MANAGE COMPLICATIONS OF SOLE LOADING

The reduction of the load from the wall means that the load on the sole area must be increased. This increased sole load can lead to complications related to sole overload in the form of sole bruises, seroma and abscesses. These complications are to be expected and prepared for when using various sole support products and techniques. These complications are painful to the horse and can be demanding to deal with. However, once it is known how to avoid and manage the complications of sole loading, the user of sole support will come to realize that complications don't occur very often and in most cases are not difficult to manage. Given the benefits of unloading the wall, sole loading is well worth the risk and any complication should be considered as an inconvenience rather than a disaster.

METHODS TO AVOID COMPLICATIONS

  1. Practice moderation. Use as much sole load as necessary, but when in doubt, use a shared load. The sole can handle a high load for a short time but is able to endure a medium load indefinitely.
  2. Use a team approach including the owner, the farrier, and the vet. For many mild cases the vet may be in the background. Together, determine the best level of sole support. Each member must do his/her part to manage the horse's health, environment and complications. Any one member of the team must be prepared to take initiative as necessary.
  3. Be pro-active regarding ailments of the hoof wall and the laminae. Start treatment early so there is less damage to repair. If the wall is unloaded soon enough it is possible to prevent laminae damage. It takes 10 to l2 months to grow a new hoof so start now.
  4. Proceed with extreme caution when using sole support to treat acute laminitis. Due to the all inclusive traumatic situation the sole is also inflamed. It's ability to carry a load during the acute stage of laminitis is minimal. A shared load between the wall and the sole is all that is possible. It may be useful to apply sole support by temporary means, as in taping, to enable inspection and adjustment. Prevent the expected serum fluid pressure from building up in the laminae under the wall by providing horizontal gouges through the wall thickness in the toe area to enable positive drainage. Poultices over these gouges may also be necessary.
  5. Place the horse on a pro-active health management program to establish and maintain good health. This includes such things as nutrition, vaccinations, deworming, exercise and shelter. Provide for the horse's mental health with happy surroundings, open spaces and compatible company.
  6. Promote the development of` a dry, dense, thick, tough sole. Do not trim away the sole, bars, and frog. Allow them to fill the sole cavity. Provide soft, dry, non-abrasive ground conditions. Choose soil and bedding types to keep the hoof dry. Consider using a sole support system with a protective pad to prevent abrasion on cases where the sole develops slowly.
  7. Cushion and distribute the load over all surfaces of the sole cavity using soft conforming material that will mold to the individual hoof. Natural choices are sand, loose soil, sawdust, mud pack or snowballs or a commercial sole support system may be used.
  8. Trim the hoof to align the solar surface of the coffin bone to be parallel with the ground. This will distribute the load over the entire ground surface of P3 and avoid deforming the tip of P3.
  9. Minimize the horse's body weight so there is less load on the feet. Do not starve the horse. Provide a balanced ration to promote health and hoof growth.
  10. Follow the supplier's installation instructions and recommendations.
  11. Use a new insole cushion with each re-setting.
  12. The sole, within a 3/4" radius about the point of the frog, is a common place for tenderness. For insurance, it is effective to place some soft hoof packing in this area and along the collateral sulci of the frog thus reducing the pressure in these areas.
  13. The owner should observe the horse daily. Complications can be triggered anytime by negative changes in the environment and health. The horse may feel real good one day and over do it while running and playing. The next day the sole may be sore and inflamed.
  14. Respond quickly to a problem. The condition can deteriorate with time, increasing the difficulty to gain control. The horse will suffer needless pain.
  15. Anti-inflammatory drugs are highly effective to combat early, and minor symptoms of sole tenderness and inflammation. Often that is all that is needed to gain control. During the acute stage of laminitis, anti-inflammatory drugs are necessary to help combat the rampant inflammation.
  16. On difficult cases, the use of "alternative" therapies, techniques and products such as magnets, acupuncture, massage, ultrasound, and ointments may provide that extra advantage. Anything to stimulate circulation and enhance healing is useful.
  17. Keep a log on each case. Include a description of the work done, products used, toe lengths, angles, and dates. Record observations of the horse's health and progress and even the weather. Before and after photos are good.

METHODS TO FIX COMPLICATIONS OF SOLE LOADING

  1. When complications do arise, intervene early to stop the progression. The more severe the complication, the more difficult it is to gain control.
  2. Treat initial symptoms of tenderness with anti-inflammatories.
  3. If tenderness is not improved in 2 to 3 days: determine the source. Observe the horse travel and do squeeze tests with hoof testers. Suspected areas on the sole are at the tip of P3, at the point of the frog, and the bulbs of the heels. Check out the wall areas. It could be a close nail or for laminitis cases there could be serum fluid pressure under the wall in the toe area.
  4. If the problem appears to involve the laminae: rasp a gouge through the wall thickness in the area of concern. Drainage may occur on it's own or a poultice may be more efficient.
  5. If the problem involves the sole, pull off the sole support system now. Do this when the horse is lame but will still bear weight. The simple removal of sole pressure is important to gain control. Protect the sole from direct pressure by using a boot, a thick pad or a hospital plate. Continue anti-inflammatory therapy.
  6. If there is no improvement after 2 to 3 days, suspect a pocket of seroma under the sole. The problem should, by now, be obvious to find with a squeeze test. Trim the sole thin to thumb pressure in that area. Apply a poultice on a 24 hour basis. A poultice product called ANIMALINTEX has proven very successful.
  7. If the horse is unwilling to put weight on that foot, suspect an abscess has developed. Do not leave an abscess untreated for many days. The horse suffers much pain and it is not far for the infection to move into the coffin bone, leading to irreversible bone damage. A poultice may pull the abscess out but it is probably more efficient to open up the pocket to enable drainage and medication.
  8. When treating sole abscesses, protect that area of the sole from direct pressure. Use a thick pad taped in place, a medical boot, or a hospital plate to enable daily medication. Do not cover with a permanent shoe and pad until the abscess is cleared up with no drainage and the horse will bear weight on that foot. This will take about 7 days. Then a permanent shoe and pad can be installed with a medicated packing such as "sugardine". Allow up to 6 weeks with little or no sole load to recondition the sole.

Do not give up on the original goals of unloading the wall. Consider this as a temporary set back. The complications may have been triggered by a manageable situation. Re-install the original support system. Consider using a lower level of sole loading. Make adjustments to the insole to avoid specific pressure points.

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