Care and Rehabilitation
  of the Equine Foot

Book Reviews


This book is a complete and comprehensive description of methods and husbandry that, when employed as a complete health care package, allows horse after horse to simply forget its feet ever hurt.  I have been educated, humbled, enlightened and frequently amazed while working with these authors.   Debra Taylor, DVM, MS, DACVIM



I have been "looking at" horse feet for years but until I read this book I never really “saw” the foot.  I would be a much better diagnostician if I had read this book years ago.   John Schumacher, DVM, MS, DACVIM, ABVP


Pete Ramey's Care and Rehabilitation of the Equine Foot book is probably the most comprehensive work ever written on the horse's hoof. With the help of major contributing authors and researchers, it takes a new look at growing or rehabilitating a horse's hoof from within, combining all the various aspects of hoof care, nutrition and lifestyle.

With 440 pages and over 600 photographs and illustrations, Pete Ramey, surrounded by collaborative experts in their fields, has created the ultimate reference book on equine foot health. It is deep, detailed and scientific and might well become the new way to think about care for the foot, whether shod or barefoot.  Kerry Ridgway, DVM - Institute for Equine Therapeutic Options




Book Takes A Wide-Ranging Look At Paths To A Healthier Equine Foot

Care And Rehabilitation of the Equine Foot

By Pete Ramey

Review By Randy Luikhart

This was a very interesting read. I found Pete Ramey’s open and honest assessment of how the hoof-care industry is faring enlightening. Although he is the author of this book, the list of co-authors is like a tour through the minds of some of the most reputable researchers in the industry. This is not just a book on rehabilitation of the foot, but also one containing information that any hoof-care professional can use in his or her daily work.

Robert Bowker Input

Dr. Robert Bowker’s papers provide the reader with easily understood narrative both in lay and anatomical terms. The Michigan State University researcher’s good-foot, bad-foot discussion explains the differences and how they contribute to sound and unsound horses.

The role of circulatory and micro vessels aiding in hydraulic dampening of destructive vibrational frequencies is eloquently described. Macro- and micro-structural irregularities between the good foot and bad foot are defined and explained in terms everyone can understand. Bowker makes a convincing case (and rightfully so) for hoof-care professionals to be more conservative in excessive removal of weight-bearing structures of the hoof.

In further chapters, Bowker explores the science behind hoof growth. He believes the foot grows down and gets larger in thickness and girth as it descends to the sole region. Some of the slides showing the discrete cells he is describing in the text could have been labeled better. This problem made reading and comprehending the text more difficult. He does a great job of describing the various innervations of the hoof and how each plays a role in assessing the stimuli for the hoofs environment, whether pain, temperature or locomotion.

A very intense segment on the chemicals discrete to these nerves and various mechano-receptors is all necessary information for clearly comprehending the complexity of hoof function. A description on assessing blood flow with Doppler ultrasound and the mechanics of this process was extremely interesting.

 EMS Review

If you have any desire to learn about Equine Metabolic Syndrome (EMS), Dr. Eleanor Kellon presents information defining the differing pathways of possible EMS and their differing treatment protocols. This is a must-read for any person dealing with these horses in their practice. Her easily understood narrative expands on to the hoof’s nutritional and normal mineral requirements, as well as their individual roles in hoof structure. She includes a guide to ensure the animal is receiving enough minerals.

Pasture Facts

Kathryn Watts presents a very convincing argument on the new and improved pasture grasses now being planted and how the non-structured carbohydrates (NSCs) vary among them. NSCs have long been known to have a major role in laminitis and EMS, so management of these simple sugars is crucial for healthy horses.

Kellon then makes a strong case for better hay analysis so that we actually know what is being fed to our horses, following with a chapter on balancing the diet. There is no doubt this information is often overlooked by the average horse owner. Its importance is obvious, but not often easily understood.

More Than Just Feet

One of the nice things about this book is that it flows. Dr. Kerry Ridgeway follows the metabolic and nutritional papers with a paper on the gastrointestinal tract, ulcers, colitis and the treatment of these common GI problems. This is a very informative and clearly presented section, describing in great detail the disorders and the treatment. Treatment costs and effectiveness are clear so readers get a selection of possibilities for treatment at a cost they can deal with; a very practical approach.

Dr. Debra Taylor does a great job describing the EMS patient and its problem feet. She spends time explaining the differences in treatment protocol of the syndrome and the feet, as well as the biochemical basis for some of these differences. Her very clear and adamant stance for proper radiographic marking to properly gather information on the current status, prognostication and treatment is worth the read. Another excellent chapter is on the use of venograms in information gathering and the importance this information may give you in the clinical management of these often-difficult cases. Taylor’s stance is the more information you gather, the better. More data will help you in your evaluation if you get a recurrence or setback of the patient’s recovery.

I have long loved reading the writing of Dr. Hilary Clayton and her contribution to this book is no exception. She takes the time to break down the weight-bearing phase, foot function during locomotion, forces, range of motion of the distal limb joints during load and propulsion and the resulting swing phase from that weight bearing. Clayton’s papers are always informative and written so that even I can understand it.

Ramey’s Thoughts

Pete Ramey has the task of tying all the previously presented information together and supporting his protocol for foot management. He does a stellar job in his description of “what he is seeing” in a foot and walks you through his visualization process so you may experience the same visualization. He also breaks trimming procedures down into chapters so that he may properly explain each and every component of management of the foot from his perspective. Once you understand his principles of trimming the sole, wall and frog, he ties variables into the process, so that you can visualize and understand the goals he is expecting to reach through using these procedures.

This is a long read (446 pages) and often times a tough one, but it is a read that everyone should finish. Ramey’s wonderful, clear writing style is evident in a statement like “Most domestic horses are living in the human equivalent of a pie factory.” These whimsical passages were enough to keep me reading. Among hoof professionals, no two people think alike and there are areas that Ramey talks about that will raise discussion. That is not bad. Disagreement is not bad. Drawing a line in the sand is.

Ramey has taken a huge step forward in “throwing” out lots of tidbits to discuss and backed some of his positions with science. These technical and sensible discussions will hopefully make us all think about our normal practices of hoof care. No doubt if Mr. Ramey and I were sitting around a table discussing methodologies of dealing with various hoof conformations we deal with daily, each of us would have pictures of our successes and failures. Our discussions would be lively and on many points we would agree. One of the early themes that Ramey spoke of in the introduction was the necessity for us all to think about what we are doing to feet, before we do it. I would recommend adding this book to your library and reference material. Not that this book has all the answers, but it does make you think and that is its purpose.

Finally, “The laminae were simply never intended to suspend the horse’s weight without help from the sole, bars and frog. Good horseshoeing and good trimming practices incorporate the functional congruity of the hoof.” Mr. Ramey, I couldn’t agree more.

Care And Rehabilitation of the Equine Foot is available for $176 and can be ordered through the author’s website at





I received the book today, ripped open the package in the post office parking lot, and sat there for about 20 minutes having a flip through it, with a dropped jaw. Please pass along my sincere thanks to Pete and Ivy for putting together such a fascinating, comprehensive resource of contributing authors (including Pete of course!) and including so many detailed drawings and pictures. I definitely will add it to my "suggested reading" list for my students. I can't wait to sit down and take it all in. Cheers, Lauren


I have just finished reading this book from cover to cover and feel that I have greatly increased my knowledge of the horses’ foot and how to manage it in both the normal and pathological state. Pete Ramey has brought together a broad range of authors who have all had a significant impact in their respective fields of work. The result is a well balanced and holistic view of the management of the horse which covers the foot in more detail than I have found in other references. The bringing together of various points of view of hoof care professionals with scientists, veterinarians and nutritionists, all with the healthy horse and healthy foot as the ultimate goal, has produced a resource that will stand alone for some time to come. This is an important reference for all those involved in the care of the horse and should be compulsive reading for horse owners and managers. I highly recommend the book. I have read all 464 pages but I will go back to the text and great descriptive figures time and time again in the future.  Brian Hampson,  PhD



This is much more than a book about barefoot vs. shod.  In fact, it’s not about that at all. This is the new way of thinking about care for the foot—care takes on a double meaning. Instead of just compensating for the horse’s problems, look at how to help the horse grow a better foot. Think ‘rehabilitation’ instead of ‘compensation’, when you can.  It might make people turn their heads, especially  for work on young horses—the idea is to anticipate problems and avoid them instead of fix them.

We live in an age where collaboration is not just an interesting undertaking—it's almost a requirement. Pete Ramey has wrapped his reference book in a cloak of collaborative experts to create a synergistic look at how hooves can be nurtured back to health—or rehabilitated to a state of health that the horse may never have known in its life.

Forget what you know about barefoot trimming and be prepared for the launching pad to the next era of collaborative hoofcare technology.  Ramey admits that he has softened his stance on shoeing, but believes we can do better than continuous shoeing with steel or neglectful long intervals between re-shoeings.  This book is a snapshot of where we are now—with bare hooves, booted hooves and metal/aluminum/plastic shoes creating the spectrum of choices. It may not be what we choose, he concludes, but how we use the materials and methods.

I like the way that this book opens the door to the future—and leaves it open.  Innovation is the path through the door and this book should encourage everyone to decry neglect, ignorance and lack of skill as hooves worst enemies.  Some horses may be well through that door, thanks to having new materials and methods and smart, skilled people on their side.  I hope in our quest for innovation we don't create a divided society of "hooves" and "hooves not".  The best solutions will be the ones that are affordable and usable in many hands.

Ramey also includes veterinary support, imaging, nutrition, pasture management and locomotion in his spectrum; without working them into the hoof equation,  the rehabilitation is not going to be realized.  Collaboration is not an option, it's a requirement.  The hoof needs to feel the influence of much more than a rasp and a knife to find its way along recovery road.

The road through this massive book passes through the clinics, laboratories and research expeditions of authors well-known to Hoofcare & Lameness readers.  I hope their names in the table of contents will encourage some readers who might dismiss this book as a "barefoot tome".  You can read it on many levels and believe me, you will.   Fran Jurga, Hoofcare Publishing


Pete Ramey’s new Care and Rehabilitation of the Equine Foot is singularly the most comprehensive and complete work ever written about the horse’s hoof. Prepare yourself for deep, detailed and scientific. It’s not a light read but rather a study manual that will likely take years to absorb. At least it will for me. But the 630 color pictures and diagrams help even the lay person grasp the principles and get a deeper understanding of the hoof and what makes it tick.

You’ll learn everything about growing a healthy foot from within, combining all of the various aspects of hoof care, nutrition, and lifestyle into a system that yields the best end-result for the horse, covering both the veterinary/internal and the farrier/physical sides of rehab and prevention of hoof problems. Most books only focus on one or the other.

Cover-to-cover this book never strays from the foot and conditions that affect the foot. There is no 'fluff' or 'filler'. It’s a must-have for anyone interested in knowing more about the health of their horse’s hooves than anyone else on the planet.

Joe Camp - Author of the National Best Seller The Soul of a Horse: Life Lessons from the Herd and everything Benji



To a horseman or veterinarian, the title of this book may sound suspiciously broad. Anyone familiar with horses and foot lameness knows the equine foot is a multi-faceted topic. The subtitle helps by stating the book’s purpose: “Practical Instruction for the Equine Veterinarian, Farrier and Trimmer.”  The statement following the subtitle reiterates the comprehensive treatment of the subject matter: “Details internal anatomy and development, caudal foot pain and laminitis treatment, plus help for countless other hoof problems.”

With 440 pages and over 600 photographs and illustrations, this is a textbook for both hoof-care professionals and for horse owners motivated to expand their knowledge and understanding of hoof anatomy and hoof care.

The primary author, Pete Ramey is one of the foremost hoof specialists and hoof-rehabilitation practitioners in the United States. Initially he earned his reputation on the ground and under the horse through his hoof trimming practice and work with problem feet. Later in clinics, workshops, publications, and videos, he’s presented methods and practices using barefoot trimming techniques to restore lame horses to soundness. Ramey’s practical experience is undisputed. His ten-disc instructional video series, “Under the Horse” is accredited for 20 hours of continuing education credits for veterinarians and veterinary technicians.

In the introduction, a note from the editor explains the chapter arrangement: “This book was organized to favor the target audience—equine veterinarians and professional hoof-care providers. The more technical and veterinary chapters by the contributing authors are placed in the front half of the book. Pete Ramey’s chapters—written in simpler language and tending to cover the more hands-on subjects—are placed in the back half of the book. These chapters also introduce and discuss most of the concepts covered in greater detail by the contributing authors.”

The editor goes on to explain that those relatively new to internal hoof anatomy will be best served by reading the photo captions and selected chapters by the contributing authors first, then reading Ramey’s chapters on trimming before tackling the more technical chapters by the contributing authors. The 15 trimming chapters by Ramey are meant to be accessible to layman hoof-care practitioners.

The list of contributors to this volume is impressive and diverse. The contributing authors include five equine veterinarians, all prominent in their respective fields; a renowned specialist in pasture and forage management and analysis; and an Australian research scientist who specializes in hoof development and pathology of the Australian feral horses.

Of the contributing authors, Eleanor Kellon, VMD; Kerry Ridgway, DVM; and Kathryn Watts present abundant information that should be of particular interest to horse owners with horses diagnosed with insulin resistance, Cushing’s disease, or chronic bouts of laminitis.

Dr. Kellon is one of the leading researchers in equine nutrition and metabolic laminitis. She explains her research into metabolic-triggered lameness and presents the causes, symptoms, protocols, and management practices for prevention and treatment.  In another chapter, she details the importance of balancing mineral ratios in the equine diet for hoof health and provides specific instructions on how to do it.

Kathryn Watts, equine forage specialist, clarifies historically misunderstood concepts about the fluctuating carbohydrate content in pasture grass and hay. She explains the importance and “how-to” of testing and providing low-sugar hay for laminitic and tender-footed horses.

Dr. Kerry Ridgway discusses the prevalence and significance of gastro-intestinal ulcers in horses and the relationship between ulcers and musculo-skeletal pain and laminitis. With extensive experience in ulcer diagnosis, he offers horse owners and veterinarians descriptions of little-known signs and symptoms that typically can be indicators of gastro-intestinal ulcers.

In 31 chapters, the authors cover the subject matter and accomplish the comprehensive mission implied in the title and subtitle. The technical and professional dissertations are based on well documented, state-of-the-art research and clinical trials.  The illustrations are excellent. Pete Ramey’s chapters of explanations and trimming instructions are thorough and clear enough to get a hoof practitioner started on the path of barefoot hoof rehab. With the inclusion of chapters on nutrition and management practices, it’s evident that hoof care and rehab is a “whole-horse” undertaking.  The overall quantity and professional quality of information presented in this book is exceptional.

The price is a daunting $176.  But that’s probably comparable to the price of medical and veterinary textbooks, to which it could be compared if equal importance had been given to quality editing and production. Mistakes abound that would have been eliminated with professional editing.  From typos and errors in punctuation and mechanics to awkward, hard-to-read page layout and formatting, the book suffers from the lack of professional proofreading, editing, and design.

In spite of those flaws, it is a pertinent resource for equine veterinarians, farriers, trimmers, and horse owners who want to educate themselves on barefoot rehabilitation practices. Others seeking more of an introduction to barefoot trimming techniques and rehab practices may want to access Pete Ramey’s website, or his videos, which are available to rent at

Staff review,  Modoc Independent News


I believe every vet, farrier/ trimmer, trainer, horse rescue owner, barn manager, breeder—every equine professional would do well by the horses in their care to understand everything presented in this book, because of its whole-horse approach in giving the horse it's best potential for rehabilitation. It also gives the best advice on horse-keeping from foal to adult to avoid the pitfalls that bring a horse to the place of needing rehabilitation.   Geri White, ESA EqSC



If you only buy one book about laminitis, make it Pete Ramey's Care and Rehabilitation of the Equine Foot. Expensive, yes, owing to the hundreds of colour photos and illustrations, but oh so worth it - and in fact probably no more expensive than one set of remedial shoes or one set of x-rays.  Although Chapter 28 is entitled "Laminitis", the whole book is directly or indirectly related to laminitis - understanding the equine foot, the role of diet and the environment, how to trim the foot for optimum balance and health, and how to reverse P3 rotation and distal descent - all the information necessary to rehabilitate the equine foot following laminitis and other common foot pathologies, plus how to keep the foot and horse healthy after rehabilitation, and how to prevent these problems in the first place.  There are no gimmicks, no fancy shoes or treatments - just information based on recent research, many years of experience and a good helping of common sense.  In our opinion, essential reading for any vet, foot care professional or owner dealing with a laminitic horse - or any horse, for that matter.

The Laminitis Site