Understanding the disease progression of abnormal hoof anatomy, Part 3

Understanding the disease progression of abnormal hoof anatomy, Part 3

Solving the mathematical needs of a Grade IV laminitic foot
Mar 01, 2012


One complication of deep flexor tenotomies is further contracture of the P3. Should this happen, dropping down to the level of the pastern for a second tenotomy is an option and often curative. I prefer my first attempt to be mid-cannon because, should contracture happen and I have done a mid-pastern tenotomy, I have no further options for surgical correction.

Cutting the volar nerve or the major blood vessels of the limb are other possible complications that can be avoided with careful dissection of the area around the tendon with long, curved Metzenbaum scissors—inserting closed blades and then opening the blades as you withdraw from your skin incision.

Some breeds of horses are more prone to contracture. Halter Quarter horses and some warm blood breeds will have further flexor contracture. Paso Finos, Thoroughbreds and some working Quarter horses breeds will often have a tendency to go the other direction, resulting in a negative palmar angle. These cases, regardless of the shoeing type used for realignment, will be set with a 2- to 3-degree palmar angle to avoid this problem.

Correction of a horse with FSS laminitis requires hoof wall ablation and transcortical pinning of the cannon bone (MC3 or MT3) and casting so the foot is nonweightbearing.4


All cases should be radiographed weekly to assess the continuing proper alignment and to assess growth. Horses with coronary band separation should be resected and treated daily with aseptic bandaging and topical antibiotics. Horses with solar prolapse should be treated with antibiotics and gauze packing weekly.

The work necessary to recover a Grade IV case is intensive and requires monitoring on a daily basis. All of our cases are treated in hospital as critical patients and are monitored with the use of stall video cameras. I have been rewarded more times that I can count with complete recovery and return to performance. I have also known defeat with the continual contractual cases and those sad sinking cases that get to us too late. But if we do not try, we do not learn, and if we do not learn, we cannot help.

Andrea E. Floyd, DVM, has specialized in equine podiatry for more than 25 years. She is the owner of Serenity Equine, Evington, Va., and the author of Equine Podiatry. Dr. Floyd is a member of the American Veterinary Medical Association, American Association of Equine Practitioners and the American Farriers Association.


1. Floyd AE, Mansmann RA. Table 16.2. In: Equine podiatry. St. Louis, Mo: Saunders Elsevier, 2007;323.

2. Floyd AE, Mansmann RA. Table 16.3. In: Equine podiatry. St. Louis, Mo: Saunders Elsevier, 2007;323.

3. Floyd AE, Mansmann RA. Figure 18-13. Equine podiatry. St. Louis, Mo: Saunders Elsevier, St. Louis, MO, 63146, 2007;352.

4. Floyd AE, Mansmann RA. Figures 16-19, 16-20. In: Equine podiatry. St. Louis, Mo: Saunders Elsevier, 2007;327.