Laminitis: the farrier's role in laminitis

Inside the hoof hangs the horse's coffin bone attached to the hoof wall through a fine-meshed suspension of lamellae — it is this suspension that bears the horse's weight. With laminitis (founder), an inflammatory condition develops in the lamellae and the connection weakens. In the worst case, the coffin bone's tip rotates downward against the sole, or the entire coffin bone sinks in the hoof capsule. It is extremely painful and can render a horse permanently unfit for work. For the farrier, laminitis is therefore both an acute alarm and a chronic task that can follow a horse for the rest of its life.

Laminitis has several known triggers. Feed-related cases are common: sudden access to large amounts of easily digestible carbohydrates — concentrate or sugar-rich spring grass — can disturb the intestinal flora and trigger an attack. Metabolic disorders and overweight significantly increase the risk, and serious illness such as retained placenta in mares can also trigger laminitis. Finally there is load-related laminitis where one leg is overloaded, typically because the opposite leg is injured. The farrier is often the professional who sees the horse most frequently and can therefore play a key role in detecting risk factors and warning the owner in time.

• 01The characteristic relief posture: the horse shifts weight backward and stretches the front legs forward — lameness usually affects the front hooves.
• 02Reluctance to walk, stiff, clumsy gait — particularly when turning and on hard surfaces.
• 03Hot hooves and significantly increased pulsation at the coronet band.
• 04Pain on palpation in the toe area of the sole.
• 05For chronic courses: altered hoof shape with rings in the hoof wall stretched white line and flat or vaulted sole.

The learning outcomes in the subject Diseases and Injuries state that the apprentice in collaboration with a veterinarian should be able to perform acute treatment and shoeing of laminitis as well as follow-up treatment and shoeing in horses with chronic laminitis. In practice this is about moving weight-bearing away from the painful and weakened toe-region and back towards the frog and heel. The practical learning outcomes mention the specific shoes: eggbar shoes, heartbar shoes and actual rocker shoes belong to the repertoire the apprentice should be able to hand-forge and modify. The heartbar shoe has a heart-shaped plate that supports the frog; rocker shoes ease the rollover at the toe, so the horse can roll over without twisting in the weakened suspension.

With chronic laminitis the farrier works blind without imaging. X-rays show how much the coffin bone has rotated or sunk and how thick the sole is under the coffin bone's tip — and thus where there can be trimmed at all and how the shoe should be placed. Calipers require knowledge of imaging tools such as X-ray ultrasound MRI and CT as well as understanding of radiation hygiene for X-rays. The ideal course is for vet and farrier to stand with the horse together: the vet takes the images and sets the treatment plan the farrier translates it into trimming and shoeing.

A horse that has had founder once has increased risk the rest of its life. The hoof wall grows unevenly after an attack — typically faster at the heels than at the toe — and must be corrected regularly with shorter trimming intervals than normal. The farrier becomes the horse's permanent caretaker here: he tracks hoof shape from time to time documents development in the hoof journal with photos and reports back to the vet if something is slipping. At the same time advising the owner is crucial: feeding grass management and weight control are the prevention that determines whether the attack repeats.

Laminitis is the clearest example of why the farrier training includes both blacksmith work, anatomy and disease theory. The person who can forge a heartbar but does not understand the mechanics of rotation makes a beautiful shoe in the wrong place. The person who understands the disease and masters the shoe can be the difference between a horse that returns to work and a horse that must be put down.