Managing Severe White Line Disease

Learn about the intricacies of treating and shoeing horses with white line disease.

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Managing Severe White Line Disease
Treatment of white line disease often includes removing the dead hoof wall with a hoof knife to allow oxygen to reach the anaerobic bacteria and reduce stress on the diseased hoof wall. | Photo: Erica Larson/The Horse
White line disease is a bit of a misnomer as it doesn’t actually affect the white line along the bottom of the hoof wall. Rather, it’s a disease process that sets up within the inner, nonpigmented section of the hoof wall, called the stratum medium, that can also erode into the stratum internum (where the sensitive laminae attach the hoof wall to the coffin bone). In severe cases, white line disease can damage the lamellar apparatus to the point that the horse develops laminitis.

Mike Steward, DVM, APF, of Shawnee, Oklahoma, discussed the intricacies of treating and shoeing horses with severe white line disease during the 2017 International Hoof-Care Summit, held Jan. 24-27, in Cincinnati, Ohio.


One of the big challenges in treating white line disease is that its cause is unknown. The disease process usually begins with separation of the hoof wall’s insensitive laminae from the underlying sensitive laminae attached to the coffin bone. Bacteria, fungi, and dirt can then enter the space and cause infection, which is often difficult to treat due to its location and the lack of blood flow to this area.

Veterinarians typically diagnose white line disease by looking for abnormal wall separation or wall conformation, tapping the hoof wall to listen for a hollow sound, and applying hoof testers to the sole. A veterinarian or farrier can use a hoof knife to cut away the diseased part of the hoof wall to get a better idea of the extent of infection and separation. Radiography is a useful and less-invasive diagnostic tool, Steward said

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Written by:

Sarah Evers Conrad has a bachelor’s of arts in journalism and equine science from Western Kentucky University. As a lifelong horse lover and equestrian, Conrad started her career at The Horse: Your Guide to Equine Health Care magazine. She has also worked for the United States Equestrian Federation as the managing editor of Equestrian magazine and director of e-communications and served as content manager/travel writer for a Caribbean travel agency. When she isn’t freelancing, Conrad spends her free time enjoying her family, reading, practicing photography, traveling, crocheting, and being around animals in her Lexington, Kentucky, home.

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