Creating dysmorphism as a medical practice? This concept becomes more outdated every second of time that passes. I know of no other species but the equine where creating dysmorphism is still so firmly under the umbrella of "best practices."
dys mor phism (Mirriam-Webster) - an anatomical malformation and other structural abnormalities
Hooves regenerate (at least hoof capsules do) and hooves heal. Right now it is my hypothesis that during laminitis and founder, most horses are healing despite us and not because of us. Why would I think that and how can we improve the situation?
1) We refuse to collect data on the subject (this REQUIRES baselines and controls, not conversation between people who do the same things), thus creating an "anything (that sounds impressive) goes" medical free for all, which we know, from every level 1 evidentiary analysis ever generated, does not create quality working medicine. We can do better.
2) Creation of dysmorphism, or mutilation, has been tried in human medicine. Thankfully, good research, and large scale data analyses, are regularly performed with the human species, so we have been able to phase out such approaches for ones that are more successful. Why would you believe the horses' tendons, ligaments, bones, dermis and epidermis work differently from all other species?
3) If you study my Natural Collection Presentation, what you see are horses heading from a dysmorphic state back to a more natural, or optimal, state under my care. The very trimming practices and fixed orthotics that much of veterinary medicine and many farriers use (as well as many "natural hoof trimmers") are generally what is creating that dysmorphic state to begin with. How can unnatural form, and the pain that results from it, help heal?
4) The majority of laminitis cases may arise from endocrine imbalance driven by lifestyle (much as type II diabetes and heart disease is driven by lifestyle in developed countries) choices. By chasing the red-herring of tinkering with unnatural form and cutting the capsule, we miss the whole point of setting the hoof up, as a complete biomechanical organ, to heal. Healing takes time and patience, as the hoof grows more at a glacial speed than a texting speed. We are constantly misunderstanding the effects of time, and the natural flux of symptoms in a complex healing system, with our own tinkering. Thus, again, our focus is ineffective.
Let's look at some information that should stimulate us to produce more data of better quality so that any assertions I might make can either be further supported or proven wrong.
The following X-Rays are not related to me or any horse under my care. Rather, these are an example of a vet/farrier (V/F) case study: V/F X-Ray case study "before" (laminitic horse not doing well) and "after" (laminitic horse doing better).
Some guy, at some point in time, asserted that the DDFT (deep digital flexor tendon) pulls the coffin bone away from the anterior hoof wall during laminitic episodes and thus "rotates" the coffin bone away from the anterior hoof wall. Some guy at some point said long toes create a lever force. What did that produce? Over trimmed toes and jacked heels, both in a horse's regular life and during medical crises .... an entirely dysmorphic, unnatural physical state with no known biological or boimechanical value (remember that biomechanical utility needs to be measured over time in relation to the whole organism and his state of overall biomechanical well being). Just because a percentage of horses get better with overtrimmed toes and jacked heels does not mean that those approaches helped; a percentage of horses will also have gotten better when painted blue. But I, for one, am not interested in blue paint. I am interested in true wellness.
Let's look more closely:
First, a hoof capsule that is cut open. For simplicities sake we will call the live red tissue "dermis" and the protein "armor" (here off-white) surrounding the dermis "epidermis."
Now, the following Before (no shoe) and After (shod) X-RAy.....I have layered over the X-Rays a fixed line of dots extending from the dermis through the epidermis on its way to the anterior hoof wall.
De-rotation is the claim???? Huh?
In actuality, we haven't changed the relationship between the dermis and epidermis at all, which is supposedly the relationship that changes when many V/F combos use of the words "rotation" and "derotation"......look at the red and blue dots, for example.....nothing much has rotated or de-rotated here! How about between red and yellow? Red and green? (If anything, because the capsular protein grows down and out, we will have a slight rotation, by conventional measurement, naturally built in between the dermis and epidermis, or dots, as the hoof grows). They V/F combo has, though, in this instance, as is general practice, manipulated the outer shape of the epidermis to make it look as if we have done some "de-rotation." (More detail available on this in my Modern Medicine Presentation and why making things that aren't perfect look perfect destroys their ability to heal). Ironically, trimming the capsule this way causes the hoof capsule to rotate away from the leg column and destroys skeletal alignment and the elastic energy potential of the limb. See my case studies in the Natural Collection Presentation for example after example of my reversal of this. In the Natural Collection Presentation, we see limb alignment and energetic body integrity, or lack thereof, from whole body photography. Here we see these things at the level of the bony skeleton via X-Ray.
Look at the red line, which is fixed and size-corrected between the 2 Before and After images (below), and where it bisects the fetlock joint (joint labeled 2) in the Before versus the After. As my photographs suggests, this XRay, and XRays like it , may tell a statistical tale of misalignment of the rigid or semi-rigid structures of the limb: subluxation of the fetlock joint by overtrimming the toe (which causes the heel to migrate anterior) and hijacking the coffin and pastern joints and thus destroying the elastic potential energy of the limb and body.
If you are going to induce dysmorphism, you had better have level 1 evidence, or be pursuing this level of evidence, to justify that medical approach. Otherwise, you had better be wondering if there is a better approach. And you should darn well be willing to launch some comparative analyses between researchers that take different approaches, with as much quality as humanly possible instead of defensive bias, in the interest of the horse. I am a researcher by training. I am comfortable not being right. But I am not comfortable with a lack of an authentic try to learn more and improve my practices, especially with such dismal numbers for recovery, and nor should any other equine professional.
This can't possibly relieve any "tension" in DDFT. In fact, this probably has no helpful effects at all.
Give me a chance to build more data. Let's do more comparative work. Let's look more closely at these ideas. Me versus anyone else who is involved in conventional laminitis management. Let's build a Wellness Institute and Bring Equine Care into the 21rst Century as we have done for human medicine.
Let's contemplate some elements of what would make a great Wellness Institute in future blog posts!