Bob Childs - ESA/AHA/PHCP Certified Hoof Specialist


Should pergolide be increased for the seasonal rise?
By admin | | CushingsLaminitis |

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.

ACTH interpretation
By admin | | CushingsLaminitis |

Liphook Equine Hospital have produced the graph above based on thousands of ACTH tests to show the seasonal rise and fall of ACTH.

Is it PPID or EMS?
By admin | | Cushings |

Article by Dr Dianne McFarlane – Oklahoma State University

Regarding the trim cycle…
By admin | | Hoof Care |

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.

Pasture Weed Control
By admin | | Nutrition |

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."

Early Trimming and Movement
By admin | | Hoof Care |

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 effectively permanent.

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."

Do you need hoof boots when you ride?
By admin | | Hoof Care |
Study: Barefoot Trimming Shows Positive Effects
By admin | | Hoof Care |

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 conformation.

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.

Treatment of post-laminitc abscesses
By admin | | Laminitis |

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."

Are Drugs Effective for Acute Laminitis?
By admin | | Laminitis |

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 flow.

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 cases.

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.