By
Ruth-Anne Richter BSc (Hon), DVM, MS
Equine sports medicine has become a burgeoning field
with many veterinary practitioners now spending more time focusing on this
area. The availability of more advanced and more portable imaging technology
has helped to elevate this field into a specialty. As this field evolves, it
has become apparent that a team approach is necessary in the maintenance of the
equine athlete. This team approach becomes doubly important when dealing with
performance-related injury. The ‘horse management team’ should include the
owner, +/- trainer, veterinarian and importantly, the farrier. To achieve the
desired outcome, and to function as a unit, there needs to be open and free
communication between the team members. Trying to co-coordinate schedules in a
timely manner can sometimes prove to be difficult; however, to best serve the horse
and to increase the probability of a positive result, a little effort by all
parties really does go a long way.
A number of performance-related injuries can be
helped with therapeutic shoeing to provide support and to distract negative
forces on the injured leg. However, this can become a common cause for frustration
and miscommunication when the veterinarian relies on the client to relay
prescription shoeing information to the farrier for a specified problem. This
sometimes leads to misinterpretation, the desired goal is not achieved, and the
horse does not improve. The owner then becomes discouraged and either changes
farriers or the veterinarian. To
reduce the potential for resentment, direct discussion of the case between the
veterinarian and the farrier not only helps to achieve the desired outcome, but
also often reveals a lot of valuable information to both parties that may help
in diagnosing and rehabilitating the horse. The ability to email digital radiographs has proven to be
extremely useful to the farrier when a specific shoeing request has been made by
the veterinarian, and even for routine cases.
Our practice (Surgi-Care Center for Horses), has
adopted the philosophy of ‘giving back’ to the referring veterinarian and has,
for a number of years, presented quarterly Grand Rounds at which cases and timely
topics are shared that may benefit their practices. In 2008, Surgi-Care held
the first Grand Rounds meeting that also included farriers with whom they (the
referring DVMs) have worked on foot-related problems. This event proved to be
successful, and produced positive feedback as well as some constructive
criticism. Following this, and taking some of the comments into account,
another event the following year was put on for the local farriers
specifically, with veterinarians invited to attend if they were interested. This
particular event involved the use of the ONTRACK gait analysis software and
followed one horse through a series of trimming and shoeing cycles. The event
was well attended by both farriers and equine veterinarians. A lot was learned
from the project horse, and the use of the gait analysis software highlighted
its problems, which gave the attendees a good appreciation for what actually
happens to the foot (and leg) as it goes through the arc of flight and the
stance phase. Using the software program, a second horse was evaluated when
shod with different shoe types. It was this horse that opened our eyes to a
number of things including the fact that one farrier’s interpretation of a shoeing
“prescription” might not be the same as another’s. The “shoe”, while it was
descriptively ‘correct’, was an exaggerated version of a ‘prescription’ shoe. It markedly changed the horse’s way of
going when viewed in slow motion, and not in a good way. This particular horse, and that one
shoeing interpretation emphasized the need for more direct communication
between the veterinarian and the farrier.
Veterinarians and farriers come from diverse
backgrounds, not only in education, but also with levels of experience. This
brings diversity in opinions; some based on experience, some on preconception,
some from the literature and some from what has been taught in school. Many
more recent graduate veterinarians have not had extensive equine experience,
and most receive little exposure to equine podiatry at veterinary school. This
leaves them making requests of a farrier who may have years of horse experience
when they (the DVM) may not understand some of the concepts of trimming and
shoeing, the physiology or function of the feet, nor have they had this exposure
gained from many years of practice.
Importantly, and what came out of the 2009 farrier meeting was that we
don’t all speak the same language when it comes to feet and shoeing.
How do we rectify some of these problems? These concerns spawned the idea of having
an informal evening at our practice where local farriers and veterinarians can
come to spend time every month with an experienced farrier(s). The first
evening was lead entirely by the farrier; the basics were covered for the
veterinarians in the group as well as some apprentice and younger farriers that
were attending. The most important of which was describing balance, and the
correct placement of a shoe. While the term balance is open to interpretation,
the basis of a balanced and well-trimmed foot prior to shoe placement cannot be
disputed and was agreed upon by all the farriers attending. This concept was
presented to the veterinarians in a way that was easy to understand, and was
done as the horse was trimmed so that it could be seen first hand. These
evening events have been designed to provide a friendly and open forum for an
exchange of ideas between the veterinarian and the farrier. Formats range from
having wet labs, demonstrations, lectures and informal discussions.
Participating farriers and veterinarians alike are also encouraged to present
cases that they have been working on, or ask questions about a case or cases
that pose particular problems to them. These evenings also expose both the veterinarian and the
farrier to alternative techniques in an effort to create a common ground in
language, techniques and understanding. But, most importantly, they have
promoted the development of mutual respect.
The use of the ONTRACK software at our practice has
proven to be a tool that does help to “open” that door to discussion of a
particular case with the farrier as well as the horse owner +/- trainer. Using
a team approach and using a tool such as this can only benefit the horse in the
long run. The beauty of this equipment is that the farrier can access the study
off site if he or she is unable to be at the clinic at the same time the horse
is examined.
Great opportunities to foster the
veterinarian-farrier relationship come from larger meetings when professionals
from all over the country can exchange ideas and discuss topics. Conferences
such as those hosted by the Florida Association of Equine Practitioners in
Orlando are invaluable at keeping the lines of communication open between
veterinarians and farriers. These expose both parties to new techniques,
provide updated information on timely topics, as well as providing a good
review of the basics. At the most recent symposium in 2009, a recurring theme
amongst the speakers was the importance of communication between the
veterinarian and the farrier.
As with anything, change often takes small steps; we
can affect change by starting small and building upon solid groundwork. While
all veterinarians and farriers alike do not have the perfect answer to a
specific problem, hearing each other out may reveal that while a slightly
different language is being spoken, the goal is going to be the same - to do
the best thing for the horse. Supporting clinical findings and recommendations with images
such as radiographs and ultrasound, or video of the horse, go a long way in
helping the farrier to achieve the desired shoeing result. The key to a
successful ‘horse management team’ that ultimately benefits the horse is to
develop an open working relationship that is founded on mutual respect and
trust.
Surgi-Care Center for Horses hosts their
Farrier-Veterinarian Happy Hour every third Thursday of the month at 6 pm.
For more
information about the farrier-veterinarian events, please visit the Surgi-Care
website at www.Surgi-CareCenter.com
or email Dr. Richter at rrichter@surgi-carecenter.com.
This article was originally published in Horse & Pony magazine and is reprinted with their permission.