A role of therapeutic shoe in management of chronic laminitis & navicular disease: A review of 37 cases

Abstract

Total thirty seven (n=37) horses with history of lameness presented at department of surgery and radiology. A total of 21 horses were diagnosed as chronic laminitis with help of radiographic evidence of mild to severe rotation of pedal bone (P3), while navicular disease was diagnosed in 16 horses. Bilateral P3 rotation was observed in nine horses whereas twelve horses showed unilateral P3 rotation in forelimb. Ten equines with history of lameness for thirty to ninety days were treated with therapeutic shoeing, antibiotic, NSAIDs, antihistaminic, nervine tonic, vasodilator and nutritional hoof supplements and eleven equines with history of lameness for more than one year treated with therapeutic shoeing and nutritional hoof supplements. Corrective hoof trimming was applied in all cases to restore P3 rotation wherein therapeutic heart bar shoe (n=15), reverse shoe (n=2) and wooden block (n=4) were applied based on defective hoof walls and insufficient space to apply nails. Periodic corrective hoof trimming along with therapeutic shoe application was done till P3 restored normally. Average time required for restoration is 1-1.5 years, however 4 horses had reoccurrence, due to early removal of therapeutic shoe after 4-6 months of recovered from clinical signs. Recovery was recorded 70% in early presented cases (30-90 days), while only 45.45% recovery was recorded in more than year of chronic laminitis. Horses presented with navicular disease (n=16) in forelimb showed tip toe gait in 4 cases, whereas abnormal deviated foot placement in affected limb with complete weight bearing in 12 cases. X-ray examination showed degenerative changes of navicular bone and flexor tendon. Medicinal management with antibiotic, NSAID and nutritional supplements along with high heel shoe (therapeutic shoe) applied in affected limb to provide rest to the affected part of flexor tendon for 1-2 months. Recovery from navicular disease was observed in 81.25% cases.