Vets, barefoot, evidence-based medicine...........

MontyandZoom

MontyandZoom

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I'm a 4th year at vet school and have been reading with interest the NUMEROUS posts about shoeing vs barefoot trimming.

I got to thinking about why this method of treatment has not filtered into the mainstream in terms of vets and teaching. There are lots of posts on here which talk about vets 'not knowing any better' than remedial shoeing, but this strikes me as unfair.

As a vet you should always be able to defend your chosen treatment in terms of evidence based medicine. The benefits of a particular treatment having been shown in a peer-reviewed, published study with a significant enough sample size.

If barefoot trimming really is so much better than shoeing, surely people should be lobbying for studies to be done to prove it. (they may be some already.....I'm not sure). Otherwise how can vets legally and ethically recommend it on purely anecdotal evidence? I am not at all dismissive of it but would like to know what it going on in terms of moving forward in barefoot trimming and veterinary medicine.
 
MontyandZoom said:
If barefoot trimming really is so much better than shoeing, surely people should be lobbying for studies to be done to prove it. (they may be some already.....I'm not sure). .
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I think there is a certain amount of this going on...

Also, the point you make is fine, but why are vets so AGAINST trying other things as opposed to completely shooting them down, which is what I have experienced. Fine to promote and recommend what you think works, but to make horse owners feel bad for wanting to try something else? That's what gets my back up, and I have encountered a LOT of that.
 
MontyandZoom said:
As a vet you should always be able to defend your chosen treatment in terms of evidence based medicine. The benefits of a particular treatment having been shown in a peer-reviewed, published study with a significant enough sample size.
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What you want for barefoot does not exist for shoeing and yet you are still being taught it. You cannot defend remedial shoeing in terms of evidence based medicine. There are NO scientifically valid peer reviewed published research papers for any kind of shoeing, remedial or otherwise. (please, please prove I am wrong on this!)

The last time I had this discussion with a vet she quoted one study after another. And one study after another was of tiny numbers, around ten, with NO CONTROL GROUP. Not scientifically valid in any way.

My favourite one does have significant numbers. It starts with 82 horses with navicular spectrum front foot lameness. They shoot 27 of them because they are "too difficult to help". Of the remainder of 55, an unspecified number are described as not lame enough for it to be noticeable. They bar shoe ALL of them. Around 50% are "improved", though how you judge improvement in a horse that was not lame is beyond me. No timescale was given for any follow up checks to see if the improvement was sustained. And people are seriously suggesting on this forum from time to time that this study indicates a 50% recovery rate.

It would be hilarious if it was not so serious for horse welfare.

Can I suggest that you lobby Leahurst to publish the massively successful treatment that has been going on at Rockley Farm under the watchful eye of one of their professors? It's on the website if you want to read full details and I know for a fact that Nic Barker would be absolutely delighted to receive a visit from a group of year 4 vet students so that she can show them what she does.

She's not alone, there are further large numbers of us that have done one or two rehabs, and other trimmers that have done more than that. I'm on my second. The first was booked in to be put to sleep two days after I took him on. That appointment was cancelled. He now hunts and wins at his national breed show. I'm on my second. He won't stay sound in shoes, remedial or otherwise. He's sound now and changing how he moves every day. I'm only two weeks in but I'd say that the chances of him hunting with me around New Year are extremely high.

We'd all love the research, can you point us in the direction of some funding, because there's no money in a "don't medicate or shoe" for anyone to be incentivised to fund it? I do the lottery to try to win enough money to do it. No luck so far :(



ps it may interest you to know that the one peer reviewed and published research into barefoot versus shoes showed a significant reduction in size of foot at the coronet band and an adverse change in hoof pastern axis after ONE shoeing cycle. We need more of this stuff, the numbers weren't huge and it was only one breed of horse, but at least there was a decent 100% control group.
 
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dressagelove said:
I think there is a certain amount of this going on...

Also, the point you make is fine, but why are vets so AGAINST trying other things as opposed to completely shooting them down, which is what I have experienced. Fine to promote and recommend what you think works, but to make horse owners feel bad for wanting to try something else? That's what gets my back up, and I have encountered a LOT of that.
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I actually totally agree with you in terms of things getting shot down. I have experienced that as a horse owner before.

I went to an interesting talk the other day at school regarding litigation though. I think the threat of being sued is MASSIVE as an equine vet so vets tend to be too afraid to say anything that they don't think is easily defensible if you were to be hauled in front of the RCVS.

Even on here there is alot of chat of negligence and complaints etc. (Not that I am saying people shouldn't make complaints......that's what the system is there for).

I looked into doing barefoot as my undergraduate project but it is just too big a topic and there didn't seem to be enough evidence either way for me to write a solid project.
 
cptrayes said:
What you want for barefoot does not exist for shoeing and yet you are still being taught it. You cannot defend remedial shoeing in terms of evidence baced medicine. There are NO scientifically valid peer reviewed published research papers for any kind of shoeing, remedial or otherwise. (please, please prove I am wrong on this!)

The last time I had this discussion with a vet she quoted one study after another. And one study after another was of tiny numbers, around ten, with NO CONTROL GROUP. Not scientifically valid in any way.
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You may be completely right! In terms of teaching, we get hardly any. In fact, in four years I have had ONE lecture by the farriery team which was the other night (hence why it got me thinking).

I am making some fairly huge assumptions in terms of the number of vets advising wedges and bar shoes. I was thinking that there surely must be evidence to show the benefit. If it is the case that there really is very little evidence to advocate these techniques then there is a major problem that needs to be addressed.

Incidently, i am really not biased either way, just very interested as to how this situation could have occurred when we are talking about such a huge area of veterinary medicine.
 
A basic grounding in the structures and biomechanics of the horses hoof/legs and movement now that we have the advantage of scans to see what actually happens inside gives all the proof of the potential benefits of barefoot and the potential harm of shoeing, unless outweighed by other factors (eg a horse requiring shoes for massive amounts of roadwork). You dont need a peer reviewed study to understand the implications of shoeing removing the ability of the hoof to function to absorb shocks and circulate blood around the hoof and retain the navicular in its correct position and angle - it just 'is' the case!

Particularly in the area of 'navicular 'disease'': - understanding of how to avoid it and how to treat it have been completely turned on their heads.

Shoeing is easier for owners as they dont have to pay so much attention to diet, bother with boots or conditioning, but I think it is harder to say these days that shoeing is 'good' for the horse. It is better for the horse if the owner doesnt have the time/interest to devote to hoof health.

Given the proportion of horses who are now barefoot I would think vet colleges who didnt cover this area of horse health in great depth would be rapidly left behind.
 
There is also, as always with all research, the question of who would pay. Academic institutions are far, far less likely to fund 'art for art's sake' in this day and age and outside funding is tricky to get. Unfortunately much of our current research re equine products and practices is funded by private industry. This does not negate the usefulness of a well designed, impartial study but it does tend to mean investigations that have no 'benefit' will be harder to find funding for, especially the amount that would be needed to do such a study thoroughly.

Which is not to say it's not a valid question, just to point out that it may not just be a case of people being wilfully resistant.
 
I had a conversation with another farrier the other day, not my own. The woman who owns the horse couldn't be there so I said I'd hold her horse. I told him about getting mine out of shoes as they needed it even if it was only for a break. Told him my farrier had been at me for ages to do so. He said, well any farrier that doesn't recommend a break from shoes at least once a year isn't doing the best for the horses. He said it doesn't matter how much things advance in farriery or medicine, most problems wouldn't need fixing if people gave the feet a chance to right themselves without shoes.

That's not science and it's not veterinary but the words of a man who's been shoeing horses for a long time.

Terri
 
A study will be hard to make come about. Farriers (and shoe manufacturers) have so much to LOSE once people realise barefoot is relatively easy, you'd think they will HAVE to do a study with a CONTROL group of barefoot horses.

But why would they do that? It will be commercial suicide. Most farriers KNOW horses need time out of shoes.

Barefooters have no money with which to do a study and anyway, why bother as the evidence speaks for itself. As a barefooter myself, I don't really care. If I need to shoe I will (call a decent farrier). If I don't, I won't.

It isn't complicated (hooves aren't that complicated). I sometimes feel that vets can complicate things further than they need to be.
 
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I agree that a foot is designed to work without shoes on and can agree with the theory that putting shoes on will impair the natural action of the hoof structure.

I also agree that to a certain extent convenience comes into the picture. However, vets are not generally asked to advise about foot management of normal horses. The majority of cases are horses who have been presented with lameness issues and require treatment (perhaps damage caused by shoeing in the first place.........;))

This is where studies really are needed to advise as to what 'gold standard' of treatment would be.
 
M&Z.. 4 years now .. jeez time flies!

fwiw the science geek in me would love there to be more peer reviewed evidence for barefoot... unfortunately like many things it isn't something that would easily attract research funding :). As CP also says if you get searching on WOK or others for recent shoeing papers they usually aren't great either.

So although I would have loved to have more proper evidence before my lads shoes came off and I made him my own personal case study of 1 ;) it wasn't there.

My observations of my case study were (diagnosis DJD in coffin joint and reverse pedal bone rotation - I suspect had some collateral ligament damage too) bar shoes = still lame, steroid+ HA injections = still lame, vet (and me) not keen on wedges in the long term, barefoot (march)- now sound back in medium work. That will have to do me for the time being.

fwiw my vet was not against me taking shoes off, although it was mine not his suggestion. He has sent horses to rockley and had clients home barefoot for navicular. He had no evidence to suggest it might work for Frank's diagnosis so I said I'd let him know how I got on ;)

eta further to your ^^ post.. problems def not helped by shoeing previously
 
It's also worth bearing in mind that in other areas proper research has often only come long after established practice of what does or doesn't work. If you take even a condition like colic, a hundred years ago a lot of the basic rules were the same as today. Research has given us more options for treatment in recent years, but basic principles like not allowing vigorous rolling etc remain the same. Why? Because it was anecdotal, same as the principles we still use today to avoid colic in the first place. Basically a lot of veterinary practice has come about through trial & error, with research done much later. And as far as barefoot rehab goes, there's no financial gain to be made by anyone, so no economic grounds to research it. Doing comprehensive studies into for example ligament damage, is financially a sensible move, because it has an impact on racehorses, which are the money spinners of the equine world, right down to how big a bill the one horse owner receives for treatment for their leisure horse. And the same can be said for a lot of conditions & treatment. Barefoot research isn't going to earn anyone anything, so there's no financial sense in the veterinary industry funding comprehensive research.
 
MontyandZoom said:
I agree that a foot is designed to work without shoes on and can agree with the theory that putting shoes on will impair the natural action of the hoof structure.

I also agree that to a certain extent convenience comes into the picture. However, vets are not generally asked to advise about foot management of normal horses. The majority of cases are horses who have been presented with lameness issues and require treatment (perhaps damage caused by shoeing in the first place.........;))

This is where studies really are needed to advise as to what 'gold standard' of treatment would be.
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Then, surely, as a vet it is up to you (and your profession) to get clued up about foot lameness from all angles. OR get a study going. You said yourself it is hard to do. There is no interest for anyone else to do it.

If all you get is a session with a farrier, I am not confident about calling you out for a foot issue. I'd rather call my trimmer/farrier.
 
ester said:
M&Z.. 4 years now .. jeez time flies!


fwiw my vet was not against me taking shoes off, although it was mine not his suggestion. He has sent horses to rockley and had clients home barefoot for navicular. He had no evidence to suggest it might work for Frank's diagnosis so I said I'd let him know how I got on ;)
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I know.......I might actually have to be a vet fairly soon!!!! :D

It is good that your vet had a good attitude to trying without the shoes. I'm hoping I will be open to ideas when I qualify, I reckon it helps that I'm a wrinkly (I'll be 30 when I graduate!).

I think this totally emphasises the importance of vets submitting case reports to the various publications. At least then, even in the absence of a control group, there would be enough anecdotal evidence compiled to make it a more defensible course of action. Maybe vets would then be a bit more open to it.
 
I was fully prepared for it not to work but as the alternative was retirement and he would be having his shoes off then anyway ;)
 
tallyho! said:
Then, surely, as a vet it is up to you (and your profession) to get clued up about foot lameness from all angles. OR get a study going. You said yourself it is hard to do. There is no interest for anyone else to do it.

If all you get is a session with a farrier, I am not confident about calling you out for a foot issue. I'd rather call my trimmer/farrier.
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You seem a bit annoyed :confused: We get one lecture on SHOEING......because sboeing is not my job. We get lots of lectures on foot lameness, anatomy, physiology etc because that is what I will be paid to know about.

I would love to do a study.......but I am busy trying to pass vet school first :D
 
MontyandZoom said:
I'm a 4th year at vet school and have been reading with interest the NUMEROUS posts about shoeing vs barefoot trimming.

I got to thinking about why this method of treatment has not filtered into the mainstream in terms of vets and teaching. There are lots of posts on here which talk about vets 'not knowing any better' than remedial shoeing, but this strikes me as unfair.

As a vet you should always be able to defend your chosen treatment in terms of evidence based medicine. The benefits of a particular treatment having been shown in a peer-reviewed, published study with a significant enough sample size.

If barefoot trimming really is so much better than shoeing, surely people should be lobbying for studies to be done to prove it. (they may be some already.....I'm not sure). Otherwise how can vets legally and ethically recommend it on purely anecdotal evidence? I am not at all dismissive of it but would like to know what it going on in terms of moving forward in barefoot trimming and veterinary medicine.
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Why should I want studies I am happy with what I am doing with my horses.
I am not interested in any vet seeking to micromanage my horses I am quite happy to that my self.
Vets need IMO a little more curiousity and a little less ego in many cases.
My own vet was anti the whole BF thing and told me so in no uncertain term that sport horses can't work without shoes ( in alll fairness this was my view for many years )
We did have a couple of little runs in over it but its either assist me and my choices or off I go with the around 10 k a year I spent to someone who will, now she's coming round because you can't argue with sound horses moving as well if not better than they did with shoes .
If one of the shod ones had say navicular symptons there's is no way I would consent to remedial shoeing and navilox and the like as a way forward
I am lucky in that I can afford not to insure my horses my choices are my own
We shoe horses with not a lot of research And not even the most pro shoeing vet can argue that shoeing does not compromise hoof health because it does as owner we must takes responsiblity to keeping horses in shoes all year leads to many many problems the old horsemen knew this we need to relearn that lesson
 
MontyandZoom said:
.

I am making some fairly huge assumptions in terms of the number of vets advising wedges and bar shoes. I was thinking that there surely must be evidence to show the benefit. If it is the case that there really is very little evidence to advocate these techniques then there is a major problem that needs to be addressed.
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Here's one of the studies, assuming as a vet student you can download the whole thing which someone sent me as a pdf.

The stats on this are pretty low in terms of percentage of horses coming back into full work after a traditional approach, as low as 10% for collateral ligament damage to just over 20% for ddft. I pulled these out as they were what my horse had. (He's an ex rockley horse) but I wouldn't take figures like this as a resounding endorsement of an approach.


http://onlinelibrary.wiley.com/doi/1...081.x/abstract (the site appears to be offline temporarily but I'm sure will be up again soon)

What strikes me in all these discussions is you can't have real evidence for one without the other.
Any study of barefoot horses has to have a shod control group with similar issues and the same of any study of shod horses.
 
Sorry. I'm only annoyed because vets say they "need" these studies but they can't magically appear. Someone needs to start one but as I said in my previous post, it seems there is no interest on either the farriers part nor the trimmers.

Who do you propose shells out on this study?
 
you also need several studies with everyone finding the same conclusions for anything to be classed as valid really. I certainly thinks shoes off is some time off that.
 
I will also add my own experience of vets & barefoot. My farrier is the recommended remedial farrier by my vets, & the farrier is a big advocate of removing shoes. My horse has never had any problems, so I'm not sure how pro barefoot my vet is, but I do know he agrees with his farrier on all the cases I've heard of. My mares feet are naturally big, prone to spreading & closer to flat than the perfect concave. They have to be trimmed regularly to avoid spreading & flares. So not amazingly pretty trimmed in their natural wide shape, but they more than serve their purpose & are very healthy. A new employee came from my vets for last jabs & proceeded to lecture me uninvited on my mares feet. Apparently they needed a good farrier to trim them back into a smaller, narrower, more attractive shape, & put on shoes to stop future spreading. And her current hooves are causing problems, which was news to us. In short I needed a good farrier instead of whichever cowboy does them now. All of which he was able to say from seeing her in her stable, without being asked for his opinion. I let him rabbit on, then told him the so called cowboy was the remedial farrier used by his practice, & his boss would be able to tell him that not only are he & farrier more than happy with her feet, but that she's only ever been unsound in her life a handful of times, all following injury from a specific external cause. At this point he remembered he had to hurry off to his next appointment. His ignorance wasn't anything but laughable for me, but could have had a very different impact if he worked for a vet with different views & he was called to an unsound horse.
 
I don't need any more proff, my lad was lame in shoes and lame when trimmed by farrier or trimmer. After his reverse pedal bone rotation had been found on x rays I looked at options ( he was shod on box rest and crippled) which was the norm for this horse. I had excepted the fact I probable would never ride him again so had to get him sound to keep as a pet or pts. The vets talked through my shoeing option of £150 half gel shoe things which I couldn't afford every 6 weeks so we spoke about barefoot as a option. My vet said she was open minded about it as she had seen it work before so if I wanted to take that route she would support me.
It's been 3 months now, he's sound as sound and in fact never had a days lameness since the shoes come off and back in work with boots/pads which I never thought I would see again.
Since this iv started slowly taking all my horses shoes off but it's not the easy option by far and as somebody else has said, you need to be more carefull with diet and managment as you can't get away with the same as you would with shod horses.
 
there's a huge problem with the lack of evidence based vet medicine in this country. clinicians mostly aren't interested-and my first opinion practice is a university one. too many papers written retrospectively, insufficient history taken and too much hurry to invasively treat within the 12 month insurance time frame. There's little good evidence (ie with controls, which is difficult clinically) to suggest that some of the more novel treatments (stem cell, iRAP) actually work in horses and too much reactive treatment (mostly insurance and owner driven). Some therapies are bought in with much less evidence than the anecdotal evidence with see with barefoot but yes, the risk of a malpractice suit is huge.

part of the problem with barefoot is the perceived lack of training in trimmers, the lack of regulation and the fact that many vets don't know enough about the hoof and therefore cowtow to farriers. I wouldn't let the university practice remedial farrier within 10 foot of one of my horses even before I took mine barefoot. Luckily we have a local trimmer who's been around for quite a while that local vets and farriers (rather grudgingly) think does a really good job.
 
Goldenstar said:
Why should I want studies I am happy with what I am doing with my horses.
I am not interested in any vet seeking to micromanage my horses I am quite happy to that my self.
Vets need IMO a little more curiousity and a little less ego in many cases.
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This post makes me extremely sad for the rest of my career. You have completely missed the point :( I HATE this 'them and us' attitude. This is precisely what prevents the profession from moving forwards.

No one is trying to 'micromanage' your horses. We are paid to give our opinion, and that's what we do.

I can also guaruntee that I know alot more vets than you do. Some of them are ********s, some of them are lovely. Same as any other profession.

Tallyho - I totally agree. It is a very difficult situation. Retrospective studies are not expensive if we can encourage every vet to keep good case records. Now I just need some willing PhD student...........:)
 
I have had to return to reply here.
MontyandZoom said:
This is where studies really are needed to advise as to what 'gold standard' of treatment would be.
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Emphasis on prevention as a first line... :)

ps. I do agree we need studies re treatment options. Also I find it so sad that fear of litigation is so prevalent among professionals these days. Openness with the client along with frank discussion has to be a key component of decision making imo.
 
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MontyandZoom said:
If barefoot trimming really is so much better than shoeing.
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No no no :o.

Trimming is a very small part of creating a healthy hoof.

Tools are NOT the answer.

You need to take the sick hoof, feed it properly and allow movement within the horse's comfort in order to grow a healthy and strong hoof.

This takes the owner's dedication and time (at least six months).

Not many insurance companies, vets or owners are going to want to accept a six month 'wait and see' approach with barefoot.

Not many vets are going to recommend barefoot rehab as a treatment option when the best we have to justify it all is some dubious anecdotal evidence from a bunch of militant hippies on the internet......:D

The thing with barefoot rehab is that it can go wrong if the basics of diet and movement are not in place. You are placing a lot of trust in the owner and if they mess up somehow - they will turn around and blame you, the vet :(.

The only way forward (for now) is for vets to look a bit deeper into the subject and spend some time with some of the more sensible barefoot hippies :D and see for yourself what is what.

I run a library on The Phoenix forum for members to access my personal stock pile of books and DVDs on hooves. You are welcome to join and add yourself to the list :)
 
MontyandZoom said:
This post makes me extremely sad for the rest of my career. You have completely missed the point :( I HATE this 'them and us' attitude. This is precisely what prevents the profession from moving forwards.

No one is trying to 'micromanage' your horses. We are paid to give our opinion, and that's what we do.

I can also guaruntee that I know alot more vets than you do. Some of them are ********s, some of them are lovely. Same as any other profession.

Tallyho - I totally agree. It is a very difficult situation. Retrospective studies are not expensive if we can encourage every vet to keep good case records. Now I just need some willing PhD student...........:)
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Monty and Zoom I am sorry on second reading that sounds very strong it was not my intention to be rude.
The force of my feeling is I think based on one incident vet looking at horse on yard another horse BF in stable behind stall chain so you can see it feet horse whose conformation is slightly turned in has small flares on the insides of his front feet ( these have over time almost completly resolved themselves as have the splints that I spent £££££ having shock waved , the splints almost completly disappeared after I removed the shoes.)
The vet unbidden and unasked proceeds to give me a dressing down about the flares about how they will be compressing the structures in his feet I was taken aback and tried to understand what was being said however the tone was unpleasant so I just said if I wanted an opinion I would ask and could we just deal with want we where doing I was pretty short.
If all vets are getting as little training as you on the shoeing sides of things I think I can safely discount vets opinions even more than I thought.
There a huge issues with the standard of farriers no one is addressing this it is the elephant in the room if it easy to get assess to great farriery then many going down the BF route would never have started that's what pushed me into it.
I now see there is another way to manage some horses in work even if a horse say eventing goes into shoes four months a year it better and healthier than being shod year round.
 
Goldenstar said:
Monty and Zoom I am sorry on second reading that sounds very strong it was not my intention to be rude.
The force of my feeling is I think based on one incident vet looking at horse on yard another horse BF in stable behind stall chain so you can see it feet horse whose conformation is slightly turned in has small flares on the insides of his front feet ( these have over time almost completly resolved themselves as have the splints that I spent £££££ having shock waved , the splints almost completly disappeared after I removed the shoes.)
The vet unbidden and unasked proceeds to give me a dressing down about the flares about how they will be compressing the structures in his feet I was taken aback and tried to understand what was being said however the tone was unpleasant so I just said if I wanted an opinion I would ask and could we just deal with want we where doing I was pretty short.
If all vets are getting as little training as you on the shoeing sides of things I think I can safely discount vets opinions even more than I thought.
There a huge issues with the standard of farriers no one is addressing this it is the elephant in the room if it easy to get assess to great farriery then many going down the BF route would never have started that's what pushed me into it.
I now see there is another way to manage some horses in work even if a horse say eventing goes into shoes four months a year it better and healthier than being shod year round.
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I can totally understand your point of view and experiences with vets like yours are disappointingly common. From my point of view, that's why I started the thread in the first place.

I want to be a really good vet and to me that means addressing these problems and making sure that everyone is singing from the same hymnsheet :)

I am a few years off being in a position to really do anything about it but the recent activity on here has definitely made me think. I will do my part to try and be an 'educated' vet but I think we all need to have more of an open mind when it comes to understanding the challenges from all perspectives - farriers, vets, owners so we can all acheive our ultimate goal - improving welfare for the horses in this country.

Feeling quite motivated now for the future. I have fourth year exams coming up (sitting in my pjs reading about neurology atm :( ) but once I'm done with that, if there are any barefoot trimmers/farriers/vets out there who would be willing for me to come and have a chat about it I'd be very interested.
 
MontyandZoom said:
This post makes me extremely sad for the rest of my career. You have completely missed the point :( I HATE this 'them and us' attitude. This is precisely what prevents the profession from moving forwards.
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Exactly.

It's a common theme among barefooters where they dread calling the vet and become very anxious about having a confrontation over the hooves.

Some vets will see any lameness as being caused by the lack of shoes. This is sometimes the case, but not EVERY time.

It's especially difficult for owners who have had to rehab their horse alone, secretly, and with no support from a vet (and sometimes farrier) and are happy and established with the hooves.......then something else goes wrong and they are frightened to call the vet because of the, "you must put remedial shoes on" reply.
When the owner has already been through remedial shoes and finally got healthy hooves growing - that's the last thing they want to hear.

There have also been occasions when barefoot endurance riders have been made to feel uncomfortable by the vet at rides, suggesting their horse will be ruined by the end of the ride :(.
Of all horses - barefoot endurance horses have the hooves you really want to hold in your hand and gaze upon for a while ;).
 
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