Coffin Bone : The red line shows the level of the coffin bone….

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Ms. Menken's natural horse delights - Natural Horse treats - For the Horse Horses-store.comCoffin Bone : The red line shows the level of the coffin bone….

www.americashorsedaily.com “TOOTER” KISER REMEMBERS THE DAY IN 2004 THAT HIS GOOD RANCH HORSE, PEPPEROANI Wolf, came walking across the lot, just looking a little stiff.

He didn’t know it then, but that was the beginnings of a case of laminitis in all four feet that very nearly spelled the end of “Pepperoani.” Tooter, who lives in Sulphur, Oklahoma, took the horse to his regular veterinarian, where he got the diagnosis and a recommendation to take the horse to a local sale, where he’d most likely go to a slaughter house. “I said, ‘Hey doc, this is a little better gelding than what you give him credit for,’ ” Tooter says.

He didn’t want to put the horse down, nor did he take him to the sale barn, but he left the vet’s office downhearted and unsure of his next option.

Then from two different people, he heard of a veterinarian just 60 miles away in Shawnee, Oklahoma, who was putting wooden shoes on laminitic horses and having some success at it.

Tooter and his wife, “Sissy,” even got their hands on a video of Dr.

Micheal Steward working on some horses. “We looked at each other and said, ‘What have we got to lose?’ ” When Tooter took Pepperoani, a grandson of Peppy San Badger, to Dr.

Steward, the little red roan gelding could barely walk off the trailer.

But by the time Dr.

Steward and a farrier finished with him, “I led that horse out of that X-ray room and he hit that concrete and gravel, and he gave just a little.

It was like he was already 95 percent better,” Tooter says. 2 www.americashorsedaily.com within the hoof capsule, to the point that it comes through the bottom of the sole.

Laminitis is considered a medical emergency, and as you might guess, there are some horses with it who can’t be saved.

But this is where Dr.

Steward delights in stepping in.

Some laminitic horses “need to (be euthanized) because they’re in so much pain, and it’s very selfish of us to keep them alive,” he says. “But having said that, we typically save 99 percent of them.” One client brought him a horse whom two other veterinarians had recommended be euthanized. “I was the first guy to come along that said, ‘Kill it? Let’s ride it.’ I’ve given some hope.

If (the hooves) have blood supply, we can usually make it work real good,” Dr.

Steward says.

His weapon of choice consists mostly of plywood and some deck screws.

The plywood typically comes in 1.125inch thicknesses, and several layers of it can be used to create a shoe that resembles the square-toed, rockered Natural Balance shoe.

Farriers use an adjustable band saw or a belt sander to create a 45-degree angle on the toe of the shoe and a 30-degree angle on the heel side.

The bottom is left flat, to This digital X-ray shows how wooden shoes can help align a horse’s bony column, while still protecting the provide stability.

Dense rubber can also be stressed deep digital flexor tendon.

The red line shows the level of the coffin bone, or third phalanx, as being parused on the bottom for better traction, and allel with the horse’s sole (shown by the yellow line).

That alignment helps restore blood flow to the damaged commercial versions, made of different foot.

But by wedging the heels of the wooden shoe, those structures don’t necessarily have to be parallel with the material, are also available.

Ground (shown by the green line), which removes stress from the deep digital flexor tendon.

Dr.

Steward first tried a crude version of the Pepperoani continued to improve, and today, he’s wearing concept more than 20 years ago, when he screwed a plain piece regular shoes and is back helping Tooter work cattle on the of plywood on the hooves of a horse whose coffin bones were 15,000-acre ranch where he lives. “Where we live and work, it’s not a rough place, but it is pretty rocky,” Tooter says. “I ride him hard, and he has never come up crippled.

I have had zero trouble with him.” He’s a firm believer now in the wooden shoes. “It worked for us. (Dr.

Steward) fixed my roan horse, and I’m sure glad he did,” Tooter says.

To the uninitiated, these screwed-on shoes can look pretty strange, even prompting a few “Frankenhorse” jokes.

But to Pepperoani and other horses they’re helping, it’s no joking matter.

To understand how the wooden shoes work, it’s helpful to first review the mechanics of laminitis.

Laminae are the soft tissues that anchor the coffin bone, or the third phalanx, to the inside of the hoof wall.

They, in effect, are the main support system for the bony columns of the horse’s legs.

When Coffin Bone laminitis strikes – from a multitude of causes, including (Third Phalanx) grain overload or overweighting one foot to compensate for soreness in the other one – the laminae become inflamed.

Deep Digital As they swell, blood flow within the hoof is compromised.

Flexor Tendon And as the laminae die off, the coffin bone loses its attachments to the hoof wall.

Without that counter-balancing force, the deep digital flexor tendon, which runs down the Laminae back of the leg and attaches to the bottom of the coffin bone, exerts enough pressure to rotate the coffin bone downward, so that it points toward the bottom of the foot.

It can also sink www.americashorsedaily.com 3 www.americashorsedaily.com The finished product: This hoof has had the fiberglass casting material wrapped around it, topped with a layer of self-adhering elastic bandage. coming through her soles and whose owner couldn’t afford expensive treatments.

Three months later, that horse owner brought in a sound mare – whose wooden shoes were beveled off by wear in exactly the patterns Dr.

Steward uses now. “I didn’t invent them,” he says. “I just discovered them when the horse showed them to me.” But what is now known as the “Steward clog” actually has been around for a long time.

After Dr.

Steward had been using the wooden shoes for a while, a client brought him a copy of “Magner’s Classic Encyclopedia of the Horse,” which was originally published in 1887.

In it, he found a description of a “rolling motion” shoe fashioned out of metal that was very similar to what he’d been using.

And it also substantiated one of Dr.

Steward’s convictions. “It has taken me 20 years to figure out what they knew back then, which was No. 1, do no harm.” In his modern-day interpretation of that, the screws, set in with a cordless drill, don’t add trauma to an already-injured hoof like hammered-in nails would.

He likens it to someone with a concussion who goes to the doctor, only to have the doctor hit him in the head with a hammer. “These guys are so critically ill, just one pounding of your hammer can be the difference between life and death.

Any injury results in more inflammation,” Dr.

Steward says.

And the screws can be removed and reset to adjust the shoe as necessary without adding any more trauma.

But before the shoes are set on, X-rays are essential.

The radiographs of the feet and lower legs show how much the coffin bone has rotated and whether it has dropped to one side or the other (medially or laterally).

The thickness of the front hoof wall and the thickness of the sole are among other parameters that help the veterinarian and farrier formulate a plan.

Of course, there are many things to take into consideration, but one that’s of paramount importance is de-rotating the coffin bone by lowering the horse’s heels.

It may not be possible to put the bone back in its rightful position in one trim, but every little bit helps.

When the bone is de-rotated, that takes pressure off the blood vessels that were compressed by its rotation and helps restore blood flow to the foot.

Www.americashorsedaily.com But the laws of physics don’t always work in favor of a laminitic horse.

When the heels are lowered, that often tightens up an already tight deep digital flexor tendon, creating pain.

So wedged heels are incorporated into the shoes, propping up the back of the feet and taking the pressure off the deep digital flexor tendon without affecting the new position of the coffin bone.

Dr.

Steward also tries to bolster blood flow to the foot in another way, similar to the 1880’s tradition of packing oakum into a laminitic hoof. (Oakum is loose fiber, usually mixed with tar, historically used to caulk the seams of a ship.) With input from Gene Ovnicek, who developed the Natural Balance shoeing system, Dr.

Steward began using rubber-like impression material, which is malleable until it “cures,” to fill in the crevices around the frog and over the sole.

He recalled horsemen of the past who said horses had two hearts – one in their chests and another in their feet.

And indeed the vascular system in the hoof plays an important role in dissipating concussion when the horse is moving.

As concussive forces move through the hoof, the energy is dispelled into the fluids of that “hemodynamic system.” So, for the injured laminitic hoof, adding this firm cushion to the bottom of the foot is a bit like performing CPR, helping blood flow in and out of the hoof as the horse moves and distributes weight on and off its feet, Dr.

Steward says.

The better blood flow the hoof has, the more it’s able to grow healthy sole that will protect the compromised coffin bone, he says, and that’s crucial to recovery.

Dr.

Steward says another very important factor is breakover, or the point in the stride at which the foot “breaks over,” or rolls forward.

If the hoof breaks over at a point toward the front of the foot, more force is applied to the deep digital flexor tendon at the back of the leg – which worsens the laminitic horse’s pain.

But if the breakover point is moved back, toward the middle of the hoof so that the hoof rolls easily over in the stride, the horse is much more comfortable. The screws that attach the wooden shoes do not penetrate any sensitive structures, and many of the screws actually just rest against the hoof wall and function as strut supports to improve the stability of the shoe. 4 www.americashorsedaily.com Treating Chronic Laminitis AFTER “TOOTER” KISER SAW THE SUCCESS HE’D HAD WITH Pepperoani Wolf, he came up with another challenge for Dr.

Micheal Steward: an aged bay gelding who had been dealing with a chronic case of laminitis for more than a decade.

Sonoitas Morning Dew came into the Kisers’ life as a 2year-old, when he was purchased to help Tooter work a feed yard in Kansas.

Tooter nicknamed him “Marley,” after the man he bought him from.

Marley, who’s now 25, became laminitic about 10 years ago, and Tooter tried all the remedies he knew of.

Vets told him there wasn’t much to be done. “We didn’t want to put him down, but I had to quit riding him,” Tooter says. “He’s like one of the family.

We just babied him around, and sometimes, all he wanted to do was lay around. “We had talked about, probably a dozen times, just callThe rockered toe of the wooden shoe allows for breakover to be moved back as much as an inch and a half. “You’re reducing the forces,” Dr.

Steward says.

Another feature of the wooden shoe is that it can be easily hollowed out in the toe, to accommodate horses whose toes are so sore they can’t stand to bear any weight there.

When farriers hollow out the toe – or apply little or no impression material there – the horse’s weight is transferred to the healthier parts of the hoof, toward the back of the foot.

All told, the system supports the hoof and helps it heal.

The screwed-on shoe is shored up by being wrapped with fiberglass casting material. “That coffin bone, you want to treat it like a broken bone,” Dr.

Steward says. “That thing’s in there wiggling and working, and you want to stabilize it.” The casting material also covers the screws and helps prevent the shoe from being torn off.

And in all things, the horse’s opinion is respected. “I listen to the horse on most everything we do,” Dr.

Steward says.

Horses are not sedated as he works on them, because he wants their feedback. “As we’re shoeing these critically ill patients, we want them ing a vet and putting him down and getting him out of his misery, but then he would get a little bit better,” Tooter says.

By the time the Kisers learned of Dr.

Steward, Marley had lost about a third of the coffin bone in his front feet to deterioration and was lying down almost all the time, Dr.

Steward says.

Today, Marley still wears wooden shoes, and he isn’t ridden, but “he gets around good,” Tooter says. “He’s still in the family.” Dr.

Steward was happy with the progress: “He went from 99 percent of the time down to 90 percent of the time on his feet with the first shoeing,” he says.

And it just left Tooter with one regret. “I wish I would’ve known (about the Dr.

Steward and the wooden shoes) when my bay horse first got (laminitis).

He could’ve fixed him, too,” before the bones became irreversibly damaged.

To tell us ‘Did I do good, or did I do bad?’ along the way.” When the horse walks off after the initial shoeing – before the casting material is applied – he should show a noticeable improvement.

If he doesn’t, Dr.

Steward and the farrier will rethink the application of the shoes and make some adjustments.

The success of the shoes is spreading.

Dr.

Stephen O’Grady of Northern Virginia Equine uses a modified version of the Steward clog, and he says “it’s the greatest thing we’ve used in years. (Dr.

Steward) has started a great thing.” Dr.

O’Grady presented a paper on the shoes, co-authored with Dr.

Steward, at the 2007 American Association of Equine Practitioners convention in December.

It’s Dr.

Steward’s hope that word spreads of the wooden shoes, which he doesn’t hold a patent on or make any commissions off the commercial sales. “I have to pay the same price as everybody else does when I buy them” from a supplier, he says. “But this is from the bottom of my heart: I’ll do anything to alleviate the suffering that these guys have to go through.” Dr.

Micheal Steward practices out of the Shawnee Animal Hospital in Shawnee, Oklahoma. Discomfort radiated from this laminitic mare’s body language as she was led up for a wooden-shoe demonstration led by Dr.

Micheal Steward. After her shoes were applied (See bottom photo, previous page, for a close-up look at her shoeing job), her comfort level was greatly increased, and she walked much more easily, even when she went on concrete.

She had been given no drugs. www.americashorsedaily.com 5 www.americashorsedaily.com www.americashorsedaily.com 6

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