• Holistic Equine

Use of wedged pads and boots - "Sun"

In this article, learn how we assessed, trimmed and provided ongoing stimulus without compromising on balance and protection in a 21 year old TB mare with a broken back hoof pastern axis (HPA) and history of mild, chronic grade 2 laminitis.

"podiatry is both art and science - the need for balance without compromising on protection and support"

Author Beccy Smith

Whats the problem?

We love Metron-Hoof for more detailed analysis and objective documentation but "in the field", we often use HoofmApp iPhone app to help us assess and formulate a solution. Below is the LF hoof on a 21 year old 16.2 TB mare under vet care for chronic lameness issues. She recently came out of Formahoof (more on this at a later date) and has developed much needed sole depth, caudal foot and hoof structures and is sounder.... but still has a way to go!

From our full assessment and with the help of HoofmApp used on the lateral view as seen above, we have identified the following issues:

  • The heels are long and under run

  • There is a marked broken back HPA (which indicates the phalanges are not aligned - this was previously confirmed on radiographs of the same view)

  • In addition the palmar angle will be low for the conformation of this horse (note the upright, short pastern)

  • the toe:heel ratio is poor (more then 60:40 toe:heel ratio is inadequate in a barefoot horse)

  • There is too much foot and hoof forward of the limb axis and increased strain on the caudal foot and limb

  • The depth of the hoof is adequate and Sun is sound on a level or slightly stony surface

  • The ratios and proportions indicate Sun is at risk of tissue breakdown, pathology and lameness; primarily in the foot and above.

  • They also indicate Sun is at risk of secondary issues created by compensatory posture associated with this hoof morphology

What's the solution?

In hoof care, there is a need to ensure optimum balance without compromising on protection. This is particularly important in a reductive trimming approach (eg, barefoot and without the application of a "shoe"). Removing too much material in order to achieve "improved balance" compromises on protection and comfort, which can lead to pain, lameness, pathology and reduced balance. Likewise, removing too little can create further imbalance and lead to a similar outcome.

The solution we formulated in this case was influenced by the history and health status of the horses, her environment and what is currently available! Assessment of the hoof only has NO place in efficacious hoof care so we assess the whole horse and carefully consider the anticipated environment the horse is exposed to currently and what she might be exposed to in the coming days and weeks.

Our ideal solution would be to have a suitably qualified and experienced farrier fit a modern composite shoeing package and support the caudal hoof with dental impression material (DIM). This would be fitted in a way to reduce break-over further and provide closer to 50:50 toe:heel support around the center of rotation (COR) of the coffin joint. It would also provide a straighter HPA and therefore improved phalangeal alignment. This would also provide optimum protection on all surfaces and continue to stimulate the return and maintenance of healthy ideals in terms of hoof shape and posture. Over time, the caudal structures should continue to develop and in an ideal world, she could return to barefoot or barefoot and booted.

Currently, we don't have access to a farrier who can apply the ideal shoeing package so we created a solution based on trimming and booting which would help her hoof rehab without compromising on protection and comfort.

Step 1 - apply a trim without compromising on protection

Step one was to remove as much hoof material as safely as possible then provide ongoing support to assist in balance and caudal hoof development in the form of a wedged pad contained within a well fitted and adapted hoof boot. As all hoof flare was previously removed prior to formahoof application, we are careful not to remove any more outer hoof wall (flare) from the top two-thirds of the hoof. As this horse is retired and lives on a very conforming surface in boots, a cast or shoe isn't necessarily to provide stability and protection to the capsule following outer wall removal. If this horse was expected to perform however, we would advocate for additional support beyond barefoot and booting.

In the above image, we can evaluate that we have achieved improved proportions and ratios associated with what is considered a healthier hoof in terms of morphology, and its association with resilience and soundness. In summary, there is;

  • healthier HPA associated with improved balance, phalangeal alignment and palmar P3 angle

  • shorter toe and less under run heel with improved toe:heel ratio

  • more hoof under the limb axis

  • associated less risk of pathology, lameness and compensatory posture

So this horse requires additional support to assist with current and ongoing static and dynamic balance and for protection.

Step 2 - provide ongoing support for balance and protection

We decided to use cloud hoof boots which we believe most horses find comfortable and can be ideal for prolonged periods of use. Cloud hoof boots come supplied with wedged EVA pads. Over time these compress and the wedged effect reduces. In this instance, we fitted a firmer 3 degree wedge under the compressed cloud pad. This assists with balance, protection, support and comfort.

We adapted the boots too - The boots' solar surface was bevelled with a sharp hoof rasp to reduce break-over in the toe and quarter region.

For additional comfort and to assist with fit, we used scoot boot gaiters which sit under the hoof, cover the bulb of the heel and wrap around the pastern. We find more air is circulated around the coronet band and hoof wall when we combine this boot with a gaiter and less material finds its way into the boot.

Hoof boots should be removed daily and the hoof checked and allowed to dry. Sun is turned out on wood chip during the day and stabled on wood pellets overnight. Her boots are checked twice daily but they are worn almost all the time. This suits Sun and the environment she lives in.

Below shows the break-over in the adapted cloud hoof boot (right) compared to the unadapted boot (left)