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  • Therapeutic Shoes for Hyperextension Foals

    Written March 2014 by R.F. (Ric) Redden, DVM I devised a new concept a few years ago that sorts out foals with weak flexors. This foal with weak flexors (left) was treated with the bungee concept described below. The photo on the right was taken one week after application of the bungee and therapeutic shoe. Most foals will only be weak in one limb. However, if the case is bilateral, a shoe on each foot is indicated. Add a piece of 3mm (1/8") aluminum to the bottom of the Dalric heel extension shoe. Use a clip up front to take load off the rivets and add a leather or nylon loop in the extended area. Back the heel up to the widest part of the frog before gluing the Dalric shoe on with Equilox or Vettec SuperFast. Bandage the leg using 50" of good, firm cotton wrap.  Select a bungee that will be compatible with the size of the foal.  Remove the hooks from the end of the bungee and run it through the loop of the shoe and up the back of the leg.  Pick the hind leg up by the hock when hind feet are involved. This will naturally flex the joint.  Then tape the end of the bungee to the upper portion of the bandage using 4" Elastikon. You can also use a single bungee as shown above, or a piece of rubber inner tube as your elastic support. Flexing the fetlock and coffin joint while taping the bungee in place offers just enough tension when you set them down. This creates a natural, elastic tendon response that offers good healing time for the exceptionally long flexor muscle. Where casts seem to weaken the muscle, the bungee appears to offer just enough support to allow it to strengthen. Normally most foals only wear the bungees for a few days with mild to moderate cases and the shoes for a couple of weeks. Those with long pasterns and weak flexors may require more time. Even very difficult cases have responded very well using this concept. Give it a good effort, and if you have any questions get back to me as I will be eager to help you and see your results.

  • Toe Cracks

    2009 In-Depth Equine Podiatry Symposium Notes Written and presented January 2009 by R.F. (Ric) Redden, DVM Toe Cracks Full thickness toe cracks are frequently found in brood stock and a few sport horses. The cracks are the result of mechanical failure. Normally the anterior/posterior balance is off the scale, and the horse has a long toe, underrun heel and dropped soles. A club foot can develop an abscess in worn areas of the toe that have been invaded by bacteria, which invariably breaks at the coronary band, resulting in a permanent scar. The wall fractures due to internal bending stress and the lack of anterior hoof capsule integrity. As the deep digital flexor (DDF) transfers load to the bone, the bone pulls on the laminae that were once secured to a very strong but now weakened wall, and the system fails. The laminae pull causes closing of the crack when the foot is loaded. The sole sags as the bone travels away from the normal arch of the wall, to seek ground support as the wall can no longer maintain the natural internal balance. Many people are surprised that center toe cracks do not open when loaded, as the cow's foot would. It closes and closes very tightly, folding the sensitive laminae in on itself, perpetrating a permanent scar that becomes thicker and more invasive every time an abscess breaks at the coronary band. The sensitive tissue at the top of the crack becomes a painful area. A thin sole and traumatized apex also contribute to the painful condition. Treatment The best option is an example of physics 101: Stop the movement of the two wall sections on each side of the crack and it will heal. There are two basic ways to stabilize the wall with rigid implantation. Pull the crack together and lace or band, or hold it apart and lace and band. I prefer the latter as this is the more natural anatomical position of each side of the crack, and it prevents the inevitable scar that forms when the crack is pulled together. The DDF influence is the major force influencing movement in the wall, laminae and bone. Therefore the major goal regardless of bands, stitches and so forth is to significantly reduce DDF tension, as it continues to be a key player even when the wall is made less flexible with the band. This can be accomplished by creating a 20 degree palmar angle (PA). Using only wedges to produce the 20 degree PA will reduce DDF tension, but also crush the heel very quickly. Wedges and high breakover mechanics will accomplish the same with less heel crush. Add contact sole support (no positive pressure) and sole sag is significantly diminished. Add positive frog and buttress support to help open the contracted heels and you have a highly functional shoe. Once shod in this fashion, the breakover will be directly beneath the center of articulation. The toe is only backed up at the ground surface. The dish will grow off as new horn grows in line with the face of PIII and the new horn wall will remain intact as long as the DDF tension is adequately reduced. As a rule, I no longer band toe cracks unless the described rocker action shoe that provides a 15-18 degree PA fails to promote strong horn growth without evidence of the crack. Very extensive toe cracks that occur in thin wall, poor quality feet may require a metal band to hold the crack apart. The goal for the shoeing concept is to prevent the crack from being pulled inward, closing the gap. If a band is required, I use a 10 gauge strip cut in the shape of the curvature of the wall. Drill three to four 3/16 inch holes in the plate on either side of the crack. Pick the foot up (unload the DDF) and hot seat the band onto the foot. Burn it in good, then place the screws in while the foot is totally unloaded. Four 1/2 inch number 8 pan head screws on either side of the crack work well. Dr. Redden's Toe Crack Treatment Loading the foot or closing the crack can also aid healing, but invariably creates a thicker scar as the laminae is folded tightly on itself. Quarter clips look great on paper but do nothing to stabilize the crack, as it does not open when loaded. They do, however, help hold the shoe on. The high score rocker rail shoe accelerates sole growth and subsequently toe growth. This shoe is often all that is needed to prevent new horn from being torn along the old scar. Chronic cracks that have caused several abscesses at the heels and coronary band will show signs of each blow out. Normally I will band these as well, to assure optimum mechanics. Radiographs used as an initial planning tool and for subsequent resets are an invaluable resource for the vet/farrier team. Prognosis is good for all toe cracks regardless of chronicity or severity.

  • Shoeing the Laminitic Horse

    SHOEING THE LAMINITIC HORSE R. F. Redden, D.V.M. P.O. Box 507 Versailles, Kentucky 40383 Reprinted with permission from the American Association of Equine Practitioners. Original printed in the 1997 AAEP convention proceedings. INTRODUCTION: Laminitis is a complex disease syndrome often seen subsequent to a variety of primary diseases. The prognosis ranges from good to grave and is dependent on the degree of damage to the vital supporting structures and mechanical stability of forces perpetuating displacement of PIII. This syndrome demands the expertise of professional farriers, as well as veterinarians as therapeutic shoeing plays a major role in the successful treatment of the majority of laminitic horses. Treatment length can vary from a few weeks to years, requiring commitment and dedication for seemingly endless maintenance regimes. Establishing an effective protocol to treat laminitis will improve the treatment regime and help farriers and veterinarians gain good experience. Success rates vary from horse to horse and are greatly influenced by the ability of veterinarians and farriers to assess the damage, read the particular needs and treat the syndrome with a progressive attitude, built on knowledge of the subject and professional camaraderie. INITIAL EXAMINATION: Obtain a good history and carry out a thorough physical examination to include radiographs on the first visit. Laminitis often follows other primary disease maladies, such as colitis, pneumonia, pleuritis, retained placenta, dystocia, potomac fever, blister beetle ingestion, protracted diarrhea, salmonella, selenium toxicity, fescue poisoning, injudicious use of corticosteroids, stress, contra limb acute lameness and others. Be alert to the hoof characteristics that vary from normal, both grossly, as well as radiographically. Being focused on details will help rule out other acute foot problems that closely mimic the signs of laminitis. TAKING RADIOGRAPHS: A methodical, disciplined technique assures consistent, good quality, pure lateral projection. Soft detail images reveal anterior-posterior balance and the relationship of PIII to horn and horn to load. These parameters must be clearly demonstrable as they become an essential guideline for pathological shoeing. Most professional farriers have become quite proficient reading good quality, soft tissue detail film, as it relates to their task of re-establishing a meaningful equilibrium. Films taken before and after each shoeing session tremendously increase the knowledge bank and efficiency of farrier and veterinarian and consequently improves the prognosis. Practice tips that have improved my technique: Pure lateral, primary beam strikes the foot in a horizontal plane, just above the ground surface. Zero film, subject distance. Opaque marker, detailing the face of the horn wall, as well as ground surface. Positioning block, 3 x 5 x 7, with a wire running through the long axis is compatible with most all x-ray machines. RADIOGRAPHIC INTERPRETATION: The distance from the face of PIII to the outer horn wall is referred to as horn-lamellar space. Become familiar with normal parameters. Most light breeds will measure 15 to 17 mm., heavy, older broodmares, stallions and most Standardbreds will measure 20 to 22 mm. Base line views become most valuable as they establish a starting point. The depth of sole and cup directly beneath the apex of PIII is quite easy to monitor with pure lateral films. Extensor process relationship to coronary band varies from horse to horse and foot to foot. Rely on the base line film to assess starting location. CLASSIFY THE DAMAGE: Rotation is significant with acute cases but is very misleading with chronic cases due to abnormal horn growth. Classify the damage before establishing protocol. A scale of 1 to 1000 offers a realistic classification system for all laminitic cases. Classify each horse at onset based on history, physical and radiographic examination. Design therapy to reverse forces at play and meet the needs of the patient. This system enables me to treat not only each case but each foot as a separate entity and to better explain the seriousness of the syndrome to my clients. TREATMENT: Acute laminitis should be considered an emergency because the window of maximum response closes rapidly. Sound mechanical therapy applied in a timely fashion can be very effective against secondary compressive damage seen subsequent to displacement of PIII. Preventing and or minimizing displacement in the face of this syndrome can alter the course of the disease. THERAPEUTIC: Treat the whole animal, address primary problems when known. Use anti-inflammatories with discretion. Phenybutazone remains the drug of choice. Many others have good to excellent anti-inflammatory properties and can be useful. Nitroglycerin creams and patches have been advocated recently and may have potential. Caution; use with discretion and be judicious. Teach proper use and handling of these products as they have precautions and contra indications. Apply emergency aid designed to significantly reduce deep flexor pull, Modified Ultimates, Advance Equinea. The clinical response will aid in assessing soft tissue damage. Before applying any therapeutic device become familiar with the specific conformation characteristics of each foot. Learn to read positioning of PIII within the capsule with the aid of radiographs as well as without. Three basic principles are very effective against deep flexor pull as it opposes diseased laminae: Raising the heel 10 to 18 degrees significantly reduces pull on the tendon. Placing breakover directly beneath the apex of PIII, (phalangeal point of rotation), eliminates opposing lever arm and significantly reduces lamellar stress and sub solar compressive forces. Utilizing sole, frog, bars and sulci as uniformly loaded support zones. Success with mechanics lies in applying a device that meets the specific needs of each foot. Years of experience are required of veterinarians and farriers to properly read feet. A common error is to lump all feet and all cases in a basic category. This philosophy fails to produce favorable results the majority of the time. Very basic guidelines to help load the heel and unload the apex and laminae: When rotation is present the hoof capsule must be trimmed in a fashion that re-aligns PIII with the natural load surface, otherwise the apex of PIII continues to compress sole corium, further compromising circulation. Trim the heel parallel to the freshly trimmed frog starting at a point just behind the apex of the frog. Rasp the heel down at the base until good, sound horn tubules are evident at the widest point of the frog. Use discretion as over trimming can produce harmful results. The horn capsule forward of the apex of the frog will not make contact with the shoe, therefore we are shoeing to the heel, not the toe. All nails must go behind the widest point of the hoof in order to secure the shoe to the heel. Re-alignment normally increases deep flexor pull depending on severity of displacement, hoof angle, heel angle and breakover placement. Raising the heel once properly derotated increases load to the heel area and reduces tendon pull influencing sole corium and lamellar perfusion. Leave all the sole and foot mass possible as it is natural protection and desperately needed. Design the shoe so breakover is 3/4 of an inch forward of the true apex of the frog. Note; many times the frog will lay on top of the sole giving false impression of the true location. Trim the toe at a 45 degree angle with the ground surface to avoid breakover contact. Stay well forward of the natural sole. Resilient custom fit arch support offers a broad spectrum, evenly distributed support surface that reduces load on the diseased laminae, Advance Cushion Supportb . Strict stall rest throughout the recovery period reduces unwarranted stress on the healing laminae. Note; recovery period is dependent on damage. Cases with significant rotation and/or sinking must re-establish lamellar integrity or relatively normal horn growth pattern and a dense sole to reach optimum recovery, six months to one year is a normal recovery period. UNFAVORABLE TREATMENT RESPONSE: When faced with an unfavorable response take lateral radiographs with the shoes on. Routinely taking films following every therapeutic shoeing and focusing on small details improves the end result. Check for proper derotation, mass of heel, sole impingement, progressive displacement (rotation, sinking and lamellar thickening). Keeping in mind the normal, evaluate the coronary band and look for sensitivity, discoloration, moisture and abscessation. Take dorsal-ventral views, look for pathological solar fractures. A venogram of the digit is a helpful aid for determining circulatory damage1 & 2. Classic sinkers have a stark loss of contrast throughout the laminae, sub solar area and within the semilunar canal. Subsequent venograms can aid in assessing progress with cases showing marginal loss of contrast on the initial examination. When faced with a poor or slow response following proper derotation and shoeing, consider deep flexor tenotomy as an adjunct to therapy. Deep flexor tenotomy should be considered a viable means of treating complicated laminitis. Proper derotation, shoeing and timely surgery can offer penetrated laminitic cases full recovery. THERAPEUTIC SHOEING: Therapeutic shoeing is indicated for laminitic cases that develop five degrees of rotation or greater and all with sinking of any degree. Progress in the field of pathological shoeing has accelerated over the past ten years due to combined efforts of farriers, veterinarians and research. Currently I prefer to fabricate a four point rail shoe, similar to the shoe by Gene Ovnicek3 . I have modified the concept to increase toe protection and applied a sole to ground resilient arch support. There are many ways to make this shoe. Farriers need to know the basic principles of construction and application. Breakover is at the widest point of the foot, just in front of the apex of the frog. Rails reduce tendon pull and enhance medial-lateral breakover. Arch support offers broad spectrum support to the sole, frog and bars. Properly placing the shoe on a derotated laminitic foot with adequate mass of heel can offer a more consistent measure of successfully treating laminitis. The shoe has offered a favorable response for sinkers and cases with penetration. This shoe and technique enhances the effects of deep flexor tenotomies. CONCLUSION: Ninety-four horses were shod with four point rail shoes with Advance Cushion Support. 75 had greater than ten degrees rotation. 38 had greater than 1 centimeter of sinking. 40 penetrated the sole. 38 treated with deep flexor tenotomy. RESULTS: Twenty-four returned to previous status.Of these twenty-four there were seven broodmares, one stallion, one Arab show horse, one Quarter Horse, one Paso Fino, five Walking Horses, one Saddlebred, one Morgan, one Show Hunter, two riding horses, three were penetrated; one Paso Fino, one Walking Horse and one Thoroughbred broodmare. Thirty-one returned to pasture soundness. Sixteen were penetrated, three Saddlebreds, one Arab, four Thoroughbreds, two Quarter Horses, one Standardbred, four Walking Horses and one Morgan. Nineteen were euthanized. Nine sinkers with penetration, one penetration and nine chronic cases with extensive osteomyelitis. Thirteen could not be located for follow-up. REFERENCES: 1. R. F. Redden, D.V.M. The Use of Venograms As A Diagnostic Tool. Bluegrass Laminitis Symposium, 1993. International Equine Podiatry Center, P.O. Box 507, Versailles, Kentucky 40383. 2. Chris Pollitt, DVM. Personal communication. University of Queensland, Saint Lucia, Queensland 4072, Australia. 3. Gene Ovnicek. 525 Half Moon Road, Columbia Falls, Montana 59912. FOOTNOTES: a. Modified Ultimates. Advance Equine, P.O. Box 54, Versailles, Kentucky 40383 b. Advance Cushion Support. Advance Equine, P.O. Box 54, Versailles, Kentucky 40383

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  • Redden DVM | Equine Podiatry Products & Courses | United States

    Ultimate Care for Your Horse Education Consultation See More Courses See More Events See More The Redden International Consultation Service Starting at $250 Learn More The Redden International Consultation Service Starting at $250 Learn More We have partnered with Vets First Choice and now offer an Online Pharmacy to bring you even more quality products. Browse the extensive selection and get free shipping on most orders over $49. NANRIC is Your Source for Dr. Redden's Equine Podiatry Products & Courses. Our product line includes NANRIC Ultimates, Advance Cushion Support, Aluminum Rail & Full Rocker Shoes and Inserts, Steel Full Rocker Shoes, Dalric Glue-On Shoes, Rocker Cuffs, Biotin 100, Specialty Tools and X-ray Items. Subscribe to NANRIC Join our newsletter to receive blog and video updates, special offers, and events notifications. Join Thanks for submitting! Please leave this field empty.

  • Courses | Redden DVM

    Courses Dr. Redden's Equine Podiatry Courses Dr. Redden's 5 Day Equine Podiatry Courses are held at his clinic (8235 McCowans Ferry Rd, Versailles, KY 40383) shown above. The week includes 3 days of lecture with some afternoon hands on sessions (Mon-Wed) followed by 2 full days of hands on work sessions (Thur-Fri). The courses provide an invaluable opportunity for vets and farriers to focus on podiatry and work together as a team. Below are our upcoming course dates. ​ 2021 Update Nancy and I are hoping that the world is making great strides against the COVID-19 pandemic and we are looking forward to offering our 5 day in-depth Equine Podiatry courses in 2021. We originally had dates selected for 2 classes but due to the demand we added Aug 16-20, 2021 to the roster. There will be several changes made in order to keep everyone as safe as possible. One of those changes will be the size of the class which will be limited to 12 students each. Masks will be worn, temps taken daily and proper social distancing will be required. The course itinerary will focus on the basic mechanical formula and case studies relevant to a variety of foot issues. Since there will only be 12 students, I will customize the course for those that are attending for the first time and for returning students that have attended a previous course or numerous courses. There will be interesting new concepts, practice tips, and challenging cases for all involved. Each course will cover identical basic information with some differences involving horses used in each course. Thank you for all your support and we look forward to seeing you soon! Course Dates Jul 26-30, 2021 ( ) Sold Out Aug 16-20, 2021 ( ) Sold Out Sep 6-10, 2021 ( ) Sold Out Contact us to get on the waiting list. Course Details Review the course details on our Registration Page . Our Previous Courses


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