Fostering the Farrier-Veterinarian Relationship, Opening the Doors to Communication
Ruth-Anne Richter BSc (Hon), DVM, MS

Equine sports medicine has become a burgeoning field with many veterinary practitioners now spending more time focusing on this area. The availability of more advanced and more portable imaging technology has helped to elevate this field into a specialty. As this field evolves, it has become apparent that a team approach is necessary in the maintenance of the equine athlete. This team approach becomes doubly important when dealing with performance-related injury. The ‘horse management team’ should include the owner, +/- trainer, veterinarian and importantly, the farrier. To achieve the desired outcome, and to function as a unit, there needs to be open and free communication between the team members. Trying to co-coordinate schedules in a timely manner can sometimes prove to be difficult; however, to best serve the horse and to increase the probability of a positive result, a little effort by all parties really does go a long way.

A number of performance-related injuries can be helped with therapeutic shoeing to provide support and to distract negative forces on the injured leg. However, this can become a common cause for frustration and miscommunication when the veterinarian relies on the client to relay prescription shoeing information to the farrier for a specified problem. This sometimes leads to misinterpretation, the desired goal is not achieved, and the horse does not improve. The owner then becomes discouraged and either changes farriers or the veterinarian. To reduce the potential for resentment, direct discussion of the case between the veterinarian and the farrier not only helps to achieve the desired outcome, but also often reveals a lot of valuable information to both parties that may help in diagnosing and rehabilitating the horse. The ability to email digital radiographs has proven to be extremely useful to the farrier when a specific shoeing request has been made by the veterinarian, and even for routine cases.

Our practice (Surgi-Care Center for Horses), has adopted the philosophy of ‘giving back’ to the referring veterinarian and has, for a number of years, presented quarterly Grand Rounds at which cases and timely topics are shared that may benefit their practices. In 2008, Surgi-Care held the first Grand Rounds meeting that also included farriers with whom they (the referring DVMs) have worked on foot-related problems. This event proved to be successful, and produced positive feedback as well as some constructive criticism. Following this, and taking some of the comments into account, another event the following year was put on for the local farriers specifically, with veterinarians invited to attend if they were interested. This particular event involved the use of the ONTRACK gait analysis software and followed one horse through a series of trimming and shoeing cycles. The event was well attended by both farriers and equine veterinarians. A lot was learned from the project horse, and the use of the gait analysis software highlighted its problems, which gave the attendees a good appreciation for what actually happens to the foot (and leg) as it goes through the arc of flight and the stance phase. Using the software program, a second horse was evaluated when shod with different shoe types. It was this horse that opened our eyes to a number of things including the fact that one farrier’s interpretation of a shoeing “prescription” might not be the same as another’s. The “shoe”, while it was descriptively ‘correct’, was an exaggerated version of a ‘prescription’ shoe. It markedly changed the horse’s way of going when viewed in slow motion, and not in a good way. This particular horse, and that one shoeing interpretation emphasized the need for more direct communication between the veterinarian and the farrier.

Veterinarians and farriers come from diverse backgrounds, not only in education, but also with levels of experience. This brings diversity in opinions; some based on experience, some on preconception, some from the literature and some from what has been taught in school. Many more recent graduate veterinarians have not had extensive equine experience, and most receive little exposure to equine podiatry at veterinary school. This leaves them making requests of a farrier who may have years of horse experience when they (the DVM) may not understand some of the concepts of trimming and shoeing, the physiology or function of the feet, nor have they had this exposure gained from many years of practice. Importantly, and what came out of the 2009 farrier meeting was that we don’t all speak the same language when it comes to feet and shoeing.

How do we rectify some of these problems? These concerns spawned the idea of having an informal evening at our practice where local farriers and veterinarians can come to spend time every month with an experienced farrier(s). The first evening was lead entirely by the farrier; the basics were covered for the veterinarians in the group as well as some apprentice and younger farriers that were attending. The most important of which was describing balance, and the correct placement of a shoe. While the term balance is open to interpretation, the basis of a balanced and well-trimmed foot prior to shoe placement cannot be disputed and was agreed upon by all the farriers attending. This concept was presented to the veterinarians in a way that was easy to understand, and was done as the horse was trimmed so that it could be seen first hand. These evening events have been designed to provide a friendly and open forum for an exchange of ideas between the veterinarian and the farrier. Formats range from having wet labs, demonstrations, lectures and informal discussions. Participating farriers and veterinarians alike are also encouraged to present cases that they have been working on, or ask questions about a case or cases that pose particular problems to them. These evenings also expose both the veterinarian and the farrier to alternative techniques in an effort to create a common ground in language, techniques and understanding. But, most importantly, they have promoted the development of mutual respect.

The use of the ONTRACK software at our practice has proven to be a tool that does help to “open” that door to discussion of a particular case with the farrier as well as the horse owner +/- trainer. Using a team approach and using a tool such as this can only benefit the horse in the long run. The beauty of this equipment is that the farrier can access the study off site if he or she is unable to be at the clinic at the same time the horse is examined.

Great opportunities to foster the veterinarian-farrier relationship come from larger meetings when professionals from all over the country can exchange ideas and discuss topics. Conferences such as those hosted by the Florida Association of Equine Practitioners in Orlando are invaluable at keeping the lines of communication open between veterinarians and farriers. These expose both parties to new techniques, provide updated information on timely topics, as well as providing a good review of the basics. At the most recent symposium in 2009, a recurring theme amongst the speakers was the importance of communication between the veterinarian and the farrier.

As with anything, change often takes small steps; we can affect change by starting small and building upon solid groundwork. While all veterinarians and farriers alike do not have the perfect answer to a specific problem, hearing each other out may reveal that while a slightly different language is being spoken, the goal is going to be the same - to do the best thing for the horse. Supporting clinical findings and recommendations with images such as radiographs and ultrasound, or video of the horse, go a long way in helping the farrier to achieve the desired shoeing result. The key to a successful ‘horse management team’ that ultimately benefits the horse is to develop an open working relationship that is founded on mutual respect and trust.

Surgi-Care Center for Horses hosts their Farrier-Veterinarian Happy Hour every third Thursday of the month at 6 pm. The annual farrier-veterinarian meeting and wet lab is on Saturday April 17th 2010.

For more information about the farrier-veterinarian events, please visit the Surgi-Care website at www.Surgi-Carecenter.com or email Dr. Richter at rrichter@surgi-carecenter.com

This article was originally published in Horse & Pony magazine and is reprinted with their permission.

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