Thursday, May 25, 2006

Laminitis Prevention for Barbaro: Copper Sulfate Silicon Hoof Packing and Sigafoos Glue-On Shoe on “The Good Foot”

Barbaro's "good" foot is shod with a glue-on double hospital-plate support device. Photo © Rob Sigafoos.


Photos by Susan Hankin, JD, MPH

Many thanks to Upenn Chief of Farrier Services Rob Sigafoos for sharing with us the first official release of photos and information on the shoe designed for Barbaro’s “good” foot. The good foot must be supported in an effort to prevent what is called “support limb laminitis”, caused by over-stressing the good leg during recovery from an injury in the opposite limb.

While support limb laminitis is more of a risk in horses who injure the front legs, which bear more weight than the hind, there is still a risk of developing laminitis in the hind limb.

According to Rob, who granted Hoofcare & Lameness his first interview on the case today, Barbaro was laid down on the surgical table around noon on Sunday, after being admitted on Saturday following his injury in the Preakness Stakes in Baltimore, Maryland.

All the colt's race plates were pulled off by Rob and his feet were trimmed. Rob traced the left hind at this time, and went to work building a shoe to fit the tracing while Dr Dean Richardson moved the horse into the sterile surgical suite to begin surgery.

Later that night, when the operation was finally complete, Rob returned to the surgical suite and met up with Barbaro again when he was removed from the sterile setting and the cast was applied to his injured leg. Rob glued the shoe on the left hind (“the good foot”) at that time, while the horse was laying down. The horse was then lowered via hydraulic sling into the recovery pool, where he emerged safely from anesthesia.

The shoe is a double hospital-plate device. It is quite possible that blog viewers will not be able to read the fine lettering on the art that accompanies the official statement from the vet school about the device, so I will describe it to the best of my ability:

The bottom layer is what is called by farriers a hospital plate. It is a 1/8” thick sheet of aluminum, cut in the shape of the foot, and is held on with four bolts that are threaded into the two bottom layers of the device.

The “sandwich” layer is high-density polyethelene used as a spacer, followed by the second plate, also made from 1/8” high-grade aluminum, which attaches to the shoe, which is made from 3/16” high-grade aluminum, and is bonded to high-performance polyurethane, which is in turn bonded to Vectran/polyester braided fabric, which forms the “cuff” of the shoe. Thickened with adhesive, the Vectran becomes an artificial outer wall for most of the hoof and holds the shoe in place. A PMMA-type adhesive is used; in this case the commercial name is EquAcrylic.

The spacer plate (white polyethelene) is used to equalize the horse’s limbs, so that they will be the same length and increase the probability that the horse will easily shift weight from one leg to the other and bear weight normally while standing in the stall.

Rob’s secret weapon is the use of copper sulfate-impregnated silicon hoof packing. While no one is predicting that the horse will develop laminitis (according to Rob, the foot looked normal in conformation, with no visible evidence of past hoof disease), it is important to be pro-active. The hoof packing will keep the sole clean, in the event of laminitis.

The hospital plates can be unscrewed and removed to check the bottom of the foot. If the horse does develop laminitis, the sole and frog will be accessible for medication and treatment without removing the shoe.

“This copper sulfate silicon packing is the closest thing I have seen to a silver bullet in laminitis treatment,” Rob told me today. “In this case, of course, the use is prophylactic and we certainly hope that this horse does not develop laminitis.”

The wad of blue hoof packing will pop out of the foot once the hospital plate is removed. In addition to keeping the sole clean, the copper sulfate will toughen the sole as well. It will be carefully monitored.

Shoeing to prevent support-limb laminitis in orthopedics cases is often a “Catch 22” situation, according to Rob. If the horse does not get laminitis, the shoe will not get the credit, the horse will, for standing on both legs. If the horse does get laminitis, the shoe design will be blamed—-it should be have shorter, taller, more support, different configuration, etc.

Rob didn’t mention it, but the horse is probably also wearing support wraps on the good leg.

In closing, both Rob and New Bolton Center farrier Laura Florence remarked on the media frenzy and the outpouring of support from the public. Delivery trucks are bringing cases of apples and carrots, and a wall of get-well wishes lines the highway outside the campus.

Sigafoos shoes link (Sound Horse Technologies in Pennsylvania):  http://www.soundhorse.com Copper sulfate silicon link:  http://www.soundhorse.com/copper_sulfate.htm

Text and photos © 2006 Hoofcare Publishing. Text and photos posted on “The HoofBlog”, a casual news source for subscribers and friends of Hoofcare & Lameness: The Journal of Equine Foot Science. Learn more (and subscribe online using our secure server) at http://www.hoofcare.com or write to Hoofcare Publishing, 19 Harbor Loop, Gloucester MA 01930 USA. Tel USA 978 281 3222; Fax 978 283 8775, or email hoofblog@hoofcare.com

Note: this blog is an interactive web page. By clicking on the envelope icon at the bottom of an article, you can instantly email that article to a friend. By clicking on the word “comment” after a post, you can leave a message, which may be viewed by future blog readers who click on the same “comment”. Commenting may require registering with Blogger.com. You may also comment by emailing the author, Fran Jurga, at fran@hoofcare.com and your comment will be posted for you, technology willing.

Diagram of Support Shoe Package for Barbaro

Barbaro's shoe to prevent support limb laminitis

This artwork was provided by Rob Sigafoos and New Bolton Center. In order to post it here, it had to be reduced in size and resolution. I hope you can still see it. My narrative post (see above) explains the layers and construction of the device.

To learn more about Sigafoos shoes and copper sulfate silicone hoof packing, please visit: http://www.soundhorse.com/

If you wish to contact Rob Sigafoos directly, and of course many people do want to, please DO NOT call the central switchboard at New Bolton Center. They are swamped with calls.

To reach Bill Kirkpatrick at Sound Horse Technologies, manufacturers of the Sigafoos shoes and the other products used on Barbaro, please call call 1 800-801-2654 in the USA or 610-347-0453; fax: 610-347-1822 or email horseshoes@soundhorse.com.

Text and photos © 2006 Hoofcare Publishing. Text and photos posted on “The HoofBlog”. Learn more (and subscribe online using our secure server) at http://www.hoofcare.com or write to Hoofcare Publishing, 19 Harbor Loop, Gloucester MA 01930 USA. Tel USA 978 281 3222; Fax 978 283 8775, or email hoofblog@hoofcare.com.

Note: this blog is an interactive web page. By clicking on the envelope icon at the bottom of an article, you can instantly email that article to a friend. By clicking on the word “comment” after a post, you can leave a message, which may be viewed by future blog readers who click on the same “comment”. Commenting may require registering with Blogger.com. You may also comment by emailing the author, Fran Jurga, at fran@hoofcare.com and your comment will be posted for you, technology willing.

Official text from New Bolton Center on Barbaro’s support shoe




One of the complications that can occur following leg fractures in horses is the risk of developing laminitis in the opposite foot from bearing extra weight. In an effort to reduce this risk, New Bolton Center farrier Rob Sigafoos applied a supportive shoe to Barbaro's left hind foot immediately following the surgery for the fracture of his right hind leg. The shoe is designed to reduce the risk of laminitis in several ways:
1) by supporting the sole of the left hind foot;
2) by containing materials that minimize weakening and possible infection of the sole; and
3) by being built up to extend the length of the left hind foot, which compensates for the additional length of the right hind limb created by the cast.

The shoe used is a glue-on shoe designed and patented by the University of Pennsylvania, and has been in use for over 10 years. This shoe is a three-part device.

Photos by Susan Hankin JD, MPH, courtesy of Rob Sigafoos.

Text and photos © 2006 Hoofcare Publishing. Text and photos posted on “The HoofBlog”, a casual news source for subscribers and friends of Hoofcare & Lameness: The Journal of Equine Foot Science. Learn more (and subscribe online using our secure server) at http://www.hoofcare.com or write to Hoofcare Publishing, 19 Harbor Loop, Gloucester MA 01930 USA. Tel USA 978 281 3222; Fax 978 283 8775, or email fran@hoofcare.com.

Note: this blog is an interactive web page. By clicking on the envelope icon at the bottom of an article, you can instantly email that article to a friend. By clicking on the word “comment” after a post, you can leave a message, which may be viewed by future blog readers who click on the same “comment”. Commenting may require registering with Blogger.com. You may also comment by emailing the author, Fran Jurga, at fran@hoofcare.com and your comment will be posted for you, technology willing.

Dutch Hoof Balance PhD Thesis "Distal Limb Development and Effects of Shoeing Techniques on Limb Dynamics of Today's Equine Athlete" by Meike Van Heel Published


"Distal Limb Development and Effects of Shoeing Techniques on Limb Dynamics of Today's Equine Athlete" has been published in The Netherlands! Dutch researcher Meike van Heel PhD has assembled her papers and dissertation on hoof balance into the pages of a lovely book. It is 174 pages, with color photos and art (though not enough of either).

Here's the blurb from our sale flyer on this book:
A landmark study of hoof balance and growth uses traditional and high-tech research modalities to bring new information to equine hoof science. Pressure mats, force plates, video gait analysis, radiography and keen observation of equine posture and behavior yield a document rich in the use of science to back up common sense. Studies examine the prevalence of uneven feet (so-called “high-low syndrome”). Documents how a horse compensates for hoof growth to maintain balance and how a rolled toe shoe aids in efficient movement and joint mechanics.

Chapters:
  • Lateral grazing behavior induced by foal conformation 
  • Potential consequences of uneven feet in foals 
  • Effect of trimming on dynamic pressure measurements of hoof balance 
  • Changing center of pressure and hoof-unrollment over 8-wk shoeing interval 
  • Hoof growth effects on P3 vs P2 joints 
  • Compensation for changes in growth between shoeing sessions 
  • Rolled toe effects on breakover in sound warmblood horses 
  • Discussion and Summary
Watch for Meike to be a lecturer at conferences later this year or next year. She will be consulting for Mustad on innovative development of products and trends from her base in Holland.

Meike was a featured speaker at the International Conference on Equine Locomotion, hosted by Dr Hilary Clayton at Michigan State University in 2004. Her research was featured in an article on gait analysis and videotaping of horse movement in Hoofcare & Lameness #78.

Note: Meike's book is no longer available for sale. If a new edition is printed, it will be announced on The Hoof Blog.

Text and photos © 2006 Hoofcare Publishing. Text and photos posted on “The HoofBlog”, a casual news source for subscribers and friends of Hoofcare & Lameness: The Journal of Equine Foot Science. Learn more (and subscribe online using our secure server) at http://www.hoofcare.com or write to Hoofcare Publishing, 19 Harbor Loop, Gloucester MA 01930 USA. Tel USA 978 281 3222; Fax 978 283 8775, or email hoofblog@hoofcare.com

Note: this blog is an interactive web page. By clicking on the envelope icon at the bottom of an article, you can instantly email that article to a friend. By clicking on the word “comment” after a post, you can leave a message, which may be viewed by future blog readers who click on the same “comment”. Commenting may require registering with Blogger.com. You may also comment by emailing the author, Fran Jurga, at fran@hoofcare.com and your comment will be posted for you, technology willing.

Wednesday, May 24, 2006

Bachelor's degree in farrier science in the future?

"As a result of the validation of both (these) courses, farriery is now recognized as a true profession alongside Doctors, Lawyers, Accountants and, heaven forbid, even Veterinary Surgeons" writes Myerscough College Senior Farriery Lecturer Mark Caldwell.

Big news from England this week. Myerscough College and the University of Lancashire have announced a new program in advanced farrier science. The education system is a bit different in the UK, as compared to the USA, but this program will be open to US students and will also have some distance-learning components. It will be designed to prepare farriers to pass thet Worshipful Company of Farrier's Associates test, which is their mid-level of advanced farrier, followed by the Fellowship.

We are waiting for the official paperwork on the course structure from the unversity.

First of all, Mark says that there is no other program like this, anywhere in the world. "There is an amendment being put through UCLAN academic standards for the BFSc; this is available to USA students from September 2007, subject to qualification and the completion of bridging modules." he wrote to Hoofcare & Lameness in an email on 24 May. He is interested in collaborating with farrier education programs in the USA and other countries. "We are hoping to recruit some students from the USA and the practical sessions will be conducted during a month-long summer-type school," he writes.

Here are some main points about the course, which Mark has also posted on web sites in the UK:

1. The honors degree course, which includes the foundation degree, has been set up in conjunction with University of Central Lancashire as a modular route to the Worshipful Company of Farriers (WCF) higher examinations. Both courses have had the benefit of external academic advice from the WCF and are in fact supported whole heartedly by the WCF.

2. The content of both courses has been written by the course team which includes myself, Neil Madden FWCF and Major J. Reilly PhD, BVSc, MRCVS and has followed the WCF higher examination syllabi.

3. The foundation degree is a distance learning course incorporating periodic college attendance (currently 2 days per month during college semesters) and encompasses anatomy and physiology, equine biomechanics, pathology of diseases, dynamic gait analysis, teaching and assessing, lameness evaluation and diagnostic imagery, employment and health and safety regulations pertaining to small business as theory modules delivered through on-line format. Practical subjects, including shoemaking, shoeing for pathological diseases, farriery protocols and shoeing with modern materials, are taught during the monthly workshops on campus.

4. The honors degree includes a double dissertation module (10,000 words), corrective farriery for juveniles, verification and examination techniques and business planning modules.

5. All modules are assessed in part by course work and substantively by end-of-module examination. These examinations follow closely those currently set by the WCF with the final practical examination (similar in format and content) monitored by WCF examiners.

6. All examinations will have written mediation monitored by the university academic approvals body which includes two technical advisors from the WCF

7. Both the foundation degree and honors degree are validated by the university academic standards committee and have the approval of the WCF. Both courses allow the candidate, subject to the pass grade of 60%, to apply to the WCF for either the AWCF, in the case of the foundation degree, or the FWCF in the case of the honors degree in the same way as the current military B2 or B1 allow for the diploma and associate awards. Candidates that fail to reach the 60% mark will have to sit the WCF examination separately.

8. Both courses are designed with the express intent of maintaining the WCF integrity as guardian of the standard of craftsman ship whilst recognizing the science of farriery on a formal academic basis in line with the veterinary profession.

9. The foundation degree is only open to registered farriers who hold the WCF diploma or recognized equivalent, currently the American Farriers Association CJF. The honors degree will only be open to holders of the foundation degree or WCF Associate award. Those students only holding the associate award will be required to undertake 4 bridging modules before starting the honors degree in order to prepare them for the academic rigor of level 3 degree study.

More details are available in Hoofcare & Lameness Journal, issue #80. No link to further information is currently available via the Internet.
Learn more about the art and science of the horse's hoof in our journal (and subscribe online using our secure server) and on our website at http://www.hoofcare.com or write to Hoofcare Publishing, 19 Harbor Loop, Gloucester MA 01930 USA. Tel USA 978 281 3222; Fax 978 283 8775, or email fran@hoofcare.com

Can't get enough Barbaro? More links!

And the links go on...
This is getting a little lengthy...but some people want to read it all. So here you go! I am updating this regularly, with the most recent links at the top.

http://www.miami.com/mld/miamiherald/sports/horse_racing/14696028.htm
Maryland track officials analyze slo-mo video of injury from all angles, think they are 80% sure that Brother Derek and Barbaro had contact leading to injury.

http://www.sportingnews.com/yourturn/viewtopic.php?t=96169
Great essay about weightbearing and recovery after surgery with quotes from JD Howard DVM, the vet who worked with Nuryev after his leg surgery.

http://www.nytimes.com/2006/05/29/sports/othersports/29gate.html?_r=1&oref=slogin
The New York Times of 29 May gives balanced coverage to charges of vet error or assistant starter incompetence in the search to understand why the colt broke down. Includes a letter from a Montana veterinarian and his charges.

http://www.concordmonitor.com/apps/pbcs.dll/article?AID=/20060529/REPOSITORY/605290309/1043/NEWS01
Did you know that Dr. Dean Richardson is from Hancock, NH? (Not Hanover, although that is where he earned his BS, at Dartmouth) And that he operated on Barbaro on the anniversary of the death of his father? Here's the local press's angle on Barbaro's surgeon

http://www.nytimes.com/2006/05/28/weekinreview/28green.html?fta=y
"Human intervention has been so pervasive that on some level these are scarcely horses any longer but centaurs, part equine and part human, their lives so intermingled with ours that there is no separating the two."--From "Our Creation, Our Concern: Equine Evolution", a critical essay by Linda Greenhouse published in the 28 May Sunday New York Times. An interesting aside: the author is the Times's Supreme Court reporter.

http://www.npr.org/templates/story/story.php?storyId=5428731
This is a