Bob Childs - ESA/AHA/PHCP Certified Hoof Specialist
Q: Should I seasonally alter the dose of Prascend in my PPID positive patients?
A: There is clear evidence that pituitary activity increases in the autumn. Some horses test normal throughout the year but positive (for PPID) in the autumn, other horses test routinely positive throughout the year with strong positives in the autumn.
Pergolide decreases pituitary activity, therefore it is logical to consider altering the dose of pergolide during the autumn seasonal rise.
Be aware that if a horse (with PPID) has its ACTH tested in August/September and a loss of endocrine control is identified and the dose of pergolide subsequently increased, by the time ACTH is checked again 30 to 60 days later, the seasonal rise is likely to have peaked and be almost over.
However, if it is established that a horse does lose endocrine control in the autumn, then the dose of pergolide could be increased the following July/August in preparation for the seasonal rise.
It is a logical approach to increase pergolide for the seasonal rise; it needs further research, but many people have adopted this approach already.
Question: Is it possible to extend the trimming cycle longer than 5 weeks?
I've been known to say that a mediocre trimmer who comes every 3 weeks
can accomplish more than that a great trimmer who comes every 8 weeks. A
horse can go out of balance within a couple weeks post-trim and
unbalanced hooves can stress joints, ligaments and tendons causing
soreness elsewhere in the body. A short cycle can reduce joint damage
and avoid soreness. A short cycle also eliminates the need for a big
correction which may cause the horse to compensate while he adjusts to
the corrected hooves. Horses in the wild trim their hooves daily as they
trek long distances in search of food and water. They don't have to
wait weeks to balance their hooves nor do they need to adjust to a
sudden balance or breakover correction. Regularly balanced hooves
promote steady growth and proper hoof mechanics. These are only a few of
the reasons why I recommend a trim cycle of 5 weeks or less.
In regards to my work schedule... all my clients are on a 5 week cycle
and I organize each workday by geographical regions. Each 5 weeks I
return to that same region but after 6 weeks I would be in a different
region. Therefore it would not be possible to lengthen the cycle for
some - but not all - clients. As I maintain a full roster, I must be as
efficient as possible to properly treat all the horses in my care.
However, there are occasionally special cases where it is absolutely imperative to the owner to extend the trim cycle. In those cases, I'll recommend (when possible) a competent colleague with a more flexible schedule.
Quoted from Kathryn Watts, BS
"The best defense against weeds is a thick, vigorous stand of grass. Mother Nature doesn't like bare ground. Annual weeds are those that come up from seeds every year. If you cut off the tops with mowing, they cannot produce seed and therefore won't come back next year. Mowing regularly depletes the weed seed bank in the soil over the years."
A great quotation from Pete Ramey...
"Remember that all foals are 'born crooked'; they've spent their whole
life wrapped up in a ball! Movement is essential for straightening them
out. Unless directed by a veterinarian for a specific injury or reason,
do not confine foals in stalls. Every aspect of their proper development
requires movement. I also firmly believe that if every foal received
routine competent hoof trimming from the very beginning, angular limb
deformities in adult horses would virtually disappear from the horse
world; I've seen this with my own eyes in my own clientele. Birth
defects do happen but they are far more rare than most people think.
Instead, what is very common is that foals get off to a slightly wrong
start, this skews the hoof balance and then their joints, ligaments,
tendons and muscles are allowed to grow and form on the imbalanced,
neglected hooves. Eventually the horse matures and the conditions are
Most people think that hoof trimming for adult horses is a necessity and foal trimming is a luxury. If anything it should be the other way around."
This article was reposted. Read the original article on The Horse.
A team of researchers at Michigan State University's (MSU) McPhail
Equine Performance Center offers hope to horse owners facing underrun
heel and flat-footed woes with a 16-month study examining the short-term
and long-term effects of a specific barefoot trimming technique on hoof
In the study, seven previously barefoot horses were trimmed every six
weeks with a technique that leveled the hoof to the live sole, lowered
the heels, beveled the toe, and rounded the peripheral wall. The sole,
frog, and bars were left intact.
"This study has shown that a group of school horses performed well and
remained sound when trimmed so that the frog, bars, and sole of the foot
were engaged in the weight-bearing function," explained Hilary Clayton,
BVMS, PhD, Dipl. ACVSMR, MRCVS, the Mary Anne McPhail Dressage Chair in
Equine Sports Medicine at MSU. "We believe it is important for these
parts of the foot to contact the ground, not only to distribute the
weight-bearing forces and to support the coffin bone from below, but
also to provide the horse with proprioceptive input from receptor cells
in the heels."
The first four months of the study established the hoof shape
representative of the barefoot trim. From this baseline, morphological
(shape and structure) changes in the hoof's response to the trim
technique were monitored from months 4 through 16. At 0, 4, and 16
months, the researchers measured hoof morphology from lateral (from the
side), dorsal (from the rear), and solar photographs, as well as
lateromedial (side to side) radiographs.
As the study progressed, subjects showed palmar/plantar migration of the
heels, meaning the heels shifted further back underneath the limb, with
increased support length, heel angle, and solar angle of the coffin
bone. "This research has shown that the feet do indeed adapt and become
healthier," Clayton noted. "One of the interesting findings was that in
response to weight-bearing on the frog and bars, the entire heel region
migrated back underneath the limb, leading to an increased
weight-bearing area and an increase in heel angle. These findings offer
hope for treating underrun heels."
Horse owners interested in giving barefoot trimming a try shouldn't
expect immediate results, Clayton cautioned. "It is important to realize
that it takes a long time--months or sometimes even years--for a
horse's hooves to adapt to being barefoot if the horse has been
accustomed to wearing shoes for a long time," she remarked. "Owners who
contemplate changing to a barefoot trim need to find a farrier who is
trained and experienced in this manner of trimming, and they need to be
prepared for a period of adaptation.
"There is great research potential in this area. One area where I would
like to see more research is in comparing different types of barefoot
trim in horses that live in different environmental conditions (desert
vs. wet) and on different types of ground (hard, stony, sandy, soft),"
Clayton added. "We know quite a lot about wild horses' feet and how they
differ according to habitat, but less is known about managing the feet
of domestic horses under different conditions."
This study, "Effects of barefoot trimming on hoof morphology," was published in the Australian Veterinary Journal. The abstract is available here.
Comments by Gene Ovnicek
"Abscesses that occur at the coronary band and through the sole of the
foot are expected in serious cases and offer the patient a better chance
of recovering to a higher level of soundness with a much greater future
of returning to pre-disease condition. This can only happen when proper
support is given immediately to these patients in the area of the foot
that is naturally redeveloping for that purpose.
I have records of the last 30 cases that have abscessed through the
coronary band and/or through the sole within a short time after the
initial insult of laminitis (1 to 2 months). Our purpose was to record
results of those cases whose abscesses were treated, versus those who
were untreated. Over half of the abscesses were not soaked or encouraged
to dry up. The abscesses at the coronary band were left uncovered. The
sole abscesses were wrapped and protected from dirt and debris only. No
trimming of the sole in the area of the abscess was done to encourage
drainage. The wraps consisted of two layers of prepared Styrofoam blocks
applied with Elasticon tape. The other cases were soaked with Epsom
Salts or Betadine for 2 or 3 days. Some of those cases were cleaned of
debris on the sole where the abscess came through.
There were little to no set backs in healing with those who were untreated. Most cases that were treated by soaking progressed slower and some had reoccurring painful periods. All of the cases that had sole material removed around the abscess site stabilized much later and had even more setbacks. All but 2 cases survived with over 70% returning to their pre-disease purpose. The abscesses associated with laminitis are the 'mechanisms of debridement' and follow a cycle that seems to work well if left to follow its own course of events."
Article by: Nancy S. Loving, DVM March 18 2009, Article # 13802
At the 2008 AAEP Convention, which was held Dec. 6-10 in San Diego,
Calif., Bill Moyer, DVM, professor of sports medicine and head of the
Department of Large Animal Clinical Sciences at the Texas A&M
College of Veterinary Medicine and Biomedical Sciences, presented a
variety of considerations on the state of medical treatment for
laminitis. He stressed that once clinical signs are evident, damage has
already been done: Pain and lameness are preceded by vascular and
structural damage within the hoof laminae (lamellae).
So, he posed the question to the audience, "Is any specific medical
treatment for acute laminitis efficacious in altering the outcome after a
horse has developed clinical signs?"
Is any specific medical treatment for acute laminitis efficacious in
altering the outcome after a horse has developed clinical signs?
The current consensus on effective therapy revolves around addressing
and resolving the initiating cause(s) of laminitis. Other strategies
attempt to alter blood flow in the foot, decrease inflammation, and
avert endotoxemia. Moyer addressed these in his talk.
He explained that evidence is lacking about blood flow-altering agents
having any effect on increasing laminar circulation. While use of
digital nerve blocks might improve blood flow by inhibiting constriction
of blood vessels, numbing the pain stops the horse from protecting his
feet. Increased weight bearing exacerbates laminitis.
Acepromazine increases digital blood flow by direct action on vascular
smooth muscle, but studies have not shown improvement in lamellar blood
Isoxsuprene has vasodilating properties, while pentoxyfylline requires
weeks of administration to decrease blood viscosity. It does this by
acting on platelets to increase red blood cell flexibility. Both these
medications are absorbed poorly when administered orally.
Nitroglycerin placed over digital blood vessels might increase blood
flow, but it has not been shown to increase lamellar blood flow after
the onset of clinical signs. Coupling this ineffectiveness with
potential risks to the person handling the drug makes nitroglycerin a
poor therapeutic choice.
Heparin removes red blood cells from the system to decrease blood
viscosity and thereby improve blood flow, but researchers have not
examined its use in acute cases.
Inflammation is not always a component of laminitis, but when it is,
non-steroidal anti-inflammatory drugs (NSAIDs) have been used. Moyer
said there is humane justification for judicious use of NSAIDs, but one
should be aware of downsides. Pain relief might increase mobility that
exacerbates tearing of the lamellae.
Phenylbutazone (Bute) might reduce inflammation and pain, and it is
affordable, but it does not prevent laminitis if given during the
developmental stage and has not been shown to alter the course of acute
Flunixin meglumine (Banamine) provides both anti-inflammatory and
anti-endotoxin effects. However, if flunixin and phenylbutazone are
given together, there is an increased risk of loss of serum protein,
gastric ulcer disease, and/or colitis.
There is anecdotal support for use of dimethyl sulfoxide (DMSO) for its
anti-inflammatory properties and ability to scavenge oxygen-derived free
radicals, which form during hypoxia (deprivation of an adequate supply
of oxygen) and reperfusion (restoration of blood flow to tissues
following an incident or hypoxia). Damage can occur when blood flow is
restored to tissues following an incident of reduced blood and oxygen
supply. However, Moyer noted there is no evidence of hypoxia or
reperfusion in this disease.
Anti-endotoxin drugs (flunixin meglumine, ketoprofen, and polymyxin B)
might be warranted as there is an association between endotoxemia and
the development of laminitis. Endotoxin causes insulin resistance with
decreased use of glucose by the lamellar tissue. While they might not
necessarily be effective in treatment of laminitis, anti-endotoxic drugs
might be life-saving.
Moyer said caretakers and veterinarians should address environment and
ground surface, housing, causes of obesity, and management of the foot
itself. He recommends explaining to clients that the pathogenic
mechanisms of laminitis are not well-understood and that a horse's
clinical appearance might correlate with the outcome, but it is not
always an accurate predictor due to potential for complications.
In general, controlled studies do not exist regarding the efficacy of various treatments for laminitis, and some therapies have additional risks beyond their failure to improve the situation.