Veterinarians Working With Farriers
Equine practitioners have a critical role in helping horses stay sound enough to perform in their owners’ equestrian pursuits. Health of the hoof and the prevention of foot pain is a prerequisite for high levels of performance.
For success in reaching this goal, it is essential that veterinarians and farriers work together as a team in the best interest of the horse. As with anything in life, this brings together a variety of personalities and experience, some of which are in harmony and others that fiercely clash. Yet with care, respect and consideration, it is possible for even those with the most disparate opinions to find a common ground for collaboration.
Philip Himanka is a hoof care practitioner, which is the current preferred jargon for a barefoot farrier. He is certified with American Association of Professional Farriers (AAPF) as an International Accredited Professional Farrier (IAPF) and with the Pacific Hoof Care Practitioners organization (PHCP), in addition to serving as a member of the Equine Lameness Prevention Organization.
At a recent round table at the International Hoof Care Summit in Cincinnati, Ohio, one of the main discussions centered on how to encourage veterinarians to provide specific guidelines to the farrier as to what should be done for each horse. One complaint is that the vets are too busy and don’t take the time to do this. Perhaps there is more to this than being too busy. Perhaps vets don’t realize that for the farriers to be able to do a job that is satisfactory to the vet and horse owner, while achieving comfort for the horse, they must have guidelines from the vet.
In the round table discussion, it was suggested that veterinarians and farriers should provide each other with a certain set of “rules” or guidelines for how they engage together, stressed Himanka.
“Vets and farriers deal with the same thing, but often with two different approaches,” Himanka said. “If the ‘rules’ aren’t clear, then problems arise.”
It is important to define each professional’s approach to the hoof and clarify who is responsible for what, such as who determines whether the horse is lame. This relies on open communication, which comes easier with a good set of rules, Himanka said.
It is also important to recognize the third ingredient to the horse’s welfare: the horse owner. If agreed-upon approaches to a horse’s foot care are clear between the vet and farrier, then an owner tends to follow suggestions and recommendations. If there are disagreements, a horse owner often turns to the farrier for advice. Farriers visit the farm on a more regular basis and with less expense than a vet. Himanka pointed out that an owner’s tendency to turn to a farrier for assistance might simply be a financial decision.
He believes that everyone has the right to express an opinion, especially when a horse owner asks, “What do you think?” The horse, owner and farrier are all best served by a farrier clarifying that he or she has an opinion but is not in a position to make a diagnosis about the horse’s problem. Instead, the farrier should recommend that the horse owner consult with the veterinarian to pursue a thorough lameness workup to achieve a definitive diagnosis.
Furthermore, it is a disservice to a horse and owner to label a horse with a specific diagnosis, such as “navicular disease,” without evidence-based facts gleaned from a proper diagnostic workup. MRI imaging has demonstrated that what was once considered a “complete diagnosis” under the umbrella of navicular disease instead involves a potential number of pathologies within the podotrochlear apparatus. Any of these possibilities might or might not affect solely the navicular bone, and each pathology requires varied therapeutic approaches, not all reliant only on foot care.
In addition to a physical lameness workup by a veterinarian, radiographs are invaluable for both the veterinarian and the farrier. Images help to define the problem and are useful for making measurements and suggestions about what the farrier can do to correct imbalances and ease breakover. They are also useful when following up on the progress of a case. In particular, lateral and A-P radiographs enable a farrier to execute an appropriate trim and balance of each hoof.
The Blame Game
Problems arise when a veterinarian follows behind a farrier visit and the horse is found to be lame. Himanka urges veterinarians to recognize that in many cases, a farrier shows up to do his/her job and is unaware that the horse is lame until some point in the middle of the job, or not at all. The farrier finishes the work to the best of his or her ability.
A veterinarian might be inclined to cast blame on the farrier for the horse’s “sudden” lameness, but instead it is better if the vet is circumspect and doesn’t jump to conclusions. There is little way to know the soundness or lameness condition of the horse prior to the farrier’s visit.
An ideal approach is for both vet and farrier to collaborate and discuss all the details in private and decide together what strategies are best to help the horse. Once an agreement is reached, then the horse owner can be apprised of the details.
From an academic point of view, an owner might wish to sit in on the vet and farrier discussion, but if the two have a battle of wills and argue heatedly about the case, it is best done in private. Then, all a horse owner witnesses is the ultimate united front between the vet and farrier regarding methods for the horse’s care.
There are instances where a farrier, especially one starting out, might persistently trim a horse in a manner that causes lameness. Sometimes it is by accident, sometimes it is because of inexperience, sometimes it is because that is as much skill as the farrier has.
Rather than a vet turning to the horse owner and expressing a negative point of view about the farrier’s work, it is more appropriate for the vet to contact the farrier and speak directly to him or her about the problem. Veterinarians should look at this as a learning opportunity for the farrier and take the time to communicate the concerns and suggest some solutions.
Many farriers appreciate having a written “prescription” for how each hoof should be addressed. This was a main conversation point at the recent National Hoof Care Summit. Open lines of communication between the vet and farrier help each to learn from the other, and this helps to build trust over time.
Digital images of radiographs or photos, for example, are easily sent via email, but details about specific points are better conveyed in person with both parties standing by the horse to discuss the particulars. If a horse is in immediate need of farrier work, then calling the farrier by phone and also providing a written prescription via email can facilitate the proper attention to the horse in a timely fashion.
It is not uncommon to hear that horse owners feel sandwiched between personality clashes between vets and farriers. Often this occurs because of unclear communication by one or both parties. This is an unfortunate situation, because now the focus in on the wills and egos of individual people rather than solving problems for the horse. This makes the horse owner frustrated.
What works best is if both farrier and vet take the time to explain their views to each other, and also to the horse owner. Care must be taken with wording and phrases to avoid casting aspersions on one another.
If a veterinarian is precise in explaining the proposed therapy plan, then the owner is less likely to be confused, noted Himanka.
Alternatively, if egos get in the way and there is a back-and-forth “discussion” that isn’t based on facts, then the sparring individuals are simply asserting their own dogmas without evidence-based science to substantiate the arguments.
“The farrier or hoof care practitioner’s role is to help the horses have healthier hooves,” said Himanka.
The vet and farrier should work as a team. The focus isn’t just on the mechanics of a trim and application of shoes; it is about the health of the whole horse. Many conditions are considered in this approach—the horse’s breed, equestrian pursuit, exercise demands, environment and climate, housing, nutrition, and the horse’s age, body condition and endocrine status.
Hoof health is a manifestation of a horse’s overall health and also how well an owner does his or her homework. The timing and frequency of farrier visits, feeding strategies, soundness assessment, hoof care and conditioning all play a role.
It is critical that both farrier and veterinarian keep an open mind and try to learn from each other. This helps to build trust and promotes a successful working relationship. There are many situations where a horse owner asks a farrier to recommend a vet, and vice versa. This can work to the advantage of both individuals.
The AAPF’s mission statement notes: “The American Association of Professional Farriers will promote the integrity of the farrier industry by strengthening the knowledge and skills of its members through continuing education and support at the state, national and international levels while improving overall equine health through collaboration with other industry professionals.”
This covers some key points that are relevant to interaction of farriers and veterinarians. First, there is a call for continuing education, which is laudable; and, secondly there is a call for collaboration with other industry professionals, such as equine veterinarians. With this in mind, members of the AAPF organization state that they are committed to honing their skills to do the best by the horses. This quest for on-going education and improved skills is a familiar refrain, one with which dedicated equine veterinarians are familiar in their quest to become better practitioners.
It stands to reason that by working together in a team effort, farrier and vet together can keep a horse sound and the horse’s owner satisfied with their professionalism.
Editor’s note: There are other professional farriers’ associations, such as the American Farrier’s Association, as well as organizations such as NEAEP that are focused on training veterinarians and farriers together. Veterinarians and horse owners should look at a farrier’s experience and training, as well as talk to other clients of that professional, when selecting a farrier or when looking for a new farrier to work with.