NO hoof-no horse: it’s an old adage but no less true for it. I learnt at vet school, but forgot and learnt again to my cost that the first place (and the second place!) to look for the cause of lameness is the foot. There is a broad principle that equine lameness (an abnormal stance or gait) is caused by pain, nerve damage or impaired mechanical function (sometimes a combination of all three).

In the hoof pain is invariably the main cause. So search for the source and treat it locally, but also be prepared to treat any more generalised problems (such as obesity). From bruising to infection (surface like thrush, burrowed-in as in abscess) to ever deeper trauma still (hoof penetrations); from laminitis to tumours (keratoma) to pedal bone disease – these all occur in the hoof. They all cause lameness that really matters to the horse and to you – lost days riding, lost days racing.

The hoof forms a natural hard barrier between the horse and the ground surface, but it is not infallible. It bruises, it cracks and breaks and it can be made vulnerable by excess moisture. Hooves are now weaker with poorer shape in the thoroughbred than in native pony breeds – we select breeding stock on track performance not hoof conformation after all. Shouldn’t we consider the foot more? Farrier work

Even the fully healthy hoof can be penetrated at its edge by a misplaced farrier’s nail (acutely painful but rarely to long term effect) or a sharp object left lying about (with disastrous consequences if the penetration is into the more central frog region).

A skilled farrier is a delight to watch and a treasure to keep – as careful regular trimming and shoeing are key to hoof health.

Adjusting the trim and balance of the more elastic foal hoof is an invaluable way to adjust the angulation of the growing limb above it. And remember that the adult donkey has a naturally more elastic hoof capsule than the horse – if left untrimmed it grows and curls rather than cracks and breaks.

Laminitis – a disease with a name ending with ‘itis’ is one of inflammation, right? Like arthritis and tendonitis. But there’s always an exception to the rule. Laminitis is a disease of the laminae – the leaves of sensitive tissue binding the hard hoof to the hard pedal bone beneath – but it is characterised primarily by poor blood supply not inflammation.

Laminitis can be caused solely by pounding on hard roads but it is often precipitated by a more generalised toxic condition – grain overload, systemic infection, retained placenta. And so every effort must be made to identify any underlying cause and treat it at source – reducing weight and the carbohydrate load in obese horses, treating infection and the source of toxins etc. But of course we also treat the local signs of disease – the pain, the crippling disability, the reluctance to move (especially on hard ground) and to feed normally.

We use drugs that improve blood circulation in the laminae of the hoof; we certainly relieve pain (with drugs and mechanical adjustments to how the hoof bears weight); and we nurse the patient – as caring for the whole horse leads to a better outcome, for all.

And disease also occurs that involves the structures found more at the heart of the hoof – the pedal and navicular bones, the coffin joint, the deep digital flexor tendon – more commonly in the front than the hind limb.

Pedal osteitis and navicular disease are primarily characterised by degeneration of the normal bony tissues, often with a reduction in blood supply and a loss of function. These horses are typically mature if not older and long term management rather than cure is the more realistic aim here.

Good practice

Trauma and inflammation of the synovial structures (joint and bursa) and the tendon within the hoof capsule are sadly quite common too. It may be possible to inject restorative drugs locally into these areas but unless the horse changes jobs these are sadly often a recurring problem. Such conditions are especially debilitating in sports horses that jump or otherwise land heavily on their front feet. X-ray eyes are necessary to look beneath the hoof capsule and assess the health of these deeper structures.

Good foot balance, proper pain relief, enhanced blood flow to vital tissues and a good surface underfoot may keep this horse going. But if not manageable, these conditions are often the cause of retirement or rightly stimulate a conversation around euthanasia. The horse’s welfare is paramount, our responsibility as owners/keepers is to safeguard it.

Prevention is always better than cure. So keep the foot trimmed (every 6 to 8 weeks on average) and well balanced – whether shod or not. Keep the horse well-trimmed too – obesity means those neat little hooves carry too much load on a small surface area.

Attend to your horse’s diet – a carbohydrate load matched to his exercise levels; a diet naturally rich in vitamins and minerals. Hoof health is determined by what the horse eats which is why good nutrition is so important.

Consider the surface you are asking him to work, gallop and jump on – its firmness and its consistency. Don’t leave shards of glass or old screws lying about.

And select breeding stock carefully – don’t breed from a mare retired young because you can’t keep her sound; don’t select a sire with a history of navicular disease! Why stoke up more problems for the future?