22/10/2025
📐📐Degrees of P3 rotation measured from the dorsal wall - is this the best measure of successful laminitis recovery? 📐📐
In a horse with good laminae connection, the dorsal aspect of P3 will run parallel to the dorsal hoof wall (Pic A1)
During some cases of laminitis, P3 rotates away from the dorsal wall. The distance of this movement is measured in degrees (Pic A2)
If P3 stays in this rotated state, the horse will likely experience continued pain, loss of bone density, damage and death of solar corium (pressure necrosis) and much more.
The long term goal should be to re-achieve a parallel dorsal wall to P3. However, this measure being used too soon during recovery could very likely lead you to believe improvements aren’t being made when they are. Or even more concerning, that improvements are being made when they are not.
Here are my thoughts why….
Rotation of P3 causes extensive damage to the vascular structures within the hoof. In the hours, days and weeks that follow, the horse will start to turn these vascular structures into something commonly referred to as ‘repair horn’ or ‘laminae wedge’. This repair horn is vital for the healing process as it turns soft & vulnerable vascular structures into a hard and waxy horn, providing some stability and protection to the compromised hoof and ‘filling the gap’ where the P3 used to sit.
After rotation, you CAN NOT push that bone back up to its original position - that ship has sailed. The objective now is to create & grow a hoof that will put the P3 back into the most optimal position.
As previously stated, a bone that stays in a rotated state will continue to cause pain and damage, particularly to the solar corium at the tip of P3. Further pressure & damage to the sole could eventually lead to P3 penetrating through the sole entirely.
This dangerous P3 angle is NOT risky due to its relativity to the dorsal wall BUT to its relativity to the ground.
With this in mind, your first objective should be to lessen the pressure at the tip of P3 in order to limit the effects of pressure necrosis and (hopefully) improve sole thickness. This is your best ‘safety margin’ during the first stages of recovery.
Here are what I feel are more appropriate measurements post rotation.
Palmer Angle. This is where the bottom of P3 is measured in relation to the ground. In order to reduce pressure at the tip of P3 & improve blood flow to the area, the palmer angle needs to be reduced.
Sole thickness under the tip of P3 particularly must also be measured to establish your safety margin.
Please see picture AN1.
Here you can see a reduction of palmer angle and improvement of sole thickness.
At this stage, dorsal wall angle is irrelevant.
Improvement in comfort levels were also seen with this horse. Please see previous case of ‘Anoushka’.
Another example can be seen with picture E1.
Here you can see a reduction in palmer angle, improvement in sole thickness with no improvement of dorsal wall to P3 angle. With all the above in mind, I see this P3 positioning as improved, regardless of dorsal wall to P3 angle.
Improvement in comfort levels were also seen and Eric has gone to make a full recovery.
Please see previous posts for Eric.
Next we have picture J1.
Note improvement of palmer angle
Picture J2
Note improvement of sole thickness.
Yes, the dorsal wall is shocking. But at this stage, irrelevant.
Please see previous post for ‘Jilly’ giving full details on this case.
Eventually, what you should see, is a new dorsal wall angle growing in. Please see that exciting development with Jilly in picture J3.
Within the hoof care world, I often find there is an eagerness to create this parallel/straight dorsal wall as quickly as possible. This can be achieved by ‘top dressing’ the dorsal wall and bringing it down to meet P3. Doing this alone, does not change the position of P3 but if you are measuring recovery success via the P3 to dorsal wall angle, you may think you are winning when you are not.
I am not suggesting that toes should or should not be trimmed. Most horses who have experienced rotation, will need to have their toes trimmed to one extent or another eventually but I believe that each case needs to be looked at individually.
My message here is not to allow dorsal wall to P3 angle motivate a trimming technique or be purely used as a measure of success until the horse has had chance to grow an entirely new hoof (6-9 months).