Equine Podiatry Training Ltd

Journal of a Student Equine Podiatrist

Vikki Fear started the Diploma in Equine Podiatry course in September 2010. She has very kindly allowed us to reproduce here the blog she is keeping during the course.

Part 1

What is Equine Podiatry? I hear you ask. The American Heritage Dictionary of the English Language provides the following definition for a podiatrist:

“A member of the branch of medicine that deals with the treatment and prevention of diseases of the foot”

Equine Podiatry then is concerned with the treatment and prevention of diseases of the equine foot.

My interest in Equine Podiatry began shortly after I decided to take my horse out of shoes. He had been intermittently lame in spring and autumn with Navicular Syndrome type symptoms whether in shoes or without. My first barefoot trimmer got too busy and stopped visiting the area as our yard was several hours drive from his base. After some research, a friend found an EP (Equine Podiatrist) who could visit and trim our horses. It was with her help that I discovered that the reason my horse was lame was probably because he had some occasional inflammation in his feet that coincided with the seasonal grass flushes in spring and autumn. We made some management changes to restrict grazing while increasing turnout and exercise and haven’t looked back since.

Equine Podiatry Training Ltd formed in 2008 and I considered applying for the first course, but wasn’t entirely sure about the idea. The following year, I did apply and was accepted onto the course starting September 2009. I ended up deferring my enrolment onto the course due to home commitments, but eventually enrolled onto the 2010 course.

The first module of the course arrived via email after my course fees had been received. Module One is home study only and is all about Business Skills. At first I wondered about the point of this, but the tutors have been very clever – they get you thinking very hard about trimming as a business and some of the legal and tax implications, and even ask for a business plan including profit/loss forecasts for the next 4 years to be pulled together. This results in students starting the taught phases of the course fully aware of the costs involved in being a practising EP. Whilst there is no face to face tuition in module one, there are plenty of resources provided and the tutors were perfectly happy to answer questions and give pointers where necessary.

The first classroom course was a two day introduction to Equine Podiatry and the hoof and an opportunity to meet my fellow students. There are 4 of us on the course, so we should form a tightly knit group, we will also have plenty of tutor time with so few of us.

Day two of the course included a dissection of a cadaver leg. It took a little while to get over my squeamishness of the idea, but to a hoof geek like me, seeing the inside of the leg and hoof was absolutely fascinating and I soon overcame any qualms. The tutor carried out the dissection, giving us a guided tour of the various structures, so we would have more of an understanding of the “geography” during our upcoming studies.

We finished the course by receiving our homework which needs to be completed by the next course. The idea of the homework on each course seems to be to follow up and expand on what we have just been taught, plus prepare us for the next module. This time we have also been given a scientific paper to read and review to see if we believe the research was carried out appropriately; the EPA(UK) is very interested in hoof related research because there is so little published with regards to barefoot hooves, but it is important that we are able to distinguish good from bad.

Part 2

I have just finished my second taught course on my journey to becoming an Equine Podiatrist, we have had one student drop out since the last course, but had two new students join so we are up to 5 now. The course was five days short (I won’t say long because the days flew by), focusing on Anatomy and Physiology. I left at the end of day 5 very tired, but extremely happy – my Facebook statement for that evening was simply – A-MAY-ZING!

My fellow students and I came to the conclusion during the course that someone pretty darn clever designed the horse. Complex systems interlink to make even more complex systems. During the first three days we learnt about the skeleton, the nervous, digestive, lymphatic, muscular, respiratory and circulatory systems and the major organs of the horse and how they support each other in maintaining a healthy horse. It seems that healthy hooves are not just about a good trim. We also spent some time learning about the bones, basic ligaments, tendons, blood supply and nerves within the equine distal limb (lower leg to you and me). We will be receiving more detailed anatomy training later in the diploma course from a Senior Lecturer in Veterinary Anatomy at the University of Melbourne (the lecturer is from there, we don’t get to go).

Day 4 was very exciting, we were outside and carrying out our own cadaver dissections – this sounds gruesome and we had issues with the idea to start with but, believe me, it is fascinating seeing all the internal structures of the equine leg, and truly remarkable how well everything is designed and put together, and how much force it takes to get them apart. This was not the first time I have seen inside of a hoof, but the first time I have gone inside by myself – our tutor demonstrated the basics of removing the sole and hoof wall then the skin of the leg and handed out some gloves and tools and let us loose on a leg each. We have been informed that this is the first of many dissections that we will carry out during the course, so the first one was just meant to be a journey of discovery – it did not matter whether we damaged structures, we just had to see if we could find some of the major structures that we had learnt about over the previous three days.

Day five was dedicated to a mini research project. We were split into two groups, one looking at potential causes of flaring (unnatural widening) of the hoof capsule, and one looking at whether the sole was uniform in thickness either side of the frog. Whilst we didn’t manage to come to any conclusions during the project, we were apparently consistent in our inconclusiveness with previous students, so the body of research is growing.

I now have my notes to write up and some home-study to do, the home work is in two halves, one reinforcing what we have learnt on during the 5 days, with some additional learning thrown in for good measure, and the other preparing us for our upcoming gait analysis course. More on that to follow soon.

Part 3

It has been a busy month, I have had two classroom modules this month, of 3 days each with tons of information in both. We also have our first theory exam to revise for next month and have still had to do homework for each of the taught modules. Don’t get me wrong, I’m not complaining, I’m just constantly amazed at the amount of information that is provided during this course.

At the beginning of the month, we looked at Diagnostics and Gait Analysis. The focus areas of the course were photographic techniques, understanding radiographs and a look at other imaging techniques, and then we moved on to body condition scoring and lameness analysis. We finally talked about the importance of record keeping.

I always thought taking photographs was easy, especially with modern digital cameras – turn it on, point, shoot right? Wrong! Or at least wrong when talking about taking good meaningful photographs of hooves for record purposes. Distance from the subject and camera angle are really important for good images, too close and the shape of the hoof capsule can appear to be distorted, likewise, if the angle is not exact, you could end up making the hoof look long-toed with under run heels, or boxy and upright – get the angles wrong on a pair of feet and you could look back and think the poor horse had very odd feet!

The section of the course looking at radiographs was very good. The tutor provided loads of samples of good and not so good radiographic images of both healthy and unhealthy feet and we spent some time looking at each one trying to decide what was wrong (with the unhealthy ones). We also spoke for a while about the different views typically used by vets for what problems and the terms used to describe those views.

This module was hosted by a horse rescue charity, so after a quick classroom introduction to condition scoring, we headed outside to look at some of the residents. They were very patient while 6 complete strangers prodded them and squeezed their crests while we learnt practical condition scoring.

Back into the classroom and we sat down to watch some lameness analysis videos. This was brilliant for me, I have often looked at a horse and thought, “ooh, you’re lame”, but have not been able to pin that lameness down to front or back, left or right, but with these videos, we were able to slow down the action a bit, and most importantly, play them over and over while trying to see what was wrong. Once we had our eye in, we went back outside to look at some real cases; once again, our “victims” were very patient with our fumbling attempts.

The final part of the course was looking at the importance of record keeping, not just to see improvements, but if anything goes wrong, good notes will help to see where things started failing. Good records also form the basis for research as EPs can compare notes between them, for example, does everyone see an increase in laminitis during the snow, or after frosty mornings?

The homework for this module was to design some case recording forms, then go out and use them on a horse, and take a complete set of photographs of that horse – I have been taking photo’s of my horse’s feet for years, but a new camera and a different horse lead to some frustratingly amusing moments until I found myself a helper and the camera instruction manual.

The second module this month was looking at the influence of nutrition and environment on hooves. We had our first visiting speaker for day one, an independent Equine Nutritionist who talked about the digestive system, the types of feed that are best for horses and in what situations and where the different components of a balanced diet are absorbed within the gut. She also talked about how to balance a diet, the importance of fibre and most importantly with the current economic climate, how to feed a good diet without spending a fortune, something I’m sure my future clients will want to know.

The second part of this course was looking at environment, not just grass or stable, concrete or gravel, but we also looked at chemicals, both ingested and external and the affect they can have on hoof horn. Surprisingly, most of the chemicals we have traditionally used to treat thrush and white-line disease in the UK are actually damaging to hoof horn and therefore predispose the hoof to more infection (the cynic in me is trying not to think this is by design!!). We also considered work loads and type and how that can affect the feet – a horse living in a stable 12 hours per day and working in a rubber surface arena for an hour or two a day is going to have completely different feet to a horse that lives out 24/7 and is training for endurance – both are going to be pretty fit, but their feet will have adapted to work load and surfaces and will look different even if both horses are perfectly sound. As part of our look at different surfaces, we talked about how feet could be conditioned for different surfaces without having to travel around the country riding on different surfaces.

We also found out that this barefoot horse keeping thing is so old it’s new again! Xenophon wrote in 300BC:

“Even naturally sound hooves get spoiled in stalls with moist, smooth floors. The floors should be sloping, to avoid moisture, and, to prevent smoothness, stones should be sunk close to one another, each about the size of the hooves. The mere standing on such floors strengthens the feet. […] the place outside the stall would be best suited to the purpose to strengthening the feet if you threw down loosely four or five cartloads of stones, each big enough to fill your hand and about a pound and a half in weight, surrounding the whole with an iron border to keep them from getting scattered. Standing on these would be as good for him as travelling a stony road for some part of every day.”

Having finished the weekend by looking at some case studies, we were issued with our homework, and some hints for exam revision. Talking of which, I really must stop writing and get back to the revision.

We start trimming next month, so yet more excitement on the way soon…

Part 4

When I wrote last time, I was in the middle of revising for my first theory exam of the course. I am very pleased to be able to say I passed this, so can now concentrate on finishing various homework modules, writing up my notes and playing with my recording forms that I have already decided need tweaking before I use them again.

We have just come back from our first hands on trimming course. Five days away from home with a bunch of great students sharing a house is not particularly conducive to study or early nights, but we survived the week and more importantly learnt to use all of our brand new tools safely and came away with minimal injuries, a few rasp marks to my fingers was all for me, where I took my gloves off before putting my rasp away and no-one needed first aid.

We were working with cadaver legs for this first trimming course, which meant that if we got a little blasé and trimmed too much frog or toe off we weren’t going to cause any discomfort to the horse in the process, in fact, a couple of times, we were actively encouraged to go as far as we dared so that we could get an idea of what close to the edge of safe looked like. Another great thing about using cadavers is that the feet are usually in a shocking state before we start and we were able to see how simply applying a good trim made the foot look so much better.

Once each hoof was trimmed, we applied the Equine Podiatry Association’s usability scoring technique to the hoof so that we could get some practice judging the quality of hooves. Initially, we found this very difficult and basically had the tutors providing the scores for us, but, by the end of the week, it was getting easier to come up with a score for each foot, and more importantly be able to justify and discuss that score with the tutors.

As well as learning to trim, we were also helping out in a research project that is being run by one of the tutors. The aim of the project was to find out what the angle between the ground and the bottom of the pedal bone would be in a horse with healthy feet in good balance. Unfortunately, it is rather difficult to find healthy feet on cadavers, but, we were able to put good balance on the feet and found that where the back of the hoof was in good condition, we were getting good pedal bone angles. We also found some complete shockers, but the foot score indicated that this would be the case.

The course was held at the farm of one of the tutors, so we got to meet his horses and often had an audience while we were working as the horses looked in through the windows to see what we were up to, one horse in particular was fascinated and tried to eat ANYTHING that we put on the window sill, including hoof trimmings and kitchen knives!

I was thoroughly exhausted by the end of the week, and felt I had made real progress and in-roads into the pile of legs available to use, but when I added it all up, I discovered that I had managed to trim the grand sum of 3 ¼ horses in 4 ½ days. I’m thinking I may need to speed up a little before I go out trimming case studies, otherwise I may have some rather unhappy clients.

Part 5

Having got our exams out of the way, and knowing a little bit about trimming feet, it was time to learn about handling horses, before being let loose on real live horses with our still sharp tools.

Easy right? We all know how to handle horses, at least we think we do if we have horses in our lives, but what about the horse that doesn’t trust you to touch its leg, never mind pick the leg up and hold it between your legs while you wave a knife or rasp around? It is amazing how many owners think that it is the hoof care specialist who needs to teach this to their horse, and not their responsibility as an owner. This is why we have a Horse Behaviour and Horse Handling module as part of our course.

I must confess, I was a little sceptical about this course – I’ve been a student of natural horsemanship for a number of years now, and have a great relationship with my horses (I believe), so why would I need someone else to teach me about horse behaviour and handling?

Ben Hart (www.hartshorsemanship.com), our second guest instructor was the tutor for this course and he did a fantastic job at helping me to see things from a different point of view. Rather than teaching us how to do something – such as how to get a horse to walk past a scary object, or load into a trailer, he turned things around and made us think about our comfort zones and how much it would take to get us to cross that line. How much money would you need to be offered to go into a room with something that really scares you (I am reluctant to admit that I slightly lost the plot here because Ben started talking about me going into a room with one of those vile and very dangerous eight-legged creatures that lurk in corners catching flies!)? What about if an army drill sergeant yelled at you – would you do it then? Now think whether a mint or sugar cube is going to persuade your horse to go past that thing that really scares him, or whether you shouting at him will make him do it faster. This is what the course was about, how to convince a horse that we are not going to kill him when we take and hold on to his leg. We talked about training plans to help a horse get over its issue and how to devise a training plan to give to an owner to work on between visits.

As well as talking about the training plans and watching some videos of Ben using the plans in the real world we also got to play with this ourselves by trying to get a fellow student to do a series of tasks without speaking to them – this was very scary for the student who was “learning” the task, you suddenly realise what a horse might be going through and I for one was looking for regular reassurance from my “trainer” that I was on the right lines, I also got easily frustrated when I couldn’t find the right answer – how many times have we seen that in a horse?

Following on from the course (I’m writing this a couple of months after the event :oops:), I can say that this module has really helped me when out and about actually trimming – it has helped me to be far more patient with the horse that won’t keep its foot where I want it, and given me ideas how to help the horse to understand what I am asking for.