The veterinary–farrier relationship: Establishing and sustaining amutually beneficial liaison
Reprinted with permission from Equine Veterinary Education (EVE).
Original published in Equine Veterinary Education Vol 30 November 2018.
W. A. Moyer†
, H. W. Werner‡
, S. E. O’Grady§
and J. T. Ridley¶
† Large Animal Clinical Sciences, Texas A&M University, Billings, Montana; ‡ Werner Equine LLC, North Granby, Connecticut; § Virginia Therapeutic Farriery, Keswick, Virginia; and ¶ Ridley Horseshoeing, Leighton, Iowa, USA
The importance of farriery and thus hoof care in veterinary practice is undeniable (Merriam 2003; Werner 2012). The intent of this article is to explain the veterinary–farrier relationship, its current status and importance of developing and sustaining a working, trusting relationship. The benefits of such a relationship include acquiring and maintaining clients, the ability to perform various actions that one profession is better equipped to provide than the other, a constant source of experiential learning and most importantly benefitting the horse. Thus, the relationship centres foremost on the health and welfare of the horse. The authors describe why such a ‘marriage’ is important, how they may begin and sustain, as well as errors that will harm or negate such a relationship.
Farriers, historically, were recognised as the primary source of medical care for horses well before the late 18th century when veterinary medicine as a discipline emerged as an educational process and profession (Bullock 1929). The progression of knowledge concerning anatomy, function and physiology, diagnostic tools, as well as previously unknown treatments evolved (especially in the last few decades). Those factors continue to create opportunities for both professions. Ideally both professions should work ‘hand-inglove’ to the benefit of the Equidae world. Understanding the history and culture of both professions is the lead in to logically using the skills of both.
Contrasting and comparing the two professionsEstablishing a relationship
Veterinary medical practitioners are required to acquire considerable educational experiences followed by strict credentialing to practise legally. The ultimate acquisition of a veterinary licence requires success in a variety of undergraduate courses (mostly basic sciences) followed by acceptance to an accredited college/school of veterinary medicine. The present veterinary medical curriculum is easily as robust, if not more so via the many species a student is exposed to, as that required for human medicine.
The educational experience encompasses most all species (dogs, cats, cattle, horses, exotic animals, aquatic species, wildlife, etc.). It is universally agreed that the present veterinary medical curriculum is on ‘overload’ as a direct response to ever growing knowledge and technology advances (diagnostic and treatment tools). A few decades ago radiographic imaging was a ‘stand alone’ course in diagnostic imaging; now students are exposed to ultrasonography, scintigraphy, digital radiography and MRI. Therefore, student exposure time to a variety of entities has to be limited. The point being that student experience with regard to the art and science of farriery is minimal (for example, many colleges do not have a ‘in-house’ farrier) (Kirker-Head and Krane 2010). Thus the importance and necessity of seeking help from the farrier community is clear.
Once DVM, VMD, MRCVS (or equivalent) designation is earned, licensing requires both national (and state) board requirements to attain a licence in a given jurisdiction. Some graduates, not all, may choose to enter into specific internships and ultimately residencies, perhaps additional degrees such as an MS or PhD. All holding a valid licence are also required to attain continuing educational credits on a yearly basis to maintain such a licence.
A variety of reasons and experiences, or lack thereof, determine the level of confidence a given veterinary medical practitioner has regarding handling and managing foot problems. It is safe to state that ‘hands-on’ experiences are often minimal for most recent graduates; further it is safe to state that some practitioners are not comfortable, lack the interest, or physically are unable to handle certain aspects of foot care. There are those who are experienced and credentialed to do both, they are, however, in the minority.
In some countries farriers (horseshoers and blacksmiths) are able to practise and open a business in the absence of a required education or credentialing process. Educational experiences may come in one of the following ways: a formal 2–3-year apprenticeship with an experienced farrier; a broad variety of structured farrier school courses exist – the time spent varies with the course; and some are literally selftaught by watching others. Unlike some European countries, the USA does not require specified training and credentialing to open a business. Thus, the range of experience and expertise can vary between highly trained and experienced to little or no training and a part-time business. The location, the financial strength of the horse-owning population and the discipline in a given area will also reflect the farrier’s experience. Disciplines within the equine athletic world vary with what a given sport or purpose requires and request with regards to farriery: for example, trimming and ‘plating’ TB and QH racehorses vs. the same with trotters and pacers vs. gaited horses vs. dressage vs. showjumpers vs. ranch and stock working horses vs. ponies vs. donkeys and mules vs. brood mares and foals, etc. The desired hoof wear and understanding of the various equine endeavours can vary and so can the experience of a given farrier.
To summarise the education and training of the two professions; the veterinarian undergoes an intensive approved curriculum of a specified length of time leading to a veterinary licence but lacks the exposure to and experience in farriery. In contrast, the farrier may pursue a field or trade with no standardisation or approved curriculum for varied lengths of time and taught by individuals with varied thoughts, theories and methodology. Therefore, this scenario does not detract from the importance of farriery in equine veterinary practice but may present an initial hurdle or challenge to both parties as to ‘what constitutes good basic farriery and how it is applied’ has not been defined.
Developing and maintaining a business (veterinary and farrier practice) requires and is enhanced by collegial and cooperative professional behaviour. The specific working environment (racing stable/backside of track, backyard horse operation, breeding facility, etc.) determines which of the two practices has the most respected and frequent contact with a client. A large operation may involve multiple farriers. The key being that of a respectful interaction as well as recognising that an individual farrier may have significant influence with an owner or trainer. Thus, respect may or may not have anything to do with one’s educational experience, initials after one’s name or a farrier’s knowledge and skill. Clients can and will determine the level of respect and very clearly prefer an approach that is co-operative. The rewards via a respectful relationship can be many and may include:
- Referral in either direction and thus an opportunity forincreased exposure and business
- Farriers are very often excellent ‘horse people’ and attimes recognise health-related problems that an ownerfails to note
- Either person can be very helpful by providing adviceabout a specific horse’s behaviour or how best to handlea particular client
- A rewarding and continuous learning experience caneasily evolve
- And, lastly, a trusted friendship may well happen
Initiating a relationship begins with a simple introduction and evidence of respect for both professions. The ‘I’m a Doctor and thus know it all’ attitude on the part of the veterinarian is likely to fail; the same being true with the farrier with the ‘I have been doing it this way for decades’ attitude. A mutual concern for the horse and owner should be made the foremost attitude. Admitting one’s weaknesses, be it the medical knowledge by the farrier or inabilities or lack of experience in farriery by the veterinarian is a good beginning. In other instances, both individuals are experienced and knowledgeable which should lead to experiential exchange. Suggestions include: providing one another with convenient contact information, treating one another as equals, demonstration of ‘old fashioned’ good manners, sharing relevant current continuing education information and a ‘how can I help’ presence. Avoid as often as is possible any negative discourse about other professionals. It should not be surprising that such discourse often is embellished and is shared with others (social media and Internet). An example is that of a horse acutely lame as the result of what appears to be a misplaced nail or nails; all too easy to blame the farrier. A combination of factors determines the placement of any nail: the horse’s behaviour, handlers’ ability to stabilise the horse, configuration of the hoof (thin, upright quarter wall) or maybe the horse torqued the shoe which changed the position of the nail or nails. Managing horses with chronic laminitis is perhaps the greatest challenge for both parties (Moyer and Schumacher 2000). A myriad of techniques are ‘out there’ with unfortunately little or no repeatable and documented evidence suggesting one is better than another. The outcome, regardless of the approach, may be that of a failure. Blaming one or the other for failure in these cases is generally illogical and harmful.Enhancing the relationship
How then might one enhance a relationship? Thoughts andexperience in this regard include:
Damaging a relationship
- When one sees good work by either party, it is useful andso rewarding to verbalise that to the owner/caretaker. It isnot surprising that such information is often forwarded.
- On a given day offering a cold drink, cup of coffee, orwhatever is a cheap and positive investment.
- Assuming that listening is part of one’s work ethic and thatnew or enhanced knowledge is acquired, a ‘thank you’ tothe provider is welcomed.
- Mentioning, promoting or even inviting the other party toupcoming appropriate clinics, lectures, etc. is often metwith enthusiasm.
- Calling and/or sending digital images to either party fordiscussion or as a follow-up is greatly appreciated – and soeasy these days!
- Taking a few moments to ask about one another’s ‘otherlife’ away from horses is invariably both positive and attimes interesting.
- Admitting errors and mistakes is often rewarding as well asan additional learning experience.
- A simple ‘thank you’ when one or the other helps is themeasure of a good person.
What are the elements that may damage or negate a relationship? That may include the following while also knowing that there are times when one is not able to understand a failure:
- Sharing negative information with others about oneanother (could be pricing, horsemanship, appearance,lack of knowledge, etc.) invariably enhances negativity
- Farriers making diagnoses, taking radiographs or otherdiagnostic images (other than photos) providing treatmentplans, performing invasive hoof wall penetration surgeriesand/or providing medications is not only unlawful but alsoa guaranteed negative response.
- Inexperienced veterinarians pulling shoes for whateverreason and causing hoof wall loss; failing to protect thefeet of a now barefoot individual; not saving the removedshoes (owners and farriers end up losing).
- Veterinarians criticising farriers (and vice versa) withoutknowing the circumstances; for example, the owner/trainerinsisted that a given horse be trimmed and shod undertheir misguided direction; the horse is incredibly difficult towork on; and/or the handler is part of the problem, etc.The point being – the veterinarian was not present whenthe work was performed on the horse and thus cannotknow the circumstances.
- Veterinarians leaving incomplete instructions (so-calledprescription) for a selected trimming/shoeing without directcontact with the farrier; admittedly, such conversationsmay be difficult to arrange, but leaving a voice mail, textmessage and contact data is easy.
As in all relationships, conflicts may arise. Quick recognition and frank, yet discreet discussion is indicated to preclude destructive circumstances. Effective communication between all parties – farriers, equine practitioner and owner/handler/trainer is essential in providing the best care for the horse and service to the client.
It is difficult to overstate the importance of a strong veterinarian–farrier partnership(s) in equine practice. A mutually shared dedication to doing what is best for the horse will continually cause the farrier and veterinarian to examine their respective ‘business models’.
Those practitioners with insufficient formal education and/ or experience with farriery can lead to conflict and reduce owner/trainer confidence in case management. It is the responsibility of the equine practitioner to acquire and maintain competence with regard to the equine digit (anatomy, biomechanics, treatment options) as well as familiarity with the selection of available farriery appliances and materials. Such knowledge is acquired by asking those who know as well as access to a variety of farrier publications. It is very useful for both parties to know that progress has been made in clearly defining terms used in equine podiatry – thus an accepted terminology should be used (O’Grady et al. 2007; Parks and Mair 2009).
Effective and timely communication between all parties involved (to include the owner/handler/trainer) to create a ‘team effort’ to maximise the care and service to the client and horse should be the goal (Moyer and Werner 2008). Given today’s convenient technology, verbal and document communications are easily facilitated. All clients have expectations – realistic or otherwise – regarding prognosis, rate of progress and costs. Timely and effective communications are essential, useful and usually rewarding.References
- Bullock, F. (1929) Notes on the early history of the veterinary surgeon in England. Proc. R. Soc. Med. 22, 627-633.
- Kirker-Head, C.A. and Krane, G. (2010) Farrier services at veterinary teaching hospitals in the USA. Equine Vet. Educ. 22, 519-525.
- Merriam, J.G. (2003) The role and importance of farriery in equine veterinary practice. Vet. Clin. North Am. Equine Pract. 19, 273-285.
- Moyer, W. and Schumacher, J. (2000) Chronic Laminitis: considerations for the owner and prevention of misunderstandings. Proc. Am. Assoc. Equine Pract. 46, 59-61.
- Moyer, W. and Werner, H.W. (2008) Developing and sustaining a mutually functioning relationship with farriers. Proc. Am. Assoc. Equine Pract. 58, 176-177.
- O’Grady, S.E., Parks, A.W., Redden, R.F. and Turner, T.A. (2007) Podiatry terminology. Equine Vet. Educ. 19, 263-271.
- Parks, A.H. and Mair, T.S. (2009) Laminitis: a call for unified terminology. Equine Vet. Educ. 21, 102-106.
- Werner, H.W. (2012) The importance of therapeutic farriery in equine practice. Vet. Clin. North Am. Equine Pract. 28, 263-283.