Getting the vet, EP and farrier in the same room?

Michen

Michen

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Or should I say stable. Is this a bonkers idea? I posted in The Tack Room about the on going saga with my ex racehorse re feet and the remedial shoeing vs barefoot idea. I've spoken to Nic at Rockley today and was told I need a more definite diagnosis for him to go there which would mean MRI and nerve blocks, not keen to do that at this stage. Anyway, he's currently in gel pads and heart bar shoes and is very comfy and sound (not great on a circle but I'm not expecting miracles just yet) but I am fully aware and that unless those changes are on the x rays, they are just a sticky plaster. I'm listening hard to all of you guys about going barefoot but I have come to the conclusion today to stick with the shoes the full three months (so 11 more weeks) until the x rays are re done to see changes.


Now.... if the changes that need to be made aren't there, I want an open, frank discussion with vet, farrier and an EP (I've already had one out to look at him). I really want to hear all opinions thrown out there by them all, I want to know what the EP has to say about some of the stuff my vet says and vice versa. Is this totally mad? Would the vet and farrier object to this? Obviously everyone would be paid for their time but I would rather have them all see the x ray for themselves and have a discussion rather than me trying to digest info from each of them. I just feel like the farrier will say x, the vet will probably say x too, the EP may say y, but if they aren't all saying it in front of each other and me then I can't really hear what each one things about the others ideas and then make an informed decision- does that make any sense?


PLEASE NOTE THIS IS NOT A THREAD ABOUT WHETHER I SHOULD TAKE MY HORSE BAREFOOT OR NOT- PLEASE NO OPINIONS ON THAT! I've had lots of awesome help from people on this forum and am doing my research :)

This is just a question as to whether it would be appropriate to ask three professionals to all be present when re x raying his feet and to between them agree (or at least have a good case for) the next steps should the shoeing have worked or not.
 
Yes. Good luck with scheduling but it sounds likethebest way forward to me if all involved in his care can discuss him together.
 
Sounds like a brilliant idea to get all the Experts together at one place and at one time. Apart from the logistics of course, which will drive you crazy trying to arrange it.

Not an easy task! - but personally I think its the very best way to find a good solution for yours; if you've not torn your hair out trying to schedule everyone at the same time!

Good luck. It would be interesting to see how it goes.
 
I have managed to get vet and farrier together to work on the same horse. Not sure about EP and farrier, that will depend on both their personalities. Personally I wouldn't want to bother with EP but my farrier is more than happy to work on bf horses and extremely knowledgeable. I'm not certain I'd be happy to work with your farrier either tbh.
 
Pearlsasinger said:
I have managed to get vet and farrier together to work on the same horse. Not sure about EP and farrier, that will depend on both their personalities. Personally I wouldn't want to bother with EP but my farrier is more than happy to work on bf horses and extremely knowledgeable. I'm not certain I'd be happy to work with your farrier either tbh.
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Eh? What do you mean you wouldn't be happy to work with my farrier?

Vet and farrier are already working together, in fact they get on like a house on fire, hence a bit hesitant about bringing an EP into the equation but I want him to throw the questions and thoughts in about barefoot
 
Pearlsasinger said:
I have managed to get vet and farrier together to work on the same horse. Not sure about EP and farrier, that will depend on both their personalities. Personally I wouldn't want to bother with EP but my farrier is more than happy to work on bf horses and extremely knowledgeable. I'm not certain I'd be happy to work with your farrier either tbh.
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Just realised about your comments on the photo on my other thread. Actually he was shod in the remedial shoes last week by my new farrier (who I'm referring to) who is working from the x rays I had done. He's not the farrier who shod him twice since his arrival in November- who, though very capable and talented, quite frankly got lazy and complacent and couldn't be assed with a complicated case like my horse.

My new farrier messages me basically every other day since he shod him for any slight update or change, and has discussed my horse at length with my vet. He's fab :)
 
The problem I see is that you're asking the EP to defend his profession to the farrier and vet.......why should he? What benefit is there for him to be put into this position? He's a busy bloke. However, just EP and vet might work.
 
Andalucian said:
The problem I see is that you're asking the EP to defend his profession to the farrier and vet.......why should he? What benefit is there for him to be put into this position? He's a busy bloke. However, just EP and vet might work.
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Mmmm that's my concern- I don't want him to feel he has to defend his profession- there's a reason I want his involvement and Its so I can hear all options and make a balanced informed decision. I feel he will obviously have the knowledge to discuss with my vet in more detail than I could, and will ask the right questions as to how they are going to improve his feet in shoes-if that makes sense? Obviously I would pay him whatever consultation fee he requested (and given he lives 2 miles from my yard it wouldn't be a trek for him) but I agree with what your saying. Him and my farrier know each other incidentally, thought I'm not sure how well.

Equally I don't want to piss off my farrier. Basically, I just want three people who are all professionals at their job to come to some kind of sensible conclusion as to what is best for this horse. I would just like to hear what farrier has to say about some of the things EP has to say, and vice versa. Both are sensible chaps and my farrier is not against barefoot- he just doesn't think it will be good for mine right now.
 
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Hi, Well done for doing all you can for this chap and I feel for your wallet! Just a tip, If you are using equigel have a look around for other makes I did and cut the cost by half for the gel, and it worked just the same.
 
Michen said:
... and will ask the right questions as to how they are going to improve his feet in shoes ...
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What you are hoping for is not achievable.

Your farrier will always promote the application of remedial shoeing. He is after all in the business of selling shoes and even though you may think he is receptive to barefoot he has chosen to shoe your horse.

Your vet will go along with whatever your farrier says.

The EP will tell you that true support comes from within the hoof's internal structure and that integrity of the caudal foot is paramount; that the presence of the a shoe will guarantee atrophy of the digital cushion, collateral cartilages and frog and thus will prevent the true heel engagement that your horse really needs.
 
Michen, although it is a nice idea and in an ideal world all three could work together, I don't think that in reality that it would work at all.

I think that you, as the owner, need to decide what is the way forwards for your horse. Ultimately the decision is yours, so doing research, so that you can make an informed decision is the right thing. I could tell you till the cows come home what I would do, but it's not my horse and I won't be the one seeing him every day.

Have a look at this website. There are some very interesting articles on there. http://www.hoofrehab.com/Articles.html The boots and pads one is pertinant for your situation.
 
Seems like you are asking everyone and not really getting one answer, you are the one who has to decide ultimately.
I would not bother with either the farrier or the vet now, you have decided to will leave it 11 weeks, well leave it.
I don't see any EP having the same expertise as Nic at Rockley,, to me she is has more experience than anyone. If you don't want to go down that route once the X rays have been taken, then I think you should try boots and pads and stuff.
I assume diet and exercise regime has been adjusted.
One person may have a good picture of what is happening and a good solution, but another may be more persuasive. You can never be 100% sure. I think it is quite possible you would end up in even more of a quandry. There are specialist vets of course, are the X rays going to be sent to them?
 
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Bonkers2 said:
Seems like you are asking everyone and not really getting one answer, you are the one who has to decide ultimately.
I would not bother with either the farrier or the vet now, you have decided to will leave it 11 weeks, well leave it.
I don't see any EP having the same expertise as Nic at Rockley,, to me she is has more experience than anyone. If you don't want to go down that route once the X rays have been taken, then I think you should try boots and pads and stuff.
I assume diet and exercise regime has been adjusted.
One person may have a good picture of what is happening and a good solution, but another may be more persuasive. You can never be 100% sure. I think it is possible you will be in even more of a quandry.
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I would love him to go to Rockley but Nic says he needs a more definite diagnosis which would include MRI and nerve blocks.
 
Ronalda said:
What you are hoping for is not achievable.

Your farrier will always promote the application of remedial shoeing. He is after all in the business of selling shoes and even though you may think he is receptive to barefoot he has chosen to shoe your horse.

Your vet will go along with whatever your farrier says.

The EP will tell you that true support comes from within the hoof's internal structure and that integrity of the caudal foot is paramount; that the presence of the a shoe will guarantee atrophy of the digital cushion, collateral cartilages and frog and thus will prevent the true heel engagement that your horse really needs.
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What an objectionable and very close minded point of view. As a farrier, I dont see myself as 'in the business of selling shoes'.
I am in the business of keeping horses sound, and whether that means shoeing or barefoot, boots, pads, any modern technological advance, meeting vets or any other professional its all ok with me, provided I have the time to do it. Like it or not, there are horses that cannot be without shoes, boots or some other type of protection to work, some even cannot cope without shoes at all. Does that mean that they should all be crippled just for an ideology? I dont think so, and I am glad that there are many others that dont.

For what its worth, I believe in barefoot and I advise most of my clients of the benefits of it. But there are some horses that simply cannot cope with it.
 
One of the of things for you to investigate then, is the possibility of getting a Vet referral.

I really wish you the best with this horse - whatever route you decide - as you obviously have his best interests at heart.
 
Faracat said:
One of the of things for you to investigate then, is the possibility of getting a Vet referral.

I really wish you the best with this horse - whatever route you decide - as you obviously have his best interests at heart.
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Easier said than done :( Will be working on it! I wish she'd take them without vet referral as I'd just pay the full amount to send him there myself, but can understand why she does. Thank you very much.
 
Graeme Burt farrier said:
What an objectionable and very close minded point of view. As a farrier, I dont see myself as 'in the business of selling shoes'.
I am in the business of keeping horses sound, and whether that means shoeing or barefoot, boots, pads, any modern technological advance, meeting vets or any other professional its all ok with me, provided I have the time to do it. Like it or not, there are horses that cannot be without shoes, boots or some other type of protection to work, some even cannot cope without shoes at all. Does that mean that they should all be crippled just for an ideology? I dont think so, and I am glad that there are many others that dont.

For what its worth, I believe in barefoot and I advise most of my clients of the benefits of it. But there are some horses that simply cannot cope with it.
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This is pretty much what my farrier has said, and he is such a lovely chap I really do trust him but I can't help but think that what everyone says re barefoot does make sense. Out of interest, what are your thoughts on improving collapsed heels and "a broken back hoof pastern axis bilaterally. This was worse in the right foot, with counter-rotation of the solar surface of the pedal bone" with remedial shoes? He's in gel pads and heart bars currently :)
 
Michen said:
This is pretty much what my farrier has said, and he is such a lovely chap I really do trust him but I can't help but think that what everyone says re barefoot does make sense. Out of interest, what are your thoughts on improving collapsed heels and "a broken back hoof pastern axis bilaterally. This was worse in the right foot, with counter-rotation of the solar surface of the pedal bone" with remedial shoes? He's in gel pads and heart bars currently :)
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I was one of those who originally said hat I would take the shoes off now but on reflection, I think that you have made the right decision to go with the remedial shoeing for now. This horse has worn shoes for almost all his life and presumably had a high starch, cereal-based diet. I would use the next 3 months to change him onto a low-sugar/low-starch diet, which will help his ulcers and his feet, so that if you do decide to go down the route of removing his shoes, his feet will be better able to cope.
Do listen to your new farrier, if he's anything like mine, who is aiming to keep our 2 youngsters shoe-free, he will thoroughly understand how the hoof works and what is possible for your particular horse.
Just to put you in the picture, we have 4 horses, aged from rising 4 to rising 22, one shod all round, one shod in front and the 2 younger ones without shoes all their lives, so no bias either way from owners or farrier.
 
Pearlsasinger said:
I was one of those who originally said hat I would take the shoes off now but on reflection, I think that you have made the right decision to go with the remedial shoeing for now. This horse has worn shoes for almost all his life and presumably had a high starch, cereal-based diet. I would use the next 3 months to change him onto a low-sugar/low-starch diet, which will help his ulcers and his feet, so that if you do decide to go down the route of removing his shoes, his feet will be better able to cope.
Do listen to your new farrier, if he's anything like mine, who is aiming to keep our 2 youngsters shoe-free, he will thoroughly understand how the hoof works and what is possible for your particular horse.
Just to put you in the picture, we have 4 horses, aged from rising 4 to rising 22, one shod all round, one shod in front and the 2 younger ones without shoes all their lives, so no bias either way from owners or farrier.
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Thanks :) I've spoken with my farrier about possibly pulling the backs this week, the hoof wall is just an utter mess all around where the nails are and I'm amazed he's kept them on at all to be honest. Farrier is in agreement if there's not enough growth to trim then shoes off and boots. Should help if I pull the fronts in a few months too.

He's been on the low sugar low starch diet since he arrived so about 3.5 months now. Fingers crossed we will get some decent quality hoof over the next few months.
 
I think rather than the farrier, vet and ep at one meeting, I'd ask the vet to discuss things with Nic, I imagine she's pretty experienced at dealing with sceptical vets.

For your own peace of mind I do think that the shoeing route sounds the right one for you for now, but definitely be prepared to push for a referral to Rockley. Many of the horses there have been in heart bars and Rockley was the last chance.

I've used heart bars before, but wouldn't again and I'm an absolute barefoot supporter now; but you need to make the decision that you are happiest with.
 
Michen said:
Out of interest, what are your thoughts on improving collapsed heels and "a broken back hoof pastern axis bilaterally. This was worse in the right foot, with counter-rotation of the solar surface of the pedal bone" with remedial shoes? He's in gel pads and heart bars currently :)
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The collapsed/underrun heel needs to brought back in stages until the heel surface is level with the widest part of the frog.

The hoof capsules need to be adjusted in such a way as to re-orientate the pedal bone to give a nominally 5 degree positive palmar angle so that as the leg is loaded, hoof mechanism will allow the solar aspect of the pedal bone to bear evenly through the corium and onto the sole.
 
Ronalda said:
The collapsed/underrun heel needs to brought back in stages until the heel surface is level with the widest part of the frog.

The hoof capsules need to be adjusted in such a way as to re-orientate the pedal bone to give a nominally 5 degree positive palmar angle so that as the leg is loaded, hoof mechanism will allow the solar aspect of the pedal bone to bear evenly through the corium and onto the sole.
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But with shoes or without them? ;) Million dollar question!
 
If possible I would not take on a referral WITHOUT having the farrier and vet in the same room.
Initially the one I don't want there is the owner.
The reason for this is that there are an amazing amount of professionals who are very concerned about saving face, thus they would rather keep quite than put there foot in it.
When the owner is not there I find all the relevant parties can have a professional discussion and work towards presenting the owner with a team decision.
The owners job is to then either, reject, comply, question or delay
I always hope that the owner would rather have a team behind them rather than a group of disunited individuals.
But don’t forget:
A vet is the only professional who is permitted to legally Diagnose, give a prognosis or treat, thus if the vet does not agree with any recommendations then this puts the owner in an awkward situation.
I have recently encouraged 4 owners to change vets for the good of the case before us, and in all 4 cases we are now all moving forward in the same direction.
 
Michen said:
He's on micronized linseed, salt, 8 hours turnout and NAF biotin extra :)
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Stop the biotin and feed a good supplement from Equivita, Forage plus or Progressive Earth with magnesium chloride. Make sure our feeding enough salt, at least 25gms.

One of mine needs no supplements and has feet like iron, the other needs a mineral balancer and mag ox or his feet are terrible. Having gut issues can mean you need to take even more care with what you feed for feet, and poor feet need even more care.

I'd cleantrax his feet as well. Crumbling around nail holes can mean infection, and any infection can affect the way he uses his feet
 
Ronalda said:
integrity of the caudal foot is paramount;
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There is no caudal foot, caudal refers to the back but above the knee/hock, the correct term is palmar for the back part of the front feet and plantar for hinds - apologies for being pedantic but all I see everywhere nowadays is the 'caudal foot' and it doesn't actually exist! Might also make vets wonder what you're on about.
 
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