cassy1993
New User
Do whatever your vet and farrier suggests I asked on hear a while aback about my horses broken pedal bone and the barefoot bregade tryed to get me to go barefoot then but thankfuly I didn't. They think it fixes every thing
Advice please for shoeing a chronic founder case
- Thread starter madaboutollie
- Start date
LucyPriory
Well-Known Member
Dr H Strasser is a woman. Please read the link posted earlier... history of barefoot movement by Jaime Jackson. Strasser does not perform a non invasive (do no harm) trim.I don't believe that invalidates all her work though.
Not only a woman - but a VET.
alsiola - I fully support your right to an opinion and for to have your own views regarding barefoot v shod. Shame though that as a vet you didn't know the welfare case was based on a technique invented and taught by a vet and that this vet is still permitted to do this.
As for statistically valid scientific studies - just how many of these exist? Please can you direct me to them because as far as horses are concerned they seem to be very few.
I used to have to edit research material and it completely undermined my faith in how research is conducted. I have seen nothing produced in recent history by the veterinary community which has restored this faith, but I am happy to change my POV if someone can supply the evidence.
quirky
Well-Known Member
Yes, I had success with Imprints.
His hoof was too brittle to nail a shoe to and it wasn't in the equation to leave him without.
Not cheap but they allowed his hoof time to recover.
I would recommend them.
Are you in Lancashire? Mark Caudwell is an excellent remedial farrier and I believe he has worked with Robert Eustace.
Good luck with your horse, I hope you make some progress.
cptrayes
Well-Known Member
This is not the whole truth Cassy. I for one told you that I would shoe for a pedal bone fracture and there was considerable discussion and quite a lot of criticism from some barefooters of others. In your case we were not " a Brigade" in any sense.
alsiola
Well-Known Member
I don't know the full details of the case, and I really am not that interested in whether she is a woman/man, vet/trimmer or whatever else. Judge people by their actions not their qualifications.
There are some, not as many as I, or anyone else would like. It is a sad fact of veterinary medicine that we have very poor evidence for the efficacy of many treatments. This doesn't strengthen the claims of barefoot in any way, which has even poorer evidence for its efficacy. Here is a recent example, unrelated to this debate:
Tiludronate infusion in the treatment of bone spavin: A double blind placebo-controlled trial
EQUINE VETERINARY JOURNAL
Volume 42, Issue 5, July 2010, Pages: 381387, M. R. GOUGH, D. THIBAUD and R. K. W. SMITH
Multi-centre, randomised, double-blind and placebo controlled. This is a study of high evidence value. These studies can be and are performed. Of course, this was funded by the drug manufacturer, but funds are available elsewhere. Maybe whoever supplies Pete Ramey with boots could consider making a contribution to the advancement of equine science?
cptrayes
Well-Known Member
The homeopathy discussion is valid. One because horse lovers are often the kind of people who believe in it, and I will eat my hat if some of the people who are criticizing barefooters for being unable to come up with scientific research don't believe in it.
Two because in humans it DOES work. Not for the reasons that the homeopaths say it works, but because the consultations are way, way, way in excess of the length of time anyone gets to talk to a non-homeopathic doctor. It's the talking and the faith of the patient that cures, of course, not the funny water. In that situation, if someone was suffering from a disease that all else had failed, wouldn't you, if you were a doctor, refer them for homeopathy if you could?
All we want is for vets and farriers to listen about the number of horses that we have managed to bring sound when they had had every treatment available and were still lame. And to tell owners that there may, just, be a last resort before having their horses shot or permanently retired. You can tell them that you cannot recommend it wholeheartedly as it is not scientifically tested, but that there is information in the public domain should the owner choose to research it. Will you do that, after what we have told you that we can do? And if not, what other information can we give you that would change your mind instead of telling those owners to retire their horses or put them to sleep?
cptrayes
Well-Known Member
Maybe the Farriers Registration Council or Worshipful Company of Farriers should prove their products aren't the primary cause of failure to restore soundness in horses with navicular syndrome, and ddft, collateral ligament and impar ligament strain first? Maybe vets should prove that adequan, tildren and HLA which they charge large amounts of money to administer actually work better than a barefoot rehab?
Have you looked at the Rockley Farm stuff? Are you aware that a typical length of time to restore soundness is well under four months? My navicular (diagnosed by xray) rehab had adequan tildren HLA and bar shoes and was still so lame that his owner was a day of having him put to sleep. He was sound with me in TEN WEEKS and did a farm ride with jumping in twelve and has been sound ever since.
This is what is so frustrating alsiola, and why we are called zealots and a lot of other nasty things. You see, we just can't believe that if we were vets we wouldn't be on the phone to Rockley to ask Nic how in heaven's name she is producing these astonishing results time after time. Not on this forum trying to justify why we won't tell our clients that these horses even exist.
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alsiola
Well-Known Member
My opinions are worthless. So are yours, so are everyone elses. What isn't worthless is evidence based medicine. This is the point that I have been repeatedly trying to put across. It is not my opinion that treating laminitics with shoes is superior to barefoot, it is what the evidence currently supports. If, as others allude to, you have a case report in preparation on barefoot management, then I urge you to push as hard as you can to get it published. I support the advancement of knowledge regardless of whether it upsets people, disagrees with the opinion of many, puts people out of business or anything else.
I try and keep my opinions to myself, as they are not relevant to a discussion of facts. As it happens my personal opinion is that laminitics need multi-faceted care: nutrition, endocrine problems and foot balance all need addressing. As has been pointed out to me in this thread then the social/psychological needs of the horse must also be met. If we have all of this sorted, then whether we finish by sticking a shoe on the foot or not probably makes little overall difference, although I have no doubts that some horses will do far better shod, and others will do far better unshod. My personal experience suggests that shoeing is helpful more often than not. This is anecdotal crap though, so ignore it.
I am not judging barefoot by standards any different to how I judge my own work. If I treat a horse with antibiotics and it gets better, then I am happy the horse is better. In truth, I cannot in any scientifically valid way say that my antibiotics cured the horse's problem.
LucyPriory
Well-Known Member
This research was based on 108 - not statistically valid and only 87 completed the trial according to the protocol - so even less validity.
Still looking for proper science - anyone got any?
cptrayes
Well-Known Member
I'm sorry, but that study has nothing to do with whether the horse recovered, or how well, does it? As I said before, my own belief is that heart bars appear to work because they reduce pain, and reducing DHW strain will reduce pain. So will bute and danilon and sedation will allow a horse to cope with it. That study does not show anything about the best prospects for long term soundness of the horse, only for reduction in DHW strain in the short term (in the long term, with a correct diet, the DHW strain issue resolves itself by the production of a newly attached foot. Barefooters report that horses come much sounder, or sound, and that flat footed horses concave up (as the pedal bone is pulled up inside the foot) after only a relatively small amount of the top of the foot has regrown, so we are not talking major lengths of time here for the pain to be treated by other means.
alsiola
Well-Known Member
Of the 3 treatments you list, I have read studies on adequan and tildren. Adequan has fairly weak evidence supporting it, and I would rarely recommend it. Tildren has some of the best quality evidence possible showing it to be useful. HLA I am sadly ignorant of the current evidence status. (I am a first opinion equine vet - I see loads of laminitis, but other lameness cases I tend to send to my colleagues who are more interested in, and better at dealing with them. They send me the medicine ones back!
)The issue here is that barefoot trimming is not the only other treatment modality that is raved about. If we have to prove these treatments are better than barefoot, do we also have to prove they are better than acupuncture, chiropractice, EMRT, homeopathy, etc etc. The list is potentially endless. Unfortunately at the moment barefoot has no more evidence supporting it than any of these other modalities, so there is no reason to test against an unproven treatment. If there was some evidence produced for barefoot, then the reason to test becomes greater.
I don't think I've called you anything nasty. I am happy with the results I see when treating laminitis, and as I have said before when you have a well balanced foot I don't believe shoe on/off status makes all that much difference. Please don't assume what I do or don't tell my clients. In fact, not 2 days ago I spoke to a client whose pony had been shod with Imprint shoes, and had not done spectularly well with them. The conclusion we came to was that the best way forward was to remove the shoes and not replace them. I am not a closed minded person, I just need things to be justified to me (not by stories on a forum or blog) before I can recommend them without a heavy heart.
cptrayes
Well-Known Member
THIS IS NOT TRUE!
The first time any drug or treatment is discovered it is only the opinion of the researcher that carries the study forward to clinical trials. It's only the opinion of the researcher that makes them look in a particular area in the first place.
Just because evidence is anecdotal does NOT MAKE IT INCORRECT.
For example:
ecstasy is currently being used, illegally, to treat post traumatic stress disorder. Some bright spark put two and two together and thought that the feeling of wellbeing and friendliness that ecstasy creates could possibly be used to help remodel the memories of sufferers. Apparently, it's extremely successful. This is entirely anecdotal. But on the strength of those anecdotes some psychiatrists are using it and helping people. There is money at stake here of course, and I am sure that some drug company will be scientifically testing it soon to produce a packaged drug that they can charge a lot of money for.
The problem with our barefoot anecdotes is that it is like asking turkeys to vote for Christmas. It will mean massive loss of revenues by vets and remedial farriers.
ps I said "we are called", and we are. I didn't say you had called me anything. I take your answer to mean, no, you will not tell someone who is about to put to sleep a navicular horse that it is possible that barefoot might cure it?
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alsiola
Well-Known Member
Your understanding of statistical validity is incomplete. There is no magic number that makes a study significant or insignificant. It is based on various things I cannot recall. I am no statistician so I cannot tell you exactly, but statisticians worked with the researchers here and it is statistically significant.
alsiola
Well-Known Member
True, but until that drug has been through clinical trials it is completely unproven. If that researcher were to recommend it as a treatment then his opinion would be worthless.
Just because there is anecdotal evidence does not mean there is any validity to the claim. To return to homeopathy, there are many anecdotal reports of its efficacy in horses on this forum alone. Both you and I know that no matter how many anecdotes we hear, the claim that homeopathy is effective on horses is never going to get any truer.
At the moment, there is nothing in the literature to distinguish your anecdotal reports from those of homeopathy zealots (I am prepared to insult homeopaths). As such, there is no reason why the veterinary profession should treat the two any differently. It is up to the barefoot community to produce evidence that it is not in the same league as homeopathy. This does not need to be top quality evidence - well written case reports in reputable journals would suffice to pique some interest.
The emphasis is mine. Without proper evidence we do not know if these psychiatrists are helping people or harming them.
Farriers maybe. I say maybe because on a time taken/price charged basis they are often better off doing more trims and less shoeing.
Explain to me how vets would lose out if barefoot became the accepted treatment for laminitis. I do not apply shoes. I receive no financial gain from a farrier applying a shoe. When I see a horse with laminitis the only thing that is important is the best way to get the horse sound in the short and long term. If it turned out that the best treatment was barefoot was the best treatment, based on evidence, then that is what I would recommend.
Well don't complain about it to me then. Personally I feel that calling someone a member of the "Barefoot Brigade" or whatever anyone else has said is far less insulting than implying that vets refuse to recommend barefoot because they are spineless immoral people who would rather look after their profits than the horses they see.
If I had exhausted all options supported by evidence for treating navicular, I would have no qualms with saying:
"We have tried all the accepted treatments for your horse's disease, but unfortunately we have not been successful. I hesitate to recommend this to you, as there is no evidence to back it up, and I do not want to give you false hope, but there are anecdotal reports of barefoot trimming being beneficial. I cannot recommend it strongly, but as we have no other options to explore I would be remiss if I did not mention it. The final decision is your own and I will support you either way."
As before, please don't make assumptions about the way that I, or any other vet, practices.
LucyPriory
Well-Known Member
I am not a statistician either but I spent decades working with them, and they would never accept such low numbers (unless they were being paid to do so).
As indeed I used to, until the shame of it became unbearable, that so many people were being mislead, including the expert community, and not just by the dodgy research. So sorry, but no this research is not valid statistically (unless you are prepared to accept very broad boundaries), the numbers are too low.
As you know for statistical significance it is necessary to use a valid sample size and a valid methodology for selection of the sample. (and this opens up another can of worms)
As a rough rule of thumb, the sample should be about 10% of the universe, but not smaller than 30 and not greater than 350.
It is important to define what confidence level is required and what margin of error is acceptable. A confidence level of 95% and an error margin of 5% provides a result that will be within 5% of the true answer 95% of the time.
The correct sample size is a function of those three elements--the universe, the desired error margin, and the preferred confidence level. For varying sizes of universe here are the ideal sample sizes (the first at a 10% error margin, the second at 5%):
50 in the universe, sample 33 or 44
100 in the universe, sample 49 or 80
200 in the universe, sample 65 or 132
500 in the universe, sample 81 or 217
1000 in the universe, sample 88 or 278
My advice? Never marry a statistician
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cptrayes
Well-Known Member
OK lets use cannabis as the example, then, since the ecstasy one isn't yet finished. Cannabinoids are now being licenced for use in the treatment of MS and diseases that cause chronic pain.
This drug started entirely anecdotally, where someone tried their son's stash and found it helped. When enough people had done the same thing, a drug company produced a drug they can sell.
At some point, the number of anecdotes becomes a driving force and I sincerely hope we are nearly there with barefoot.
This drug started entirely anecdotally, where someone tried their son's stash and found it helped. When enough people had done the same thing, a drug company produced a drug they can sell.
At some point, the number of anecdotes becomes a driving force and I sincerely hope we are nearly there with barefoot.
alsiola
Well-Known Member
I am not a statistician either but I spent decades working with them, and they would never accept such low numbers (unless they were being paid to do so).
As indeed I used to, until the shame of it became unbearable, that so many people were being mislead, including the expert community, and not just by the dodgy research. So sorry, but no this research is not valid statistically (unless you are prepared to accept very broad boundaries), the numbers are too low.
As you know for statistical significance it is necessary to use a valid sample size and a valid methodology for selection of the sample. (and this opens up another can of worms)
As a rough rule of thumb, the sample should be about 10% of the universe, but not smaller than 30 and not greater than 350.
It is important to define what confidence level is required and what margin of error is acceptable. A confidence level of 95% and an error margin of 5% provides a result that will be within 5% of the true answer 95% of the time.
The correct sample size is a function of those three elements--the universe, the desired error margin, and the preferred confidence level. For varying sizes of universe here are the ideal sample sizes (the first at a 10% error margin, the second at 5%):
50 in the universe, sample 33 or 44
100 in the universe, sample 49 or 80
200 in the universe, sample 65 or 132
500 in the universe, sample 81 or 217
1000 in the universe, sample 88 or 278
My advice? Never marry a statistician
I find statistics extremely interesting, and it something I wish I knew more about. Actually considering an OU course in Medical Statistics as a hobby. It is true that vets are sad sad people!
Potentially our reliance on statisticians is a folly - when I read a paper I will question if statistical analysis has been performed, and to what level, but not whether the methodology was correct. I'm sure I'm preaching to the converted if I mention incorrect choices of statistical tests. However, I don't have the knowledge to determine if the correct test was used, or if the methodology was correct. If you know of any good resources for this information, without it getting too in depth then please let me know. I have tried and failed.
When you say 1000 in the universe, what do you define as universe? Every horse? Every lame horse? Every lame horse with a diagnosis of lower hock joint arthritis? If its every horse, then given that there are c.6billion humans in the universe, would a medical study need 600 million samples for validity? If its either of the latter two, then how do we know what these numbers are? Every horse we could maybe get a handle on. Every lame horse would surely come down to plucking a number out of the air?
My understanding was that to determine approximate number of samples needed, then you needed to know the variance of the value being measured, and the expected difference between positive and negative samples. Between these you could work out the number needed for significance at whatever level you like, say 95%. Equally I guess the fidelity of measurement would matter? I.e. the more accurately one can measure, the less samples will be needed. Is this covered in the error level in your post?
alsiola
Well-Known Member
People made anecdotal reports to doctors --> Doctors wrote case reports --> Drug companies did proper testing --> Drugs were licensed
Only after the case report phase at the very least would any right minded doctor recommend the treatment. Most would wait until proper testing was done. Some would wait for a licensed product.
We are not yet at the stage with barefoot where any case reports have been produced. While it is incumbent upon vets (I feel, not legally) to publish case reports of horses they have seen treated barefoot succesfully (or otherwise, we don't want any publication bias!), it is not incumbent upon them to recommend a treatment that has only anecdotal support.
If you are succesfully treating animals, then try speaking to a vet and explaining to them that you have had good results with a new technique, and would like them to prepare a case report for publication. If someone approached me with this then I would certainly listen. (If I were to do it funding would be needed, not for me but for my boss whose time I was using!). This is the way to proceed, not waxing lyrical on public forums. While you may get converts in this manner, all this will accomplish is more anecdote. If you truly believe barefoot works (and I'm fairly certain that you do), then what you need is not more anecdote, but simply a small amount of more formal evidence.
LucyPriory
Well-Known Member
Quite - although it is relatively easy to define the universe on paper, for example all horses diagnosed as suffering from x. We all know that an incorrect diagnosis is all too frequent. And truly if I had a brick for every one I've come across just personally, I'd be pretty wealthy by now.
If I remember correctly I think you expressed a distaste for observation - but of course degree of lameness is judged by observation. The trouble with observation is not that it is right/wrong, but that it is in the eye of the beholder.
Which is why it is always entertaining to watch a bevy of vets do a lameness evaluation. See I am pretty sad too!
But enough already - it is off topic too much.
If I remember correctly I think you expressed a distaste for observation - but of course degree of lameness is judged by observation. The trouble with observation is not that it is right/wrong, but that it is in the eye of the beholder.
Which is why it is always entertaining to watch a bevy of vets do a lameness evaluation. See I am pretty sad too!
But enough already - it is off topic too much.
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cptrayes
Well-Known Member
Alsiola you write as if we are asking you to "prescribe" barefoot. We are not stupid, surely you realise that by now? We do understand that scientific evidence is not available. We know that you cannot recommend an "experimental" procedure over an approved one. We also know that research is not going to happen in the short or medium term. But we know that our experiences are NOT value-less just because they are not part of a clinical trial.
"Waxing lyrical" on forums is our only way of letting people know that they don't need to have their horses shot. Many of them are not lucky enough to have a vet like you who says that they would mention a barefoot rehab as a last resort. We are a group of people with experiences to share but there is no organisation between us. We do not have funds to do this research, we have no organisation and there is no reason why we should. We know what can be done, we see the results in front of our eyes.
If you continue to pick holes in examples where anecdotal evidence was of value lets go right back to aspirin. Long long long long before doctors had licenced drugs or any drug was scientfically tested at all, aspirin was in widespread use BECAUSE IT WORKED. People recommended other people with headaches to chew willow bark. It was entirely anecdotal. It was entirely true.
There ARE case studies for the recovery of foot-lame (non laminitic) horses. If you want them, contact Rockley and they can put you in touch with the vets who referred the horses there.
"Waxing lyrical" on forums is our only way of letting people know that they don't need to have their horses shot. Many of them are not lucky enough to have a vet like you who says that they would mention a barefoot rehab as a last resort. We are a group of people with experiences to share but there is no organisation between us. We do not have funds to do this research, we have no organisation and there is no reason why we should. We know what can be done, we see the results in front of our eyes.
If you continue to pick holes in examples where anecdotal evidence was of value lets go right back to aspirin. Long long long long before doctors had licenced drugs or any drug was scientfically tested at all, aspirin was in widespread use BECAUSE IT WORKED. People recommended other people with headaches to chew willow bark. It was entirely anecdotal. It was entirely true.
There ARE case studies for the recovery of foot-lame (non laminitic) horses. If you want them, contact Rockley and they can put you in touch with the vets who referred the horses there.
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Lainey123
Well-Known Member
My vet refered my horse to Rockley as other option was pts. I found Rockley and it was a last resort for a horse that had been lame for 2 years, many different shoes, tildren, IRAP, you name it he had it and nothing worked.
All i can say is that my horse is no longer lame, and is back hunting again, and competing again this summer. He's the best he has ever been and without Rockley i wouldn't have a horse. Everyone was against it as you could flex his soles with your finger, had badly underun heels. Now, he is amazing, never in a million years did i think that he would come back this good. Give Nic a call what have you got to lose, after all it's only an email or phone call. She is an amazing woman.x
All i can say is that my horse is no longer lame, and is back hunting again, and competing again this summer. He's the best he has ever been and without Rockley i wouldn't have a horse. Everyone was against it as you could flex his soles with your finger, had badly underun heels. Now, he is amazing, never in a million years did i think that he would come back this good. Give Nic a call what have you got to lose, after all it's only an email or phone call. She is an amazing woman.x
MerrySherryRider
Well-Known Member
Hi again all - it's me, the original poster
Many thanks for all your private messages - from both the Barefoot Brigade and the Shoe Team (I can say this without getting struck off or beheaded or having my eyes poked out with a hoof pick because I have one barefoot horse and my laminitic, who's own personal motto is 'No shoe, no horse')
Just to update you, the steel heart bars have been removed, as my lovely gelding is clearly not tolerating them. I have opted to put the Stable Support System on for a few weeks (styrofoam pads) to give his feet a rest, as I feel they've had a lot of trauma recently.
So, barefoot aside for this moment in time please, does anyone have any ideas on where to go next? Has anyone had success with Imprint shoes after the steel heart bars have failed? Or the adjustable Eustace shoe?
My horse remains happy and resilient and a long, long way from giving up on life, so any advice would be gratefully and warmly received.
Really hope you find the answer for your lad, its good to hear that he is happy,resilient and coping. Bet you never expected such a hot debate when you started this post ! Hopefully, someone on here will be able to give you first hand experience of the information that you are looking for. Good luck with him, he's lucky to have an owner so determined to do the best for him.
LucyPriory
Well-Known Member
Second that
soloequestrian
Well-Known Member
Hi again all - it's me, the original poster
Many thanks for all your private messages - from both the Barefoot Brigade and the Shoe Team (I can say this without getting struck off or beheaded or having my eyes poked out with a hoof pick because I have one barefoot horse and my laminitic, who's own personal motto is 'No shoe, no horse')
Just to update you, the steel heart bars have been removed, as my lovely gelding is clearly not tolerating them. I have opted to put the Stable Support System on for a few weeks (styrofoam pads) to give his feet a rest, as I feel they've had a lot of trauma recently.
So, barefoot aside for this moment in time please, does anyone have any ideas on where to go next? Has anyone had success with Imprint shoes after the steel heart bars have failed? Or the adjustable Eustace shoe?
My horse remains happy and resilient and a long, long way from giving up on life, so any advice would be gratefully and warmly received.
Okay, so this is still on the barefoot theme, but might be worth you looking at - there are hoof-casts or hoof-wraps (can't remember the exact name, but someone else might) - which are bandages which you can wrap the foot in and then they go hard and get left on for a while. That is a really bad description because I haven't used them or even seen them, but have heard good things about them for horses with particularly sensitive soles.
cptrayes
Well-Known Member
It's not perfect but I have just found this:
http://www.hoofrehab.com/Taylor26horses.html
26 laminitic horses. No shod ones, so equal to the studies into heart bar shoes with no barefoot ones. Much greater numbers.
http://www.hoofrehab.com/Taylor26horses.html
26 laminitic horses. No shod ones, so equal to the studies into heart bar shoes with no barefoot ones. Much greater numbers.
alsiola
Well-Known Member
Great, I am glad that there are people out there doing this work. Is there any possibility this will be written up into a proper case report? The stats there are interesting but it would need a good deal of 'fleshing out' before publication.
soloequestrian
Well-Known Member
This was a study on dead horses, or rather the disembodied limbs of dead horses. That doesn't count as robust evidence for the efficacy of shoeing!
Tiny Fluffy Coblet
Well-Known Member
The lack of decent statisticaly sound empirical evidence is depressing in most fields of equine science not just shod/unshod. Part of the issue is that one can fiesibly keep 300 mice in a large lab under exacting conditions, horses not so much. Though I would say that most evidence for remedial shoeing as has been mentioned compares only to standard shoeing not to barefoot and I have yet to find a study comparing standard shoeing with not in sound horses.
I would like to see:
- a study using a sample of over 100 (in each group) sound horses of varying breeds showing that the size/shape of the hoof differs significantly from a shod to an unshod hoof. The second part of the study using internal examination (x-ray at least) to show that the internal structures differ significantly (digital cushion ect)
- a study using a sample of over 100 (in each group) sound horses of varying breeds showing that the action differs significantly (with particular reference to heel/toe first landing and breakover)
- Studies showing that any differences in the above are actualy beneficial?
If I ever win a multi-million rollover jackpot you people will be the first to see my published work.....
It would be very nice if there could perhaps be a central database that extracted information directly from vetinary records (which I imagine would be in a database anyway?) regarding treatment, care, success rates, contributory factors, situation ect on lameness and everything else for that matter.
If the db had no access to personal information of owners or names of horses ect merely the fact of 'shod horse gets laminitis having had previous bout- suspected cause breaking into grain bin - showed little improvement in heart bars but recovered well after having shoes removed' or 'unshod horse had recurrant abcesses, diet was altered with no improvement, now sound with shoes'.
If it was set up right it shouldn't waste the Vet's time and I'm fairly sure people wanting to prove/disprove things would be prepared to pay a fee to use it therefore funding it. Would be useful to vets too I'd imagine. Unfortunately in my experience most veterinary practices are not open to helping with research or providing any information unless it is to other vets. I'm not sure if it is confidentiality related or what.
I would like to see:
- a study using a sample of over 100 (in each group) sound horses of varying breeds showing that the size/shape of the hoof differs significantly from a shod to an unshod hoof. The second part of the study using internal examination (x-ray at least) to show that the internal structures differ significantly (digital cushion ect)
- a study using a sample of over 100 (in each group) sound horses of varying breeds showing that the action differs significantly (with particular reference to heel/toe first landing and breakover)
- Studies showing that any differences in the above are actualy beneficial?
If I ever win a multi-million rollover jackpot you people will be the first to see my published work.....
It would be very nice if there could perhaps be a central database that extracted information directly from vetinary records (which I imagine would be in a database anyway?) regarding treatment, care, success rates, contributory factors, situation ect on lameness and everything else for that matter.
If the db had no access to personal information of owners or names of horses ect merely the fact of 'shod horse gets laminitis having had previous bout- suspected cause breaking into grain bin - showed little improvement in heart bars but recovered well after having shoes removed' or 'unshod horse had recurrant abcesses, diet was altered with no improvement, now sound with shoes'.
If it was set up right it shouldn't waste the Vet's time and I'm fairly sure people wanting to prove/disprove things would be prepared to pay a fee to use it therefore funding it. Would be useful to vets too I'd imagine. Unfortunately in my experience most veterinary practices are not open to helping with research or providing any information unless it is to other vets. I'm not sure if it is confidentiality related or what.
alsiola
Well-Known Member
Retrospective studies can be useful, and are sometimes performed usually as a clinical audit. This is done by many of the larger equine hospitals (Universities and Newmarket ones I know do it). The problem is that unfortunately there is no standard record keeping software, and none of the available software is even close to doing it automatically. It comes down to someone sitting and trawling through records, which is why only the biggest places can afford to do it. Data protection and confidentiality wise, I am not entirely sure. I think it would probably be OK to publish based on these as long as no identifying information was used. The big hospitals are covered because the first thing you do when you arrive is sign a form saying they can use your horse's information in research.
The other problem with these sort of studies is definitions. When designing studies, extremely strict criteria are laid out as to what constitutes a diagnosis. For example, a recent paper on hind limb suspensory desmitis defined the disease as:
Hindlimb lameness
Negative Low 6 point nerve block
Negative Tarso-metatarsal joint nerve block
Positive deep branch of lateral plantar nerve block
With various other criteria as to why a horse could not be included in the study, e.g. recent treatments, concurrent problems.
When doing a retrospective study, we do not know what criteria have been used by different vets, so horses with different conditions may be lumped together, and horses with the same condition may be given different diagnoses. Unfortunately this is a reality of practice - not all owners have the funds to perform all testing for a truly definitive diagnosis, and not all vets believe it is always needed. For example, if funds are limited and I am going to treat with rest and bute, does it matter whether I am treating a TMTJ arthritis with rest and bute, or treating a high suspensory desmitis with rest and bute? Why waste limited money on tests that won't change the course of action.
All this leads to a great deal of unreliability in records, that can only really be accounted for by a human assessing each one individually. Nice idea though, and I really wish it was a practical option.
LucyPriory
Well-Known Member
How refreshing!
- if only all vets were this practical - having had one vet wanting to do £3.5k worth of tests on an injury we agreed was a groin strain and which ultimately resolved to full soundness in 48 hours without bute. Why?