The radiograph in Figure 1 is that of a middle-aged gelding that presented for intermittent foot pain. One year prior, the gelding had developed a high fever of unknown origin (presumed viral). During the weeks that followed the high fever, the gelding was slow to walk in small circle and on concrete surfaces. Over several months, the gelding's lameness improved however he was consistently tender immediately after being trimmed by the farrier. There are 2 disease processes identifiable in Figure 1. The first is chronic laminitis or founder.
Often, the early signs of white line disease can be detected at the time of hoof trimming and appear as a shallow crack at the toe region. The opposite foot of this horse had the very beginnings of white line disease evidenced by a small amount of gas lucency noted at the very tip of the hoof (Figure 5). When identified at this early stage, the condition is easily managed with regular balanced 4-pt trimmings by the farrier. Successful management of white line disease is best accomplished through a farrier-veterinarian team effort. The farrier is the most important part of the team since they will be doing 99% of the work. The veterinarian will provide the radiographic studies to verify that adequate exposure of the diseased foot is accomplished.