The Missing Link to Hoof Regeneration in a Non Responsive Case – A Case Study by Joel Brown, USA

About Joel

Joel is a born horseman with more than 41 years of experience in shoeing horses in the USA. Having attended formal farrier school in 1979 at Porterville Horseshoeing school, under Hugh McEwen, Joel shod horses as he pursued higher education, receiving a bachelors in Ag science from California poly technical in San Luis Obispo and a masters in Ag business from UC Davis. Joel has managed several purebred and commercial cattle ranches over 35 years in the States, where “horses were a business venture and brood mares and saddle horses were employees and an asset on the balance sheet”. Consequently, the phrase ‘no hoof, no horse’ has been at the heart of Joel’s daily life for many decades.

Joel has now retired from managing ranches and is enjoying a simple life right back where he started 41 years ago – shoeing horses. His work covers a wide range of animals, from backyard ponies, ranch horses and rope horses to imported warmbloods. From backyard trims to FormaHoof applications, whatever fits and is best for the horse and the owner.

According to Joel, his “approach to farrier science is based on a holistic viewpoint addressing the anatomy, physiology, and biomechanics to enhance comfort and balance, across all equine types and disciplines. In totality, the hoof is the foundation the horse stands on. FormaHoof is providing a progressive modality enabling these goals, while providing the horse with a voice in the conversation towards an enhanced and productive life. This also benefits the relationship between the horse and owner, as happy horses make for a happy life!”

Navicular Case History

This case of a 13 year old American Quarter Horse was referred to Joel by a cattle rancher in April 2020. The history relayed from the owner was a vet assessment of navicular syndrome. Past radiography referenced cysts in the navicular bone with no demineralization. The D/P view presented a broken back hoof pastern axis. Post assessment, 3 rounds of Osphos-clodranate disodium* over 3 months and a shoeing package that addressed break-over and frog support was implemented.

According to the horse’s owner, although the horse was sound to ride, the stride length was short, upright and choppy, and the hoof grew little sole with a contracted frog.

“I reviewed the horse barefoot, as a transition was in play. A base narrow conformation presented a medial toe flare, forward run heels, with shunting present in the lateral heel bulbs. Establishing a trim, I utilized leverage testing, live sole mapping with proportions of toe length, center of force, center of rotation and a compromise of long and short axis views as considerations to prepare for FormaHoof.”

1st FormaHoof Application

Initially upon the 1st application, the horse was still prone to toe landing, exploring its proprioception. I trimmed the mold mid cycle, simple rasping, addressing an imbalanced M/L wear pattern discrepancy. The horse improved in motion; improved movement through load, land and breakover and set up the medial flare of the hoof wall to start regeneration into symmetrical proportions. As FormaHoof grows with the hoof from the coronary band, I feel early recognition of imbalances can be addressed in a similar fashion to barefoot trimming and in my opinion a simple trim of the mold showed dividends a few applications later.

Initially the baseline dorsal toe angle was 54 degrees. Heel angles weren’t recorded, but quite run forward and asymmetrical to the toe.

30 Days

At 30 days, the 1st application produced 1/8” heel growth, together with considerable bar, sole corium and toe growth, though it was weak and exfoliated easily. FormaHoof facilitated a healthy, bacteria free environment, giving the non responsive and challenged structures the ability to regenerate. The 3D fit provided a template for the hoof, allowing the medial capsular deviation to remodel and respond to the extensor apparatus and limb. The toe clip polymer attachment that FormaHoof provides with proper mold placement, guided the toe into the correct position of leading the limb in flight and stance.

60 – 120 Days

The time line from 60-120 days in FormaHoof brought considerable changes in the horse’s hoof morphology.

The asymmetrical M/L hoof walls became balanced in length and angle. The medial toe’s predisposition to flare lessened. Heel growth strengthened and straightened, and the distance from Duckett’s dot to symmetrical length improved.

A trimming protocol of maintaining proportions, a long axis view supporting the limb, trimming heels to solid structure, not solar position and not chasing collateral groove depth and frog height allowed the haemodynamic structures to initially fill through the coronary band.

FormaHoof at 90 days.

With this particular horse, support, comfort, even hoof loading, perfusion and elevation and addressing HPA facilitated regeneration of the supporting structures. This improvement was palpable at the wings of the coffin bone, digital cushion and visually as the heel bulb hairline has relaxed and filled as the capsule has deepened.

At 120 days the horse’s frogs showed much improvement, as the central sulcus opened with this last cycle from 19-25 weeks showing great improvement in the frog’s structure. Continuing proportional trims and heel height with FormaHoof’s structure and environment will add value as well.

The results

What is amazing about this case is that the improvements were achieved after 3 years of “static” non-response, where the horse was growing no foot and had a withering frog and contracted heels.

Without radiography, utilizing the coronary band as a reference was essential. The medially shunted hair line relaxed immediately at 1st application, and the D/P view of the hairline pathway continues to improve as the horse balances 3D under itself.

After the 1st application at 30 days, I maintained symmetrical toe lengths and a 56 degree dorsal toe angle. Through these cycles as the hoof became centralized, the horn quality became denser, stronger with defined coloration between zonal changes. Zona Alba reflects the same, with a more consistent width, structure and colour.

At 25 weeks, I established symmetrical proportions on the near fore (dominant) foot. The heels trimmed to the widest part of the frog, while increasing dorsal toe angle from 56 to 57.3 degrees. My goal for heel toe angle symmetry was 5 degrees, when it was attainable and appropriate. Heel angle recorded presently at 56.3 degrees, a 1 degree variance.

As radiographs and MRI’s are not an option to date, a complete vet assessment as to lingering soft tissue issues from navicular syndrome and a true view to phalangeal alignment may never be known. However, utilizing FormaHoof as a progressive modality and reading the hoof, limb and the horse is resetting these feet back under this horse, with stance and motion moving in a positive direction.

In simple cowboy terms, “the toe now leads the limb.”

Proprioception, loading, landing and breakover are similar; with FormaHoof or barefoot.

“I can sit that horse” is a simple but effective dynamic review, that fits this horse.

In this case, for this horse, FormaHoof is true to its name, successfully reforming a hoof capsule. With a whole horse approach, the ability to rebuild a foot and allow a horse to continue to be a horse with land, load and breakover on a centralized foundation is key to all horses’ welfare. FormaHoof provided a 3D structure, elevation and comfort, equal perfusion to the foot and was the missing link to hoof regeneration in this non responsive case. The inability to support caudal failures or provide an environment promoting growth and support is what separates the modalities; trimming and basic farriery, from FormaHoof. Everything I’m doing utilizes progressive approaches and draws on 41 years of farriery experience and in my view FormaHoof is the answer in the 3D plane of X Y and Z that horses require.

Horses by nature are a prey animal, they mask pain. I hope in the future and with a more progressive outlook, providers can help promote animal welfare, utilizing compassion and skill in providing care for horses that is fitting to the generosity of the horse’s spirit. For me, FormaHoof is now my go to, along with horsemanship skills and 41 years of farriery, to facilitate my part in this goal. A conversation fitting to the horse.

About Navicular Disease:

Navicular disease is one of the most common causes of chronic forelimb lameness in the athletic horse but is essentially unknown in ponies and donkeys. Navicular disease is a chronic degenerative condition of the navicular bone that involves 1) focal loss of the medullary architecture (with subsequent synovial invagination), 2) medullary sclerosis combined with damage to the fibrocartilage on the flexor surface of the bone, 3) traumatic fibrillation of the deep digital flexor tendon from contact with the damaged flexor surface of the bone with adhesion formation between the tendon and bone, and 4) enthesophyte formation on the proximal and distal borders of the bone. (source: https://www.msdvetmanual.com)

For more information on FormaHoof and other case studies on lameness rehabilitation see www.formahoof.com.

* Osphos-clodranate disodium is an injectable bisphosphonate solution used in the control of clinical signs associated with navicular syndrome. In this case it was utilized to help rebuild the areas of the navicular bone that showed cysts upon the interpretation of the radiographs by the veterinary surgeon.