Risk Management

Even with careful application of the 5S Equine Sole Support System, there is still a risk that bruising and abscessing may occur.

Treatment of acute laminitis presents some specific challenges. We have now developed some dependable procedures that consistently overcome these problems and minimize the development of associated complications. You are invited to read Recipe for Treating Acute Laminitis. Meanwhile, many of the techniques to manage the risk of complications of sole overload, described below, are also applicable for acute cases. When using the 5S system to treat chronic laminitis cases and hooves with a healthy circulatory system, the occurrence of sole blistering, bruising and abscessing is quite minimal and a number of things can be done to further reduce the risks involved:

• When trimming the hoof, lower the heel to position the sole surface of P3 to be parallel with the ground. This will minimize pressure around the tip of P3 and the circumflex artery. X-rays are helpful in establishing the position of P3 for trimming.
• When using the 5S system, the sole will thicken. Be sure to maintain this extra sole and leave the bars when trimming, they are your friend. After two to four months of sole support, the soles and bars may have filled the sole cavity. Rasp the full sole and bars level with the trimmed hoof wall. Leave the frog full. When this occurs, it is not necessary to use 5S Insole putty. The pad will seat comfortably on the flat sole callous.
• The ability of the sole to carry a load during the acute stage of laminitis is minimal. A shared load between the wall and sole may be all that is possible. It may be useful to apply sole support by temporary means, as in taping, to enable inspection and adjustment.
• With chronic cases, allow the horse free exercise to enhance circulation! However, monitor the situation carefully - every individual will have a different tolerance to sole support. Most horses will quickly become comfortable and active, while others may only be able to handle limited free movement. It is recommended the horse not be worked when wearing the Eliminator pads, to minimize over-stressing the sole.
• In cases where laminitis occurrence is highly probable (colic, fever, feed overload, toxins, injured opposing limb, etc.) apply sole support before any laminitis symptoms appear. Founder damage will be minimized.
• In all cases, keep the horse's body weight as low as possible to reduce the load on the hooves.
• Maintain a balanced ration - enriched with protein, minerals, and vitamins which enhance hoof growth. Keep the horse healthy!
• The horse should be observed daily. Problems within the hoof may coincide with negative changes in environment and health.
• Respond quickly to a problem. The longer you wait, the more difficult it is to gain control.
• Anti-inflammatory drugs are useful to combat early and/or minor symptoms of sole tenderness and inflammation.
• The buildup of serum fluids under the hoof wall and the sole is very painful. This is to be expected and prepared for, especially for acute laminitis cases. It is critical to keep the laminae unloaded to stop the traumatic injury in the laminae. However, the sole support system may cause some additional inflammation of the sole. Be proactive. Provide for positive drainage of the seroma. Cut or rasp a horizontal groove through the hoof wall at the toe, approximately 1 inch above the ground. Rasp through the full wall thickness, exposing the soft laminae tissue without drawing blood. Apply a poultice over this groove and any other soft areas such as the coronary band and the bulbs of the heels, where the horse exhibits tenderness. Maintain the poultice on a 24 hour basis for several days until there is no more fluid being drawn out, and the horse is more comfortable.
• If there is no improvement in the horse's comfort after one to two weeks, it may become necessary to temporarily remove the sole support system to initiate drainage from areas of the sole that exhibit extreme tenderness. These spots are usually found in the toe area of the sole, along the outline of the P3, or around the apex of the frog. Thin the sole over the suspected area, as well as around the point of the frog. It is usually not necessary to expose the sensitive tissues. Apply a strong poultice on a 24 hour basis until the drainage stops. The sole support system can be modified to avoid pressure, and allow for medication to these areas while minimizing the load on the wall.
• Should the problem progress into a full-blown abscess, it will become necessary to open up the abscess pocket to provide drainage and medication. Do this within two to three weeks of first symptoms of soreness to prevent the infection from spreading into the P3.
• It may become necessary to forget about unloading the wall for several weeks. Some method of shoeing should be applied to protect the sole while it is being medicated and given time to recondition without pressure.
• Once the sole is healed up, do not give up on the original goals of unloading the hoof wall. It may be necessary to use a lower level of sole loading, and make adjustments to the insole to minimize pressure over a specific area.

The 5S system, despite its many promising benefits for the recovery of chronic hoof problems, is not a magical cure! As with any individual, the entire situation must be managed. The horse's owner, the veterinarian, and the farrier should be involved in the overall health and care of the horse.

While there are risks associated with sole loading, these risks are manageable and in most cases are outweighed by the advantages to be found in application of the 5S system. For some horses, the use of sole support is the only sure road to recovery. And as euthanasia is often the only other alternative when traditional methods fail, the risks associated with sole loading are well worth taking!

In cases involving ailments of the hoof wall and laminae the simple reduction of the weight bearing load on the laminae and hoof wall allows those tissues to heal quickly and more completely.

RECIPE FOR TREATMENT OF LAMINITIS

Here is my recipe for treating laminitis. This recipe has not failed me yet. The key is to unload the laminae and then provide for fluid drainage from within the hoof capsule. When the horse is suffering a systemic condition that could lead to laminitis, or if the horse is exhibiting symptoms of laminitis, action must be taken immediately. Do not wait to see how bad it will get. The horse owner, the veterinarian and the farrier must work together as a team toward the common goal of returning the horse to normal soundness.

• Initiate farrier care to unload the wall - NOW. This will minimize damage and suffering on acute cases. For chronic cases, the sooner you start, the sooner you get your horse back.
  • Remove the shoes.
  • Trim heels lower to position P3 level with ground.
  • Trim the walls level with or shorter than the sole - Do not remove sole callous, bars or frog.
  • Provide soft ground such as sand, saw dust, snow.
  • Or apply a good commercially available sole-support system.
• Initiate veterinary care to treat the systemic problem that triggered the laminitis.
  • Expect and manage inflammation and build up of serum fluids under the hoof wall and sole callous. The pain level increases as the fluid pressure rises in these seroma pockets. Pro-active mechanical drainage via grooves cut through the hoof wall and poultice application are effective to minimize the pressure. Systemic anti-inflammatory therapy is also very beneficial. During these traumatic times, it is important to keep priorities in perspective. It was the weight bearing load on the wall which caused the initial injury to the laminae. That load must be minimized throughout the healing process or the laminae will continue to be injured and the situation cannot be resolved. When the horse is suffering periods of pain relative to inflammation and serum pockets, do not give in to the temptation to abort unloading of the wall in favor of treating the more immediate symptom. It may, however, become necessary to temporarily remove the sole support system to initiate drainage. Areas of extreme tenderness or exposed sole corium can develop anywhere but will usually be at the toe area or around the apex of the frog. The sole support system can be modified to avoid pressure in these areas. This will make the horse more comfortable and allow for application of medication.
  • Administer anti-inflammatory agents.
  • Rasp horizontal grooves in the hoof wall at the toe.
  • Apply a poultice over the grooves.
  • Monitor the situation closely.
  • Make adjustments as required.
• Provide a healthy environment
  • Deep soft bedding such as sand or saw dust to encourage laying down.
  • Nutrition, shelter, social company.
  • Free roaming exercise is important but avoid overdoing it.
  • Lay the horse off work.
  • .
  • Use a moderate level of sole support when possible.
  • Use a quality support system to cushion and distribute the load.
  • Keep the horse’s body weight down.
  • Provide soft, dry ground conditions.
  • Monitor the situation and make adjustments as necessary.
• Guard against sole overload
  • Use a moderate level of sole support when possible.
  • Use a quality support system to cushion and distribute the load.
  • Keep the horse’s body weight down.
  • Provide soft, dry ground conditions.
  • Monitor the situation and make adjustments as necessary.
• Maintain a reduced load on the wall until the new wall and laminae are grown (8 to 12 months).
• Reset the sole support system at 4 to 5 week interval.

Return to the 5S Equine Sole Support System home page.

How to Choose the Correct Level of Sole Support, and Using the 5S Equine Sole Support System

Case studies using the 5S Equine Sole Support System