The Pressure of Dealing with Frog Support Patty Stiller CNBF CLS CE Copyright 2010 If a little of something is good then a lot must be better. Right? Maybe not, especially when it comes to dealing with prolapsed frogs. All farriers come across situations where the frog in a weak foot has prolapsed beyond the trimmed heels. This can be due to an under run weak foot with a severe negative palmer/plantar angle coffin bone. It may be from a farrier using thick heeled wedge shoes without any support under the frog for a long time. At any rate we need to try to assist the foot in gaining back the internal support the prolapsed frog is not offering. Various kinds of artificial materials are available to so this. Choosing the wrong material at the wrong time can result in a sore foot. A shoeing package designed to assist the frog and help correct the alignment of the bones inside needs to be successful without adding too much movement in the frog all at once. In the learning curve of dealing with prolapsed frogs fifteen years ago some of us tried to literally mash the frogs back up into the foot in one shoeing with a hard plate under the shoe. Some of the time it worked but a lot of the time the horse got really sore and the shoeing had to be modified a few days later. A lot has been learned by trial and error since then. I hope to explain how to get the most success in dealing with correcting this condition, without failures. SUPPORT vs. PRESSURE There is a critical difference between frog “pressure” and “support”. Pressure is when there is constant pushing into tissue by an object such as a shoe or pad. An example is sole pressure, when part of the shoe pushes on the edge of a sole constantly whether the foot is on the ground or not. A heart bar shoe with the bar bent up too much so it constantly presses on the frog whether the foot is loaded or not is another example of pressure. Frog “support” is when the frog has something to load onto when there is weight on the foot but unloads when the foot is not weighted. So “support” gives the frog something to load onto when the foot is weighted, and does not actively push up into the frog when the foot unloads. It is more dynamic, a give and take. And support does not push the frog up into the foot very much when loaded. It mostly just prevents the frog from sinking down beyond where it is when unloaded. Support can turn into pressure if the frog support appliance extends distally past the ground surface of the heels of the shoe. ASSESSING THE FROG For optimal success, before you decide what support materials to place on the foot you need to consider a list of factors? HOW BAD IS IT? How much is the trimmed frog prolapsed past the trimmed heels? If it is just a little bit past the heels (say 1/8” to 1/4”) then you may not need anything but the thinnest shoe possible to keep the frog in contact with the ground. And remember the ground itself will support the frog if it is a soil type that can pack into the foot. However, very serious cases can be prolapsed past the heels nearly an inch. If the most seriously prolapsed frog is quite “live”, you will not be able to trim it because you will hit sensitive tissues. Those take some very careful consideration and a long process of helping. You may also have to very carefully hot seat the shoe to get the heel buttresses down flat around the live frog. This is because you can not trim the corners of a seriously prolapsed frog out of the way of the inner edge of the shoe. Hot seating will create a flat place for the heels of the shoe to sit without cutting into the frog. Be careful to not burn the corners of the frog and hurt the horse. A very brief burn (one second or so) with a dark orange heat in the heels of the shoe should do it. HOOF TESTERS ARE YOUR BEST FRIEND How sensitive is the frog? This calls for your hoof testers. Try to determine what part of the frog is most solid. Sometimes where you place the support on the frog is important for success. Not all frogs can tolerate support material covering their entire length. Quite a few horses with severe negative palmer/plantar coffin bones can be very sore to hoof testers over the center of their frogs. This is about where the impar ligament lies. I often use dental impression material just over the rear third of a frog and commissures. I use with soft packing such as Hawthorn’s, Forshner’s, or Magic Cushion covering the rest of the foot under the pad. I will also usually use a plain pad (wedged if needed) to hold the material in and act as a gentle support. That or a bar pad acts like a gentle support for a prolapsed frog and gently helps it back up into the foot without pushing it up too fast. I do not worry that a plain pad bulges out around a prolapsed frog as I nail the shoe on. The pad is flexible enough that the frog will tolerate the gentle “sling” effect. In the past when I tried to support sore frogs with a frog support type pad and dental impression material right away, it sometimes made the horse sore after a few days because there was too much pressure into the frog. INCREASE THE SUPPORT OVER TIME I can usually change a plain pad with soft packing to more firm support like a frog support pad and impression material over the whole frog in a subsequent shoeing. However, before making the change I hoof test them again and re-assess the health of the frog and its ability to accept more load. It sometimes takes a shoeing or two with softer support to get the inflamed tissues under the frog to quiet down and accept more load. PERFORMANCE Is the horse going to be idle or in use? If used what is the discipline? The performance of horses in some disciplines such as speed events, reining and dressage may be affected negatively with too heavy or too thick of a shoeing package. Also detrimental is a package that adds too much traction from the frog piece of a frog support pad. Therefore in some cases you may have to compromises what you use. It may take longer to get the desired change in the foot but the horse’s performance will not be affected negatively in the process. In these cases you might use just a bar wedge pad with some Equi pack just under the bar to keep debris out. Try a regular plain pad with packing underneath or maybe use a perforated pad with Equi pack under it but not filled up all the way to the ground level. (Tip: Cover the perforated pad with duct tape so it fills only under the pad.) If added weight of the pad and packing is a concern for the horse owner, suggest a change from steel to aluminum shoes to offset the pad and material while the condition is being treated. THRUSH When padding prolapsed frogs it is necessary to treat thrush if present. Be sure to do something to help the owner continue to medicate existing thrush under the pad. I pack the central sulcis with foot felt and saturate it with thrush medication. I then make sure the felt is exposed in the rear of the frog just enough so the owner can continue to medicate through the felt. The felt acts as a wick, taking the medication into the foot. I would not recommend using Cotton as it does not work well because it absorbs water based materials like urine. If you do not have foot felt, use oakum. TAKE HOME MESSAGE To summarize, do not just arbitrarily stick a frog support pad and impression material on every negative palmer/plantar angle foot. Go through a process of assessing the frog and its ability to take a load and move slowly back into place without pain. Your hoof testers are your best friend in these cases. Be prepared to correct the problem slowly over several shoeing cycles. Increase the frog support over time as the tissues underneath it get less inflamed. Build in something to allow for treatment of existing thrush if necessary. Use common sense and be patient with the severe cases. It is far better for your public relations to get results slowly than to make a horse sore by getting in a hurry. ******************************************************************************************************************************************