Questions About Hoof Conditions
Farrier Science Clinic
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Please Note: This survey has not been evaluated by the FDA and is not intended to diagnose, treat, cure, or prevent any disease. It is not to be used as a substitute for good veterinarian care, surgery, or to supersede any veterinarian advice. Please consult your veterinarian for any diagnostics or treatments that may be needed.

Please supply the following information and then click the Submit button at the bottom of the form.

This checklist is design to record information about 1 horse. If you wish to report information on more than 1 horse, resubmit this form for each addl. horse. Results of this survey will be used to further research on hoof wall disease.
Tip: you can click File and Print to print this form as a checklist.   Our Privacy Policy
I Am: Owner Veterinarian Farrier Trainer Stable Manager
1. Does your horse or mule have hoof  problems? Yes   No   Sometimes   Other
If so, how long has the problem existed?  
2. What Breed?
3. Use? Pleasure Race Work Hunter/Jumper
Show Other
4. Age Weight Height Sex
5. Housing: Grass Pasture Paddock & Stall Stall
Paddock & Feed Lot Other
6. Do you use: Disinfectant Lime Clorox & Water
7. Do you open and air stalls? Yes No Rotate
8. Climate: Hot Cold Wet Dry
9. Soil: Sand Clay Rocky
10. Feed: Sweet Oats
11. Suplements: DLMethionine Biotin Calcium/Vitamins
Other
12. Salt Blocks: Plain Mineral None Other
13. Hay: Cubes Alfalfa Fescue Grass
Other
14. Do feed anything to promote hoof growth? Yes No
If so, What?
15. Confirmation: Good Fair Poor Deformity
Other
16. Illness: Now Past Lameness Laminitis
Navicular Hoof Wall Disease Seedy Toe
Other
17. Medication Used: Bute Lasix Other
18. Do you de-worm your horse? Yes No
How often?
How do you de-worm? Vet Paste Tube
What type of de-wormer? Ivermectin Other
19. Exercise: Light Normal None
20. Hoof  Problems? 1 Leg 2 Legs 3 Legs 4 Legs
Front Back Sole Frog
Wall Heel Toe Quarter
21. Anterior/Posterior to apex hoof balance equal? Yes No
22. Medial/Lateral to apex equal? Yes No
23. Has veterinarian recommended wall resection? Yes No
24. Farrier use: Filler Tape Acrylic
Cut Out Leave Open
25. Has Farrier or Vet asked for another opinion? Yes No
26. Do you keep historical records of your horse? Yes No
27. Do you medicate damaged hoof wall? Yes No
28. Do you use a commercial product? Yes No
29. If so, what kind? Merthiolate Clorox Benzoyl Peroxide
Iodine C Sugardine Other
30. With what success rate? 25% 50% 100%
31. And for how long? 6 Months 1 Year
32. Has there been and increase of hoof wall disease in your stable? Yes No
33. Do you wash the horse? Yes No Often?
34. Do you use and have X-Rays? Yes No
35. Is there a hoof maintenance program? Yes No
36. Are you interested in learning more facts about hoof wall problems? Yes No
37. Is your horse shoed? Yes No
If yes: All Four Front Only Only when necessary
38. Stall bedding: Sawdust Shavings Straw Other
Please supply the following information so we may respond: Our Privacy Policy
Name
E-Mail  (required)
Address
City, State  Zip
Phone / Fax


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