Ronald Aalders wrote:
Perhaps all hoofcare professionals should consider that addressing and eliminating the cause of laminitis is imperative to successful treatment. Otherwise, what you do or don't do to the feet is moot. I've known of many horses with laminitis that responded very well to either diet changes or proper medication for Cushing's with NOTHING done to the feet. Remember, the feet are attached to a whole horse. We must attend to the whole horse.

I think the problem lies with the fact that there is too many variables involved with the onset of laminitis to successfully compare one horse with another. Even with the use of xrays and venograms, we are, unknowingly, trying to compare apples to oranges, in most cases.

For instance, in the last couple of weeks I've been dealing with 3 acute laminitis cases, all severe and I can't tell which of any will get "better"/survive or which will die.

the first is a lateral sinker that will most likely slough the right front and probably the left also; she's never really been that lame and has a very bright outlook. wearing wedges and equicast, hard to keep her from trotting in the stall.

The second is a Potomac fever survivor, slight rotation but still has 12mm to 13mm of sole depth wearing styrofoam and impression material. Reluctant to move much, still very depressed not much "will to live".

The third is a morbidly obese, large pony, severe rotation in all 4 feet, with less than 5mm of sole and draining abcesses in all feet; wearing glued up alum "W" shoes on front and she's hard to catch in a 24' x 24' dirt lot "diet pen" because they don't have a barn/stall

All are laminitic but certainly not the same...

Katy Watts wrote:
Really Katie, Two suggestions is all I give. Third time is woeful misery. Owners are responsible for their horses, not farriers. Our responsibility is to do the best we can do with what is presented; not a church sermon to the "-d-umb (m)asses".

Jaye Perry wrote:
Yeah I sort of agree Jaye... well fully agree.

'Cept if one on my book starts looking a bit cresty, I read the riot act to the owner... laminitis is the last thing I want to contend with if it can be avoided with a bit of 'shock treatment'.

Ronald Aalders wrote:
Yeah, well heart bar shoes work sometimes and NB shoes and glue on shoes and clogs and casts and barefoot and Redden ultimates and banana shoes and boots and (get the point?)...everything works on some horses, nothing works on every horse.

According to Jeff Holder, intracranial pb injections work on all of 'em. It's a one shot deal.

tbloomer wrote:
That works on a lot of things.

Jaye Perry wrote:
Agree you are not responsible, but you can be a hero if you get them to change the diet along with your hoofcare. That is why the barefooters are successful coming in after a farrier who will not take the time or use the right tactics for educating the owner. Perhaps if you could change your style of delivery from preacher to educator you could be more effective? Stress the 'new science' aspect.

Katy Watts wrote:Though I have seen a lot of "claims" on various barefoot web sites in regard to this "success" getting owners to change diet, I have not seen this "barefooter educator" phenomena deliver such results in the real world of my experience in my sand pile.

Out of the hundreds of clients that I have referred to safergrass.org for the latest "new science," I have seen only 2 or 3 of these referrals actually go look at the information.

Perhaps If I took the time to sit down with these people at their computer and read it to them out loud . . . then call them every day and ask them what they fed their horse, did they remember to put on the grazing muzzle, did they soak their hay . . . Oh, but I've been there and did that too!

In my experience with chronic metabolic laminitis cases, most horses I see are suffering as the result of willful neglect. And when I have had a chance to compare notes (trying to get a truthful history, because as Dr. House would say, "People lie about history") with the previous hoofcare provider, attending vet, etc. invariably I discover that HISTORICALLY, everybody else that ever saw the horse in the past gave due diligence warning and attempted to "educate."

Tom,
That's very depressing.

As an experiment: Pete Ramey says sometimes this works: Say 'I cannot fix this horses feet until you do your job of changing its diet. This is a waste of my time. ' then pack up and leave without attending the feet. He said sometimes his butt hits the truck seat before they call him back and are ready to listen. Maybe some of you need the work, but others may truly get torn up by these horses and it might be better for your own peace of mind to walk away from the heartache. Maybe they will find someone who they will listen too before the horse completely crashes.

Maybe by continuing to let these clients think its all about hoofcare, you are enabling them? I dunno why some people won't listen. I've an appointment next week for a call with a PhD in psychology who wrote a book about horse people. We are planning to write an article for Safergrass.org about feeding horses to fulfill our own emotional needs. Maybe it will help. After my 8 hour lecture on metabolic issues in horses and how to fix it, women still come up and say 'but he won't love me anymore if I don't give him grain'. These are the owners that are very hard to reach with a rational, scientific approach. They want someone to hold their hand and say 'you are such a Good Mommy, but here's a way you can be an even better Good Mommy. I have little patience with them as well, which is why I can't write this article without a diplomatic collaborator.

Katy Watts wrote:
I disagree Katy. I do not think farriers should be emulating the barefooters who profess to be an expert in feet and diet and lameness and training. I am not an expert in nutrition, and I know this because I have listened to countless lectures on nutrition and diet. I do know where to find the expert, and I happily refer the owner to the expert.

Farriers providing advice on nutrition is just as inappropriate as a nutritionist providing farrier care to a laminitic horse. Point people in the right direction, but let the experts be the experts.

Thank you Patrick.

This is a situation where professional ETHICS involves recognizing and delegating authority. I don't consult on diet, bloodwork, etc. "Don't ask me, ask your veterinarian." And, I don't give 'second opinions' or undermine what the vet says about diet and management since the owner can always get another veterinarian's opinion.

Besides, the more occupied the vet is discussing diet and management issues with the owner the less inclined they are to tell the owner how I should be shoeing the horse. :cool:

reillyshoe wrote:
I'm not sure they claim to be expert, but its pretty easy for many horse people to know more than some horse owners. Lets face it; some horse owners are pretty clueless. We make attempts at educating them for the good of the poor horses who have ended up in their care.

You may not be an expert in YOUR opinion, but if you know more about the dietary causes of laminitis from attendance at recent conferences, then for sure you know more than the owner does. And often you know more about training and lameness than they do. You don't need to dictate details of the diet. You just have to get them to seek out someone who is willing to educate them. Say "hey, I just went to a conference that explained how laminitis can be caused by insulin. Your horse's cresty neck and the fact that he's overweight says he's a pretty good candidate for insulin resistance. If a person cuts out the grain and finds hay low in sugar, it can stop laminitis or prevent it from happening in horses that look like yours. Here's some websites that can give you more details. "

The definition of expert: A person with a high degree of skill in or knowledge of a certain subject.

You don't need letters after your name to be an expert. Anyone can be an expert. I am acknowledged as an expert in carbohydrates in grass. It was from self study.
Perhaps there are others out there who have done enough self study to be considered an expert in diet or lameness or training. That's how it works in the horse world outside of academia. More knowledgeable folks teach the newbies.

Some of the barefooters who take the time to educate horse owners with a 'holistic' approach are much appreciated by their clients, and the horses are often better off for their efforts. Some, maybe not all. No reason that farriers with some extra time, who are experienced horsemen can do the same and charge for it just like the barefooters do.

Katy Watts wrote:
Katy,
Do you feel comfortable evaluating the hoofcare on a laminitic horse? If so, do you charge for your assessment?

I certainly agree that you do not have to have letters after your name to be an expert. There are certainly very skilled and knowledgeable farriers who have not achieved certifications. In my opinion, it would be better for me to refer a client with nutrition questions to you and to have you refer farrier questions from your clients to a farrier of your choice. There are not many people with the education to be a holistic equine practitioner, and we do everyone involved a disservice if we try (especially the horse).

reillyshoe wrote:
I am not suggesting that you hang out your shingle as a holistic practitioner. I would just like to see farriers pass along some useful tidbits of information about possible causation and where owners can get more information when you see feet with signs of laminitis. Like all caring horse folks do when they see a horse who's owner is not up to speed on current knowledge. Especially when you are making part of your living off that horse.

I am looking forward to hearing Dr. Don Walsh talk at ELPO this weekend. He is saying the same thing I have been attempting here. Farriers are an important resource for noting signs of impending or mild laminitis before uninformed owners would notice. You can help in a much needed role for prevention, if you care to participate.