Talk:Laminitis/Archive 1

Miscellaneous
This is one of the best pages I've found on laminitis, keep up the good work everyone, thanks

Bananas'n'Cream —The preceding unsigned comment was added by Special:Contributions/ (talk)

"No cure"? I don't agree at all! This is the traditional point of view, but it is not a complete one - a mention to barefoot laminitis rehabilitation is mandatory in my opinion, and I'm going to add it now. I added a subtitle "The traditional point of view", some rows titled "The barefoot rehabilitation practice", and a link to Pete Ramey website.

--Alex brollo 13:05, 6 November 2005 (UTC)

I also had a horse who had laminitis (among other health problems) who was given to me. I had a specialized natural hoof trimmer treat him every three to four weeks untill the hoof began correcting it self. No western medicine or shoeing has been used at all and the horse is almost 100% sound now. --User: Mallory Schuckert 10:02, 5 May 2006

Recent updates of Laminitis
I see many edits by user:Ronald Aalders, that are (as I can see) the only contribution of the user to en.wiki. Ronald: I encourage you to put something about you into your user page! And - please - add something to Talk page when editing an article!!

Ronald underlines the "anedoctical" nature of laminitis rehab reports by the Barefoot movement. Nevertheless he added a link to a single (reputated!) professional farrier and deleted a link to a (reputated!) professional barefoot trimmer webpage (http://www.hoofrehab.com), where you can find lots of scientifical and professional links. Why?

I hope in some discussion about (I'm not a vet nor a large experienced professional trimmer); I agree that there is some lack of scientific method in rehab reports by barefoot enthusiasts and by current leaders of the barefoot movement (there are too few numbers!), and I'd like to encourage any of them to more formal, documented reports; nevertheless, as a human pathologist involved in scientific research, I see too:


 * there is a firm biological plausibility in favour of barefoot laminitis rehab approach, from dr Hiltrud Strasser studies on hoof physiopathology, confirmed by other;
 * a main difference in outcome (from "no cure" to "almost 100% rehab") is considered a good indicator of "evidence";
 * the hoof should be considered a Complex system. The science of complex systems is relatively new, but the "holistic approach" ("systemic approach") to hoof rehab, firmly suggested by any barefoot movement leader, is really very interesting and firm-grounded;
 * academic vet research on this issue is going on (see http://www.hoofrehab.com/if__you_are_interested_in_doing.htm )

In my opinion, much of traditional "knowledge" about horse hooves and horse soundness is a matter of retained ideas, with a very low degree of "scientific" evidence. On the contraty, I think that the sentence "Every system of horsemanship practised in the horse world today should come under scrutiny" by Jaime Jackson, one from the leaders of Barefoot Movement, is inherently a very good proof of a right "scientific method and mind", even if Jackson is not considered a "scientist" so far. --Alex brollo 07:41, 10 May 2006 (UTC)

I very much doubt that whoever said "no cure" has much first hand experience of treating laminitics. A full clinical cure can be achieved, and would normally be expected if there are no complicating factors (e.g. Equine Metabolic Syndrome or Cushing's Disease). As to whether a micro-anatomical cure can be efected - that is still under debate, for both systems. But as a practicing equine vet, a clinical cure is good enough for my patients and my clients, and should be good enough for most people. For what its worth, my personal opinion is that some individual horses do well on the barefoot programme, whereas others go catastrophically wrong. I suspect that some individuals are better candidates for one system of treatment, some for another. But to claim that "conventional treatment" cannot effect a cure is propaganda at best, and a malicious lie at worst. (Dlh-stablelights 10:55, 12 June 2007 (UTC))

As a professional Barefoot trimmer that works with Vets on all facets of hoof care, I feel that the old methods while they may work is more upto the genetics rather than the applicator. One trimmer uses the term "inspite of the efforts of humans". Barefoot allows a precise analysis and support of hoof repair, we delude ourselves if we claim that we fix the hoof. The real trick is to help nature work effectively and not to cause futher damage. One local farrier had a client painting Iodine with Formalin onto the exposed coffin bones of a horse nearby. The horse was getting worse, with the application of barefoot trimming the horse could have been ridden if you wanted to. The owners are annoyed they did not try barefoot 3 months ago when the horse first foundered.--Thehoofsmith (talk) 11:03, 10 December 2007 (UTC)

Barefoot point of view section edited back
I edited back (with much effort to NPOV: at my best!) the section on barefoot movement point of view. Here the previous version:

After the studies on hoof health by Jaime Jackson and dr. Hiltrud Strasser, an alternative and much more optimistic point of view on laminitis is growing up. Unfortunately, no scientific studies exist in support of such optimism and the claims of the barefoot advocates are purely anecdotal. For an overview of anecdotes which comprise the Barefoot movement "state of art" on laminitis and lots of other horse health topics, see Barefoot for Soundness by Marjorie Smith. See also Barefoot horses. For a comparison of the efficacy of various protocols, see any edition of Stashak's "Adams Lameness in Horses" or Rooney's, "The Lame Horse"; both are standard veterinary texts. Additionally, http://www.hopeforsoundness.com offers a proven successful protocol that involves both correct trimming and the application of specific orthotics to manage and remediate the pathology.

Please search Google with the keywords "Barefoot horses laminitis" and you'll find something more than "anecdotes"!

When I did that, I was not logged in! I apologyze...--Alex brollo 23:19, 10 May 2006 (UTC)


 * I have modified the Barefoot treatment section to show verifiable and repeatable information about hoof repair.
 * I have tried to avoid point of view arguments by concentrating on the things that can be verified by anyone who wants to by checking on the web for more info. You will always get some that do not want to check deeper into the facts.--Thehoofsmith (talk) 10:53, 10 December 2007 (UTC)

Treatment edited (NPOV and promotion issues)
I removed this section from "Treatment": ''There are several techniques to treat laminitis. Two main streams can be detected. One developed by the late world-renowned farrier Burney Chapman, of Texas USA, another by the veterinarian-farrier Ric Redden of Kentucky, USA. On both information can be found on the web and in various published articles.'' It seems promotional and not NPOV.

I added this coming from a previous edit of the next section (see previous talk post): For a comparison of the efficacy of various protocols, see any edition of Stashak's "Adams Lameness in Horses" or Rooney's, "The Lame Horse"; both are standard veterinary texts.

I didn't add this from the same source: Additionally, http://www.hopeforsoundness.com offers a proven successful protocol that involves both correct trimming and the application of specific orthotics to manage and remediate the pathology. because I feel it a little promotional (even if Gene Ovniceck, the page owner, is a really highly reputated farrier and trimmer).

Please note: barefoot horses and horse disease treatment are flaming topics. NPOV is very difficult to obtain - help us with comments and good research quotes!Alex brollo 06:31, 11 May 2006 (UTC)

Foundering
The article currently states that foundering is "related" to laminitis, but Foundering currently redirects to Laminitis. Should it have its own article? ~ Booyabazooka 03:15, 22 May 2006 (UTC)
 * "Founder" and "foundering" indicate the most common form for "laminitis", that looks like a rotation of the coffin bone relative to the hoof walls (as in RX into the article). Another form is called "sinking"; it's more severe. No matter: just to popularize something about this very intriguing disease/syndrome, founder can be consider a synonym for laminitis. --Alex brollo 05:04, 28 May 2006 (UTC)
 * As I understand it, there may be a different shade of meaning, either side of the Atlantic Ocean. In the UK, I believe it used to apply to 'sinking' while in the US, to all forms of chronic deformity associated with the post-laminitic foot. The term 'laminitis' itself should, I believe, be reserved for the active inflammatory process. As to the question of a new page for founder, I personally think not. - Ballista 05:44, 28 May 2006 (UTC)
 * For a brief introduction and definition of laminitis, "foundering" and "sinking", and lots of recent horse-related new opinions, take a look to Laminitis on the beautiful divulgative website of Marjorie Smith ; for a deeper insight see the websites of dr J. Steward and of Pete Ramey.--Alex brollo 06:08, 29 May 2006 (UTC)
 * Founder should have its own section due to the fact you can have a laminitic episode with out founder. Laminitis is the chemical inflammation and breakdown of the laminae from and external trigger. Founder which is literally a nautical term to relate the sinking of the pedal bone, is quite seperate from laminitis and can occur in the hoof without laminitis.--Thehoofsmith (talk) 10:45, 10 December 2007 (UTC)

dr John Steward's revision
I e-mailed dr John Steward (as a reputate expert on laminitis: http://www.johnthevet.co.uk) as suggested by User:Malcolm Morley. He took a look at Laminitis page, and his review is rather severe. I'm waiting for an explicit permission to publish here his original, private e-mail; nevertheless his opinion, in brief, is that he can't personally review the article, because it's so far from current research and form his knowledge and professional experience.

I'll try a deep revision of laminitis, much bolder than my previous one, based on recent scientific sources (as suggested and quoted by dr Steward) and with much more emphasis to recent, "unconventional" points of view and experiences (dr Steward has a personal, NPOV experience about dr Strasser opinions; I'll add something deeper about AANHCP approach).

I encourage any of you to have a good look to dr Steward's website and to follow all from its links for its "sources of information"; unluckily, as I presumed, much about horses disease and management on wiki has to been hardly reviewed, because retained ideas (even if so widely believed) are so "far from infrequent". The fight between current, widely believed, undocumented opinions about horses and NPOV is a very interesting general problem in my opinion--Alex brollo 05:38, 29 May 2006 (UTC)

Dr. Steward opinion: details
My question to dr John Steward:

John, [...] 1. First, the main reason I'm writing you. Do you know anything about wikipedia (http://en.wikipedia.org)? It's a free, international, multilengual enciclopedia, really a "free knowledge container" following the philosophy of the GNU project [...]. There is currently a discussion about Laminitis into wikipedia, and an expert opinion is needed about. A "wiki-friend" (Malcolm Morley, a vet surgeon) suggested me to ask you if you would like to be such an expert. [...] Look for "Laminitis" and take a look to Talk page too, if you are interested about.

3. [...] -- You mention the website of Pete Ramey as a source of information, but you seem not considering so much his content (and in general, the AANHCP approach to laminitis and barefoot horse); your discussion about is mainly centered on dr Strasser research and practice. Why? -- The hoof mechanism is the key to understand both the the phisiology and the pathology of the shod, and of the barefoot hoof. An a pathologist, I'm fully convinced by the Strasser ideas about - that is, in brief, that hoof expands when loaded and contracts in its suspension phase [...] This is - more or less - the opinion shared by dr Strasser and by all from the various barefoot trimming schools; this is why solar concavity, and a free hoof mechanism (almost completely suppressed by shoes), is so important in our opinion, both in healthy horse (to prevent disease) and in diseased hoof (to fasten healing). The hoof mechanism is detailed into The Natural Horse by Jaime Jackson, a really excellent book in my opinion; obviously Jackson quotes scientific research, not at all "his own" ideas and opinions! [...] Alex

Here Dr. Steward'd kind replies:

Alessandro, I have looked at the Wikipedia site before and there is so much in it that I disagree with, starting with the first line "Laminitis is inflammation of the sensitive laminae of the foot in a horse". However I do not feel it is my place to change things. My views on laminitis have been formed by studying scientific papers, investigating horse's feet and what I see clinically when dealing with cases of laminitis. Not enough to present as acceptable scientific evidence.

The advantage I have with my website is that I can supply up to date information on what we do know and is generally accepted as true (not much of that), report a range of other's ideas and in the controversial areas I can use photos and argue the point for my opinions.

Why do I feature Dr Strasser's views but not much about other barefoot trimming techniques? This is obviously a question I have been asked before.

As you will see from my site it is "Why do we fail?" that I consider the real question. In the search for this I attended a weekend course given by Dr Strasser. Some of her ideas I agreed with and some I did not believe, and still don't, but there was a lot that I just didn't know. Since then I have been studying quite a number of these aspects of horse's feet and I now am questioning many of the often repeated traditional "facts" about feet.

Researching different opinions, I suggest that traditional farriers study and deal with hoof form whereas those in the barefoot movement consider hoof form and function. It seems to me that most barefoot trimming methods are basically along similar lines with Strasser at one extreme and traditional farriery techniques, by some distance, at the other.

I have insufficient knowledge about the differences in other's methods, but having read material by Peter Ramey and others, and agreeing with a lot of what they say, I have included them in my Links. Having said that, I have also included links to other sites where I know that the authors will disagree with what I say. It will be up to each individual to decide which way is "right".

The last bit about hoof mechanism. I just think that any movement of the hoof wall will be as a result of the opposing forces between the ground and the weight of the horse. With that much compression, I just think that the blood has to be forced out of the foot and could not possibly draw it in.

I am sure there will be other parts of the site that you will question. Its other function - to stimulate discussion.

The next things to add to the site will be other pieces questioning "traditional thought".

Cheers

John ---

Alex,

This morning I have been thinking of Wikipedia and Laminitis.

We have very little fact and enormous amounts of speculation and theory.

With at least half a dozen theories on how it develops. The list of causes (on wiki) including things that have been speculated to fit into the above theories, but we have no evidence for, or necessarily against for that matter. Symptoms (on wiki) including 4/9 that are general signs of pain and discomfort and in no way specific to laminitis. Complications includes the cause of rotation that I disagree with, Treatment doesn't tell us anything and The barefoot movement at least gives directions to go looking. There is nothing about management but fortunately medication has not been entered because we could have an endless list of things that people have used with absolutely no evidence for their efficacy.

I am sure the principal for Wikipedia is excellent and perhaps it should be the site "for the people" because the opinions of those studying the condition can be very polarised.

I repeat what I wrote at the end of the piece I did "In Defence of Strasser"

- Many of the people who are critical of Dr Strasser have never attended one of her courses or read her books. My criticism after I attended her course was that she was selective of the science she uses, but when it comes to matters of the horse's foot then I believe we are all guilty of that. I certainly am.

There are too many things said about laminitis that I have doubts about or disagree with for me to monitor the Wikipedia Laminitis site fairly.

I will have my work cut out to try to keep my website up to date.

Cheers

John ---

Dear Alex,

1. I am very happy for you to add my reply to the discussion page.

[...]

John

A main source for laminitis understanding & updating
OK guys, there is no limit to MY ignorance... I just read something from http://www.safergrass.org and this is the only NPOV conclusion I can draw! How could I miss this website??? If you didn't read it, do!

I see many recent edits in this page. Thank you! I'm really happy for my "first step" when starting a discussion about, some months ago. I'll work to it again, as soon I feel myself a little more confortable with this topic; but first I've to discuss it with my friends at our forum.--Alex brollo 05:41, 1 June 2006 (UTC)

Image of Radiograph
I took the radiograph on the laminitis page. The angle between P2 and P3 depends mostly on how the pony is weight bearing on the foot. If I had stood the pony in a different position, the angle would have been completely different. We see that time and time again. The dorsal wall of P3 is no longer parallel with the hoof capsule and so P3 must be rotated RELATIVE to the hoof capsule (although this case does not actually show much rotation). It doesn't really matter whether you say P3 or the hoof capsule is rotated.... it is the relative rotation that is important. The sole at the toes is, by definition, also thinner with rotation because the tip of P3 has to drop. This is basic interpretation of radiographs. Malcolm Morley BVSc MRCVS. Malcolm Morley 16:20, 2 June 2006 (UTC)
 * OK! Now the text is good; I like that "relative". Nevertheless, I think that the term "rotation" will be edited in the future; I'd like something as "P3 dropping". "Rotation" seems related to a pathogenetic role of a "tendon's contracture" no more seen as so important, but that suggests some inappropriate treatment (like as putting a wedge pad under the foot, higher below heels, to "decontract" the flexor tendon: I just got some pictures from a friend some days ago).
 * Why the sole under the toe is thin? Well, in the opinion of Pete Ramey, simply because... someone rasped it away: I personally see more horses lamed by the farrier’s rasp than by every other means combined. I would love to see a rasp designed to deliver a strong electric shock to its handler if it gets closer than 5/8 of an inch away from the bottom of any collateral groove for any reason. A hoof knife that shocks its handler if it gets closer than 5/8 inch away from a coffin bone or lateral cartilage would be nice as well. I would spend my very last dime; buying them and distributing them all over the world. There is no excuse for such a blatant misunderstanding of the foot. Most subsolar abscesses and EVERY coffin bone sole penetration I have ever seen came along in the wake of previous trimming away of the sole material under the coffin bone or lateral cartilages. This is a strong statement, I know, but painfully accurate.. A rotated toe of P3 could buldge the sole in front of frog; probably it can't thin it.--Alex brollo 21:47, 4 June 2006 (UTC)

WIP in Horse hoof
I'm working on a new Horse hoof article. We are speaking about a advanced hoof topic without good bases here into wiki!--Alex brollo 14:57, 6 June 2006 (UTC)

Founder specimen picture added
After the opportunity to meet Sonja Appelt and Matthias Gerss, I could take a picture from some of their very interesting hoof specimens. The picture needs some graphic editing (mainly, some edit of its background). Do it if you can. --Alex brollo 06:13, 19 June 2006 (UTC)

Cryotherapy
The cryotherapy addition requires some form of reference/support - also, perhaps it is not in the correct position in the article? - Ballista 19:24, 15 August 2006 (UTC)

Images
The two images on this page need some comparison. I know that when I look at them I don't quite understand visually what exactly is wrong with the hoof, and I'm sure there are other readers that feel that same way. It shouldn't require you to be knowledgable of a hoof. I think both an x-ray, and a bisected specimen of a the same hoof (i'm not sure if this only afflicts horses, or if it's all hooved animals) so that a visual comparison may be made to better understand what is happening. Bignole 17:14, 31 January 2007 (UTC)

Thanks !
Thanks for a thought provoking article and talk page. I have tidied up some references using the WP:Citation_templates formats. I know nothing about the subject, but due to the uncertainty of the causes, I think that there needs to be clear separation at every level of the article between fact and conjecture. Reasoned conjecture doesn't need to be excluded, just clearly identified as such. Perhaps explore BOLD, revert, discuss cycle and WP:Consensus combined with WP:Verifiability. Good work - thanks ! -- John (Daytona2 · talk) 11:43, 20 November 2007 (UTC)

Disease articles follow MEDMOS
How to organize this article? Since laminitis is a disease, follow WP:MEDMOS, which includes a recommended list of sections. --Una Smith (talk) 22:21, 16 February 2008 (UTC)

History
A PhD dissertation on the (European) history of laminitis is here. It is in German. --Una Smith (talk) 22:31, 16 February 2008 (UTC)


 * Thehorse.com has a lot of articles on recent research, and they are in English. They do not always reference the actual peer-reviewed journals, but sometimes they do, and the magazine is, I think, published by the AAEP, so a fairly reliable source.  Medical material in Equus Magazine is also usually sourced to something as well, usually in fine print at the end of the article. I wish I had the time to tackle this one... but don't at the moment.   Montanabw (talk) 01:52, 17 February 2008 (UTC)

Re-organizing
I have started to re-arrange some of the information on the page. For those concerned about deletion of information, I have not deleted anything unique, but many things are moved, and some redundant phrases have been removed. There is still some redundant stuff (the Complications and Complications of laminitis sections cover most of the same ground). This re-organization moves maybe a little closer to the medical formatting found at MEDMOS as Una Smith has recommended, but I think it is still in need of help. For one thing, I think there are too few citations in the text of the article, and way too many 'recommended readings' and 'external links.' These should be folded into the article as citations where appropriate, and moved out of these accessory lists.

I did attempt a re-writing of the barefoot section. This was done to attempt a more NPOV. I did not remove anything except some peacock terms, but attempted to structure phrases in a more neutral way. This section is currently high on proclamations of success, and completely lacking in any specific information on approach to treatment. This section was made a sub-category of a new section called mechanical approaches to hoofcare.

The Nolan Hoof Plate section is now also under mechanical approaches to hoofcare, along with a few other currently used orthotic devices. This list of orthotic techniques is definitely incomplete, and currently only in skeletal form. The Nolan section still seems a bit POV to me.

I think that the causes section could be re-organized, and possibly consolidated (for instance, carbohydrate overload, lush pasture, and frosted grass are essentially the same thing.)

A history section would be very interesting. Maybe Una can translate the German dissertation on European history of laminitis as a start. I can contribute some information from some 100-year-old veterinary books which might at least give some recent historical perspective.

I am hopeful that this will generate positive discussions and not edit warring. The changes I made are certainly not etched in stone. Currently, the article still needs lots of wikifying love...--Getwood (talk) 22:21, 19 April 2008 (UTC)


 * I don't have any problems with your work, personally, you are credible in your contributions, source your edits and clearly have expertise in the subject. I've really liked most of what I've seen you do here! Of course, saying that, I will probably bring the wrath of some of the other folks who have personal issues with me down on your head, so I shall apologize in advance if that happens! (LOL)


 * In terms of content thoughts, I think a full-on discussion of the whole "safer grass" trend would be worthwhile, as what is coming out on NSC (and by the way, there is no article on what NSCs are, it would be a useful new article link off this article, off easy keeper and maybe some others.) and such challenges a lot of the conventional wisdom that horse people relied on for at least half a century.  I would also be interested in seeing a good, balanced (NPOV) discussion of the "better off barefoot as a rule"  versus shoe treatment question, as I have heard mainstream farriers and veterinarians come down on both sides of the issue.  Probably can't do more than a basic summary of the main positions, with refs for more info.  But better you write it than me!  (LOL again!)   Montanabw (talk) 05:24, 20 April 2008 (UTC)