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Tales of a Country Vet

Karla was a little girl who loved horses. She was twelve years old, had darkish blond hair, cut moderately short and had a face full of freckles. When I say she loved horses, that?s not quite accurate. She adored them and thought of nothing but horses from the moment she woke up until her final sense of consciousness flickered before falling asleep. Unfortunately, her family lived in town and had fallen on rough times. There was no chance she would ever have a horse of her own. So, she did the next best thing. She volunteered to work at a local stable. Karla was at the barn after school and on weekends, mucking out the stables, grooming who ever needed grooming and feeding and watering her charges. Lost in the sounds and smells of a horse barn on summer evening she was always dreaming of the day she would have her own horse. Her particular favourite in the barn was Rebecca, a 7 year old Arab mare. She had a mind of her own, but was a beautiful rich bay. A very impressive mare to anyone who saw her. Karla would spend extra time grooming her and would often save an extra carrot or a piece of apple for her. Rebecca responded with an inordinate degree of affection any time Karla was in the barn.
Everybody acknowledged the bond which had developed between these two. Rebecca?s owners were kind people who didn?t fail to see the love that had grown between Karla and Rebecca. However, unforeseen circumstances developed that would require them to sell Rebecca. They had anticipated the emotional devastation this would cause, both to Karla and Rebecca and dreaded having to break the news. They spoke with Karla?s mother, Sandra, to see what kind of impact this might have. When told, Sandra?s faced dropped. Eventually, she composed herself and said that they must do what ever they had to. But in a low, quivering voice she told them that Karla really had nothing else in her life. All she ever talked about at home was Rebecca. So the owners thought about it long and hard and decided to forego the sale of Rebecca, and instead, presented her to Karla as a birthday present.

The ecstasy of the moment when Karla was told Rebecca was hers was indescribable. Furthermore, once Karla owned Rebecca, her fixation on the mare grew exponentially. Karla was at the barn every waking moment. Grooming and feeding, riding and hugging. Her whole world was walking around on four feet. And she loved every minute of it.

The love affair was in full bloom, with Karla making plans for her and Rebecca for this summer, and next summer, and the summer after that, when she noticed a small area of hair loss on the horse. She wanted to call in a vet. Her uncle, a kind and well-meaning, quiet-spoken man, who also owned some horses, told her that she should consider calling in someone else. He called himself a ?Para-Vet? and he was cheaper than a real vet. Since they didn?t have any extra money to spend, they called this fellow. It turns out that he was actually a self-taught Farrier who?d always fancied himself a wizard with animals. So, with these impeccable credentials and the
chance to save a couple of dollars, how could you lose?

The Para-Vet showed up and diagnosed that the horse had an allergic reaction to some fly -wipe. He gave her an injection of an anti-histamine. ?While I?m here, I might as well give her her ?Spring Shots?? he said. They thought that since he gave the first needle so well, he could surely give another. And he was certainly cheaper than any of those over-rated and over-priced Vets.

The next day, Rebecca was a little sore on the leg that had been given the anti-histamine injection. Karla?s mother phoned the Para-vet a couple of times. He was kind of hard to get in touch with. Once she finally located him he came out and looked at the horse. He thought that she might have a problem in the stifle. ?Don?t worry. It should get better on its own.? He offered confidently. However, it didn?t. Rebecca got progressively more and more lame as the day wore on. By evening, she couldn?t move. She was left outside in the hope that the problem would pass. It didn?t. By the next morning the leg was swollen and the mare was unable to stand on it.

Karla?s mother, who admittedly knew nothing about horses was now extremely concerned. The owner of the stables was also very worried and thought that the leg might be broken. When they were able to contact the Para-Vet, he told them they should probably leave it for another day. With Karla near hysterics, her mother decided to get a second opinion.

I was called on Thursday. Because Karla?s mother was so distraught, she relayed only a small part of the story. I was told that their Farrier had diagnosed a possible stifle problem but they thought it might be a broken leg. What should they do? I told them the best thing would be to have a vet look at it because there was a big difference between what you do for a broken leg versus a strained stifle, if in fact the problem was either of these two. I also said that there was no way this could be diagnosed over the phone and that it sounded pretty serious. They then said they had no money to pay a vet.

She was so upset that I lied and told her I would be passing near the farm and would have a look at the mare if she could meet me there. With profuse gratitude she agreed and I arrived on the farm about an hour and a half later. I had earlier been called out to stitch up a torn eyelid on another horse nearby which I obviously had to attend to first.

My first glance told me the mare was in serious trouble. The mare had been pivoting on her right hind and had dug a hole in the dirt about 8 inches deep and a foot across where her right hind foot had been standing. The left hind leg was fixed in a flexed position and was non-weightbearing. The leg was at least twice its normal size. My first thought was that she had broken the right hind leg, but as I looked around the paddock I couldn?t see anywhere she could have hurt herself. The paddocks were almost spotless. There was nothing to indicate how or where she
could have possibly acquired such an injury. I checked her temperature and her attitude, neither of which were consistent with a broken leg. I then ran my hand along her back and felt the unmistakable sound of crackling. This meant gas was being trapped under the skin. The crepitance extended from the middle of the neck, along the back and down the back of the hind leg. A Clostridial infection! I checked the leg just to be certain. There was no fracture but the entire leg was exquisitely painful.

In addition to the swelling in her leg, the bottom of her abdomen along to the base of her tail, including the vulva was edematous and swollen. This mare was definitely in very serious trouble. When I told this to the mother, I thought she was going to collapse. She burst into tears and was unable to control herself for about 5 minutes. Her thoughts were only of what this would do to Karla.

I then got the full story and the time line of what had happened. Her mother kept repeating that the Farrier had told her that he was fully able to diagnose and treat horses. Sandra realized too late she had made a terrible mistake in taking his word. I didn?t have the heart to mention to her that the vaccine (?Spring Shots?) he supposedly gave were the wrong ones for horses in the Fraser Valley.

Clostridium infections are extremely lethal bacterial infections. We immediately instituted therapy to combat the infection, in a last ditch effort to try to save the mare?s life. Blood samples were collected to try to confirm the diagnosis. This was 1:30 pm. With some of the painkillers now taking effect, we were able to move her into a sheltered stall. I told her to phone me if any further problems arose, otherwise to give me a call around eight o?clock. They phoned at eight to say that the mare had just gone down. I arrived at the barn to a hoard of friends, relatives, neighbours, all trying to give assistance and offering to help in any way they could. For the next three and a half hours we worked to get the mare up, or at least make her a little more comfortable. She gamely tried to stand. With every violent struggle to get her feet under her she would thrash against the walls and the floor. Each time this happened, Karla, and her friends would cry out in empathetic agony for the horse. Once, after a monumental struggle, she did finally was able to get to her feet. This was greeted with a triumphant round of cheers, but almost immediately she collapsed again. Several people risked their safety to work on that mare. There was no shortage of sweat nor tears. One of the crew knew the owner of a rental store in Abbotsford. They were able to persuade them to open the store at around eleven PM and obtained a block and tackle. The then sizable work party cut some holes in the floor of the barn?s hay storage area directly over the stall and set the block and tackle up to lift the mare. By this time, she was so worn out that she wouldn?t even try to stand. At this point, I had pretty well given up and was packing to leave. Back at my car I slowly and methodically replaced my
equipment. I knew, and dreaded, what I was going to have to tell Karla and the rest of the crowd, the mare would have to be put down. As I replaced the last of my kit in my truck, another round of cheers exploded form the distant depths of the barn. At the eleventh hour, just like in the movies, she finally stood on her own. And this time she didn?t fall. I waited to see if she would go down again, but she didn?t. She was very unstable but she stood on her own. So I explained what they needed to do over the next hour or so. I also said that it was great that she was standing, but her prognosis was still extremely poor, maybe 20 %. However, as I drove off, I sensed much more optimism than pessimism in those I?d left behind. As for me, I still had the knot of experience deep in the pit of my stomach warning that miracles rarely come true.

The next morning at seven the phone rang. It was the owner of the stable. Her voice trembled as she told me that Rebecca had died over night.

The rest of this story unfolded in small claims court. Somewhat surprisingly, Karla was eventually awarded the costs of treatment and the value of the horse. As expected, the ?Para-Vet? had no money to make good on the judgment. It was a Lose-Lose situation from beginning to end.

What we ended up with was a distraught mother and father who blamed themselves for this tragedy, a little girl whose whole world had collapsed, a beautiful mare that died a senseless and horribly agonizing death and a quack who was only about $50 richer. It can be awfully expensive to save a couple of dollars.

If this were just a single occurrence, it would be a rare tragedy. Sadly, stories like this are all too common. Unfortunately, owners are often too embarrassed to talk about them, and the guilty just keep plying their trade of misery, giving the Farrier community a black eye. As a consequence, it is important that every horse owner take responsibility to protect their animals and their investment in those animals. Ensure anyone working on your horse is covered by insurance

Skilled, reputable Farriers are so busy, they have neither the time nor the inclination to break the law, for that is what they are doing when they go beyond working with feet. Farriers are critical and highly-valued members of the horse-care team. Every equine veterinarian respects their abilities and relies on them to do their job. Unfortunately, where there is a dollar to be made, unscrupulous individuals are only too eager take advantage, regardless of the carnage they leave in their wake.

Dr. Bruce Burton DVM

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How to Pull a Shoe Off

By Marie Leginus

It was finally here, you and Studley have been waiting all summer for that perfect day; the day to load up and hit that favourite trail at the park. The sun was shining, and the sky was blue, and you knew it was going to be a great day. Once you were parked, and in the trailer unloading your steed you notice something funny about Studley?s hoof. You unload him and tie him to the trailer to take a better look, and to your amazement his shoe is half off and twisted on his hoof. Now what? Call the farrier; that came to no answer.

This article will help you, the horse owner, prepare for emergencies like this.  

Tools that would be needed could either be bought/borrowed from your farrier, or purchased from a local feed /supply store. From Left to right, Pull offs, clinch cutter (top), hammer(bottom), crease nail pullers, rasp and apron. Not all of these are required, and none of them have to be top of the line. If you are at a boarding barn, suggest to have a set of these tools for emergencies, however if you are on your own, having just the pull offs, crease nail pullers and a rasp will do.

Assess the situation.

How bad is it? Is the shoe twisted on the hoof, are there nails that could puncture the hoof, is a clip in a dangerous spot? Or is the shoe just a bit loose, and there would be no harm done to the horse.

The Quick and Easy Way

A quick way to remove the shoe would be with a pair of crease nail pullers. Taking each nail out separately will do less harm to the hoof wall and less force upon the hoof itself. Clamp its jaws around the head of each nail in turn and pry the nail out by pushing the handle away from you. When all the nails are out, the shoe should come off easily ? though if one or two nails are too worn down to grab with the nail-puller, you may need to work the shoe free with the pulloffs as shown earlier. In an emergency, you can use pliers or wire-cutters instead of a crease nail puller. If, instead of a loose shoe, you have a single loose nail, but the shoe is still firmly on the foot, you can pull out the one loose nail and leave the shoe on until your farrier can come.

Using Pull Offs

Another option is to use only the pull offs to take the shoe off, they may take some hoof wall off as well, but in an emergency, it will be for the best.

Hold your horses hoof up off the ground, between your legs, standing slightly pigeon toed while under the horse?s front leg. Having your tools close to you as you do this is a lot easier, especially if there is nobody to pass them to you.? Positions the pull offs on the shoe at the heel and close the handles together.

Once the handles are closed, grip the hoof with your leg and give a quick, fast push on the pull offs away from you.

Alternate from heel to heel with every push on the pull offs.

If under the hind leg, position yourself the same, except the hoof will be sitting in your lap, rather than between your legs.

Once the shoe is off, make sure the hoof is wrapped in duct tape, or if you have a boot to put on, to protect the hoof until you are able to have a farrier replace the shoe.

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Quarter Cracks

By James Findler and Marie Leginus

Definition

A vertical crack in the hoof wall that is parallel to the hoof tubules, originating at the coronary band. 

?Anatomy

The structures involved are the hoof wall, the coronary band and the laminae in the affected area.

?Clinical Signs

  • The horse may or may not be lame, it will depend on the severity of the crack. Early signs that a horse may develop a quarter crack may show the hoof wall shoved upwards in the affected area, and/or a hairline crack that is minimal.
  • More severe quarter cracks will have a distinct crack line in the coronet, and may be bleeding as sensitive tissues are involved.

?Causes

  • There are two types of forces that act upon the hoof as its being loaded, and when it is loaded; the ground reaction force, and the horse?s gravitational force upon the hoof and limb. If these forces aren?t distributed evenly, due to conformation or improper trimming, there will be negative effects, and possibly quarter cracks.
  • Conformation is an important factor, as a lot of horses have deviations within the hoof and limb. Horses that are base narrow, toed in, or have angular limb deformities would be more prone to quarter cracks as they have uneven stress placed upon their hooves.
  • Imbalanced hooves can be a problem as well, due to uneven loading and stress. A horse left consistently high on one side, or one area will have excess pressure and upward forces and eventually the strength of the hoof in the affected area will break down.
  • Injury or trauma to the hoof capsule and coronary band that is deep enough to damage the sensitive structures making up the hoof wall will affect regular hoof growth.

?Treatment

  • There are different ways to treat quarter cracks, some may work for certain horses, while others may not.
  • Determine the cause of the quarter crack; is it conformation related, trimming related, or is there an old injury in the area.
  • Unloading the affected area is important and making sure the hoof is properly balanced.
  • Stabilizing the hoof 
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Open Toed Shoes

By James Findler and Marie Leginus

Description

A shoe to alleviate caudal hoof pain, or excess stress to the navicular area. This shoe would help reduce coffin joint pain, and horses with broken back HPA issues. May or may not be a permanent shoe.

?Anatomy Involved

 The caudal hoof: Deep digital flexor tendon, navicular bone, navicular bursa, navicular ligaments, digital cushion, medial and lateral branches of SL, distal interphalangeal joint.

?Signs

  • Current X-rays beneficial
  • Severely broken back HPA
  • Significant Caudal heel pain
  • Atrophied bars/heels
  • Negative heel when sighted
  • Lameness apparent
  • Consistent pointing on affected limb/limbs

Cons

  • Specific use only (Therapeutic shoe, treated as such ? no mountain riding etc)
  • If applied incorrectly, will have negative effects on other structures.
  • Toe can be worn back too far on abrasive footing
  • Abrasive footing may create fissures and white line separation if horse is living in an un-ideal environment
  • Sole pressure may occur if not eased
  • Cautious with toe nails, if the shoe is not fit properly
  • Positive frog pressure if applied without pad (occurs when heels are sunken below the plane of the frog)
  • Dorsal coronary band dropping (?) – * If improperly fit ? may occur

Pros

  • Relieves stress on Deep digital flexor tendon, Navicular bone, navicular ligaments, navicular bursa, distal interphalangeal joint, medial and lateral branches of Suspensory Ligament, Digital cushion
  • Positive improvements on HPA
  • Positive change in hoof symmetry over time

?Application

  • Recommended to be applied to fore limbs only.
  • To be fit to the toe pillars of the hoof (not to be set underneath extremely).
  • Should have clips at the toe pillars as well. (this will help stabilize the hoof capsule and reduce movement and shear of the shoe)
  • Seating out the ground side of the shoe at the heel will reduce ground friction/force as the foot is landing. (Preferably heel first, or flat landing)
  • If altering a keg shoe, be sure to not punch the nails deep, or fuller too deep.?
  • In cases of thin soles, a full leather wedge pad is beneficial to support the foot.
  • Leather will be a better choice, as it is more forgiving than plastic.
  • The frog area on the pad may have to be cut out to avoid positive pressure
  • The use of softer equithane, and making sure the pour hasn?t created a convex plane
  • In stronger feet, a bar wedge may be sufficient on cases that have a heel lower than the plane of the frog
  • Use of copper sulfate underneath the pad will help kill bacteria and fungus that is diminishing the quality of the sole/frog/bars (will help develop a healthy sole)
  • Choosing a shoe that is going to support the limb, and factoring in a leather pad. (too small a shoe will have improper effect)
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Farrier X-Rays – An Exercise in Teamwork

By Robert Moats DVM & Marian Moats DVM

For a number of years (since 1982), when Rick Redden introduced me to the concept, I have encouraged owners and farriers to rely on radiographs when abnormalities of the foot are involved. This is especially true when laminitis is thought to be or known to be a problem.

This can be a challenge because veterinarians and farriers often don?t cooperate very well. In my experience with these situations I usually find the procedure to be a positive knowledge building and bonding experience where all three parties ? the horse, farrier and veterinarian benefit.

With the advent of modern radiology and crucial knowledge of laminitis and the foot from the likes of Redden, O?Grady, Chapman, and Pollitt, the only x-ray you?re sorry for is the one you didn?t take. To quote Mark Twain ?It isn?t what you don?t know that hurts you, it?s what you know for sure that?s wrong that really hurts you.?

This article is a brief outline of a number of reasons why ?farrier x-rays? are important.

In my practice ?farrier x-rays? historically refer to views of the foot to detect front wall thickness and rotation and accurately measure both. It also detects other details of laminitis and look-alike disorders.

Positioning and aiming the x-ray beam is critical to accuracy. The system I use is to stand both forefeet on lazy susan round blocks. This is amazingly well tolerated. The block is custom built so the top is exactly plumb with the horizontal ?cross hairs? of the collimator of my x-ray machine. The collimator is a lighted site like the crosshairs of a rifle scope. My blocks are round (never out of line to position the cassette). They have lazy susan bearings so that the horse can adjust to small misalignments and have a wire ring embedded in the top. (Figure 1 & 2).

Figure 1 & 2

The reason for the wire is to confirm that the aiming is exact. If the positioning is correct the ring appears as a straight line under the foot. (Figure 3). If the floor is off level or the operator (me) makes a mistake the ring appears as an oval and has to be repeated. (Figure 4)

All laminitis is not created equal and is not always obvious. Sometimes an increase in front wall thickness is th only sign. One of the gems of knowledge from Dr. Pollitt?s lecture is the geometry that allows calculation of the normal front wall thickness. Everything above this thickness is abnormal and laminitic and as stated above can be the only sign.

By measuring from the tip of the coffin bone to the navicular joint and dividing by 4, the maximum normal front wall thickness for that foot is calculated.

Prior to Dr. Pollitt?s work, all we had were breed approximations which were inexact in marginal cases. These measurements are now very precise.

The side bonus of farrier x-rays is detecting related abnormalities that may otherwise be hidden.

Seedy toe which often masquerades as laminitis or is combined with it. The separation in these cases occurs from the ground up and often intrudes close to the coffin bone. (Figure a)

Laminitis with separation between sensitive and insensitive laminae which is a much more serious situation when present. (Figure b)

Club feet with contracted deep digital flexor tendon (Figure 6)

X-rays of these cases look dramatic and terrible but often have a much better outcome than laminitis. The case here responded very well to check ligament desmotomy to decrease the tendon pull and allow lowering of the heel and reshaping of the toe. (Figure 7)

With fairly routine follow-up farrier care this horse went from three legged lame to a mid-level riding horse and brood mare.

Additional changes seen on farrier x-rays:
i. Club feet often have remodeling of the ?point? of the coffin bone
ii. Marginal (on the edge) fractures of the coffin bone
iii. Osteomyelitis ? which are changes caused by infection

The above information shows the truth of the adage ?Knowledge is power?. Knowing what you?re dealing with gives much better opportunity for a good treatment outcome.

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Billing is a Privilege

By Cindy Eldstrom

In today’s world of credit, many people have come to expect a “charge account” procedure. In the farrier industry, client credit is becoming rare. Farriers are receiving bounced cheques, and other clients ignore billing terms, paying at their own convenience. Clients have even blatantly refused to pay for services they contracted or disappear from boarding barns with their horses, and can’t be traced for collection. 

The results are obvious: losses increase farrier costs. Carrying charges increase farrier costs. Some farriers discontinue service until payment is made-many farriers now demand payment upon service, or will only work for cash payment. I have experienced all of the above billing problems, and each client pays in increased fees for losses, administration, paperwork and legal fees.

Since billing is becoming more of a nuisance than a benefit, I am giving serious consideration to payment upon service, or cash service only. If you find billing a convenience, there are some things you can do to ensure that the service continues:

1. Be aware of your horse’s six-week schedule, and budget for it.
2. Leave a cheque or cash ahead, when you can.
3. Mail payment when you receive the bill. All billing terms are: Payable upon Receipt.

SCHEDULING :
Most horses need their feet attended to every six weeks, and in a few cases, more often. The average, well-established farrier regularly attends to about 200 horses and services approximately 100 horse owners. It is not uncommon to receive 30 to 40 phone calls per day during the busiest season, which is April to October. This is before factoring in time considerations for emergency services (pulled shoes or lameness), public interest service (lectures or show farrier) and educational upgrading (conferences, certification testing, etc.).
It is easy for anyone to see that routine scheduling is a must, or a farrier would be running helter-skelter day and night, without a moment’s peace.

6-WEEK PLAN
The average horse needs its hooves attended to on a six-week basis, so I run a six- week schedule. After one appointment, I book my clients for their next appointment six weeks later. A very limited number of horses need to be done more often and I try to do everything possible to accommodate them. Any horse owners who do not wish to follow the six-week scheduling have the option of phoning one or two weeks in advance to see if there are available openings. If you choose this option, you must understand that there may not be available time, since all clients who follow six-week scheduling are given priority.

CANCELLATIONS
“The best-laid plans of horseshoers and horse owners…” There are rare times when you may need to change an appointment. Except in cases of extreme urgency, changes should be made NO LESS than 24 hours in advance. This allows me to adjust my scheduling by contacting clients who may be waiting for service. Calling the night before, or worse yet, waiting until I arrive to change an appointment, leaves large gaps in my scheduling and therefore directly affects my ability to earn a living. Although your horse is your hobby, farrier work is my business, and mutual consideration of one another is a necessity for everyone to feel satisfied. If you cancel an appointment in advance, your appointment will be rescheduled at the first available opening.

ONE JOB DOES NOT EQUAL ANOTHER
To trim a horse and put four shoes on can take between an hour or two hours. A trim only requires 1/3 of that time, and costs much less. Please give advance notice if you wish to change the amount of work required at your next appointment.