Rehabilitation of the horse with chronic laminitis is not a "cookbook" process as affected horses with chronic laminitis will vary from horse to horse and foot to foot and our understanding of the disease is still vague. However, the understanding ofdigital mechanics has improved and technological advances in shoe design / materials and techniques continue to expand. Chronic laminitis defined means that the distal phalanx (P3) has displaced within the hoof capsule. The distal phalanx can rotate downwards at the toe, rotate to either side (laterally or medially) or it can totally displace (sink) within the hoof capsule. Rehabilitation of the horse with chronic laminitis will again depend on the amount of viable lamellae that remain intact, the conformation of the foot and the ability to realign the distal phalanx within the hoof capsule. The question is often asked as to when to shoe a horse with chronic laminitis. The guidelines that may be used are that the horse is becoming more comfortable (stability) on decreasing medication, and that the foot has stabilized (i.e. there has been no further radiographic changes in the foot for a given period of time). The author has not been successful nor observed improvement in the laminitic state of a horse when having to use local anesthesia in order to lift the horse's foot and apply a shoe before the foot has stabilized.
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