In this second installment of our special Horse-Health Q&A series with world-renowned veterinary practice Rood & Riddle, podiatry expert Dr. Raul Bras answers a few questions about Thoroughbred feet.
Dr. Bras discusses the all-too-familiar laminitis ailment to which Thoroughbreds are particularly susceptible, as well as the possible connection between systemic illness and development of hoof ailments, as well as and how to gauge a horse’s chances to founder.
A 2005 graduate of Ross University School of Veterinary Medicine, Dr. Bras has been a leading veterinarian at Rood & Riddle since joining the Podiatry Center as a fulltime associate in 2007. Before he arrived, he completed a yearlong internship at Rood & Riddle and trained in podiatry under the mentorship of Dr. Scott Morrison. He is also a graduate of the Cornell University Farrier School and is one of only five veterinarians in the United States to earn Journeyman Farrier certification from the American Farrier Association.
Q: People are always talking about a Thoroughbred’s feet. What are some of the most common hoof ailments Rood & Riddle treats, and do you have tips for spotting a potential problem before it worsens?
Laminitis is the most common hoof aliment treated by the Rood & Riddle podiatrists. Laminitis is the failure of the attachment between the distal phalanx (coffin bone) and the inner hoof wall causing unrelenting pain and characteristic lameness. It is the most serious disease of the equine hoof that can leads to devastating loss of function. In order to understand how to rehabilitate the laminitic horse we should have an understanding of the normal supporting structures of the digit, the disease process, and the structural failure that results.
Other common hoof ailments are foot infections from the usual abscess to more complicated infections involving vital structures such as the coffin bone (osteomyelitis), and/or synovial structures (coffin joint, navicular bursa) due to puncture wounds.
Some of the common hoof ailments in racehorses are quarter cracks due medial/lateral imbalance, sole bruising (more commonly on the heel region), and coffin bone fractures. These ailments in the racehorse are most likely due to their strenuous training regimen, and thin sole, low heel, long toe syndrome, which is very common.
A general tip for spotting a potential problem before it worsens is maintaining routine foot care regimen. Some of the clinical signs are lameness, increased digital pulses, swelling, heat, draining tracts, and evidence of hoof injuries.
Q: Could you please explain how an illness elsewhere in the body can have such devastating effects on the feet?
Despite significant research and recent findings over the past decade, a complete understanding of laminitis and its complex pathophysiologic processes remains uncertain. Before the clinical signs of foot pain present, the horse usually experiences other systemic illness in organs anatomically remote from the foot, such as gastrointestinal tract (grain overload, colic, diarrhea), respiratory (pneumonia), reproductive (retained placenta, metritis), vascular insult (ischemia, endotoxemia), renal, endocrine (metabolic syndrome), musculoskeletal (contralateral laminitis), and immune disorders. Lamellar tissues of the feet are exposed to triggering factors, which lead to separation and disorganization of lamellar anatomy. The exact nature of these factors reaching the lamellar tissues via the circulation has yet to be clarified.
Q: Are Thoroughbred feet more vulnerable than other breeds to developing ailments?
Thoroughbred horses are equally vulnerable as other breeds to develop laminitis, but due to some issues with poor hoof quality they are more vulnerable to the complications of foundering with a lower success outcome. Thoroughbred’s feet are considered to have a thinner sole/wall, or in general terms to have “weaker” feet. Low-grade chronic laminitis seems to be very common in thoroughbred horses, and these are the horses that will go unnoticed until further complications arise (lameness). Abnormal hoof growth is a common finding in the low-grade chronic laminitic horse with evidence of more heel growth compared to the toe (dorsal hoof wall) with a dished dorsal hoof wall and toe cracks. There are two components to the management of the foot; the trim and the therapeutic shoe. The goal of the trim is to establish the distal phalanx alignment, and to balance or even weight distribution. The therapeutic shoes are designed to offer support, ease break over in all directions, and to address the pull of the deep digital flexor tendon.
My TB mare showed evidence of mild founder which caused her feet to appear dished with a low heel. My farrier has been working on her for about a year to slowly get her feet back in shape however her heels are still on the low side and now she is showing slight lameness in her front right. Not sure if he is doing all he can to help her. Any thoughts?
Hi Jeanne,
Thank you for writing in. As a blog author, I do not know the answer to this question. If you like, I could try passing your question along to Rood & Riddle, who so generously agreed to answer questions for a Q&A series I did with them, or, I might also suggest fellow blogger Fran Jurga, author of The Jurga Report at EQQUS and The Hoof Blog. She has wonderful information.
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Thanks for this post, and for involving Dr. Bras. This is great information–we need more of this type of education-sharing for horse owners!
I just did a Twitter alert about it and hope that it brings more readers to your blog.
Thank you Fran!
Hi Dr Bras,
I am Deena’s owner. (The foot in the Photo) 🙂 Thank you for the information regarding laminitis and thoroughbred hoof problems. I have been told that Deena is very fortunate to have healthy hooves. She does have cushings disease, therefore is on a daily dose of pergaloid (sp?) and limited amount of sweets as a laminitis preventative. Aside from a few abscesses that she experienced in her 28 years, we have been lucky. I do have shoes on her front feet for support as a result of two very badly bowed tendons several years back. Her feet grow very quickly and it is necessary trim her every four weeks. Is this a result of her diet? I cannot let her go past the four weeks. I am very pleased with the care that she gets from my farrier and the relationship that he has with my vet to give my horse the best possible foot care. Thank you again!
Louise: Here is a message from Dr. Bras of Rood & Riddle to you:
Dear Louise,
I am glad to hear your mare is doing well, and that you have a great team of vet-farrier-owner relationship. That’s the key to success. I recommend you have your vet take radiographs of her feet at least twice a year so your farrier has a better idea how much he can do to help her coffin bone alignment. The rapid growth of her feet could be due to her diet (depending on her body condition, and whether she is an “easy keeper”), or it could be a normal hoof growth response (lots of heel growth) to alleviate the pull and tension of the tendons from the laminitis. I usually recommend trimming and shoeing a horse every 4 to 6 weeks, depending on their hoof growth. Therefore, I think you should continue to have your farrier trim and shoe your mare every 4 weeks since that’s what has been working for her.
Hope this helps you understand your concerns.
Hi Dr Bras,
I have a 2 y.o. TB gelding who has a turned out right front foot. It turns out from the knee down. I have been considering bring him down to R&R to have him evaluated to see if there is something we can do to get him to land flat, he currently lands on the outside and rolls the hoof down to the inside. I am concerned about his prognosis for long term soundness and am wondering if you deal with this much? His left front is very boxy in shape. He’s trimmed every 3 weeks but trimming him so he stands level makes him roll that foot.
Thanks for any suggestions.
Heidi: Here is a reply from Dr. Bras of Rood & Riddle about your gelding:
Dear Heidi,
When a horse turns out it is usually due to a rotational deviation, but it is usually from the shoulder down. Since you mentioned that your horse turns out from the knee down, I wonder if it is due to a conformational deformity that was not corrected when he was young. Unfortunately, due his age (2 years old), there is not much we can do to fix the problem. But it can definitely be managed. Forcing the horses to land flat could create more problems in the long term, potentially creating hoof capsule distortions and joint problems. I recommend taking radiographs of his feet to evaluate his medial/lateral balance, (bone alignment in the hoof capsule), and using a shoe that will facilitate his landing and break over.
On the other hand, I know you also mentioned that his left front foot was “boxy” in shape. I wonder if he has what is known as a clubfoot, which could be an acquired flexural deformity (contracture of his deep digital flexor tendon/muscle). This is also something that could be managed with shoeing as well.
Hope this helps you understand your concerns.