The de-rotational trim: Trimming a laminitis foot with rotation of the coffin bone is best accomplished with the aid of radiographs. To be precise when trimming, I need a Lateral and A/P (anterior to posterior) view.
It is very important not to remove any sole from the frog forward; the goal is to relieve all sole pressure over the anterior border of the coffin bone. This aids in restoring compromised circulation and new sole growth. I determine where to begin the trim anteriorly from the lateral x-ray. Measure the sole thickness from back to front; determine the most anterior point where the sole depth is 20mm’s and start the trim at this point and work toward the heels, trimming the heels as low as possible. I take another lateral x-ray to be certain the trimmed portion of the foot has anatomically aligned with the solar border of the coffin bone and make any necessary adjustments.
Note: In Some cases of laminitis with severe rotation of the coffin bone I cannot trim the heels low enough to correctly align the coffin bone with the sole. These cases require the use a reverse wedge between the foot and shoe for alignment.
Fitting the Rocker Rail Horseshoe
The shoe is placed on the trimmed foot aligning the midpoint of the shoe (start of break-over) 1” behind the true point of the frog or to be more accurate, a distance determined from the lateral x-ray, a perpendicular line from the center of articulation of the coffin joint to the sole. The shoe is adjusted for medial /lateral symmetry and a SHARPIE marker is used to trace the hoof outline to the shoe.
- The marked shoe is then ground, sanded, or band-sawed to the mark for a perfect fit.
Attaching the Rocker Rail Horse shoe to the foot
The shoe be attached to the hoof by 3 methods depending on the individual case and integrity of the hoof wall:
- If the hoof wall has good integrity, I will simply drill nail holes in the shoe and attach with horseshoe nails.
- The shoe can be attached with acrylic adhesive mixed with shredded fiberglass and fiberglass tape. I prefer Equilox or Grand Circuits Pro-fast acrylic.
- I now use plastic or aluminum side clips that screw onto the shoe, the clips are perforated. The shoe is held in place by an assistant and acrylic adhesive is injected into the hole in the clips until it protrudes from the clip. The shoe is held in place until the acrylic sets (approx…2 minutes) and is then returned to the ground.
- When I have everything organized for gluing, I mix dental impression material and pack the sole of the foot from the frog back, set the shoe and glue it.
- Note: Don’t use too much impression material; keep the heel of the shoe tight to the trimmed heels while the acrylic is setting.
Fitting Wedges to relieve tension the Deep Digital Flexor tendon
- Let the horse stand on a hard flat surface and find his comfort zone by rocking up on his toe to relieve any tension on his tendon.
- Measure the distance from the ground surface to bottom of the shoes rail and apply a plastic wedge the same thickness as the measurement.
- Don’t forget to insert the aluminum cover plate over the treatment area before screwing on the wedge.
- If the horse in still uncomfortable in 24 hrs. remove the wedge and re-adjust the distance from bottom of the show at the heel to the ground.
Monitor the patient
- Monitor comfort level, pain, heat in the foot and coronary band, digital pulses, appetite and general attitude.
- I reset the shoes every 4 -5 weeks and make adjustments as needed.
Other indications for using the Rocker Rail Horseshoe
- Deep Digital Tendinitis while tendon is healing
- Ringbone: in these cases I rocker the back of the shoe
- Pathology in the palmer heel area of the foot
- Coffin joint arthritis
- To promote heel growth
- Certain hoof abscesses: the shoe acts as a hospital plate to protect the sole, relieves pressure over the toe and eases break-over
- As a diagnostic aid: Duct tapering the shoe on at trimmed foot allows the horse to tell me if he needs heel elevation and if so, how much
- Horses with ankylosed (fused) fetlock, pastern, or coffin joints: Grind down the rails in the heel area to give a full rocker motion
If you don’t have heel wedges or want to customize your own, here is one way to do it using acrylics