Hooves from the veterinary perspective

This article was published a couple of days ago and is doing the rounds of the internet: http://www.thehorse.com/articles/31912/veterinarian-reviews-the-barefoot-concept.

Rather like the Horse and Hound article earlier in the month, it seems that vets are finally beginning to wonder if there might be something in this barefoot malarkey after all.

This latest article summarises a presentation by US vet Debra Taylor. One encouraging aspect is that she is obviously more familiar with a hard-working bare hoof than the author of the H&H article:

"In transitioning horses from shod to barefoot...she's observed that as the heel's structure improves and adapts to the stimuli from the ground, other hoof characteristics—such as solar thickness and solar concavity, both of which increase the coffin bone's distance above the ground—appear to follow suit and fall into place."

Good for her - and even better she cites the importance of correct movement and nutrition - a real step forward. Its great news for both horses and owners that vets are starting to become more interested in bare hooves but there is something really very strange about all this as well.

The article outlines the many problems commonly found as a cause of lameness in horses, particularly in the palmar hoof - underrun, low, crushed, sheared or contracted heels. The vet goes on to say that "additional research is needed to evaluate the barefoot concept as a potential method by which to rehabilitate horses with weak or diseased feet, as the improved heel structure that often accompanies a barefoot lifestyle could prove beneficial."

Is it me? Surely it would be more appropriate to stand that idea on its head and say that we need research to asses why so many of our horses are developing "weak or diseased feet" in the first place?

Here is the mad thing - this vet's starting point (which is not her fault, as its overwhelmingly the case with all the vets I've spoken to as well) is generally that shoes are normal and barefoot is not (this article refers to barefoot as a "bandwagon" - its a new, internet-led trend, apparently).

This is something I've blogged about before - when I noticed that in a leading veterinary anatomy book the shoe was labelled as part of the limb in a dissection illustration.

As I said in that post: "Its as if a medical text book listed the parts of the human body and then went on: gloves, hat, shirt, trousers - but of course that would be unthinkable(!)..."

And yet, as in this article, the routine veterinary assumption seems to be that horses come as standard, complete with a set of metal shoes...If you are taught this way, its not surprising it will stick with you once you are practising - and of course its not just vets, there are many owners (including me!) who never questioned shoes being put on their horses' feet every few weeks. 

The nearest equivalent I can think of would be medical students being taught how patients breathe on a ventilator without being taught about normal lung function.

The point is, when did veterinary education become so limited that it starts with a shod foot and has no knowledge of how a foot functions BEFORE it is shod?

This is even more important since - as I posted a couple of weeks ago - a shoe fundamentally changes the way a hoof loads and has an enormous impact on the strength and development of the palmar hoof - heels, digital cushion and frog.

Dr Debra Taylor goes on to state "At present time, there is very little science to support the hypothesis of the barefoot hoof care professionals. There is an enormous amount of scientific investigation that needs to be done to test the hypothesis that the equine foot can undergo structural change in response to mechanical usage."

Hang on, back up there a second...Do you REALLY mean that the focus of research should be on whether a hoof can function without a shoe? Even though your own work indicates that hooves tend to get stronger when working out of shoes?

Let's be logical (humour me, since you are a scientist...). The horse has been walking, trotting and cantering on a single-toed hoof over all sorts of terrain for 10 million years (I've blogged about this before as well!).

Instead of researching something that has been functioning perfectly well for 10 million years, perhaps we should be looking at the far more interesting question of why it stops functioning and is developing all these problems today. 

And by the way, its not an answer to say "its because they didn't evolve to be ridden" or "its because we ride on roads" - that's not scientific (and anyway we both know that those aren't the causes of palmar hoof pain and collapsed heels!).

Don't get me wrong - as someone who has spent the last 9 years and more trying to interest vets in barefoot rehab (yet another thing I've blogged about before in last year's "Dear Vet" post) I would be the first to jump up and down with excitement if a huge research grant came along (though, if I am honest, its a waste of money to spend it on seeing whether working a horse barefoot results in healthier heels. That's a complete no-brainer).

It would be far more interesting to have research into how horses feet deteriorate and weaken and why this happens. But that of course would require an understanding of what a healthy foot is like  - and an appreciation that weak palmar hooves are made, not born. The irony is that looking at barefoot horses in work will already give you some of the answers to that question, so maybe it cuts both ways!

This is not a dig at vets, by the way. There are some fantastic vets out there - just as there are some fantastic farriers - but it seems we need attitudes and education to shift faster - or perhaps to start looking at hooves and shoes from another perspective...

If we are being logical and scientific (and yes, I've blogged this before too) then the more invasively and aggressively you want to intervene in a hoof the more research you should need to justify it. So if you want to resect it, use a remedial shoe or perform a neurectomy you'd better have some pretty convincing clinical trials to back you up.

But barefoot? Research is always nice to have - and there has been little enough done - but make no mistake: a hoof without a shoe is the default position, not the other way around, so its not barefoot that should have to prove itself with research.