Ask a Farrier: How Do You Treat an Upright Foot in an Old Horse with EPM?

chesnut horse in sunshine - ask a farrier - how to treat an upright foot in an old horse with epm

This month’s question comes from Margery, who asks: how do you treat the development of an upright front hoof in a 25 year old horse when it is caused by unbalanced/leaning hind end due to the effects of EPM?

First Things First

For those of you who don't know what EPM (equine protozoal myeloencephalitis) is, it's a neurological disease caused by a protozoal parasite called Sarcocystis neurona. Horses who ingest opossum feces can be exposed to the parasite, although it doesn’t cause symptoms in every horse.

The symptoms are very similar to West Nile Disease and Wobbler Syndrome. The horse can lose all control of its hind end. The horse in question is trying to balance himself by standing with his front feet farther back under him so he doesn't fall over. If the disease is caught early enough it can be treated, but it's difficult for vets to diagnose it because the symptoms are similar to other diseases and vary in different horses.

First Treat the Cause

With this horse, I’d first want to know: is the horse even sturdy enough to stand on three legs to trim or would you need a narrow cattle chute or hoist to hold the horse up? If your plan is to sedate the horse and trim him laying down, will he be able to get back up on his own? Honestly, as a farrier, I wouldn't change the angle of the hoof until you’ve treated the EPM.

The horse is compensating for its weak hind end by standing with its front feet farther back under him to help with balance and possibly ease some pain and discomfort. Standing like that puts more weight or pressure on the toes and none on the heels, causing your horse to wear the toes down faster.

Trim a Little at a Time

The heels will continue to grow until they touch the ground where the horse is a little more comfortable, hence the upright, club foot look. Once you treat the EPM and the horse's hind end is sturdy enough to support its own weight, the angle of the hoof will be easier to fix by slowly trimming back the heels, bringing the front legs farther forward, a little at a time, until they're back to that horse's normal.

If you trim the heels back too much or too soon, the horse could either be sore or off balance again. There's also a good chance that he'd have his heels grown back in a month or two anyway.

If you're really worried about the angle, you could trim the heels and put shoes with wedges on his fronts. Make sure you really round off the edges of the shoes all the way around and smooth out the clinches so the horse can't catch one with his hind feet. He doesn't know where his back feet are and doesn't have full control over them.

Thank you for the great question. I hope this helps. Best of luck to you.

This is our monthly feature, “Ask a Farrier,” a Q and A with farrier Karen McMann. Karen has been a full-time farrier for 17 years. She graduated in 2002 from the Canadian School of Horseshoeing, where she studied under Pat Cullen. She serves on the Advisory Board of Equi-Health Canada and Equi-First Aid USA as a Farrier/Hoof Health Support specialist. Karen lives and works outside of Okotoks, Alberta.

If you have a question you’d like to ask a farrier (about horseshoeing, farriery, hoof and horse health, blacksmith tools, working as a farrier, etc.), email or leave it in the comments below. Every month, we’ll pick one question to answer in our feature.

Image credit: Kelly Forrister