Advice please for shoeing a chronic founder case

MerrySherryRider

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bensababy I do feel the need to point out that a considerable number of people who stick with the vet and farrier will end up with their horses put down, even more will never be properly rideable, and some will go through horrific treatments like sectioning the hoof completely unnecessarily. It's not that simple a decision, though one is certainly easier that the other because all you need to do is say to yourself "I did what the experts told me".

My post was not intended to be the unqualified approval of treatments offered by most vets and farriers that you took it to be, sorry :) !

This has to be the most outrageous piece of claptrap I've ever heard. Shame on you.
 

ameeyal

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I am finding all this very interesting reading {even if i dont understand half of it ;)} my horse is still lame 7 weeks down the line with laminitis, i have to admite he did walk better with heart bars on, i do like the natueral approach to keeping horses, my youngster isnt going to have shoes on, but im also consisering having my laminitics shoes off but im SO SCARED of it not working and i have to have him pts because of my decision.
 

emmachiro

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This is all very interesting reading....good debate!

Thought I'd try and give a 'brief' synopsis of what we've been through - imprints, barefoot, the lot...

I probably should PM this to you, but i'm a bit useless at this!


My 25 yr old arabx welsh mare was diagnosed with rotation when she was about 12, went to see Robin Compton (www.problemhooves.co.uk), who fitted imprints and cut toes right back. From memory she was sore for a couple of months, but then returned to light work and generally being her cheeky self for years, with episodes of abscessing, intermittent bouts of lameness, that has either been laminitis exacerbated by cushings or mechanical laminitis through one foot having to support the other.

She came off imprints and went back onto normal shoes for a while, (can't remember which, sorry), and seemed to go downhill again, so went back onto imprints, which were fitted by a different farrier.

The last 2 years have been interesting to say the least. She has quite severe rotation in both feet, but touch wood is only a founder, not a sinker. She has been barefoot for the last 2 years following a bad bout of lameness. She has had varying amounts of serum production coming from old abcsess sites which is the result of an unstable pedal bone causing pressure and tearing of the laminae. She also hops from one foot to the other, and isn't 100% sound, but she is still the same old cheeky minx that bosses us around.

We have recently gone back to Robin who is about the only person who seems to look away from the text book and look at the individual case. At the moment she is barefoot, is in 'RX boots' with sole cushion support (similar to styrofoam), and she has wedges to help relieve the pull of the ddft which has contracted on the left. I'm sure a lot of people are gasping at the thought of wedges, but her whole body relaxed when they were fitted (they aren't permanent, instead are screwed to her RX boots so she only has them during the day).

We have had so many sleepless nights over this, I know what you are going through. But you know your horse, if they're still eating/standing/looking bright then THEY haven't given up. One vet said who isn't scared of laminitis "where's there's life, there is hope". He said that on the morning we were going to have her put down, that was 9 months ago.

I have a lot of respect for the farrier who has done the interim work, but he himself put his hands up and didn't know what else to do. The local vet took a knife to the sole of her foot and did a partial dorsal wall resection last year, which relieved some pressure but lord knows what it did to the state of the pedal bone. It seems all to easy to throw in the towel with this disease, but my girl has been coping 70% of the time without too much of a problem for 12 years.

So, to try and answer your question, imprints have worked, barefoot hasn't made anything particulary worse, wouldn't say it has been a life saver either, frog supports definately help, RX boots are bloody brilliant.

The best piece of advice I can give you is TIME!!! Your horse has been through sooo much, and probably will need to go through more yet. Perspective for us came when we realised that a family member needed 1 months rest off for having a small operation. 1 month! Your vet is suggesting "see how they are in a few days???????????" How about lets see how they are in 6-8 weeks at least with the full knowledge that this might be really ugly for the first few days/weeks???????

The nutritionists at Topspec have been brilliant with diet advice too. Speak to Robin.

Be brave, take your time, let your horse rest and heal. Good luck.
 

cptrayes

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This has to be the most outrageous piece of claptrap I've ever heard. Shame on you.

No shame accepted, sorry. Well, to be truthful, not sorry either. Shame on the vets and farriers who are refusing to look at the increasing body of evidence that their treatments are either not working, or appear to work but are actually in many cases completely unnecessary.

Congratulations to the brilliant farriers and vets, and there are more and more of them, who are questionning the old received wisdom.

Horserider which bit of what I wrote do you find to be inaccurate, may I ask?
 

brucea

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^^ what CP said.

I've known 5 laminitics up close and personal in recent years, a number of others less so.

The two of them who were put to sleep were the ones under vet and farrier management - and had all the shoeing interventions that you could wish for. Sad, but absolutely true.

Sorry, no shame here either.
 

alsiola

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Shame on the vets and farriers who are refusing to look at the increasing body of evidence that their treatments are either not working, or appear to work but are actually in many cases completely unnecessary.

Where is this body of evidence?

Congratulations to the brilliant farriers and vets, and there are more and more of them, who are questionning the old received wisdom.

I can only speak for myself, but I question any received "wisdom". I treat horses using the principles of Evidence Based Medicine, not on how isolated cases respond to treatment.
 
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Luciejjkk

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My horse had been lame for a very very long time and when I suggested taking his egg bar shoes off, my vet and farrier half looked at me in disbelief, like I was having a laugh. I tried every 'conventiional' and 'traditional' treatment and nothing worked.
It makes me sad to think that if I hadnt gone down the barefoot option, I dont think my horse would be here today.
He is now in full work for the first time in almost 2 years... barefoot :D
 

cptrayes

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Where is this body of evidence?


Alsiola these cases aren't isolated, they are everywhere! Look how many people have posted on here. How many more must there be worldwide? The number on here can only be a tiny fraction of those that exist. Have you read Jaime Jackson's book on Founder? Did it not make sense to you?

If you really want to know about the evidence, then look at the references that have been given on this thread. Search "barefoot" in the search facility on this forum and you will find a dozen and more other references to research, some peer reviewed some not, that you can follow up if you are interested. The main names for academic research into the effects of shoes are Rooney and Bowker. Jackson has published the most about laminitis, I think. Just listen to all the people on this forum who have horses that vets and farriers have told us will never work again whose horses are sound and in work. Look at Luciejjkk's post above. If she had not been brave enough to ignore her vet and farrier, her horse would be dead by now. She is FAR FROM ALONE and we are banging our heads against a brick wall trying to get people in a position to change things to understand what can be done.

Rockleyfarm.co.uk have now returned seventeen, and growing, horses to work that had been failed by the conventional treatments for non-laminitic foot lamenesses of adequan, tildren, HLA and "remedial" shoeing. There are now so many of us who have cured laminitic, navicular, ddft/collateral ligament lame horses that I am baffled at the level of resistance that still exists to believing that most horses know how to heal themselves if they don't have their feet bound with steel.

And before anyone else starts with the "anecdotal isn't good enough" argument, just because most of it is anecdotal doesn't mean it isn't TRUE. Aspiring was used as a painkiller long, long, long before doctors stopped being the local barber. Because Fred told Agnes that chewing willow bark worked, and she tried it and it did.

And please, no more about why barefooters aren't funding research (not on this thread, but several others). It is extremely difficult to get money to research a treatment which will not sell a product (drugs) or service (remedial shoeing). Rockleyfarm's Project Dexter was originally supposed to publish at ten horses. Nic has now done 17 yet the Professor at Leahurst that is sponsoring the project does not want to publish. How many more does she have to do before vets get the information they need from a source they can trust?
 
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alsiola

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I really do want to know. I am not fundamentally for shoeing and against barefoot. At the moment it is simply that the body of evidence for shoeing is much stronger than the body of evidence for barefoot. I am aware that "absence of evidence is not evidence of absence", but I cannot ethically recommend a treatment that is unproven over one that is proven. Obviously I am keen to see any studies on barefoot trimming as if the current body of evidence points toward an incorrect conclusion, the sooner the veterinary and horse owning community knows about it, the better.

I appreciate that getting funding for studies is not easy - there are thousands of potential studies that could be performed every year that will never be performed in all likelihood. However, funding difficulties exist for everyone, not just barefoot practitioners. I really dislike the calling of conspiracy theories e.g. there is no money in shoeing, so no-one will fund it. Yes, a big company with a new drug or treatment will fund a trial (often a woefully inadequate and inaccurate trial but that is beside the point), but there remain many charitable organisations who fund studies with no commercial motivation. As an example, I believe you mentioned the Laminitis Trust earlier in the thread. The LT gains money through licensing its safe feed tick to feed manufacturers, its premium rate "advice" line and charitable donations. Why does it have a financial motivation to encourage shoeing? Or how about the HBLB Trust, whose only stated aim is to improve horse welfare in the UK?
Calls to imagine conspiracy theories do nothing more than liken the foot trimmer to the homeopath. Funding is available to those with the time and knowledge to perform the studies adequately.

I do also have some problems with the philosophy of some foot trimmers. For example, earlier in this thread it was stated that Imprint shoes were detrimental as they made the horse too comfortable, so it moved around more. The implication being that debilitating pain is an appropriate tool to use. I do not know if these are your views, but regardless, they are espoused by barefoot devotees and reflect dimly on the community.

And before anyone else starts with the "anecdotal isn't good enough" argument, just because most of it is anecdotal doesn't mean it isn't TRUE. Aspiring was used as a painkiller long, long, long before doctors stopped being the local barber. Because Fred told Agnes that chewing willow bark worked, and she tried it and it did.
The joy of living in an enlightened age of scientific reasoning is that we no longer have to rely on the anecdotal. Experience has shown time and time again that anecdotal evidence can be completely wrong, and that only properly conducted trials can be trusted. For example, for many years A&E doctors gave spinal cord trauma patients steroids, because it was supported by logic, and had anecdotally good success. Eventually a double-blind placebo controlled randomised trial was performed, and the death rate of patients receiving steroids was significantly higher. Years of medical "wisdom" and anecdotal "evidence" was overturned, and standard practices were changed. How many patients died due to the power of anecdotal evidence however?
Human instinct cannot be trusted - we are hard-wired pattern spotters. The human who mistook a pattern of leaves for a tiger and mistakenly ran survived better than the one who mistook the tiger for leaves. If we are to improve medical knowledge, we now realise it is not sufficient to trust our own pattern-recognising behaviour.

For every anecdotal success that barefoot supporters can list, I could counter with a success story for shoeing. How about the 17 year old mare with a history of lameness? She had chronic laminitis with mild rotation and moderate sinking, and had not been ridden for 3 years. I saw her at this point when she was requiring a minimum of 2 sachets of bute daily to stay sound. 3 months after applying heart bar shoes I had the pleasure of watching her buck around the field bute free, and 6 months later of meeting her owner riding her out on a hack. Of course we made some dietary and management changes as well - no lami case will be a success without this whether we use shoes or not.

I haven't read Jaime Jackson's book on Founder - I did read his article on P3 rotation posted in this thread. I struggled to place too much faith in it after he described the skeleton as non-weightbearing. The article as a whole was full of speculation and theorising without any proof. This makes me loathe to waste my hard-earned on a full books worth of the same.

When I ask for evidence of the superiority of barefoot over shoeing approaches to treating laminitis, then to be convinced I would need to see a study showing statistically significant differences between the two, such as length of time spent on box rest, length of time receiving painkillers, objective lameness grading, survival time. If this exists then please point me in the right direction.
Another study might compare non-diseased horses kept barefoot vs non diseased horses kept shod, and compare the incidence of lameness between the two. Again, this does not exist to my knowledge.

I am not interested in supporting one treatment or another based on fundamental beliefs, but based on published sound evidence. My rebuttal of barefoot trimming is based solely on the evidence, and I would happily be convinced as to its superiority.
 

alsiola

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Rockleyfarm's Project Dexter was originally supposed to publish at ten horses. Nic has now done 17 yet the Professor at Leahurst that is sponsoring the project does not want to publish. How many more does she have to do before vets get the information they need from a source they can trust?

Why the resistance to publishing? While a case report of 10 or 17 horses would not be sufficient evidence to change my mind (or many others I suspect, see my post above for what would be sufficient to change my mind), this is not the goal of a case report. A published case report will serve to stimulate more research, which can only be a good thing. Which Professor at Leahurst was sponsoring the project?
 

mrdarcy

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riding her out on a hack. Of course we made some dietary and management changes as well - no lami case will be a success without this whether we use shoes or not.

.

Why do you think it was the shoes that made the difference and not the dietary changes? Can you point me the direction of a study where dietary changes plus remedial shoeing were compared to remedial shoeing alone?
 

alsiola

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Why do you think it was the shoes that made the difference and not the dietary changes? Can you point me the direction of a study where dietary changes plus remedial shoeing were compared to remedial shoeing alone?
I can't, which is exactly my point. A case report is not evidence enough to change clinical acumen, and you are right to question it. I used this as an example as to why all the anecdotal evidence for barefoot trimming is not enough evidence either.

However, I can show you published work on the efficacy of shoeing a laminitic:

Equine Vet J Suppl. 1998 Sep;(26):111-8.
Digital perfusion, evaluated scintigraphically, and hoof wall growth in horses with chronic laminitis treated with egg bar-heart bar shoeing and coronary grooving.
Ritmeester AM, Blevins WE, Ferguson DW, Adams SB.

Equine Vet J. 1989 Sep;21(5):370-2.
Treatment of solar prolapse using the heart bar shoe and dorsal hoof wall resection technique.
Eustace RA, Caldwell MN.

Equine Vet J. 1989 Sep;21(5):367-9.
The construction of the heart bar shoe and the technique of dorsal wall resection.
Eustace RA, Caldwell MN.

Vet Clin North Am Equine Pract. 1989 Apr;5(1):73-108.
The treatment of laminitis in horses.
Goetz TE.

This is just what I can find in 5 minutes before work. The first is probably the most significant, showing that applying bar shoes significantly improved perfusion of the laminae.
 

MerrySherryRider

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Thanks for the links Alsiola, I have asked for the evidence that is not anecdotal regarding the barefoot approach, but got slapped down for it. I want the best for my mare and have trawled research papers for the best way forward for my navicular mare.
All I know is, that so far, remedial farriery is doing the job and yesterday, out exploring and cantering in the sunshine, I was very happy, and so was she. I do agree with looking at the whole horse and its management is vital, hence my frustration at the lack of evidence to back up the claims of the barefoot approach.
 

AmyMay

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All I know is, that so far, remedial farriery is doing the job and yesterday, out exploring and cantering in the sunshine, I was very happy, and so was she. I do agree with looking at the whole horse and its management is vital, hence my frustration at the lack of evidence to back up the claims of the barefoot approach.

Nail on head Horserider. At the end of the day a holistic approach is always the best approach. If that means shoes off, fantastic. And if it means shoes on, no one should be made to feel guilty or an inadequate owner......
 

touchstone

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From my standpoint I've seen a fair few remedially shod horses when working as an instructor, however I tend to find that shoes are simply a temporary fix and often the underlying condition doesn't improve or resolve, and in some cases is worsened. After a time remedial shoes seem to be less effective and I've seen more navicular cases pts long term than I'm comfortable with. Just my personal experience of course.

In cases of laminitis I can't grasp why you'd want to nail metal that can't be adjusted and loads periphally onto a sensitive foot, when a natural trim and boots and pads if necessary give the required support :confused: Just seems a no brainer to me.

Whether science decrees it or not, the results I've seen with my own eyes mean that for me barefoot will always be the method of choice for me, I think my horse would say the same too. :)
 

soloequestrian

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To the OP!
If I were you, I'd invest in a couple of types of boot - the Easyboot Rx and probably a set of Old Mac's and pads too. Then take the shoes off and see if you can get the pony comfy in boots. I've never used the Rx, but they are designed for your sort of situation. I have used Old Macs extensively, and for a laminitic. You can get several different densities of pad, which can all be cut to different shapes, and I have used a soft pad near the hoof (deforms around the hoof) and a medium pad under that (a bit less deformable, but provides a nice thick pad).
It was a different situation to yours - my mare got laminitis as a result of a general anaesthetic for something else, so I didn't have to search for the trigger, but the pathology is the same. My vet put her in heart bars, which I hated - I'm a barefoot devotee - but at the time I was to distraught to argue. When we came up to six weeks in shoes, I had read everything I could about treating laminitis barefoot. The vet still said to shoe, and the Laminitis Trust said that I would NEVER be able to remove her shoes ever again, but with everything I'd read plus may years of having barefoot horses, I decided to take the shoes off. At the same time, I took her off the ACP she had been on and chucked her out, in very well padded boots, to eat haylage and grass with her pals. I was petrified, of course, but she didn't look back. I had to keep her in the boots and pads permanently (night and day) for a month, and then she went onto some time with boots and some without, depending on ground conditions. She is now fully recovered and her new foot has grown in, she is in work and has been galloping and schooling with no problems.

To the people demanding massively expensive controlled studies into all of this - it's not going to happen!
 

cptrayes

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I can't, which is exactly my point. A case report is not evidence enough to change clinical acumen, and you are right to question it. I used this as an example as to why all the anecdotal evidence for barefoot trimming is not enough evidence either.

However, I can show you published work on the efficacy of shoeing a laminitic:

Equine Vet J Suppl. 1998 Sep;(26):111-8.
Digital perfusion, evaluated scintigraphically, and hoof wall growth in horses with chronic laminitis treated with egg bar-heart bar shoeing and coronary grooving.
Ritmeester AM, Blevins WE, Ferguson DW, Adams SB.

Equine Vet J. 1989 Sep;21(5):370-2.
Treatment of solar prolapse using the heart bar shoe and dorsal hoof wall resection technique.
Eustace RA, Caldwell MN.

Equine Vet J. 1989 Sep;21(5):367-9.
The construction of the heart bar shoe and the technique of dorsal wall resection.
Eustace RA, Caldwell MN.

Vet Clin North Am Equine Pract. 1989 Apr;5(1):73-108.
The treatment of laminitis in horses.
Goetz TE.

This is just what I can find in 5 minutes before work. The first is probably the most significant, showing that applying bar shoes significantly improved perfusion of the laminae.

I am going to try and read your referrals Alsiola and I hope that they had a control group of laminitic horses taken barefoot. Regarding two of them, though, I know one and suspect that there are plenty of vets who think that Robert Eustace's enthusiasm for dorsal wall resection is uncalled for. It reminds me of the enthusiasm in the old days for firing tendons. What I don't understand is that if a horse is laminitic and you get the diet right it will regrow its own feet with attachment. What is the point of a dorsal wall resection when the hoof will grow again anyway?

There is an interesting bit of research into navicular which compared different methods of treatment. ALL the horses improved, but no-one made the connection that in order to rule out the effects of shoeing, all the horses had their shoes removed. The improvements were simply put down to the medication.

One of the things that is missing so far in this discussion of the benefits/drawbacks of shoes is that most laminitis is diet related. And unless you have the shoes off the horse, you miss all the very early signs of a laminitis build-up, which begins without pulses or lameness and manifests itself simply as an inability to walk happily on rough surfaces which were previously coped with well. If you do not have those signs any more because the horse is shod, how can you know that you have corrected the diet sufficiently to prevent a further acute attack? Perhaps the ongoing problems which seem to require dorsal wall resection are actually still dietary????

Your point about pain is very interesting. Of course there must be a balance, but, if it came down to it, I would choose a short period of lack of movement due to acute pain if it resulted in a horse which was totally pain free and able to work normally for the rest of its life. I can't help wondering how many of the "just about comfortable" horses which are actually in constant low grade pain, hobbling around in heartbar shoes could be perfectly sound without them, given a proper rehab (which can be VERY difficult with metabolic horses, I do understand that, and this suggestion does NOT include horses with Cushings laminitis, which can be a dreadfully difficult thing to control).

Off to read now to see if your clinical trials are as unbiased as they should be, if I can get a synopsis at least online.
 
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cptrayes

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Digital perfusion, evaluated scintigraphically, and hoof wall growth in horses with chronic laminitis treated with egg bar-heart bar shoeing and coronary grooving.
Ritmeester AM, Blevins WE, Ferguson DW, Adams SB.

TEN horses, all shod. Five resectioned, five not. The resectioned horses did better, fine, but no-one knows how they would have done if they had a proper barefoot rehab.

And you don't think 17 horses at Rockley is significant enough to take account of if published?
 
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cptrayes

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Equine Vet J. 1989 Sep;21(5):370-2.
Treatment of solar prolapse using the heart bar shoe and dorsal hoof wall resection technique.
Eustace RA, Caldwell MN.


Ten horses all in heart bars. No control group without shoes at all.
 

cptrayes

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Equine Vet J. 1989 Sep;21(5):367-9.
The construction of the heart bar shoe and the technique of dorsal wall resection.
Eustace RA, Caldwell MN.


Description of how to use a heart bar shoe in the resectioning of a foot and description of a number of cases treated. Not research, no control groups of any kind.
 

cptrayes

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Vet Clin North Am Equine Pract. 1989 Apr;5(1):73-108.
The treatment of laminitis in horses.
Goetz TE.

No research, description of how to trim and apply heart bars. Abstract not entirely clear, but strongly suggestive that heart bars were not tested against no shoes but were the only treatment considered.
 

cptrayes

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Conclusion.

On the evidence so far, there is no more research which says that heart bar shoes are better than barefoot than there is that barefoot is better than heart bars.

I stand by my comment that the use of heart bar shoes for treating laminitis is "received wisdom", not clinically tested.

I suspect it has become received wisdom because it has a painkilling effect, not a curative one, but I would just love the research to be done properly. (Yes, Solo, I know, I know!! :))
 
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amandap

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The reliance on scientific trials is fair enough but the scientific world is rather cut throat and often driven by money too.

A vet told me last year that 'wet grass' causes scour in horses. I asked him for evidence and he said he had observed it over his 45 years of being a vet.

I'm just a non scientific owner and have been studying BF approaches and thinking for the last nine years or so in my informal way.
To me it all makes total sense but has huge implications for how we manage our horses from birth.
Prof Chris Pollitt, Dr Robert Bowker, Dr James Rooney, Kathryn Watts have all done research into various aspects behind barefoot thinking. I'm lazy so will just give links for peeps who are interested to find out more and find the papers.

http://www.horseshoes.com/farrierssites/sites/rooney/index.htm
http://www.wildhorseresearch.com./index.htm
http://pathobiology.msu.edu/people/bowker.html
http://www.hoofrehab.com/AuburnUvetschool.htm
http://www.hoofrehab.com/hoof articles by Pete Ramey.htm
http://www.aanhcp.net/Laminitis Rep... Reduce Laminits by C Pollitt and K Watts.pdf
http://www.safergrass.org/
 

alsiola

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Conclusion.

On the evidence so far, there is no more research which says that heart bar shoes are better than barefoot than there is that barefoot is better than heart bars.

I stand by my comment that the use of heart bar shoes for treating laminitis is "received wisdom", not clinically tested.

I suspect it has become received wisdom because it has a painkilling effect, not a curative one, but I would just love the research to be done properly. (Yes, Solo, I know, I know!! :))

I agree with you wholeheartedly that there is no research directly comparing shod vs. unshod horses, and it is something I would like to see performed. I haven't picked those papers because they are especially good science, or because I agree with the authors' views (as it happens I don't agree with many of Robert Eustace's approaches, conclusions or the actions of the LT as a whole!), just to demonstrate that there is literature out there on the benefits of shoeing, which does not exist for barefoot. If reports on barefoot showing benefit are being prepared, I would wholly support their publication.
Until there is either a direct comparitive study done shod vs. barefoot, or the literature gives us a comparable level of evidence that barefoot can work, then there is no justification not to recommend shoeing.
 

soloequestrian

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Until there is either a direct comparitive study done shod vs. barefoot, or the literature gives us a comparable level of evidence that barefoot can work, then there is no justification not to recommend shoeing.


But surely the converse also applies i.e. there is no justification not to recommend bare. Taken with 'do no harm', I'd say bare would win every time.
 

alsiola

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A vet told me last year that 'wet grass' causes scour in horses. I asked him for evidence and he said he had observed it over his 45 years of being a vet.

This vet is using false logic. What he has observed is a correlation between A - the grass being wet, and B - horses scouring. Just because the two frequently occur together does not mean that A causes B. How does he know that increases in day length don't cause scouring. In this hypothetical case, increased day length is associated with wet grass (ie higher precipitation in spring), and also scouring. A fairly absurd example, but it shows how a third variable, unaccounted for (in this case day length), can cause two unrelated events. The human observer, being a natural pattern recogniser spots this and assigns causation to the events, where in reality none exists.

Equally, while there may be an association between barefoot treatment and laminitic recovery (as yet unproven), this is not the same as saying that barefoot treatment CAUSES laminitic recovery. There may be a confounding variable, for example, it may be that barefoot treatment is associated with dietary change, and the dietary change causes laminitic recovery. The shod vs unshod state of the horse may make no difference, but because it is coexistent with a third variable it gets called a causative factor.

The bottom line is we cannot trust what we observe with our own eyes, I can't, you can't, no-one can. Unless the scientific approach is used, then the conclusions we draw mean nothing.
 

alsiola

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But surely the converse also applies i.e. there is no justification not to recommend bare. Taken with 'do no harm', I'd say bare would win every time.

I would say not. Although direct comparitive studies have not been performed, there is a body of literature describing improvement in laminitic horses that have been shod. This does not exist for barefoot.

The NHS uses the following guidelines to grade the quality of evidence, (A best, to D poorest):

Level A: Consistent Randomised Controlled Clinical Trial, cohort study, all or none (see note below), clinical decision rule validated in different populations.
Level B: Consistent Retrospective Cohort, Exploratory Cohort, Ecological Study, Outcomes Research, case-control study; or extrapolations from level A studies.
Level C: Case-series study or extrapolations from level B studies.
Level D: Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles.

What research do we have?
Shoeing approach - We have some Level B studies (outcomes research), many Level C studies (many case series studies), and tons of Level D (expert veterinary opinion almost exclusively supports shoeing).

Barefoot approach - One rumoured, as yet unpublished Level C study. Arguably no Level D evidence (I say arguably because I know you will cite Jaime Jackson etc. as experts, even though in this context they are not).

Does this demonstrate how clearly the evidence for barefoot approaches is overshadowed by the evidence for shoeing?
 

alsiola

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A fairly sensible site, but not one that comes down in favour of either shoeing or barefoot. This is verbatim from the page entitled "Barefoot or Shod":
The various "systems," such as Duckett's dot, Natural Balance, Strasser trim, Bergeleen’s etc. may all have merit, but I think one is fooling oneself to believe that any one system applies to all horses and all feet. Any system offered is, in fact, a theory. There is nothing wrong with that, but theory must be adjusted to the immediate vagaries of the real world – the real foot. The basic thing, and I repeat myself, is to learn as much as possible about the normal working of the digit, and then go to the horse. Don't try to force a system, just do your thing, and your thing should be better because there is more in your brain to work with. Don't say, Rooney says to do thus and so or Bergey says do this or that. What you do say is I have read and understand Rooney and Ovnicek and the others, and I shall continue to read and learn whenever and wherever I can. Always, however, with a skeptical eye and a well-honed bulls**t detector. And now I’m now going out and shoe that damn horse!

Looks to be an interesting research project. No support for barefoot vs shod I could find, and in fact there is currently no information on their hoof research.

Interesting research, but don't see any papers relevant to the debate.

Seems to pretty much accept that managing horses barefoot is impractical, only their solution is glue on boots rather than shoes. If anyone can explain the difference between a glue on boot, and a glue on imprint shoe with sole filler then please do.

Both these are regarding the nutritional side of laminitis. Any self respecting horse worker, be they a vet, a farrier or a barefoot trimmer recognises the importance of nutrition in laminitis. Just because I personally recommend shoeing laminitics does not mean I don't also examine the diet extremely closely.
 
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