Reggie arrived at our facility Saturday, November 1, 2003, referred to us by Washington State University Veterinary Teaching Hospital. He arrived wearing a single layer of styrofoam pads, and exhibited a Obel grade 4 lameness on both front feet on 4 grams of Bute. 

These first two pictures are the lateral and bottom view of Reggie’s right front foot before we started to work on him. 
 

These second two pictures show the lateral and bottom view of the same foot after rockering his toe and preparing a base at the back of his foot. Notice the bruising and stretched seedy toe as a result of the lamellar wedge.

Reggie had a history of chronic laminitis and recurrent abscessing in both front feet, on-going for 2 years. He had been on 4 grams of Bute per day and had been wearing Heart Bar shoes for most of that time.  

We discontinued the Bute immediately, as we needed Reggie to be able to give us some honest responses to what we were planning to offer him. We then monitored his comfort level for the next 48 hours. 

Monday, November 3rd, Reggie was still an Obel grade 4 on both fronts, but became non weight bearing on his Right Hind due to an abscess which had probably been developing for some time, but was retarded due to the Bute intake. 

Some equine health professionals disregard Bute as inhibiting the abscess cycle. But we have found Bute to be a very consistent interruption in a horse’s ability to release abscesses. We do not think it is a coincidence that Reggie’s right hind abscess erupted within 48 hours of discontinuing the Bute. We have seen this cycle many times.  

Front Feet - We removed the single layer of styrofoam and significantly rockered his toes to unload the dorsal wall and provide drainage through the lamellar wedge. Dental impression material was added to the back of the foot, then the entire foot was covered by 2 layers of Purple Podiatry Pads (3P’s) with a duct tape wrap. This type of support lifts the coffin bone up and forward in the hoof capsule, via the digital cushion, while minimizing the load on the hoof wall.  

The Right Front was grooved horizontally below the coronary band to relieve the pinching of the extensor process, restore vasculature to the coronary band and further relieve the load on the dorsal wall. This technique allows the horse more appropriate use of the back of the foot. The improvement was immediate.  

Tuesday, November 4th, Reggie was standing more comfortably on his fronts, but totally non weight bearing on the Right Hind. We continued to soak. The right hind abscess drained two days later (Thursday), and he showed immediate and rapid improvement.  

Friday, November 7th - Applied a glued on Double Nail Pad system (DNP) to both front feet, and then grooved the Left Front. 

 

The glued on DNP system allows us to relieve the stress on the compromised hoof wall, offer support and protection to the compromised anterior sole, increase the depth of the palmar region of the foot and reduce the tension on the Deep Digital Flexor Tendon (DDFT). This system also minimized the torque on the distal boarder of P3 and the interphalangeal joints. This has been an effective method to initiate healing on compromised feet.  
 

We continued hand-walking Reggie for several days, then started him on some limited turnout in the round pen for 1-2 hours per day. He continued to do extremely well, and had had no Bute since his arrival.  

Radiographs were taken just before Reggie went home, wearing the EDSS system. You can see the distal displacement of P3 relative to the coronary band. The coronary groove is also visible, it’s purpose, to give the extensor process a place to go when being lifted up and forward in the hoof capsule by the load introduced through the EDSS frog support.  
 

In these before and after pictures: While this hoof capsule still has a lot of remodeling to do, this is a very healthy, functioning foot, even though it’s appearance at this stage is unusual. Horses that have suffered severe laminitis will ultimately have a nicer foot, in both function and appearance, than they had prior to the laminitic episode. This is due to the fact that most domestic horses do not receive all of the important ingredients that are offered to our “model” feral horse, such as, load sharing capabilities through the back of the foot, maximum sole depth underneath the tip of P3, and proper equilibrium of the hoof capsule around the coffin bone.

Owner comments after he returned home. - “Thanks for all the great care of Reggie. He is still doing great! I rode him around the arena 4 times, and he was so fluid in his stride. It’s wonderful to have him back to his totally obnoxious self”.  
 

We don’t know why horses like Reggie recover so rapidly, when other horses take significantly longer and some never recover. It probably has to do with a whole combination of things, age, general health before the laminitic episode, and other perhaps unknown systemic issues. We still have a lot to learn. 
 

We’d like to thank Washington State University Veterinary Teaching Hospital for their referrals. What a pleasure it is to work in conjunction with true equine health care professionals who are committed to the health and well being of the horse.