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Saturday November 18, 2017
12
Jul
Category: Essays For Horse Owners
Hits: 5880

Founder. The very word can send a cold shiver down the spine of many a horseman. This misleading and potentially devastating condition has meant the end of many horses' careers; and sometimes even their lives. But just how does a bellyache or other stress cause a horse to be crippled? And what can be done about it?

To understand the answers to those question, one must have some basic knowledge of the anatomy of the equine foot. The hoof wall is the primary weight bearing structure of the foot. Within it is the PIII (Third Phalanx or Coffin Bone). The PIII is attached to the hoof wall by laminae. The laminae are special tissues which provide awesome attachment strength, but also allow the wall to grow down in relation to the bone.

The laminae are nourished by tiny blood capillaries. These capillaries normally provide a steady flow of oxygen and nutrients to the vital laminitic tissues. As a precaution against frostbite, the circulatory system of the hoof has structures called AVAs (Arterio Venous Anastomoses) which can channel blood directly from the arteries into the veins, bypassing the fine capillaries. When the hoof becomes too cold, the AVAs open up and allow large amounts of hot blood to rush through the foot without being slowed by the high-resistance of the capillary network. This continues long enough to warm the foot up, but not so long as to starve the laminae.

Poisons ingested by the horse, toxins created within the horse after a feed binge, and a number of other systemic illnesses can create body chemistry imbalances that can cause the AVAs to malfunction. If the AVAs "lock" open for an extended period of time, the hoof will become hot from the rapid flow of blood within it, while the laminae will begin to die from the lack of blood actually reaching them. This is laminitis.

Recent studies have shown that the laminar tissues can survive ischemia (lack of blood flow) quite a long time. But this ischemia was triggered by exposing the hooves to cold, which caused the AAs to open. Cold tends to reduce cellular metabolism, and the need for blood in the tissues. Laminitis involves ischemia while the hooves are quite hot, and the tissues have an increased need for circulation.

Because of the heat and high blood flow through the foot, laminitis has often been misunderstood. Even the word laminitis, which basically means inflammation of the laminae, reflects this misunderstanding. The problem is not the "fever" in the feet, but ischemia of the laminae. Thus the long standing remedy of soaking laminitic feet in cold water is indicated only during the initial phase of laminitis, when cooling the laminar tissues might help them survive the ischemia caused by the locked-open AVAs. After the early phase of laminitis, cold water may numb the pain a bit, but it also retards blood circulation which could make things worse. If enough laminae are killed by laminitis to allow the PIII to loose its attachment to the hoof wall, and the bone begins to sink within the hoof, you have founder.

Because the laminae at the toes of the front feet are under the greatest mechanical stress and have comparatively precarious blood supply, most founder cases involve separation of the laminae in that area. In such cases the toe of the PIII sinks, causing that bone to rotate in relation to both the hoof wall and the pastern bones. The tip of the PIII moves down toward the sole of the foot, often causing bruising, hematoma, and the loss of the sole's concave shape. At the same time, the hoof wall at the toe is free from its moorings and begins to "peel" away from the PIII. The increasing gap between the wall and PIII is filled with scar horn material.

As if all this weren't bad enough, the separations in the foot's protective structure, bruising, loss of circulation, and necrosis all team up to make nasty abscesses in the hoof likely. The burden of early treatment of laminitis falls primarily on the veterinarian. This treatment often involves dealing with the cause of the toxic reaction that instigated the laminitis and trying to promote capillary circulation through drugs. The vet may also administer pain killers, but most agree that these should be used only in the short term and within limits. The pain of laminitis tends to make horses stay still and off of their feet, which is just what they need to do.

If the laminitis progresses into founder, the treatment burden shifts to the farrier. The traditional approach for farrier treatment of founder is to lower the heels until the frog bears weight, then dress back the toes back as far as reasonably possible. This practice helps to shift the weight bearing away from the damaged toe to the heels, which are usually in better shape. Dressing back the toe reduces breakover stress and helps prevent the hoof wall at the toe from being pulled further away from the PIII. Lowering the heels also brings the PIII closer to its normal position in relation to the ground and pastern bones. Although the frog need not bear weight in a normal hoof, in a foundered foot, the frog can provide valuable support. Some farriers also cut a horizontal groove across the front of the hoof about an inch below the coronary band. This provides a flex point to prevent stress from being transferred up the toe to peel back the laminae which are left intact in the upper part of the hoof, and helps prevent the blood flow from being pinched off between the extensor process of the PIII and the hoof wall.

A shoeing remedy for founder which no doubt owes part of its popularity to the fact that it requires minimal skills to fabricate is the backwards shoe. Mechanically, this shoe acts as a rockered-toe eggbar. As such it provides the horse with extra posterior support to compensate for the great lack of anterior support and reduces the stress on the Deep Digital Flexor tendon which pulls on the underside of the PIII and contributes to rotation. The rockered-toe effect reduces breakover stress which is also a benefit to foundered feet.

Because the sole is already compromised at the toe by the sinking tip of the PIII, pressure applied to the sole by the shoe can have ugly results. Since the backwards shoe places no metal on the toe of the hoof, it can create no harmful sole pressure there. Unfortunately, it also does nothing to protect the delicate anterior sole from pressure or injury from the ground. The backwards shoe also holds the frog up off the ground, depriving the PIII of the support in would have received from the ground through the frog. This makes the backwards shoe a less attractive approach when dealing with severe, active rotation founder cases.

Burney Chapman, veteran farrier, has expanded on the concept of supporting the PIII via frog pressure. Over the last decade and a half, he has popularized the use of the heart-bar shoe in treating founder. The heart-bar shoe is used to create carefully applied pressure on the frog. This supports the PIII and helps prevent further rotation. Supporting the bone helps restore the circulation that was compromised by its sinking. This improved blood flow is needed for the laminae to regenerate.

The main drawback to the heartbar is that it must be applied with precision. Pressure in the wrong places, or the wrong amount of pressure in the right places can do more harm than good. Mr. Chapman maintains that the reason many practitioners don't like the heartbar is that they do not know how to apply it correctly. While Mr. Chapman recommends the rigid heart-bar shoe, some farriers like to apply his basic approach using flexible frog insert pads.

Another method for treating founder has been popularized by veterinarian Ric Redden of the International Equine Podiatry Center. This method features dramatic raising of the heels using wedges and is based on the fact that the tension of the DDF tendon is an important contributing factor to the rotation of the PIII. The DDF runs down the back of the leg, passes under the navicular bone, and attaches to the underside of the PIII. Raising the heels reduces the pull of the DDF. As a salvage measure, Dr. Redden sometimes cuts the DDF altogether. The problem with heel elevation as a founder treatment is that, while it temporarily reduces one force responsible for PIII rotation, it also focuses mechanical loading where the hoof is least able to stand it; at the toe.

All of the shoeing treatments for founder outlined here have their own merits, and despite the fact that some of them seem diametrically opposed, they have each worked on given horses. It is up to the farrier to know which approach will work best based on his experience and the specifics of the case. In some cases, the farrier will combine aspects of each approach or change approaches as the progression of the founder dictates. This is why professional farriers are always continuing their education and trying to keep up with the latest techniques and research about this insidious condition. The more we know, the better the odds we can successfully diagnose and treat treat laminitis and founder.

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