Realigning Trim - Dorsal rotation/long toes
Sonny - Realigning trim for hoof with significant dorsal rotation
Sonny, a teenaged Shetland x pony, had frequent bouts of laminitis. Eventually he was diagnosed with PPID and EMS and x-rays showed a considerable dorsal angle due to a large laminar wedge, some palmar rotation and considerable distal descent. His new farrier carried out a realigning trim, he started treatment with pergolide and management changes were made that included a low sugar/starch diet with added minerals. A year later his owner reported that he was back in work and able to graze on a track, and had had no further laminitis.
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Toe
Light green marks P3 (the pedal bone). The line carried down the front of P3 to the ground marks the position that breakover could be brought back to. Purple lines – breakover could be trimmed to the straight purple line (or just in front of this) using a bevel (an angle of around 30-45 degrees to retain strength/protection from the wall). This could be slightly rounded – the curved purple line shows how the bevel might be extended through the laminar wedge. NB the bevel was always kept at least 5 mm outside of the live sole. Red line marks the position the toe should be in after 9 months of correct growth, with a correct breakover. |
Light pink line - when there is so much excess toe/laminar wedge, this could probably be removed at least as far as the light pink line without compromising hoof integrity, by rasping off straight across the toe.
Walls
The outer wall was bevelled to reduce weight bearing – see: http://www.hoofrehab.com/HoofRehabProtocol.html
Heel
Dark green line marks a 5 degree palmar angle.
Dark pink line - the heel needed to be lowered to the dark pink line (parallel to the dark green line) to give an eventual palmar angle of around 5 degrees. The heels weren't lowered by more than 10 mm in one trim to avoid soft tissue damage – it’s often best to lower the heels in several trims at least a few days apart. However it is advisable to lower the heels as quickly as the horse is comfortable with, because while the palmar angle is too high, there is an increased risk of further damage/rotation – see: http://www.thelaminitissite.org/2/post/2014/01/faq-rehabilitating-the-feet-after-laminitis.html. NB heels must always be kept above (or no lower than) live sole.
Sole
There was reasonable sole depth, this was preserved and developed. The heels were lowered by floating the rasp above the sole in front of the apex of the frog (see demonstration of floating the rasp at around 3:30: http://www.youtube.com/watch?v=utIPx1vhs4s&feature=youtu.be). This left the ground surface of the foot slightly in two planes until the sole thickened, but the pony was comfortable on deep conforming bedding and/or boots with thick pads. Measuring the collateral groove depths gave a good indication of sole depth – see: http://www.thelaminitissite.org/2/post/2013/11/measuring-collateral-grooves.html. Thin soles (i.e. collateral groove depth at the apex < 10-12 mm) should be protected.
Walls
The outer wall was bevelled to reduce weight bearing – see: http://www.hoofrehab.com/HoofRehabProtocol.html
Heel
Dark green line marks a 5 degree palmar angle.
Dark pink line - the heel needed to be lowered to the dark pink line (parallel to the dark green line) to give an eventual palmar angle of around 5 degrees. The heels weren't lowered by more than 10 mm in one trim to avoid soft tissue damage – it’s often best to lower the heels in several trims at least a few days apart. However it is advisable to lower the heels as quickly as the horse is comfortable with, because while the palmar angle is too high, there is an increased risk of further damage/rotation – see: http://www.thelaminitissite.org/2/post/2014/01/faq-rehabilitating-the-feet-after-laminitis.html. NB heels must always be kept above (or no lower than) live sole.
Sole
There was reasonable sole depth, this was preserved and developed. The heels were lowered by floating the rasp above the sole in front of the apex of the frog (see demonstration of floating the rasp at around 3:30: http://www.youtube.com/watch?v=utIPx1vhs4s&feature=youtu.be). This left the ground surface of the foot slightly in two planes until the sole thickened, but the pony was comfortable on deep conforming bedding and/or boots with thick pads. Measuring the collateral groove depths gave a good indication of sole depth – see: http://www.thelaminitissite.org/2/post/2013/11/measuring-collateral-grooves.html. Thin soles (i.e. collateral groove depth at the apex < 10-12 mm) should be protected.
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This is how the foot would look after lowering the heel (to restore the palmar angle to normal) and bringing breakover back (to correct the dorsal angle). P3 is correctly aligned, more stable and the pressure under the tip of P3 should be reduced. Any bony rotation should sort itself out – if significant/long-term bony rotation had been present, the heel would have been lowered particularly slowly.
When there is a lot of laminar wedge, the farrier may be able to take more off. It is important to keep as much hoof wall as possible for strength/protection - it's what happens at ground level that's important at the toe. Once the realigning trim has been done correctly, the hoofprint should look like any healthy hoofprint. |
The aim - a balanced foot with the hoof realigned to the pedal bone
Boots
Boots and thick pads are likely to be needed during rehab, particularly if the collateral groove depth at the apex is less than 10-12 mm – see: Boots and Pads: A True Breakthrough In Healing by Pete Ramey - Foundered Horses: Support, Stimulation and Pain Relief towards the end.
Other rehabilitations of feet with long toes
Haggis - WHW - example of how Aladdin's slippers can be cut off.
More information
Hoof Rehabilitation Protocol - Debra R Taylor, Ivy Ramey, Pete Ramey
Recognising coffin bone rotation - Pete Ramey
Why does my horse have a thin sole? - Pete Ramey
Realigning Trim - ECIR website
DDT - Trim - ECIR website
Feet - thelaminitissite.org
A balanced foot - thelaminitissite.org
Boots and thick pads are likely to be needed during rehab, particularly if the collateral groove depth at the apex is less than 10-12 mm – see: Boots and Pads: A True Breakthrough In Healing by Pete Ramey - Foundered Horses: Support, Stimulation and Pain Relief towards the end.
Other rehabilitations of feet with long toes
Haggis - WHW - example of how Aladdin's slippers can be cut off.
More information
Hoof Rehabilitation Protocol - Debra R Taylor, Ivy Ramey, Pete Ramey
Recognising coffin bone rotation - Pete Ramey
Why does my horse have a thin sole? - Pete Ramey
Realigning Trim - ECIR website
DDT - Trim - ECIR website
Feet - thelaminitissite.org
A balanced foot - thelaminitissite.org