Daisy Bicking, a farrier based in Parkesburg, Pa., has been documenting horses’ hooves for more than a decade. Over this time she has built a database of around 200,000 hoof images and radiographs—many of which belong to horses suffering from equine metabolic syndrome-associated laminitis. She has also developed a program for rehabilitating horses recovering from this endocrine-related disease. To determine how effective her strategy really is, she conducted a retrospective study and presented her results at the 2013 International Equine Conference on Laminitis and Diseases of the Foot, held Nov. 1-3 in West Palm Beach, Fla.

“Equine metabolic syndrome (EMS) is one of the most common causes of laminitis,” she said. “Due to the diverse management issues, a comprehensive protocol is critical to successful rehabilitation. But many owners are unprepared to care for EMS horses at home.”

This is where Bicking’s management program comes in. She provides specialized care for affected horses until they’ve recovered enough for their owners to resume care. In doing so she follows five steps:

1. Obtain a veterinary diagnosis of laminitis secondary to EMS;
2. Feed a customized, low-glycemic diet;
3. Provide corrective hoof trimming;
4. Institute environmental corrections (e.g., a drylot and/or grazing muzzle); and
5. Ensure caretaker compliance in all these areas.

To determine her success rate following this protocol, Bicking looked back at 110 horses she managed during the past nine years that had been diagnosed via blood tests with EMS-associated laminitis. She measured success based on improved radiographs, pain level, and body condition over time