K85 Ranch Equine Sports Therapy

02/24/2026

Most of our performance horses are relatively safe from this issue mebtioned below because exercise is shown to be an effective way to control insulin, however, this study is so interesting because it was performed on metabolically normal geldings. This has huge implications for those with insulin deregulation issues that need care.

🚨 Steroids, Insulin, and Lamellar Structural Failure: What New Research Means for Our Horses 🚨
As many of you know, at our clinic we frequently discuss the risks associated with corticosteroid use—especially in horses with underlying metabolic risk. A large number of our lamellar structural failure cases each year are steroid-associated.
In many of these horses, the metabolic dysfunction was likely subclinical… until the steroid pushed them over the edge.
📚 Recent Research Adds Important Insight
A recent prospective, controlled crossover study evaluated the effect of the SGLT2 inhibitor ertugliflozin on insulin response after intra-articular corticosteroid administration.
Study Summary
8 metabolically normal geldings
Received intra-articular triamcinolone (18 mg)
Compared no treatment vs. 7 days of ertugliflozin before and after injection
Measured resting glucose, resting insulin, and oral sugar test (OST) responses
Key Findings:
✔ Insulin significantly lower 2 days after steroid injection with SGLT2 inhibitor
✔ Resting glucose significantly lower at 8–48 hours
✔ Resting insulin significantly lower at 12–72 hours
✔ Suggests reduced hyperinsulinemic response after steroid administration
Even in metabolically normal horses, insulin and glucose responses were blunted with SGLT2 inhibition.
The authors concluded that further investigation in insulin dysregulated horses is warranted — particularly regarding laminitis risk reduction.
🧬 Why This Matters Clinically
⚠ Hyperinsulinemia = Lamellar Risk
We now understand that hyperinsulinemia alone can induce lamellar pathology, even in the absence of systemic inflammation. Steroids can:
Increase insulin concentrations
Worsen underlying insulin dysregulation
Trigger lamellar structural failure
In horses with:
Equine metabolic syndrome
Regional adiposity (cresty neck, fat pads)
Obesity
Previous laminitis
Subclinical insulin dysregulation
…the addition of corticosteroids may be enough to initiate failure at the lamellar interface.
🐴 Equine Metabolic Syndrome (EMS)
Equine Metabolic Syndrome is characterized by:
Insulin dysregulation
Regional adiposity
Increased laminitis risk
Many performance horses today are:
Easy keepers
Over-conditioned
Fed high NSC diets
Exercised inconsistently
And importantly — some appear outwardly normal but have abnormal insulin dynamics.
💉 Steroids and the “Metabolic Push”
We use corticosteroids for:
Joint inflammation
Soft tissue injury
Respiratory disease
Allergic conditions
But steroids:
Increase insulin concentrations
Reduce peripheral glucose utilization
Can unmask latent metabolic dysfunction
In our practice, many steroid-associated lamellar structural failure cases are not classic “Cushing’s horses.”
They are subclinical metabolic horses that decompensate after steroid exposure.
💊 Where SGLT2 Inhibitors Fit
SGLT2 inhibitors:
Promote urinary glucose excretion
Reduce circulating glucose
Lower insulin concentrations
Improve insulin dynamics
Over the past few years, we have recommended SGLT2 inhibitors in suspect metabolic cases, particularly:
Prior to or surrounding steroid use
In known insulin dysregulated horses
In high-risk laminitis patients
This new research supports that strategy — showing measurable reduction in insulin and glucose changes even in metabolically normal horses.
🔎 Practical Take-Home Points
✔ Not all metabolic horses look obviously metabolic
✔ Steroids can induce hyperinsulinemia
✔ Hyperinsulinemia drives lamellar structural failure
✔ SGLT2 inhibitors may reduce steroid-associated insulin spikes
✔ Screening (resting insulin + oral sugar testing) matters
🧠 Our Philosophy
We are not anti-steroid.
We are anti-uninformed risk.
Every decision should be:
Mechanically informed
Metabolically informed
Individualized
If your horse requires corticosteroids, especially if:
Overweight
Previously laminitic
Cresty
Has regional adiposity
…let’s discuss metabolic screening and risk mitigation strategies.
Because when it comes to lamellar structural failure, prevention is always easier than rehabilitation.
— Dr. Sammy L. Pittman
Innovative Equine Podiatry & Veterinary Services
Helping Your Help Horses — From the Ground Up 🐴

02/19/2026

Some times a “just ain’t right” lameness is deeper than just body soreness.

Many equestrians are aware of the signs of severe vitamin E deficiency, which include neurological issues and muscle wasting. However, subtle signs, like stiffness and a poorly developed topline, often go undiagnosed.

Test your knowledge of the signs of vitamin E deficiency at the link in the comments.

02/16/2026

What a cool display! I really wish I had one of those!

02/16/2026

Surprisingly many training and behavioral issues can be traced to discomfort in the mouth. Best case scenario the cheek pieces of the bridle exert enough pressure from the outside of the mouth, rubbing the tender inside of he mouth against sharp enamel points, causing discomfort. Worst case scenario there are some fractured or diseased teeth that need to be evaluated. Horses will not show you they are specifically having oral pain, their survival instincts are too strong, they will rarely stop eating or drinking water as a symptom.

Did you know that February is ? 🦷

Your equine's dental health is an essential part of their overall health and well-being. Therefore, it is imperative that your veterinarian perform AT LEAST one dental exam on your horse per year to ensure that their teeth, gums, and other oral structures are healthy. Poor dental health can also have adverse effects on other areas of the body if not addressed.

This graphic offers a quick overview of things you might not know about equine teeth and tooth wear.

If you're interested in learning more about equine dentistry, check out the recording of the webinar for horse owners that was presented last week on the topic of dentistry here: https://youtu.be/ABqWu9XMAi8?si=_O-L_OGFbyfaIh3p

Thank you to the Horse Owner Education Committee for providing this information.

If you have questions or concerns about your horse's dental health, contact your veterinarian.

02/15/2026

Wow! How interesting!

Skeletal atavism is an inherited throwback to an earlier evolutionary stage. It's often found in shetlands and miniatures, usually affecting the ulna and/or fibula.
Here's the radius and ulna of a miniature horse with dwarfism compared with that of a Thoroughbred (not to scale... but you knew that). The olecranon is the point of elbow, so we're looking at the upper foreleg from elbow to knee.
From the UC Davis's Veterinary Genetics website: "Horses with skeletal atavism typically display short legs, a low rectangular shape body, narrowing at the knees, clubfoot, and impaired movement. The angles of the legs and pattern of movement progressively worsen as the foal ages..."

02/14/2026

The Plexus Brachialis, a.k.a the Brachial Plexus, is the series of major nerves exiting the spinal cord at the lower cervical vertebrae. These nerves feed the arms (front legs), chest and diaphragm. Sometimes there is a chicken or the egg debate when it comes to front end lameness on weather the source is the feet or the neck. The only individuals able to make this distinction is your vet, but in the mean time, a little PEMF of the lower cervical can help, regardless if it is the source or the compensation.

Last post about the plexus brachialis created a bit of confusion in some of you - it was about the spinal nerve C8. The horse has, of course, 7 cervical vertebrae! But there are 8 pairs of cervical nerves!

I prepared an image to illustrate the numbering of the cervical spinal nerves.

There is a unique system for numbering the cervical spinal nerves, which is the confusing part.
The first cervical nerve emerges through the foramen on the wing of the atlas (seen almost in the front of the atlas). The second cervical spinal nerve emerges through the intervertebral foramen of the axis (C2). So, unlike the rest of the body, cervical spinal nerves C1 - C7 emerge cranial to the vertebra of the same number. And then, there is a nerve emerging caudal to vertebra C7, in between C7 and Th1, and that is the mysterious C8 cervical spinal nerve.
The good news is that the rest of the spinal nerves emerge just caudal (behind) their corresponding vertebra.

02/14/2026

It might be a little far to go to Signature Equine in Texas for this biologically derived treatment, but the information and benfits are the same. Take a look and see if it is right for you!

🐴 𝐏𝐥𝐚𝐭𝐞𝐥𝐞𝐭-𝐑𝐢𝐜𝐡 𝐏𝐥𝐚𝐬𝐦𝐚 (𝐏𝐑𝐏) 💉

Regenerative therapies like Platelet-Rich Plasma (PRP) are changing the way we treat soft tissue and joint injuries in horses. Rather than just managing symptoms, PRP helps stimulate the body’s own healing response at a cellular level. This therapy is especially useful for equine athletes recovering from tendon, ligament, or joint damage. We’re proud to offer this advanced treatment right here at Signature Equine Hospital!

🔹 𝐖𝐡𝐚𝐭 𝐢𝐬 𝐏𝐑𝐏?
Platelet-Rich Plasma (PRP) is a regenerative treatment made from your horse’s own blood. It contains a high concentration of platelets (tiny cell fragments packed with over 200 growth factors that promote tissue healing) that reduce inflammation, and support regeneration. PRP has been described as a “soup” of healing proteins, and when injected directly into an injury site, it jumpstarts and accelerates the natural repair process.

🔹 𝐇𝐨𝐰 𝐖𝐞 𝐇𝐚𝐫𝐯𝐞𝐬𝐭 𝐚𝐧𝐝 𝐏𝐫𝐨𝐜𝐞𝐬𝐬 𝐈𝐭:
To prepare PRP, we draw a small sample of blood from your horse, then process it using a specialized centrifuge to separate and concentrate the platelets. In some cases, additional steps may activate the platelets before injection, helping them release their healing factors more effectively. The entire process is done same-day, right here in the clinic, using sterile techniques.

🔹 𝐖𝐡𝐞𝐧 𝐖𝐞 𝐔𝐬𝐞 𝐈𝐭:
PRP is commonly used for injuries to tendons, ligaments, and sometimes joints. It’s particularly helpful in conditions like suspensory ligament desmitis, tendon lesions, superficial and deep digital flexor tendon injuries, and even chronic joint inflammation.

🔹 𝐖𝐡𝐲 𝐈𝐭’𝐬 𝐁𝐞𝐧𝐞𝐟𝐢𝐜𝐢𝐚𝐥?
PRP delivers a potent mix of growth factors exactly where your horse needs it most. These proteins help reduce inflammation, stimulate collagen production, and encourage proper fiber alignment. This results in stronger, more elastic tissue and fewer long-term complications. In clinical studies, PRP has helped many horses return to their previous level of performance faster and with a better quality of healing. It’s a valuable tool in our regenerative medicine toolbox.

Every horse and injury is different, which is why we tailor each PRP treatment to the individual case. From diagnosis to injection and follow-up care, our team is here to support your horse’s recovery and long-term soundness! If you think your horse might benefit from PRP, or you’re curious about other regenerative options like Pro-Stride or stem cell therapy, give us a call! We’d love to talk through the best path forward!

📸: Palm Beach Equine Clinic, Rogue Equine & Companion Animal Clinic

www.sehtx.com | 📱 254-968-7898

02/13/2026

While experienced farriers are worth their weight in gold as far as being a part of a team keeping your horse sound, sometimes they need help. As miraculous as it seems to be able to visualize from external cues what is going on inside the foot, they do not, in fact, have X-rays vision. This is where your veterinary team can come in handy evaluating and monitoring progress with what is actually happening inside of a foot, and that can have so many implications and effects on your horse’s soundness.
The images here are excellent examples of getting as close to perfect balance through the joint spaces with appropriate palmar angles of th coffin bone, all of which sets the foot and soft tissues associated with the lower limb to not be over worked. If there is too much toe or shoe in front of the point of balance, there is excess leverage created on the lamina of the hoof and the tendons and ligaments of the lower limb are stretched too much, like a rubber band that has been stretched too much and no longer has appropriate elasticity.
The amazing thing is that horses are awesome at healing, if these issues in the foot are addressed, unless there is significant damage and injury, the soft tissues can also recover with appropriate rehabilitation and treatments.

Why is defining an ideal model for hoofcare so challenging?

In hoofcare, many approaches are closely tied to philosophy, training lineage, or personal success stories. That makes it difficult to agree on the most basic goals for our hoofcare work.

The horse is not a collection of parts to be managed independently, but a complex, adaptive system—physical, neurological, emotional, and environmental factors constantly interacting and reorganizing in response to load, stress, and experience. The hoof reflects this complexity rather than existing apart from it. Posture, movement, behavior, and hoof form are all expressions of how the whole system is coping in that moment.

Which makes it difficult to be objective and scientific about the outcome of our day-to-day decisions for the horse.

An ideal model doesn’t replace professional judgment—it sharpens it. At ISIH, we use a model for the horse's hoof based on supporting the whole horse and structural integration with gravity.

Our Ideal Hoof Model isn’t based on opinion, tradition, or geography—it’s based on patterns that repeat across horses, disciplines, and environments worldwide. By studying and documenting a large, diverse database of horses that consistently demonstrate square posture, functional movement, and long-term stability, the same hoof characteristics show up again and again.

That’s the key. When a model holds true across climates, footing types, workloads, and breeds, it stops being a theory and starts becoming a reliable reference. The ideal hoof isn’t something we force onto the horse—it’s something the horse creates when load is balanced, posture is supported, and the system is allowed to organize efficiently. That’s why this model works globally: it’s grounded in how horses function on the most basic biological level.

Without a defined model, how do we objectively evaluate whether our decisions are helping the horse—or just aligning with our preferences?

02/12/2026

So cute! I love that Jack is in a more social place! Horses, like people, are not designed to be solitary.

02/12/2026

This is more prominent than people might think, it can have some significant effect on hind end soundness and comfort.

Low Heels In The Hind Feet - An Often Overlooked Problem
A look at two treatments with succesful clinical results

1. Introduction
Low, underrun or collapsed heels affecting the health of the foot or as a cause of lameness has been well documented in the front limbs. However, very little information has been written concerning the effects of low or damaged heels in the hind limbs.

Horses with structural damage to the heels of the hind feet will suffer the same consequences associated with the hoof capsule as noted in the front feet, but the hind feet don't appear to be affected with disease of the internal structures as noted in the forefeet.

This difference may be due to the anatomy of the hind limbs and the propulsionary function of the hind feet. Damage to the structures of the hind feet may be well advanced before lameness is noted. Underrun or collapsed heels in the hind feet may lead to a subtle bilateral lameness, which is often attributed to hock, stifle or back pain.

Lameness issues in the hind limbs are often localized to the proximal suspensory ligament, the hocks or the stifle. Part of the therapy for lameness involving these structures is to raise the heels of the hind feet regardless of the conformation of the hind foot. Long egg bar shoes or egg bar shoes with wedge pads are generally used for this purpose.

Yet there is absolutely no documentation that confirms that heel elevation exerts significant influence on any part of the hind limb anatomy above the distal interphalangeal (DIP) joint.

Furthermore, heel elevation applied to the hind feet that have existing low heels or underrun heels appears to damage the heels further, leading to an additional lameness problem in and of itself. The lameness caused by damage to the heels is often diagnosed secondary to the affected ligament or joint for which the heels were originally elevated.

2. Clinical Examination Of The foot
Abnormal heel conformation of the hind feet is easy to recognize. When looking at the limb from the side, the digit will show a broken back hoofpastern axis. The slope of the coronary band from the toe to the heel will have an acute angle. The bulbs of the heels will have a bending appearance and can be seen lying against the shoe palmar to the end of the heel. The dorsal hoof wall begins to take on a "bull nosed" appearance

Looking at the foot from behind, the frog is situated well below the hoof wall and the frog can be seen to prolapse down between the two branches of the shoe.

The frog is generally large from the constant stimulation with the ground. The clinical appearance of a hind foot with the heels damaged by an egg bar shoe and a wedge pad are much the same. The broken back hoof pastern axis will not be as marked and the angle of the coronet will not be as acute, but the damage to the heels and soft tissue structures heel of the foot will be greater due to the continuous pressure exerted by the length of the shoe and the wedge pad.

Upon removing the shoe, the end of the heel of the hoof wall is located well forward from the base of the frog. The horn tubules will be parallel with the ground. The hoof wall at the heel will be thin, there will be no angle to the sole and the bars will be absent. The whole frog will be pushed down below the hoof wall

When the foot is placed on the ground, total weight bearing will be placed on the frog and many horses are reluctant to stand on it when the opposing limb is lifted off the ground.

Viewing the ground surface of the foot, there will be a "trough" noted between the apex of the frog and the inner branch of the shoe at the toe. Hoof testers placed on either side of the heel at the angle of the sole will elicit a painful response

3. Radiographs
A lateral radiograph of the hind foot will show a broken back hoof pastern with the second phalanx (P2) being pushed palmarly and distally relative to the distal phalanx (P3) during weight bearing. This places excessive stresses on the palmar section of the joint capsule.

The palmar margin (palmar angle) of the distal phalanx is lower when compared with the dorsal margin of the distal phalanx. Damage to the heels of the hoof capsule can be noted below the palmar process of the distal phalanx as lucent areas in the hoof capsule.

The sole depth below the dorsal margin of P3 is markedly increased relative to the heel and the perimeter of the distal phalanx can be seen migrating toward the dorsal hoof wall. This is what causes the "bull nose" appearance of the dorsal hoof wall. The soft tissue structures in the palmar section are noted to be lying against the shoe.

4. Treatment
Damage to the heels of the hind feet is often easier to improve than damage to the forefeet, possibly due to the difference of the load encountered on the hind limbs vs. the fore limbs. Two methods can be employed to treat this condition.

First, allowing a horse to go without hind shoes - if possible - for 4 to 8 weeks can be very effective.

This approach can also be used with horses that are resting due to proximal suspensory ligament disease. The shoes are removed and the hoof wall at the heels is moved palmarly until solid structures of the hoof wall are encountered. The hoof wall at the toe is lowered appropriately and the edges are rounded.

Over the next few weeks, the pressure on the frog will compress and displace the frog until it assumes the same plane as the heels on either side

If the horse needs to continue in work and wear shoes, the approach will be different. The shoes are removed and the heels are moved palmarly until solid horn is established. Excess dorsal hoof wall is removed from toe quarter to toe quarter. The pr*****ed frog needs to be compressed in order to have a flat, even plane that includes both the heels and the frog. The back section of a degree pad is cut out to fit over the frog as a mirror image. A thin strip extending across the toe is left attached to the frog wedge and two 4.5 race nails are placed through this strip into the hoof wall at the toe quarters to hold the frog wedge directly over the frog

An Animalintex self-contained poultice is saturated with water and applied so it envelops the whole foot. It is secured to the foot with brown gauze and elastic tape. The horse is now placed in a stall with a firm surface for 24 to 48 hours. During this time, the feet are submerged in a bucket of water a few times to keep the poultice saturated.

At the onset of applying the frog wedge, the horse is given 2 grams of phenylbutazone (Bute), as some horses will show mild discomfort and develop a digital pulse. Therefore, when medication is suggested and used, both authors contend that veterinary assistance should be solicited when performing this procedure.

When the poultice is removed, the frog will be compressed between the heels forming a flat even surface that includes the frog and both heels. The horse can be shod immediately, or can be placed in a stall bedded with sawdust for an additional day to let the feet dry out.

The frog will be soft and can be shaped further. Any additional horn at the heels can be removed so the heels of the hoof wall are solid and approach the base of the frog - being careful to keep the frog and both heels in the same plane. A shoe can now be fitted and applied.

We fit shoes on the hind feet the same as the front where a line is drawn across the widest part of the foot and the shoe is fitted so the line is placed in the middle of the shoe.

In the hind feet, the branches of the shoe may extend marginally beyond the end of the heels. If additional heel elevation is necessary, a wedge pad or a bar wedge can be placed under the heels as long as the shoe is fitted in the manner just described. This will concentrate the load under the frog and heels rather than behind the heels, which is the case with a long shoe.

5. Conclusions
The authors have used the frog pressure and soaking technique on 15 horses with low heels and pr*****ed frogs. The results have been excellent in all cases.

Damage to the heels of the hind feet are much easier to resolve or improve than the fore feet. This could be due to the anatomy of the hind limb along with the shape and function of the hind feet. Once the frog has been repositioned and the heel structures have grown, attention to the foot prep is necessary to keep the frog and heels in the same plane. The size and placement of the shoe are equally important in maintaining the health of the heels of the hind feet.

Equipodiatry.com

02/12/2026

Therapies are great, all of them help your horse feel better to a degree. Sometimes they cannot treat root causes of lameness and discomfort, this is where collaboration between your vet, farrie and others becomes important! I certainly can help your horse with some back, SI or musculoskeletal pain, but if it originates because there is something going on in the feet those treatments become a bandaide, where the pain and discomfort will never truly be addressed in a permanent way.