Treating Founder (Chronic Laminitis) without Horseshoes, Section 22
(Full-sized photo version for better print-outs.)
Bob, dark bay horse, being driven on Nancy Filbert's
exercise track--Martha Olivo right behind him!
Bob--TWH with founder and sole penetration
on all 4 feet; "Going Toxic"
What is "Going Toxic?" Why does it happen?
A HEALTHY horse living a natural life style--freedom, herd life and plenty of activity 24 hours a day--and whose hooves are an optimum form for good hoof mechanism and circulation--has several important advantages:
1. Heart function: The hooves being worked many miles a day, along with having good form for maximum hoof mechanism, result in hoof mechanism helping his heart move the blood through his body. When the hoof is un-weighted, blood flows in; when it is weighted, it pushes blood out of the foot and back up to the heart. Horses' hearts were not designed to do all the work of moving blood through the body; they need the hooves acting as "auxiliary hearts" to help with this. Horses need to be moving much of the time so the heart is being helped most of the time. Other organ systems, such as the digestive system and the lungs, also function better when horses are moving around outside most of the time.
2. Protein in the diet is actually being used, rather than backing up in the blood and overloading the kidneys, because increased circulation also enables protein to get down into the hoof corium to grow more hoof, faster.
3. A natural life for a horse also includes exposure to as few drugs and other toxins as possible, and a diet that is more like a wild horse's diet--primarily grass, not overly rich feed that also overstress the kidneys and liver.
May 27, 2001--Bob before first trim; notice stress and tension--also cresty neck.
The opposite situation is a horse, such as Bob, who had everything working against him:
1. Heart function: Circulation in the hooves is so diminished because of improper hoof form (high heels, contraction, and orthopedic shoeing, which restricts circulation even more than "normal" shoeing) that the heart has to work harder because it does not have hoof mechanism to help it pump blood.
2. Stall confinement and lack of constant exercise reduces hoof mechanism; this in turn--
b. gives the heart less support, overstressing it, and
b. overloads the kidneys and liver with protein in the diet that could not be utilized to grow more hoof, faster. If protein is not being used by the feet simply because circulation is too poor to get much blood into the feet, unutilized dietary protein backs up in the blood.
3. Heavy drug use taxes the kidneys and liver, which are already being overtaxed with having to clear unutilized protein.
4. Long-term orthopedic shoeing greatly restricts circulation in the feet, resulting in contracted feet and long-term, major damage. Poor circulation can result in a lot of dead or damaged corium inside the hoof.
The longer the above factors have been the case, and the more damage has accumulated, the more likely the horse is to have a rough transition when full hoof mechanism and circulation is restored. If circulation is restored too abruptly in a horse with a lot of damaged tissue and already marginal liver and kidney function, he can "go toxic."
To quote Dr. Strasser's textbook:
|"With severely damaged hooves, the return of circulation brought about by activated hoof mechanism can flush too many toxins from necrotic corium into the blood stream, resulting in poisoning the organism. This is especially dramatic if liver and kidneys are already damaged; fatal damage of the heart muscle (due to toxic metabolic products in the blood) can result. For this reason, a blood test to help establish the condition of the metabolic organs is always a good idea before beginning trimming in such cases." (VI-116)
"A very grave matter must be considered before trimming any horse with severe damage (such as coffin bone protrusion) in its hooves is metabolic or organ failure after the onset of rehabilitation.
"Healing, by its very definition, requires increased metabolism and circulation (ie, inflammation). When a horse's hooves have been greatly damaged, and the animal has been subjected to long-term conventional treatment (shoeing, chemicals), severe liver and kidney damage are often present.
"The regeneration in the hoof includes the removal of toxins and metabolic waste products which have been accumulating in this region due to poor circulation (shoeing, improper trim, contraction) for months or years. The removal of this waste, in addition to the healing of damaged tissues in the hoof (which requires increased metabolism and, as such, produces increased metabolic waste) as well as the healing of their own damaged tissues, is sometimes too great a strain for the liver and kidneys. The horse loses weight drastically and may die.
"This risk is present within perhaps the first two months after the initial trim. If this situation is suspected, it may be better to improve liver and kidney health and optimize the living conditions of the horse before trimming the hooves, and then perhaps begin with the hind hooves, and leave the fronts (usually the worst) until a little later still. Detoxifying, while helpful, does not, however, immediately repair the damage to the metabolic organs, and a horse may still die despite implementing a detoxification program prior to beginning hoof rehabilitation.
"Horses which have already been treated with homeopathics and other natural methods, and had good living conditions, have a greater chance of survival than those not so treated. The horses with the poorest survival chances are those treated with conventional veterinary medicine (i.e., chemicals, box rest, "orthopedic" shoes, etc.).
"Whenever metabolic organ damage to the point of reaching organ failure is suspected, the owner should have blood tests done on the horse to show liver and kidney function values.
"Metabolic or organ failure is a possibility not only with protruding coffin bones, but also with horses whose coffin bones have been destroyed to a large degree (long-term unnaturally steep hoof), or who have had chronic laminitis or unrecognized coffin bone rotation for many years, or any horse that has been shod for about a dozen years or so. It is important to remember that, in a horse with a partially destroyed coffin bone, the rate of bone regeneration, as well as the rate of bone deconstruction, increases with increased blood supply. This means that, with a restoration of hoof mechanism, the coffin bone will, initially, be deconstructed faster after restoring circulation (until a nearly ground-parallel coffin bone position can be established), another argument for not taking down excess heel height gradually over a long period of time. This increased rate of tissue change will also affect metabolic organs.
"The heart, too, is stressed more with healing. One can notice that, with the return of circulation in the hoof, the heartbeat also initially increases in the first few weeks, depending on the amount of damage in the hooves. This occurs until the metabolic waste products have been mostly removed, and healing in the hoof is well underway. The heart, like the liver and kidneys, has to work harder to support the healing and detoxification process. It is possible that, in some cases, although hooves are coming along well, the heart is no longer strong enough to support the task of healing. In horses whose hearts have already been damaged due to box stall keeping and high demands while shod (without the hooves to support the circulatory system) heart failure is a possibility within the first 6-8 weeks of beginning rehabilitation.
"All things being equal, a horse with severe hoof problems that has had natural living conditions most of its life is less likely to die of metabolic or organ failure than one with was subjected to conventional boarding conditions. (VI-134-136)
"After the shoe is removed, the hoof is trimmed properly, and the horse is turned out to natural living conditions, the metabolic waste products and dead cells or tissue areas (which have been accumulating over years inside the hoof) are taken up by the blood stream and end up in the liver and kidneys. Unless they are still moderately healthy, these two organs can become overstressed as a result of this sudden overload of metabolic waste products from the hooves.
"Unfortunately, in many severe lameness cases (such as horses with years of chronic laminitis treated by conventional methods, or a decade of tight shoeing and contraction), they are already considerably damaged. Then, with the beginning of healing, the entire metabolism more or less collapses, with effects on heart function, digestion, and behavior. The horses can, within a few days, lose weight dramatically....If severe kidney or liver damage is suspected (or confirmed by blood test), the horse should be first treated (homeopathically) for this, before beginning work on the hooves. Orthopedic hoof care should commence gradually, perhaps with the least damaged (usually hind) hooves first, and progressing in stages, carefully monitoring the horse's condition and giving it time to heal before restoring circulation to the next damaged area (front hooves)." (XI-21-22)
"With horses whose hooves have been contracted (or shod) for a long time, altered liver and kidney function values are noticeable in blood tests.
"The kidneys and liver of a horse with contracted hooves are overstressed as a result of having to deal with the excess metabolic waste protein in the blood stream. Their function is disrupted and, especially with liver function disrupted, frequent bouts of colic and other problems can result.
"This is why it is important, before beginning with the rehabilitation of a horse with badly damaged and long-term contracted hooves, to establish the values for kidney and liver function via a blood test. The results can also aid in clarifying for the owner and any veterinarian treating the horse the reality and seriousness of the damage in the horse as a result of impaired hoof functions, as well as provide concrete records showing the effectiveness of this rehabilitation method.
"If the kidneys and liver are working only poorly, the long-term, slow poisoning of the entire organism (especially the heart) can be so severe that, after reactivation of hoof mechanism and the removal of dead corium regions (which burdens the kidney and liver even more), the overall toxicity can lead to metabolic organ or heart failure--in other words, the sudden death of the animal." (VII-35)
"Blood contains a high amount of protein, and a large part of this protein must be excreted, such as via the hooves in the form of horn, or via the skin as hair. When the blood flow in the hoof corium is restricted (such as through shoeing, contraction, lack of movement), less waste protein is excreted here, and too much remains in the bloodstream and the organism. This excess protein must then be excreted, along with the regular metabolic waste, by the kidneys and skin. For the kidneys, this extra work is a strain which adversely affects their normal functions. As a result, regular metabolic waste which should have been excreted by the kidneys remains in the organism, putting stress on other organs. The liver, as a metabolic organ, is one of these, and is then no longer able to function properly.
"This is why blood tests for horses that have been shod or have had contracted hooves for some time show abnormal values for liver and kidney functions. The reduced corium circulation in horses with long-term shoeing and contracted hooves thus also sets the stage for laminitis, which can then be triggered by even a slight change in blood composition, or metabolism--such as results from a small amount of excess grain, grass, or a vaccination (none of which are the cause of laminitis, only the trigger." (X-25-26)
(Above excerpts from: The Hoofcare Specialist’s Handbook: Hoof Orthopedics and Holistic Lameness Rehabilitation, by Hiltrud Strasser, DVM & Sabine Kells; published 2001 in Canada by Sabine Kells.)
Bob had all the risk factors for going toxic: long-term lameness and severe hoof damage, orthopedic shoeing restricting circulation, box stall rest on deep bedding also preventing hoof mechanism and circulation, massive long-term drug use (4-8 bute tablets a day) contributing to toxicity, and unnatural hoof form also restricting circulation.
I think Bob's history should be told on this site because many rank beginners reading my site will get overly optimistic and think they can tackle cases even the professionals are afraid to take on. Bob did indeed "go toxic" and have a rough transition in the beginning. I wish I had a dollar for every person I have heard say, "Well, I won't quit trying if she won't quit trying! We'll just get through somehow!" Many of these people are shocked when the horse goes toxic. These people might be more comfortable with easing into things slowly.
What is also remarkable, though, is that Bob did the "impossible"--he survived sole penetration on all 4 feet, and healed! After years of other methods failing to improve him, at last something did work. But not without trauma! I am emphasizing these problems to warn people that a rapid rehab can involve pain and setbacks.
I hope I don't scare too many people off with this story, though. Most horses are not in as compromised a condition as Bob was, and do not react as badly to the restoration of hoof mechanism and full circulation. Many are greatly relieved by the trim.
In May of 2001, a lady who rescued a foundered TWH field trial horse read my site, and contacted Nancy Filbert, a Strasser hoofcare specialist in Antigo, Wisconsin. (To contact Nancy, Click HERE) As Nancy does not check her email every day, if an emergency, Click HERE
"Bob" had been foundered for a long time, both fronts and rears, and had sole penetration on all fours, if you count a couple of the feet where the toe sole was just a loose flap of dead, blackened sole. He had been on 4-8 butes a day. He had also been getting other conventional treatment, including high-heeled shoeing with the shoes reversed, with full pads and frog supports, on his fronts. His hind feet were not shod, but he had very poor circulation and hoof form in his hinds, as well as sole penetration.
None of this conventional treatment was working very well, as it still took him 10-15 minutes to walk 15-20 yards the day Nancy and Tim first went to see him.
In light of the warnings from the Strasser text quoted above on proceeding too fast on horses who are likely to go toxic, in Bob's case, Nancy really felt she had no choice but to go faster. Despite being on 4-8 butes a day, he was still lying down most of the time, too sore to stand, and when Nancy was finally called in, the owner was very near to giving up on him and having him euthanised. Being down all the time is a tremendous strain on a horse's organ systems; so is being on high doses of drugs (in his case, bute). Plus, he had sole penetration on all 4 feet, which Nancy felt needed to be healed quickly. So, they decided to proceed as rapidly as they dared.
Bob's fores before trimming, May 27, 2001.
Notice high heels, founder ridge, obvious rotation, and very little hairline slope.
Notice that the shoes were put on backwards. This reduces pressure under the tip of the coffin bone in the toe area, and gives more frog support. Notice a plastic wedge under the frog, which is attached to the full pad. The idea behind this is to prevent further coffin bone rotation with frog "support." Unfortunately, this scenario reduces hoof mechanism even more than regular shoeing does. Also, infection under full pads is a common problem.
Here are the soles when the shoes were first pulled:
Left fore--considerable rot, hole in sole, and visible coffin bone.
Right fore--the black, rotten toe sole was actually a loose flap.
Left hind--visible coffin bone tip in toe area.
Right hind--visible coffin bone tip in toe area.
These feet had high heels, overlaid bars, rotation, and exposed coffin bones.
Tim, Nancy's boyfriend, had the strength to hold Bob up long enough to at least do a rough trim on him May 27 at the former owner's. Although the trim did not take the heels all the way down, or restore full hoof mechanism, it did give the horse considerable relief. He is wearing Sabre Sneakers on the front feet, and able to stand with his front legs more plumb because his heels were not as painful. (Earlier, he was standing with his fores behind the vertical to avoid heel pain from massive, overlaid bars.) He was walking more freely after the first trim despite protruding coffin bones.
Although the bars and heels were not taken all the way down, and there was not full hoof mechanism restored or opening cuts done, even this much improvement helped him to re-grow sole rapidly. Further, Nancy did not want to restore full hoof mechanism and circulation right away, because she knew that it was likely that Bob would "go toxic."
In the case of a horse with massive, long-term damage, it is likely that restoring full circulation quickly will result in the horse "going toxic" once circulation is restored. The biggest risk factors--long-term stall confinement, therapeutic shoeing (which restricts circulation even more than ordinary shoeing), excessive use of drugs, and improper hoof form resulting in poor circulation--were all present in Bob's case. Although his hinds were not shod earlier, they still had improper hoof form, with no hoof mechanism.
Even though the first trim did not fully restore circulation, it still resulted in rapid growth in just ten days. Photos below show first trim on the left, and 10 days later on the right, before the second trim was done. (On the LH, they began to trim the frog first before thinking to take a photo.) You can see some heel expansion, too. Already you can see sole migrating slowly forward over the thin spots, and the overall appearance looking healthier. Unfortunately, the bars were growing in really fast as well.
Bob began to "go toxic" about 3 days after his first trim, even though it had not been a trim to fully restore hoof mechanism. It began with him getting increasingly sore, developing hoof abscesses, eating less and less, and having a depressed temperature. The owner was alarmed at his temperature--97 degrees F.--and how much he was down. Part of the low temperature may have been explained by a cold snap, and the fact that he was lying down in cold mud a good bit. Nonetheless, things were not looking good. The owner decided to give him to Nancy, as she did not think she could help him. His condition bottomed out at 7-10 days after the first trim, which is around when he was brought to Nancy's farm.
On June 6, 2001, he had his second trim in a sling to enable trimming him more comfortably. He was too sore to lift a foot for someone to trim him without the relief the sling offered.
Bob, well-supported in a sling to enable comfortable trimming, munching hay.
This 2nd trim on June 6th got full hoof mechanism. One day later, he "went toxic" again. He had increased respiration and flared nostrils, he was down a lot, and wouldn't eat hay. He was rather "shocky" and lost a lot of weight (he was at his thinnest in August). He was at his worst for 3 or 4 days. They brought him fresh grass by the bushel, which he continued to eat even though he now refused hay, plus some grain. He was gotten up to be walked a minimum of 3 times a day, more often 5-6 times a day. It took several people to urge him up and forward. After his walks, they would let him lie down in the hay field, where he would twirl around on his side and graze the 4' tall grass in a 10' diameter circle. He was just left untied in the hay field because he wasn't going very far in the beginning. Nancy thinks it is interesting that he was almost exclusively eating relatively new (early June), rich grass that supposedly will trigger laminitis; it was a mix of brome grass, timothy, alfalfa and clover. Not only did it not trigger laminitis, but she believes it is what actually kept him alive, as he wasn't eating much else.
His hooves were abscessing. During walks with Davis soaking boots on, they refilled the boots often with a garden hose to flush out the open abscess tracks at his coronet bands, and the last fill-up was with a apple cider vinegar and water solution, about 15-20% vinegar. All this helped clean out the abscessing. There was a track open from the top, by the coronet band, all the way down the toe, which had no laminar attachment, and out the sole. She believes hoof mechanism accounts for why, when she cleaned his feet and put fresh water in, after walking a bit, the hoof mechanism seemed to be flushing more debris through this open track down the toe, and the water got "dirty" after more walking.
Sabre Sneakers Nancy had her local shoe repair man modify
with a 21-iron black Vibram crepe bottom outsole, grooves added,
and a 12-iron cloud crepe insole. More durability, traction and cushioning.
She likes Sabre Sneakers better for walking--they are less likely to rub pasterns.
Davis soaking boots--similar modifications.
She likes Davis boots for soaking.
For a couple of weeks, he had to be pushed to get up and walk, until the worst of it passed. He was at his worst the first 3-4 days of "going toxic."
She found that the boots were very helpful for walking him later when the ground froze hard and uneven.
Turning the corner!
They could tell he had turned a corner on getting less toxic when he began to be willing to stand and graze, and when he would eat hay willingly again. The look in his eye changed as well; he looked more comfortable. His respiration was no longer labored, and he was more cheerful. Eating more was the first sign that he was getting over it. When he was able to do two laps around the field (600-700 yard laps), and he was getting up from his grazing lying down to come back to the house or to rejoin the other horses (6-7 weeks after the 2nd trim), they knew they had turned a corner with him.
His exposed coffin bones were all covered with new sole by early- to mid-August. Once his coffin bones were covered over with new sole, they discontinued using boots to walk him unless ground conditions got unusually hard and dry. He was trimmed every 1-2 weeks. Part of the soreness he had is also due to heel expansion--often an ouchy proposition.
He was galloping by late September! He was also doing some spectacular bucking and spinning then, too.
Bob in October, much more relaxed,
and no longer needing a sling to be trimmed comfortably.
In December he was well enough to go into training under saddle, where he did well.
Later in December, the ground froze uneven and hard as a rock, and he came up sore again. However, more frequent trimming since then got him more comfortable again. He needed boots more in these conditions, and it was also more important when the ground was hard to keep his bars trimmed more often. Impacted bars and contraction have been an on-going problem for him.
Bob's soles, January 12, 2002
No signs of sole penetration any more!
Bob's feet, January 12, 2002
Bob's feet remain a work in progress, but he has had remarkable improvement!
He is presently living with Tim Wensel in Bryant, WI, firstname.lastname@example.org 715-216-2141 www.soundhoof.com
More perspective on "going toxic" from biochemist Linsey McLean, whose web site www.vitaroyal.com has a lot of interesting information:
|From: Linsey Mclean <email@example.com>
Date: Thu Jan 17, 2002 2:52 pm
"Would someone please clarify for me what happens when you trim feet and the connection of getting toxic? How it overloads the kidneys and liver?"
By opening up the foot, you also open up the meridians for Yin organs, too, that are the most compromised with environmental exposures of toxic chemicals we are all exposed to. It rains on everyone, but some get more than others....anyway, when you energize the Yin meridians of spleen, liver and kidney, you can initiate the beginnings of a detox, and that can cause symptoms of sickness as the toxins are mobilized from those organs and storage depots of the body. Detox is really a 2 step process, of which mobilization into active metabolism is the first....all the burden collected over time slowly is dumped back into the active metabolism and the body feels like a huge exposure all over again.
To successfully detox, you need the second step...adding the "escorts" for these chemicals out of the body so they do not just make a loop back into storage again. This is the specialty of my expertise. There is a lot of info on my web site for both humans and animals, if you are interested...and a whole protocol for your horse, too. www.vitaroyal.com
I have a product called Xenodetox that will detox xenoestrogens very well...good for liver, kidney and spleen, and especially for thyroid pathways...and should be used with Nutrient Buffer, as the toxins come down as organic acids and can cause colic during detox. We usually start the EI protocol for a good 5 days to stabilize the body before we add the Xenodetox to the program, and then have very little problems that way. Helps greatly with obesity and chronic fatigue, and especially horses with
"In retrospect, I think they should have eased into the first trim slower, and gradually worked up into the fores, etc."
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