Laminitis is one of the biggest hoof problems we encounter as hoof care providers. I have studied laminitis for the past 12 years extensively, presenting on laminitis at the Laminitis Conference in Florida and the International Hoof Care Summit in Ohio. I have won an award for a scientific poster on Maggot Debridement Therapy used for abscessing in chronically laminitic horses. I have helped acute and chronic horses who have laminitis from metabolic disorders, grain overload, retained placenta, lyme disease, mechanical leverage and more. Horses with inflammation, rotation, sinking, sole penetration, coronary prolapse, you name it, I’ve seen it and worked on it.
In previous EasyCare blogs I have mentioned my personal guidelines for working on the horse’s foot. One of the largest influences on those guidelines is working on horses with laminitis. Here I describe my hoof guidelines and how they apply to horses with laminitis: Rehabilitation of the Insulin Resistant Horse: DHF Style
I have discussed laminitis with many of the great researchers, veterinary podiatrists and farriers. I’ve heard every theory on laminitis and every idea about what the farrier should do about it.
One of the biggest debated subjects related to laminitis is what to do with the laminar wedge. The laminar wedge is horn that fills in the space created when the coffin bone rotates or displaces in the hoof capsule during laminitis. It is made up of several kinds of undifferentiated, insensitive horn due to the damage to the laminae during laminitis. Some experts say to remove the laminar wedge, and others recommend leaving it.
The laminar wedge can be stable or unstable. An unstable laminar wedge is one that is not keritanizing and therefore soft and feels like wet tissue paper. This is usually due to laminitis being acute, or infection present in the foot. Extreme caution should be used when working on a horse with an unstable laminar wedge. Below is a photo of a resection done with a veterinarian on an unstable laminar wedge due to infection in the foot:
A stable laminar wedge is dark yellow in color, very strong, hard and dry. In my experience a stable laminar wedge can be treated like wall and should be removed to facilitate reducing leverage of the damaged laminae.
The amazing thing about a stable laminar wedge is that they grow out and in many cases become what appears to be a tight white line again. With good realignment trimming and shoeing techniques, the new foot growing in at the coronary band follows the corrected bone position and as it grows down, the laminar wedge is trimmed out.
Here are some examples of horses who had significant laminar wedges at the first visit and how realignment trimming and when needed composite shoeing led to a tighter laminar connection:
Even this horse with significant coffin bone remodeling grew a much tighter white line after corrective trimming and composite shoeing:
The horse in the blog mentioned above also grew back a tight white line after having a significant laminar wedge.
When working on horses with laminitis, always involve a veterinarian and ask for radiographs. Realignment trimming and applying appropriate support devices, like the EasyShoe, is best done with a team approach and accurate information. I have learned reducing the laminar wedge is an important part of rehabilitating the laminitic foot and yields faster results than leaving the laminar wedge in place. I am always available to discuss pros and cons of any technique to help a laminitic horse.