Here’s a couple of recent incidents:
A good client of mine has been looking for a horse and found one she liked so she brought it by for her veterinarian and I to look at. This is a very nice looking horse but he has off-set cannon bones on the front legs which produces a pigeon-toed stance. This doesn’t bother me that much but the heels are low and the hoof-pastern axis is negative which produces an over loading to the back of the foot mostly on the outside heel. The left front foot also has a bull-nosed shape which usually means that the coffin bone is rocked back in the hoof capsule. I told the client that we would have to fix that and get the foot back into equilibrium as it was functionally incorrect, the veterinarian agreed. The client ended up buying the horse. When shoeing time came she asked if I could shoe the horse in the same manner as it was previously done because that was the instructions by the seller’s team ( Trainer, vet and farrier) that this was how it needed to be done. You know the old adage: “If it ain’t broke, don’t fix it.” Well I politely told her no and she graciously understood. I try to understand the thought process of people and how they make decisions. The seller’s team gave my client bad advise,why? Because they don’t know any better, they don’t know what they don’t know. In this case it’s the biomechanics of the foot. Although the biomechanics had been explained to the client, she’s afraid to to make any changes because she doesn’t know who to trust and everything is ok right now. I can tell you from looking at the feet of thousands of MRI cases over the last ten years is that they are always sound before they go lame. In the end the horse will pay the price.
Talking about MRI horses; here’s a scenario I’ve seen a time or two. A performance horse that comes in with a lameness issue and diagnostics are done with a bone scan and MRI but nothing conclusive shows up. I’ll see the horses to replace his shoes (shoes are pulled prior to the MRI because of the metal). Usually the feet on these horses are a disaster, they are a mechanical, physiological and biomechanical mess. When I bring this up to the attending veterinarian I always get the same answer “It can’t be his feet, nothing showed up on the MRI”. The problem is the MRI doesn’t measure pain. Using the MRI alone will over-ride common sense evaluation. Foot distortion and collapse are indicators of malfunction.
A client of mine has a metabolic laminitic pony. Her vet took some x-rays (low quality) and told her that the problem was that the heels are too high, nothing about the hoof-laminar zone, deep flexor tendon or ground mechanics. what’s funny is that I can remember having an argument 25 years ago with this same vet about a similar case. This is where the the vet was 25 years ago and here he is today, a laminitis expert. When I explained to the client that there was more involved than just chopping the heels off of the pony, she said “so you’re not going to do what the vet said?” and I said that there more to it than that and she said “but he went to vet school.” There is a misconception by horse owners that the veterinarian is the leading authority on the management of the foot. Some vets are because they worked at it, they studied, they put in the hours, they suffered the learning curve and they continually educate themselves. having a degree in veterinarian medicine and nailing a shoe on a horse back in 1973 doesn’t make a person an expert in equine podiatry. I talk to vet students all the time and I ask them if they get much podiatry in school and the answer is “No”. Veterinarian medicine has come a long way in internal and orthopedic medicine but it is sucking hind teat in the podiatry deal. There is a big opportunity for vet schools to advance podiatry if they could get their acts together.