Digital perfusion, evaluated scintigraphically, and hoof wall growth in horses with chronic laminitis treated with egg bar-heart bar shoeing and coronary grooving.

Nuclear scintigraphy was used to assess digital perfusion before and after treatment in 10 horses with clinical and radiographic evidence of chronic laminitis. Horses were evaluated for lameness, degree of distal phalanx rotation, and heel-toe hoof wall growth ratio, and randomly divided into two treatment groups. Group 1 horses received only egg bar-heart bar shoeing; Group 2 underwent egg bar-heart bar shoeing and coronary grooving. Horses were re-evaluated for digital perfusion, lameness, degree of distal phalanx rotation, and hoof wall growth at 6 week intervals over the 18 week follow-up period. Prior to treatment, relative scintigraphic activity at the dorsal laminar area was decreased and relative scintigraphic activity at the toe and adjacent solar area was increased. Egg bar-heart bar shoeing was associated with significantly increased dorsal laminar scintigraphic activity and significantly decreased solar scintigraphic activity over the 18 week period. Coronary grooving, in combination with egg bar-heart bar shoeing, resulted in a significantly lower heel-toe hoof wall growth ratio but did not enhance digital perfusion. Seven of 10 (70%) horses were responsive to treatment, defined as an improvement in lameness by at least one grade. Horses that were refractory to treatment had significantly lower dorsal laminar scintigraphic activity and higher palmar coronary scintigraphic activity prior to treatment than horses that responded to treatment. Our results are the first to demonstrate that egg bar-heart bar shoeing is associated with improved dorsal laminar perfusion, and support the use of this technique. In addition, we found that pre-treatment nuclear scintigraphy was predictive of clinical outcome in horses with chronic laminitis treated with corrective shoeing.