better results

ever taken a pair off where the entire foot is falling through the 'barshoe without a toe' ?....sometimes I wonder who is less educated, the vet that prescibes this or the farrier willing to go along with the idea....when are the farriers going to take a stand for what is right for the horse instead of what appears politically correct?

farriers, educate the vets that you work with...share the new ideas that you get at the clinics, etc.....if they aren't willing to try new things based on good solid research, their (and your) practice is going to hit a dead end soon

JMO,

Derin

[Ronald Aalders]

Hi Derin,

Obviously I could not agree more. Education is vital.

But if you allow me to be the Devil's advocate for once, there is not too much scientific research done on this particular subject. Relieving DDFT pull worked for me in a very convincing number of cases. Enough to spend a lot of time explaining it to others, owners, shoers and vets. Everyone reading my posts will learn that a high in field succes ratio is enough to convince me, but as Dr. O'Grady pointed out to me more than once, we are not discussing an approach that does not raise questions at all anymore. He's got a point I guess. (Although I really resent the implication here that -in that view-in field succes ratios apparently add up to a pile of manure.)

We all know the (very few) people who stick their necks out and promote their protocols. Thanks to those people we get closer step by step. On the other hand I can also understand vets who may well be the best to have around with colic cases, have a hard time visualising the mechanics at play in a laminitis case. Shoot, it's not always easy for me.

So in my view, this is where you come in. As a well informed experienced shoer I feel it's upon you to try and point out the disadvantages of applying just a reverse shoe on a laminitis case. And if the vet is very adamant about the reverse shoe, you may find that with a few extras even a reverse shoe could help a little on a chronic. Maybe not as much as you'ld wish but if the other option is leaving it to a less experienced shoer ánd a fight with a vet..........

When faced with a situation where egos have people drift away from what they are supposed to do, help out a crippled horse, let it be the horse shoer to pick the lesser of all evils. Like I had to once.............


Ronald Aalders

[calshoer]

I don't completely discount reverse shoes. Though I find EDSS far superior because the the adjustability, even since I began doing and teaching EDSS I have actually used reverse shoes on one case, while applying the same principles and mechanics as in EDSS to the hoof prep, breakover AND deciding is they need wedges or not. This case was a little tiny foxtrotter who was pony size and would not fit in the smallest EDSS . BUT I added frog support exactly like in the picture of Ronald's, AND was absolutely sure the foot would not need a wedge before I put the flat reverse shoe on.
Not all laminitis cases are subject to excess DDFT pull.
In my experience, If the rotated, then they are, and therefore may need a wedge after you derotate the foot, but if the sunk without rotation they are not subject to excess DDFT pull , and do better left flat.

The footfall after trimming / derotating tells me if wedge is needed or not.
If a laminitic horse is reaching out and slapping those heels down, he does not have problem with DDDF pull and a reverse shoe WITH appropriate frog suppot may be enough.

Unfortunately too many veterinarians and farriers get "stuck" on one shoeing protocol and do not know how to differenciate those that need more help and those that do not. It is a sort of "If it worked on the last one then use it on every one.." Well they forget that every one is different. That is the problem.

Actually, most cushings syndrome or otherwise metabolically imbalanced (EMS) horses do better with less movement in the heels of the foot because the laminae there are weakened too, so the "egg bar" effect of the reverse shoe helps stabilize the heels. On Those horses I will use the Steward Clogs or a similar flat solid package for that reason.

But again, frog support needs to be part of this equation. So wit hadded components , the reverse shoe itself does not necessarily dictate that the principles and mechanics you end up with have to be deficient.
Patty

[Ronald Aalders]

In my experience, If the rotated, then they are, and therefore may need a wedge after you derotate the foot, but if the sunk without rotation they are not subject to excess DDFT pull , and do better left flat.

Patty

Excactly, sinkers don't need a wedge.


Ronald Aalders

[Stephen E. O'Grady, DVM]

Hi Derin,

Obviously I could not agree more. Education is vital.

But if you allow me to be the Devil's advocate for once, there is not too much scientific research done on this particular subject. Relieving DDFT pull worked for me in a very convincing number of cases. Enough to spend a lot of time explaining it to others, owners, shoers and vets. Everyone reading my posts will learn that a high in field succes ratio is enough to convince me, but as Dr. O'Grady pointed out to me more than once, we are not discussing an approach that does not raise questions at all anymore. He's got a point I guess. (Although I really resent the implication here that -in that view-in field succes ratios apparently add up to a pile of manure.)

Ronald Aalders

Ron,

I enjoy your posts and your thinking. I don't discount the work you do in the field one bit. What I say is do***ent your work, have it reviewed and then published in a reputable journal. It then becomes part of the literature and it becomes credible vs. ancedotal. I just got a paper on laminitis accepted that I submitted three years ago. Its often a long process but I feel worth it.

I agree with Derin that the reverse shoe has little place in the treatment of laminitis. This shoe is just not logical to me as I feel there are better methods. But that's just my opinion. Remember we are heaped in tradition and all creatures of habit. The use of a reverse shoe is still taught in many vet schools.

There is no right way or wrong way to shoe a laminitic horse. If one knows the anatomy/mechanics of the normal foot and knows the anatomy/mechanics of the laminitic foot - any shoeing system or combination there of can be used to address the pathology created by the disease process.

Keep up the great posts

Stephen E. O'Grady, DVM, MRCVS

[balazsborbely]

I think that the main point is to have a lucky asessment of what type of laminitis you are dealing with and especially what Stage the process is in. Sometimes when dealing with a bit overweight, bit liverr disfunctional, elderly pony, who had the honour to mturn 2-3 kids into hunter class champions and silently developed a recurring mild laminitis, usually never lame but showing ugly massive scar tissue in the laminae and after a strong season suddenly turning very lame, the best option WAS a reversed shoe (pony living outdoors 24/7). Pony is back, up and running. I find though, that a reversed shoe is best made of racing plates, since it is only meant to encourage the horse to put its heels on the groud while getting shaped back towards normal. To the whole truth I need to say, that under the New Zealand climate you usually do not have to worry about supporting frogs, rather the opposite, how to apply barshoes and the like without putting extra pressure on the massive frogs.
So, for me the key is to understand that all cases are different indeed, and to consider any possible treatment. You also must not forget, that not all foundered hooves that you get belong to a horse of "money is not an issue"owners, so before you begin with tooo much hocus-pocus you might consider simple old stuff. It might work in some cases.
Cheers and not too many laminitic cases, everyone. ;-)
BB.

[Ronald Aalders]

Ron,

I enjoy your posts and your thinking. I don't discount the work you do in the field one bit. What I say is do***ent your work, have it reviewed and then published in a reputable journal. It then becomes part of the literature and it becomes credible vs. ancedotal. I just got a paper on laminitis accepted that I submitted three years ago. Its often a long process but I feel worth it.

Stephen E. O'Grady, DVM, MRCVS

Funny you say that Dr. O´Grady, recently one of my former lawschool professors said the same thing. So I started it, getting it published may be a challenge, writing down what your learned in the field in a comprehesible way is too!

Could you link us to that paper on laminitis, after its been published?


Ronald Aalders