Podiatric management for lower limb lameness contitions

The effect of hoof imbalance on fore limb lameness has been well documented. The fore limb hoof has little effect above the fetlock. But the rear hoof has much greater effect on the upper leg and back. The purpose of this paper is to discuss the common hoof imbalances that have been described in the rear hoof, compare those to the fore foot, discuss possible pathophysiology and finally discuss the effect these rear hoof imbalances have on lameness of the rear leg.

Different biomechanics exist between the forelimb and rear limb. Also rear hoof biomechanics effect the movement (biomechanics) of the upper limb perhaps and these alterations in biomechanics can result in lameness.

The most successful approach to shoeing is that based on individual case needs rather than a standard formula. The following principles should be followed: (1) Correct any pre-existing problems of the hoof, such as underrun heels, contracted heels, sheared heels, mismatched hoof angles, broken hoof/pastern axis. (2) Use all weight bearing structures of the foot. (3) Allow for hoof expansion. (4) Decrease the work of moving the foot. Shoeing is most effective when corrections are made within the first 10 months of lameness, up to 96% success. This is in contrast to when shoeing changes are not made until after 1 year of lameness, where only 56% of the cases have been successfully treated.

These principles can be accomplished using many different methods and techniques. Shoeing is of utmost importance in dealing with hoof pain causing the signs associated with navicular syndrome or remodeling of the bone (osseous form). It is necessary to ensure proper hoof balance and support in order to eliminate the pain and stop or decrease the stresses that are causing the problem.

Turner TA. Navicular disease management: shoeing principles, in Proceedings. Am Assoc Equine Pract 1986;32:625-633.

Tracy A. Turner, DVM, MS, Dipl.ACVS, Dipl.ACVSMR

Tracy Turner began his professional career as a farrier and used those skills to help finance his education. He received his DVM degree from Colorado State University in 1978. He completed an internship at the University of Georgia and a surgical residency as well as a Master of Science degree at Purdue University in 1981. His Master’s thesis was “Thermography of the Lower Limb of the Horse.” He served on the faculty of the Universities of Illinois, Florida and Minnesota. At Minnesota, he was Head of Large Animal Surgery and attained the rank of full Professor before leaving academics to join Anoka Equine Clinic in 2004. In 2016, he started his own practice dedicated to Sports Medicine and Surgery. Turner’s primary research efforts have focused on equine lameness with particular interest in equine podiatry, back issues in horses, rehabilitation and thermography. His podiatry research has evaluated the radiographic and morphologic characteristics of hoof imbalance, as well as the differential diagnosis of palmar foot pain (PFP) and the development of PFP treatment strategies. Turner has researched the use of diagnostic imaging techniques for evaluation of equine back problems (including saddle fit) and developed epidemiological data on overriding spinous processes in horses. He pioneered the use of thermography as a diagnostic aid in lameness evaluation, as well as its use in horse welfare regulation. Turner has extensively published on these topics and been invited to lecture nationally and internationally. In 2004, Turner was inducted into the International Equine Veterinarian’s Hall of Fame.

Turner is a Diplomate of the American College of Veterinary Surgeons, a Diplomate of the American College of Sports Medicine and Rehabilitation and is a Fellow of the American Academy of Thermology (AAT). He is an active member of the AVMA, AAEP, AAT and the American Horse Council. Turner has served as chairman of the AAEP’s Farrier Liaison Committee, served on the AAEP Foundation Advisory Council, the AAEP Educational Programs Committee and the AAEP Board of Directors. He is currently Vice-President of the AAEP. He is past-president of the American Academy of Thermology. He has consulted for United States Equestrian Federation, The USDA Horse Protection and Federation Equestriene Internationale (FEI). He has served as a Veterinarian Official at 4 Pan America games, 2 World Equestrian Games, at the 2016 Olympic Games in Rio de Janeiro and 2021Tokyo Olympics. He has participated as an instructor at Equitarian Workshops in Mexico, Nicaragua, and Costa Rica and has participated in the Equitarian projects in Honduras, Costa Rica and Peru. He is married to veterinarian Julia Wilson and has two sons. He loves the outdoors and rides whenever possible.