The Modern Equine Vet
January 2024
Vol 14 Issue 1 2024
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The Stepwise Guide to the Hoof

By Paul Basilio

Although it can be overlooked as an examination target, a sizeable portion of equine lameness starts at the hoof.

“The foot will tell us a lot of information very quickly, because it is a structure that can change very quickly,” said Craig Lesser, DVM, CF, of Rood & Riddle Equine Hospital in Lexington, Ky. “I encourage people to take a second look at the foot during lameness or prepurchase exams to see if an issue is coming about sooner rather than later.”

During a Burst session at the 69th AAEP Annual Convention in San Diego, Dr. Lesser gave a quick rundown of his thorough foot examinations.

Step 1: Look at the Horsehoof

“It all starts with just watching the horse stand there,” said Dr. Craig Lesser.

Dr. Lesser will take note of whether the horse is doing any unusual weight shifting, holding itself in an altered posture or standing camped under.

“A lot of hindlimb lameness is related to a negative palmar angle,” he explained. “Look at the overall horse, because that’s going to play into what we’re seeing with the foot.”

Pay special note of how the horse moves the foot as well—not only for signs of lameness, but also to see where it lands, whether it breaks over or if the stride might be altered. All of these things could help direct treatment.

Step 2: Touch the Foot

“When we actually get down and put our hands on the foot, there’s a lot we can see,” Dr. Lesser said. “We’re looking for layers of distortions, and whether they are due to conformation or if we just left a shoe on a foot for longer than we should have.”

Sheared heels, for example, can lead to many other issues, and they can be difficult to pick up unless you get down there and feel for it.

“Additionally, we can pick up on toe cracks earlier on [with a proper exam],” he said. “A lot of our toe cracks are clinical signs of acute laminitis, and quarter cracks could mean an imbalance. We’ll also see bruising before we start to see radiographic changes. A lot of the hoof changes we can see early on will help us get ahead of the game.”

One of the most important things to check, according to Dr. Lesser, is the coronary band.

“It’s not something that I was taught to do right away,” he added. “Now it’s one of the most important parts of my exam.”
Running your fingers along the coronary band can reveal any ledges, sensitivity, or swelling. You may also feel scars or cracks that would have gone unnoticed without the palpation.

“In a lot of our laminitic horses, we’ll start to notice a ledge formation [on palpation],” he said. “The horse might have some signs of sinking that you wouldn’t see radiographically at that point.”

Step 3: Search your Sole

“The sole tells us so much” Dr. Lesser explained. “We can start by looking at the frog, which expands and contracts like any muscle. If it’s atrophied, it’s not being engaged. That can indicate that we need to change the shoeing strategy.”

The bar is an extension of the wall. If they’re crushing or rolled underneath, that can lead to lameness and abscess.
“It’s amazing how many things you’re going to see if you take the time to take your wire brush to the foot and just looking at the bottom of it.”

Step 4: Test the Hoof

“No matter how many advanced imaging techniques we have, the hoof tester is still my best tool,” he said. “It helps me tell what hurts and what doesn’t hurt, and helps me decide where we’re going to load and what we need to protect.”

Hoof testers can vary significantly from manufacturer to manufacturer, so Dr. Lesser said that it’s important to find one that fits your hands and your examination needs.

“Finally, don’t be afraid to take radiographs,” he said. “A few radiographs can go a long way.” MeV