Page 540 - Adams and Stashak's Lameness in Horses, 7th Edition

506 Chapter 4

The Sigafoos Series II shoe (Figure 4.80) is a kit that discomfort of the animal, but also by the way the horse
is composed of a cuff bonded to a rim that is attached to lands. Adjusting the heel height so that the horse lands
VetBooks.ir foot (Sound Horse Technologies LLC, Unionville, PA). fort and stability of the distal phalanx.
slightly heel first is likely to result in the greatest com-
an aluminum plate that covers the ground surface of the
The treatment time scale is highly variable and based
The aluminum plates may be flat or wedged and have a
urethane bonding surface to which additional wedges on the severity of the original disease, recurrence of the
may be bonded. This shoe can be highly customized to disease, and the development of complications. However,
achieve the principal objectives. The attachment of the some generalizations can be made. A more severely
shoe with a cuff is atraumatic compared with nailing a affected horse that is amenable to treatment and improves
shoe on, and placement of the acrylic on the outside of in an uncomplicated manner is usually shod somewhere
the wall causes less harm to the wall than when the between 3 and 6 weeks after the onset of the acute dis-
acrylic is placed on the ground surface of the wall. ease with eased break‐over, ground surface support, and
Because the cuffed shoes follow the perimeter of the heel elevation as needed. It is desirable to remove heel
hoof capsule, they may require more extensive modifica- elevation as soon as possible after the horse is comforta-
tion to set the toe back compared with other methods of ble landing with a flat foot to limit contraction of the
shoe application. heels, usually between 3 and 6 months. Sole support may
The choice of shoe for each case is in large part per- be removed, usually in a gradual manner, between 4 and
sonal preference based on cost, experience, and avail- 8 months. The most successful cases may return to near
ability. It is important to emphasize principles over normal shoeing or barefoot trimming between 8 and
technique. There are several complications common to 12 months. Obviously, less severely affected horses that
various shoeing techniques. Where weight‐bearing has do not develop complications should recover corre-
been relieved at the toe and concentrated at the quar- spondingly quicker. Horses that suffer recurrent acute
ters, the wall at the quarters is likely to become thin- episodes or develop complications may take much longer
ner and less resilient. Additionally, prolonged heel to respond or never respond satisfactorily.
elevation frequently leads to heel contraction. Finally,
prolonged attachment of the shoe with acrylics leads Treatment of Chronic Laminitis with Distal Displacement
to deterioration in the mechanical properties of the
wall, particularly if it is applied to the ground surface Horses that suffer distal displacement present differ-
of the wall. ent challenges from those with dorsal rotation. First,
The application of the general shoeing principles treatment directed at the acute and early chronic disease
must be titrated to the specific symptoms of the indi- frequently lasts considerably longer than that for horses
vidual horse. The less damaged the lamellae, the less with rotation. Easement of break‐over and ground sur-
aggressively eased break‐over, ground support, and heel face support are both potentially beneficial and achieved
elevation are required. Improving the ease of break‐over in the same manner as previously described. However,
benefits any horse with laminitis. The amount of area there is no rationale or perceived benefit to elevating the
across the ground surface of the foot that should be heels; this commonly makes these horses worse. The
used to distribute weight‐bearing is subjective. Pressure wooden shoe/clog has gained a great deal of popularity
should be limited where compression of the underlying in the treatment of distal displacement in the forelimbs.
dermis may occur between the sole and an unstable or
displaced distal phalanx. Otherwise, the comfort of the Treatment of Chronic Laminitis with Unilateral Distal
horse and the perceived instability of the distal phalanx
are the best indicators. The requirement for (and degree Displacement (Medial or Lateral Rotation)
of) heel elevation is in part similarly determined by the The transition between the hoof care used to treat
horses with acute and early chronic disease to that of
stable chronic laminitis due to unilateral displacement is
more blurred than in the previous scenarios because
there is much less experience in treating this condition
and complications, particularly separation of the coro-
nary band, are common. However, in line with the over-
all objective to redirect the load away from the most
damaged area of the lamellae, the logical approach is to
attempt to redirect the load to the opposite side of the
foot in conjunction with ground surface support. This
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can be accomplished by either placing a 4‐ to 8‐mm
extension (concentrating ground support on the
extended side; Figure 4.81) or placing a thin wedge on
the side of the foot opposite the displacement or chang-
ing the weight‐bearing area under the foot asymmetri-
cally. Of these treatments, the wedge is the most
aggressive and does not appear to be necessary and as
such is best avoided. Therefore, starting with an exten-
sion or modifying ground surface support is suggested.
The application of a wedge to the unaffected side of the
Figure 4.80. Sigafoos Series II shoe. foot appears counterintuitive if only the radiographic