Monday, 2 January 2012

Progress and the healthy hoof

Its that odd time of year - the hiatus before the New Year really gets under way.  My inclination is to look forward and be optimistic but its still midwinter, the days are short and the weather is unkind and its a time when you can't avoid being realistic.

Over the last year, more horses than ever have come here for rehab and more and more owners have educated themselves about hoof health and lameness.

But will this be the year that vets start educating themselves about hooves?

Of course I've been fortunate enough to meet some brilliant vets - sceptical but open-minded, which is the best combination.  But I've also met complete indifference and sadly this is the more common reaction.

As I said last year, I'd understand completely if the view was "we're interested but we need more research".  I would be ecstatic if someone was intrigued enough to use the research results I've got and analyse them further, or develop more research - which is something I don't have the skills to do.

I find indifference frustrating, though, particularly when for many of these horses everything else has been tried and has failed.

This is a post I seem to write in one form or another most years; maybe next year I will be writing a different post.

I think for that to happen, though, vets would need to become familiar with something which I think most of them have never seen: a healthy, hard-working unshod hoof.
I know many of you will have read the following quote before, but its so good that I make no apologies for posting it again.  It still sends a chill down my spine whenever I read it.  It was written by David Wootton in his excellent book, "Bad Medicine"; if you don't know it, do read it if you've got a minute, because its an incredible piece of writing:

"Think for a moment what surgery was like before the invention of anaesthesia in 1842...  Imagine taking pride above all in the speed with which you wield the knife - speed was essential, for the shock of an operation could itself be a major factor in bringing about the patient's death.  


Now think about this: in 1795 a doctor discovered that inhaling nitrous oxide killed pain..yet no surgeon experimented with this.  The use of anaesthetics was pioneered not by surgeons but by humble dentists.  


One of the first practitioners of painless dentistry, Horace Wells, was driven to suicide by the hostility of the medical profession.


When anaesthesia was first employed in London in 1846 it was called a "Yankee dodge".  In other words, practising anaesthesia felt like cheating.   Most of the characteristics that the surgeon had developed - the indifference, the strength, the pride, the sheer speed - were suddenly irrelevant. 


 Why did it take 50 years to invent anaesthesia?  Any answer has to recognise the emotional investment that surgeons had made in becoming a certain sort of person with a certain sort of skills, and the difficulty of abandoning that self-image.


If we turn to other discoveries we find that they too have the puzzling feature of unnecessary delay...if we start looking at progress we find we actually need to tell a story of delay as well as a story of discovery, and in order to make sense of these delays we need to turn away from the inflexible logic of discovery and look at other factors: the role of emotions, the limits of imagination, the conservatism of institutions.


If you want to think about what progress really means, then you need to imagine what it was like to have become so accustomed to the screams of patients that they seemed perfectly natural and normal...you must first understand what stands in the way of progress"

16 comments:

cptrayes said...

It's a fabulous quote and it gets me every time! I am thinking of copying it onto HHO. Would you mind? And if you don't mind and I did copy it, would you want me to attribute it to your blog, or not (HHO can be a hostile place as you know but its getting better and better including posts by a pro-barefoot remedial referral farrier.)

C

Nic Barker said...

Of course I don't mind - it will rile some people but its such a thought-provoking quote. I don't mind you linking back to here at all - thank you :-)

Clare said...

Convention and convenience is a hard nut to crack! unfortunately / fortunately depending on how you look at it shoeing works for a fair number of people! Only with barefoot do you get a true feedback from your horse.

Wiola said...

I feel very luck to have met you Nic and to have learnt so much but it is very frustrating to see indifference indeed.
I've been teaching a lovely client for the couple of months, his horse is a 4 years old cob x and has fab set of feet. The guy just light schools him and hacks.
Then before xmas he told me he got his horse a xmas present. A set of shoes.
This is after me sharing the stories of barefoot rehab and success it brings etc

It's indifference and inability to change that's the saddest thing.

Here is to a very different post at the end of this year!

Lucy Priory said...

Ha - I think I am even more cynical than you Nic. Just today I learn of a vet that recommends shoeing as a treatment for .... thrush. Yup absolutely true. Mind this is also the same vet that said that if you deshoe a horse it will get laminitis and that IR burns itself out (ie is self curing). And that the only cure for collapsed heels and long toes is shoes..... and ....... no there is not need to go on but you get the idea!

Nic Barker said...

Wiola, thats a shame indeed, but unlike lots of owners, your client will have somewhere to investiatge if he finds that he (or his horse) want another option than shoes.

As Clare says, shoes are a very convenient option for many owners, and so they do have a purpose. It would be nice, though, if they were used with more knowledge of their consequences.

Lucy - I don't think I am cynical - I hope not!

Of course there are lots of vets who are not fans of barefoot, but that's partly a function of their training and can be a function of the barefooters they encounter.

I'd rather engage with them - as far as is possible - because even a spark of interest is better than shutting things down. Sometimes it can yield surprising benefits - Taz, for instance, came here only because of his vet, who had visited Rockley more than a year before she saw Taz, and then only for a day :-)

Frizzle said...

Wow. That's some powerful, thought-provoking stuff.

I'm just starting to deal with this phenomenon personally. My guy has always been barefoot, and I was told by vets that horses in southeast Flroida can't go barefoot because:
(from vet one, who is Ivy League-educated)--"it's too sandy here and it will grind the hooves down"
(from vet two)--"the ground is too hard here because we have coral rock."

I'm currently helping my trimmer rehab two foundred mares at my barn, and the resistance from the vet is astounding. Even though I have pictures and videos that prove these mares are improving in leaps and bounds, he thinks they were doing better under the care of the (completely incompetent) farrier. I am totally shocked that someone can look at a horse who was so crippled after being put in clogs that she didn't eat for three days, who has now been under the care for my trimmer for three weeks and is going gangbusters, and NOT see the progress. Especially when every single person at my barn can see it.

Sorry to ramble! It's just mind-boggling that there is so much resistance to this. If we were the ones crippling the horses, the vets' behavior would be warranted. But why is it that the farriers can cripple the horses and get a free pass, while we actually improve the horses' soundness and we're thrown under the bus?

Media Wurzel said...

Happy New Year Nic! May 2012 be a wonderful year for you and Andy and the ponies. My resolution is not to be cynical. Anyway, as regards your post, as well as self-image, surely filthy lucre plays a part too? Most veterinary practices I know of are parts of large businesses where the priority seems to be in making sure expensive diagnostic tools pay for themselves. There's no profit in telling you to take your horses shoes off. Darn resolution #1 is down the plug-ole already. Ah well!

Snowhawk Przhevalsky said...

I have a long, long list of reasons why I've stopped blindly trusting doctors (human and animal), most of which can be summed up by "They don't listen to the patient (or the patient's parents/owners)."

I'm not rude to them, I just don't trust them. I'm tired of my own health and my animal's health suffering because they don't like to be wrong, and because they refuse to learn anything new.

(And here I thought we never stopped learning until we died. Silly me, I guess once you have a piece of paper that says you know everything about (x) you can quit. .. Oh wait, I have one about pet grooming, but I've learned a LOT since I got that paper.)

Here's hoping enough voices can change the way so many doctors look at things, for pets and people.

Nic Barker said...

MW - I am sure there is an element of that (bad boy to break your resolution by 2nd Jan!) but OTOH they have nothing to gain by recommending remedial farriery, which is often very expensive. often unproven and unresearched and often unsuccessful, especially in the medium to long term.

Thanks for your comment too, SP, and I share your frustration(!) - I agree with you completely that its when people stop listening and learning that they become dangerous - and that's true of any profession, not just vets or doctors...

Lots of food for thought, chaps, so thank you!

Heila said...

Have you EVER come across a horse that absolutely needs shoes? Someone I know was telling me about a very bad injury to her horse's foot, which involves the coronary band. Her vet and farrier said the horse will always need shoes because the hoof is growing out malformed due to the injury. I know you cannot really judge without seeing it, I unfortunately don't have pics, just wondering if you have dealt with something similar?

Nic Barker said...

Heila, thats an interesting question. The problem is that its very common for vets and farriers to say "this horse needs shoes" but its also very common for this to be incorrect ;-)

Many think that TBs "need" shoes, or horses which work hard "need" shoes, or horses with DDFT injuries "need" shoes, so personally I treat that phrase with some scepticism, particularly if (like many vets and farriers) they do not have experience of barefoot performance horses.

In your case, I would be asking exactly what (physiologically) the shoe is supposed to be doing.

It seems odd to me that a coronary band injury would benefit from shoeing, if you mean a normal rim shoe, as that will put extra load on the injured area, compared to barefoot - however, as you say its impossible to judge without seeing the horse.

jenj said...

Horses seem to be very much "'cause that's the way we've ALWAYS done it!!!" and you don't question that. Getting people to think outside the box or look for alternatives is HARD. But I do think that the way of thinking will change, one horse at a time! Keep doing what you are doing, Nic, you are making huge strides for horses everywhere!

MegB said...

What a thought provoking post. Gave me goosebumps.

Nic Barker said...

:-)

BruceA said...

So much of the commercial reality of farriers, vets, the insurance industry and feed industries work against the best interests of the horse.