The term "hoof balance" gets used a lot - so, what do we mean when we say a horse's hoof is "well balanced"? 

Keep in mind that there are no universal definitions for hoof balance, and there is also no such thing as a "perfect foot".  But when we look at the foot from the side, the pastern and hoof should be in line with each other.  If the hoof is a steeper angle than the pastern, we call that "broken forward".  Likewise, if the opposite is true, and the pastern is a steeper angle than the hoof, we call that "broken back" (see above).  Any significant diversion from the normal straight line will put undue stress on the structures of the foot, as well as the tendons and ligaments in the lower limb.  This hoof angle can be affected to some extent (but not entirely changed) by trimming and shoeing. 

When looking at the hoof from the front, a vertical line should divide the fetlock, pastern, and hoof into equal halves.  The top of the hoof (the coronary band) should be parallel to the ground.   Deviations from this symmetry will put undue stress on the inside or outside of the hoof, and can predispose the horse to arthritis (ringbone).  Again, trimming and shoeing can help improve symmetry, but to a certain extent, this is a conformational issue. 

Finally, we look at the hoof from the bottom:

We'd like foot to be symmetrical, to have the frog in the middle with the tip of the frog a little further forward than the center point (see A, above).  In an overgrown hoof (see B, above), the heel and toe will extend too far, which can increase stress on the lamina as well as soft tissue structures at the back of the foot.   If the foot is not symmetrical, (such as in C, above), this can put additional stress on one side vs. the other.  

Keeping a well balanced, healthy foot can help to decrease the incidence of foot problems as well as lameness.  It allows the horse to move more appropriately and naturally. 

  
Thrush is a common ailment of the equine hoof.  It is a bacterial infection of the frog.  Typically it originates in the central and/or collateral sulci (the grooves along the middle/side of the frog).  It usually does not extend beyond that, but if not treated and allowed to fester, it can affect deeper structures.

This disorder is easily apparent as a black, foul-smelling thick material within the sulci.  Lameness can occasionally occur, but that is uncommon.  We generally attribute environmental conditions to causing thrush.  This includes deep mud, swampy land or wet pastures.  If horses spend a lot of their time in these moist areas, they more at risk of developing this problem.  It can occur in other horses that are kept in dry areas, but is less common.  Horses with poor conformation (frog deformities) or really deep sulci may also be predisposed.   

Treatment is generally relatively easy.  The most important thing is to remove the predisposing cause, but sometimes it can be difficult to remove them from that muddy pasture.  Especially this time of year!  Daily care is needed to get rid of thrush.  This includes picking the feet, having your farrier remove any necrotic (dead) tissue, and applying a topical remedy.  There are several out there, but we tend to recommend Thrush Buster or Kopertox.  Straight betadine  solution can often work well, too. With good attention to the feet during the muddy season, thush should not be too much of an issue.      

  Abscesses 

 
If you have been involved with horses for a long time, you have probably experienced a horse with a hoof abscess.   A common cause of severe, sudden lameness, hoof abscesses are generally localized infections within the hoof capsule.  They can originate from a puncture wound, ascension of bacteria up a nail hole or the white line, or a deep solar bruise.  Abscesses generally show up as an acute, non-weight bearing lameness.  Digital pulses become increased and the foot is usually warm to the touch.  We sometimes see distal limb swelling and soft spot may appear at the coronary band.

The best treatment for abscesses is to have your vet or farrier establish drainage by locating the problem area and paring it out.  This is not always possible.  In that case, treatment usually involves soaking the foot in a warm betadine and epsom salt bath for 15-20 minutes once or twice a day, followed by bandaging the foot with a poultice over the sole of the foot.  Many people like ichthammol, but as veterinarians we don't often recommend it.  It's not that we don't believe it works.  Ichthammol is very tar-like, and if we have to see an abscess after a few days of treatment with ichthammol, it can be difficult to see anything with a thick layer of asphalt over it.  We generally like products such as Animalintex or Magnapaste for poulticing.  A little bute can help ease the pain as well.  Systemic antibiotics should not be administered in all cases as it can slow the progression of the abscess and prolong the problem.  If it persists for several days, we will recommend radiographs be taken to be sure there are no other issues going on.

Once an abscess ruptures, the pressure is relieved and horses are walking better very quickly - sometimes almost instantly.  There may be residual lameness as the hoof grows out, so be sure to use caution in the few weeks after dealing with an abscess.

White Line Disease is also known as "Seedy Toe".  It is a separation of the hoof wall which leads to ascending bacterial and/or fungal infection.  This causes a digestion of the horn leading to more separation. It characterized by a white, chalky powder.  Lameness varies based on the severity of the disease

The etiology of WLD is poorly understood.  (We're not even sure it is always an infection, as simply doing a hoof resection of the unattached wall can be curative.)  It can occur in barefoot or shod horses, in horses in wet environments or dry environments.  Chronic laminitis cases are somewhat pre- disposed, as are horses with poor quality hooves. 

As stated above, treatment involves removing the separated wall, if there is any.  Topical antiseptics, such as iodine should be applied daily not only to treat the infection that may be there but also to prevent further infection.  If a resection is performed, protective shoeing may be necessary to redistribute the weight across the hoof wall.  In this instance, your vet and farrier should work together to resolve the problem.   

 Now here's a nasty foot problem!  Luckily, it is fairly uncommon.   Canker is a  proliferative dermatitis of the frog.  It is often confused as chronic thrush.  It can occur in one feet, or multiple feet and the excessive growth begins to undermine the frog and sole.  Draft breeds appear to be more at risk, but an actual cause of the disease process is uknown.  It has been proposed that a bovine papillomavirus may be the culprit, but that has not been proven.

Canker can be identified by the creamy exudate that appears to be coming from under the frog.  The excess, necrotic  tissue crumbles easily and bleeds profusely when removed.  A foul odor usually accompanies the dying tissue.  Lameness can be variable depending on the severity of disease and hoof wall support.

Creamy exudate

The disease can become severe enough that it can begin to affect deeper tissues such as the deep digital flexor tendon.  This can seriously complicate treatment.  Overall, the disease carries a guarded prognosis.  While it can be treated successfully, treatment is long term, aggressive and becomes quite expensive.  

Prevention is the best medicine when it comes to hoof care.  You should look at your horse's feet on a daily basis.  Become familiar with the anatomy of the foot, and get accustomed to how your horse's foot normally looks. 

Pick the feet daily and inspect for any changes.  Keep the bedding dry and allow for good drainage (if possible!) away from the barn and paddocks.  Excess moisture can cause several problems in the feet, so  decreasing this can head some problems off at the pass.  

Your farrier should visit every 6-8 weeks.  Some horses may need more frequent trimming if they have any abnormalities, and some horses do well on less frequent trimmings.  On average, though, 6-8 weeks is a good average.

Generally speaking, keep your horse in overall good body condition.  Maintain good vitamin and mineral supplementation and monitor for any signs of lameness.  If any problems are noted, get your vet and farrier involved sooner rather than later.  Early detection of problems can lead to faster resolution and a happier, healthier horse.

For more on routine care, watch this webinar from American Farriers Journal.