“No Foot, No Horse”.  This is a common saying throughout the years that has stood the test of time and has remained truthful in many regards.  The fact is that the horse is highly dependent upon their feet and thus, the external hoof capsule, for overall soundness and quality of life.  The concept of hoof health and foot related soundness is a number one area of struggle for many horse owners, often leading to not only lameness conditions, but ongoing struggles with special shoes, dietary efforts, and other modalities which have variable success.  What are we missing in these cases?It is not uncommon to attend any equine sports event and note the hoof and foot problems that are present in the competitors.  One equine surgeon noted recently in a lecture that in all honesty, there is not a single ‘sound’ horse in the competition arena.  Sadly, I’d have to agree and most of these horses are either obviously lame while competing or they have a current problem that is being addressed with injections or special shoes.  While I use the term ‘addressed’, this does not equate to being ‘treated’, as when you remove these modalities, the problems are still present often to a very high degree.

The horse’s foot is directly connected to likely upwards of 70% of all lameness conditions.  These conditions can be directly related to the foot, such as sole pain, navicular conditions, bruising, abscesses or otherwise.  However, the foot is often a primary contributor to other lameness conditions including joint issues, tendon and ligament complaints, and even SI or back problems.  In those instances, we tend to just focus in on the other issues, seeing them as primary, while overlooking the main event, which is the foot.  Foot pain and imbalance in the foot strongly contributes to compensation in the body and referred pain, which then creates the secondary distant-site lameness conditions.

Looking at the foot, it is not common to find a horse with a solid, healthy foot unfortunately.  This is actually something found only in the dreams of horse owners and farriers, and rarely achieved in the vast majority.  Direct hoof conditions that are common involve basic imbalances, improper loading, cracks, flares, thin soles, thrush, white line disease, bruises, and wall or laminar separation.  Then commonly, as a result, it is not uncommon to find cases of laminitis, navicular degeneration, failure to hold a shoe, or other soft tissue structural damage.

Band-Aids versus Clinical Resolution of Hoof Problems in the Horse

The horse’s foot and hoof are a number one area of focus for most competitors, often being more important than joint related conditions.  Most owners know that there is a problem, as do their farriers, and all efforts are being made to resolve or improve the situation.  However, most continue to struggle and continually rely on medications applied to the hoof and sole, special shoes, pads, wedges, injections, and other fillers to help maintain nail integrity.

In my equine consultation practice, the horse’s hoof is likely involved on some level in upwards of 90% of all cases seen.  This may be obvious to the owner or it may not be.  I’ve seen all types of hooves and all sorts of appliances applied currently or in the past in attempts to resolve the problems.  I’ve also seen all sorts of diets and nutrient supplements, including trace mineral blends, used to encourage healthier feet.  In the end though, most continue to struggle from month to month and year to year.

What are we missing?

My career working with horses on all levels of health and soundness has allowed me to make some observations which are often then backed up by clinical research in our rehabilitation facility.  I’ve seen all types of cases, from laminitis to the lameness conditions that have failed to respond to all sorts of therapies.  In the end, with almost all of them, there is a connection with hoof health as it is apparent clinically when looking at the feet and evaluating them.  Despite the efforts made by their owners, through diet, shoes, and supplements, the cases continue to worsen.  In our facility, these horses become research subjects, with the goal of figuring out why this happens and also what we can do to improve the outcomes.

Now, for many, the route is chosen to improve nutrition often through the use of trace-mineral supplements, which is fine and does address the importance of nutrition.  However, we have to pay attention to these cases as for many no improvements are noted or in those that improvement is noted, in regards to hoof health, growth and soundness, the results are obtained after 12 months or longer.  That is a long period of time.  Most would say this is to be expected, as hoof growth is slow and regeneration of tissue is even slower, but I would disagree.

Hoof Health in the Horse; Looking Deeper into the Problem

Hoof health and soundness in the horse is a complex problem and obtaining it revolves around several aspects or approaches, not just one.  This is what creates problems for many horses owners, especially if the horse is actively competing.

What does it take to obtain a healthy hoof in the horse?

  1. Shoes removed to allow for restoration of the hoof capsule
  2. Proper nutrition
  3. Digestive support
  4. Inflammation modification

Going Barefoot…even for a short period of time. When presented with a horse with failing hoof health, on whatever level, often one of the most basic things that needs to be done is to start from scratch.  This means that the horse has the shoes removed, the feet balanced, and then allowed time to ‘just breathe’, expand and be stimulated for proper growth. This is easy to achieve, but declined by many owners as the horse is either actively competing or they have concerns that the horse will be sore without their shoes.  I personally understand the first concern, but the concern over potential soreness is unfounded.  Many will be sore after the shoe removal mainly due to the original unhealthy status of the hoof tissue, however, the only way around this is to remove the shoes and face what we have created.  The only way to rebuild that foot properly is often to start from a baseline, which is often barefoot, even for a short period of time, utilizing boots as a source of protection and comfort as needed.  This allows for changes in the hoof capsule that simply cannot be accomplished with metal, glue, pads, or wedges applied.  Now, taking this into consideration, the proper trim needs to be applied to the hoof during this time period and in the right frequency to encourage proper growth and balance.

Proper nutrition encourages and supports growth.  Every cell in the body requires nutrients and with that, energy production in order for them to do their job and regenerate.  For every horse, the base for a good nutrition program comes from forage in the form of hay and pasture.  All too often, in my experience, we fall short in this area and feed lower quality hays, then provide trace mineral supplements to fortify what we are failing to provide.  This may work for some, but for most, these efforts fall short.  This happens in my opinion for a variety of reasons.  First, those trace mineral supplements do not provide the full spectrum of nutrition from proper forage.  This goes outside and above plain nutrient provision, but includes phytonutrients that are present in whole-foods, such as high quality forage, as compared to a synthetic-based mineral supplement.  Second, some horses have higher demands for nutrients compared to others, which is often not taken into consideration with a trace mineral supplement.  Third, some horses are just not able to digest and assimilate these synthetic based nutrients, plain and simple.  In my experience, those horses that are ‘upgraded’ to a higher quality of forage do far better than those on the lower quality forages with added trace-mineral supplements.  The first group tends to grow better quality hoof wall and at a faster pace.

Digestion plays a major role in general health and hoof health in the horse. The fact is, as demonstrated in research and my clinical experience, the digestive process goes way beyond just breaking down food components. The digestive tract needs to be balanced and healthy in order to digest the food and absorb nutrients. Digestive health is very, very important in the horse.  One can provide optimal forage and even trace-mineral supplements, but if that digestive tract and the microbiome are unbalanced, it can often be a waste of time and money.  This may be why so many horses on trace mineral supplements and even higher quality forages fail to achieve their hoof health goals.  This problem of digestion failure is evident in many horses with a history of colic, ulcers, loose stools, or even just gas problems.  But it is even more prevalent in the ‘silent’ equine patient, often seen heavily in the easy-keeper or metabolic prone horse.  It is also readily apparent in the leaner horse that is fed a high level of grain concentrate feed.  When we address this problem properly, then feed efficiency is markedly improved, and body condition and hoof health improve incredibly fast.  This is often without the need for added trace mineral supplementation because once this digestive issue is addressed properly, the horse is now able to utilize the nutrients present in their forage. It is not uncommon for us to see horses, once properly managed, to have accelerated hoof growth at a rate of one inch per month or often more.  That would be an entire hoof regrowth in 3-4 months!

Inflammation is a vital component that often impedes proper hoof health and growth.  In cases where there are obvious painful hoof conditions, inflammation is readily obvious.  However, in others, the process of inflammation is not so obvious.  This is common in cases of laminar or wall separation, white line disease, and laminitis in horses.  These patients are often the ones that are heavier set in body condition, easy-keepers, and prone to metabolic issues and insulin resistance.  In those cases, the hoof problems present are often not the ‘primary issue’ but more secondary to inflammatory events within the body, which coincidentally often stem back to digestive issues and leaky-gut conditions.  Until these internal inflammatory issues are managed, the hoof health will often continue to suffer.  Thus, many horses with wall separation and white line disease continue to contend with their problems month after month and year after year.

Hoof Health in the Horse; Wrapping it all Up!

These 4 factors are very important and each factor feeds into the equation of hoof health, contributing to each other on various levels.  You cannot fix white line disease, wall separation, flares, cracks or other external hoof ailments with just a trim or an applied shoe.  The trim is very, very important, but is not the only component of the equation.  We can also not just apply nutrition to a horse with poor hoof quality and expect results, because without proper trimming and balance, the forces will still be applied to the foot and create distortion.  Many metabolic prone horses can have proper trims applied along with nutrition, but continue to have issues and unsoundness.  In most, that is because we have neglected the two other factors which are digestive support and inflammation management.  All four components interplay with one another and all four components need to be applied for the optimal outcome.

What is interesting to me is that for many owners and farriers, nutrition and a proper trim are applied and results are gained, but the time frame is often 12 months or longer.  While this is okay, it is also part of the overall reason as to why many horses are not completely helped.  For many competitive horses with foot ailments, this 12-month period is unacceptable, and thus, they continue forward with shoes and other protective devices.  A hoof is noted to grow on average from coronary band to the ground in 6-months.  Thus, two complete hoof growth cycles in 12 months.  In my experience, when all factors are addressed properly, a complete hoof regrowth is commonly seen in 3-4 months.  Unheard of?  Yes, but I’ve seen it and it is not uncommon to have a horse presented for a second trim, at a 2 week interval, and have nail holes that were originally 1 inch off the ground now setting at ground level.  I personally feel that being a living structure, the hoof is capable of much more than we give it credit for if all factors are addressed properly.

Digestion is becoming a number one focus for myself in our research and rehabilitation horses.  It is something I can monitor in our laboratory and also monitor for clinical impact.  Proper digestion and gastrointestinal health is also closely linked to the inflammatory process, so often correcting the first will impact the second.  For many horses, the approach to digestive health can be complex, at least initially, but as we move along, the therapy provided becomes simplified.  Some horses actually respond to a very simple yet effective approach to digestive health, along with a modified diet.  So, the approach is not always complex or expensive.

Ultimately, you have to ask what you are looking to achieve for your horse. If hoof health is a concern, there are several approaches that can be used.  Some approaches go on endlessly month after month and year after year, costing the owner a good sum in farrier expenses, veterinary related costs, and often nutritional supplements.  Other approaches are actually very simple, yet very effective, costing the owner a lot less and gaining better results in a shorter period. Often, in those cases, the only hassle is a little more time invested in more frequent trims and manual labor with proper supplementation and feed implementation.

The two images below are taken from a chronic founder case associated with insulin resistance and metabolic issues in an older gelding.  Along with a progressive trim to re-balance and align the coffin bone for comfort, the diet was addressed along with digestive support.  In the original image to the left, after the first trim, you can see nail hole position.  Then compare that to the nail hole position in the second image on the right, which is four weeks later.


In the next case, again a chronic laminitic horse with metabolic and insulin concerns, you can see the improved hoof growth, overall hoof health, and improved soundness in a little over 2 month’s time.  Also note not only the improved hoof condition and growth, but the improved hair coat in the horse.  This results were obtained through routine trimming, diet and digestive support.

These are just two examples of many that I have encountered in our rehabilitation and research program.  The horse’s hoof is a dynamic and living structure, capable of much more than we give it credit for.  If we apply all aspects properly, then the outcomes can be markedly improved and often in a very short period of time.  Not only does the hoof respond but the horse’s entire body becomes healthier and responsive.

Again, the question you have to ask yourself is what are you trying to achieve?  Set the bar high because I think you can achieve it.  We are all constantly learning and when we start to look beyond our accepted standards of care, that is the point where real results are often achieved.

Let our research and clinical experience benefit your horse today!  Results can be achieved!

Clinically Relevant Formulas that I Choose To Utilize:

  • Cur-OST® EQ Total Support – Promotes healthy inflammation and digestive support in the easy keeper horse
  • Cur-OST® EQ Inflammend – Promote healthy inflammation in the non-easy keeper horse
  • Cur-OST® EQ Tri-GUT – Promote healthy digestive microbiome and digestion in the horse and reduces lactic acid bacterial populations
  • Cur-OST® EQ Pro-GUT – Promote healthy digestive microbiome balance, digestion, and hindgut pH in the hindgut with prebiotic and probiotic effects


Author:  Tom Schell, D.V.M., CVCH, CHN



  1. brian cairns on March 5, 2019 at 6:55 am

    A really interesting article, it is the horse owners who need educating, they tend to leave the horses feet till last, thank you.

  2. Carissa on May 13, 2019 at 3:15 pm

    Great article – very helpful and encouraging! Thank you!

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