Advice on torn dorsal laminae, please

[miss_tipsy]

Hi, I was wondering if anyone has any advice on torn dorsal laminae. I will give you a brief (as brief as possible, it's a long story) history.
My mare is called Kim, she is a 15.2hh, arab x DWB, 10 years old this time and somewhat accident prone.
Kim came in from the field on August 30th 06 with a small cut on the inside of her near hind, this turned out to be a chipped splint and resulted in complete box rest until Jan 4th 07, the splint has now got the all clear.
However, on Dec 2nd 06 she got laminitis / dorsal laminae tearing, different names but the same problem. I was devastated, I gave her bute, applied frog supports, gave her loads of bedding, gave her limited amounts of soaked hay, reduced her bucket feed (which wasn't that much to start with) but did keep up with the vit & mins and then clipped her (chaser) and left her un-rugged to use calories.
The vet came and he thought she'd most likely torn the dorasl laminae rather than an actual laminitis, he advised getting her trimmed to shorten the toes and keeping up with the management I'd already started and box rest for a month but we were already doing this re splint. Things improved and several checks later she was given the OK to go out in the arena for 2hrs a day, after the first day she was sore so after another call to the vet we turned her out every third day for 10 days then every other day building up to everyday for a month. This all went well and she was then allowed in the field, initially for 2hrs and building it up slowly until she was out for the day, all was going well and the vet said it was time to start back to work and get her shod. She was shod on friday (23rd Feb 07), I kept her in after she had been shod and she was great to do, didn't flinch / create when they were nailed on or anything but on saturday am she was shifting weight slightly and her pulses were raised, I gave her a bute and have done everyday since, I have also kept her box rested, deep bed, soaked hay etc none of that has stopped since 2nd Dec. Now 4 days on the pulses have lessened a bit but aren't normal so I thought it best to keep her in. The vet is coming a week tomorrow (March 5th) to check her, I haven't spoken to him as he is on his hols but he did say she would be sore for a few days. I moved her into another box today, first time she has been out since friday and she walked OK.
I was just wondering if anyone has been through anything similar? and if there is any light at the end of the tunnel, this last 6 months has been so horrid as she is my princess, I have her brother too but she's special. I am also really concerned about concussion, future bouts etc. Any advice gratefully received, sorry my brief story wasn't so brief, Thanks.

 

[miss_tipsy]

Hi, I thought I'd up date her progess.
I had the vet to her yesterday (a different one as our usual vet was on holiday).
The vet hoof tested and said she was having another flare up of laminitis as a result of being shod but it's a low grade flare up. She removed the shoes, applied frog supports, advised box rest and bute. She has also advised that I get the farrier to come back and put on glue on heart bars asap.

 

[Spot1]

Hi Miss Tipsy, sorry to hear of all the problems you are having with your mare.

[ QUOTE ]
The vet came and he thought she'd most likely torn the dorasl laminae rather than an actual laminitis, he advised getting her trimmed to shorten the toes

[/ QUOTE ]

Did your vet say anything about the possible cause of the problem? Did her toes become abnormally long when she went lame or were they long for a while?

You may want to get some radiographs (X-rays) taken, your farrier should be able to use these to correctly trim the feet. The glue on heart bars can give a more permanent support than frog pads and, if the foot is very sensitive, save any trauma due to nailing. Have you got any pictures of her feet?

Hope it all goes well.

 

[Tia]

I really can sympathise. I almost lost my beloved pony in the Summer of 2004 and it is really devastating to think that they may not make it.

We were out here at our farm in Canada when she came down with full blown acute laminitis in all 4 feet. We had to fly back to the UK to have her put to sleep. Vet was booked for an hour after we were arriving back to our house. As soon as I arrived home I went out to see the pony and oh my god! there was no two ways about it that she was dying. Her beautiful black eyes had totally lost their spark, she appeared like she didn't know who I was.....it was heartbreaking seeing our pony that we have cherished for 10 years disappear before our eyes. My daughter came out to her stable to say her goodbyes....and the moment she walked in, the pony looked up and went over to her and then snuggled her head into her tummy. That was the point where when the vet arrived I told him that I thought we should fight for her. That was the beginning of her recovery period.

The key to laminitis is finding out the trigger. Thankfully we figured our pony's out very early on so it was so much easier to handle and deal with. We had her x-rayed and in the acute stage her two front pedal bones had rotated; she was put on wedges for a couple of days and then I took them off as they appeared to be hindering her recovery. Some time later, my lovely farrier made some little heartbar shoes for her and fitted them - she could NOT tolerate these so we had them taken off 2 days later.

We opted not to have her shod again and my farrier spent a lot of time showing me how to trim her feet correctly and to the right angles. Her feet needed trimming every 3 to 4 days as they were growing soooo quickly. He still came every 6 weeks as usual and he did the scary-stuff trimming her toes right back to beyond the white line and her soles (I was not comfortable doing this part) but I was happy to keep her heels trimmed and trimmed her toes up to the white line.

I had bought her a pair of Old Mac's as I was very aware that she needed to be out and walking around - these were fantastic! These boots helped us enormously; I walked her out about 6 times a day just for a few minutes at a time to begin with and eventually she was managing to walk around the village perfectly happily.

Her feeding regime was simple - she was fed ad-lib hifi lite with a little scoop of Farriers Formula.....that was it. Nothing sugary, nothing sweet. Eventually she could manage to go out in the field. I sectioned off a tiny paddock in our field behind the house and she went out there with her grazing mask on and she became better and better every day.

Immediately before we flew her over to our farm in Canada, I had her x-rayed and her rotated pedal bones had remarkably returned to their correct positions. We flew her out to Canada in December 2004 and since being here she has never suffered from laminitis again......and she is going to be the proud Mummy of her own little baby in 1 month's time.

So.....the point I am trying to make is that not every case is a lost cause. There can be light at the end of the tunnel sometimes.

I wish you all the luck in the world. All of my very best wishes.

 

[mrsbloggett]

Hi there, Have you had x-rays taken to eliminate pedal bone rotation and / or seedy toe? If there is a breakdown of the laminae then both can occur. If the laminae is damaged, it allows the pedal bone to rotate or sink and as there is restricted blood flow to the laminae some of the structures can die, thus allowing pockets of seedy toe to develop. If there is any movement of the pedal bone this can obviously be seen in xrays, and seedy toe will show up as dark shadows.

I have been battling laminitis with my mare since August last year and hopefully (fingers crossed) we are starting to find our way out of the woods. Have you considered having plastic glue on shoes whilst she is recovering? Maisie has had two set of Imprint shoes on and they helped her tremendously whilst she was in the accute painful stage

 

[miss_tipsy]

Hi Everyone and THANK YOU for the advice.

The farrier has been today and put on a set of imprint heart bars. He was a little annoyed that the vet had taken her shoes off as he could have packed them to support the pedal bone instead of going down the most expensive route but hopefully the vets fees will cover this anyway.
He asked about x rays and I told him that no one had mentioned this until the vet came on Wednesday but then she only asked if she'd had any done.
When I told him what the vet had said about the trauma of nailing or the nails causing pressure he dismissed this and said it was her soles making her uncomfortable as we had lifted her up and given pedal bones room to move.
I am so annoyed at myself, she isn't the first laminitic I've dealt with, I've had 2 loan ponies in the past who have suffered. Why haven't I asked for x rays etc, I was so devastated in Dec when she first started and I called the vet and explained but then when he came out he played down the situation and said about the torn dorsal laminae, box rest, trim her toes etc and I felt reassured and as if I had over reacted but in my mind it was best to work on a worst case senario. Then when she started to go out and all went well I got more positive and then the vet recommended I had her shod so I called the farrier he came, shod her and expected her to be OK and now we are starting again. The farrier said she has only had a small relapse but advised x rays.

Both my vet and my farrier are great. The vet is solely an equine vet and has been for nearly 20yrs and the farrier is fantastic, he is working towards being an examiner, he does loads of remedial work and especially laminitics but somehow I just feel lost with the advise and continuity of the situation.

In reply to what was the initial cause / were her toes long, I don't know the initial cause. She wasn't on alot of feed in fact I had noted an increase in weight (but she was not massive by any stretch of the imagination) and lessened her food, she was on box rest and had been for months so was a bit stressed, she had / still has episodes of ballet dancing in her box ie cantering round a 12' x 12' box bucking, she has also developed a habit of door kicking, she had all her winter woolies on but no rugs but was quite warm which is why I clipped her and her toes were due trimming but weren't massively long, she had always been shod and was at the time of the initial splint injury but I had them removed when she was going to be box rested for so long.

As for food she is on Simple System and on the lowest calorie chaff in the range, there are NO molasses, preservatives, additives etc in any SS feed, she is also on thier forage balancer for her vit and min intake, and soaked hay approx 3 slices a day.

 

[Tia]

I am pleased that you feel you are a bit more on top of it now, with respects to where you are heading.

I have to say, as much as you seem to have a lovely farrier, he cannot really be expected to do much without x-rays. X-rays are, in my opinion, THE most important thing here as without them, no-one can figure out angles or the best way to deal with trying to fix the problem within the hooves.

I am purely speculating here, but if the horse were mine I would be thinking along the lines of box-rest being the trigger.....that causes severe lack of blood circulation in the feet which is very detrimental to a laminitic. As soon as the acute stage is over, they need to be having some sort of gentle exercise to get the blood moving in the lower legs and feet.

First thing I would do is make an appointment to have the vet come out and perform x-rays. Fingers crossed that all goes well and you both manage to escape the doom and gloom that accompanies this awful disease.

Wishing you very good luck.

 

[miss_tipsy]

Thanks, I am going to have her x rayed next week and then we know exactly what is going on in there. She seems happy in her imprint shoes and her pulses are still normal (they returned to normal 24hrs after having the nail on shoes off and frog supports on)
I will keep you updated, thanks again

 

[Spot1]

Hi Miss Tipsy, it's nice to hear back as to how its all going. With any luck you will be covered for the treatment on your veterinary insurance which makes it all allot simpler. Getting X-ray images is a great help but, as your farrier has proved, it is possible to work without them. [ QUOTE ]
She seems happy in her imprint shoes and her pulses are still normal

[/ QUOTE ] It is too late to worry that X-ray weren't taken originally, you may now be past the stage of needing them, so it then becomes a question of cost and general interest, if you do decide, along with the vet and farrier, to get X-rays, the feet will need to be marked with wire guides so that measurements can be transferred from the X-rays to the feet. (as your vet is used to equine work you shouldn't have a problem here) Decisions of the best treatment should be made in conjunction with your vet and farrier, many laminitics are happy with careful nailing, as your farrier seams to suggest, so maybe she can have nailed on shoes next time she is due to be shod.
[ QUOTE ]
as we had given pedal bones room to move.


[/ QUOTE ] You may have misunderstood your farrier here, the object is normally to support and stabilise the pedal bones, taking the pressure off of the laminae, hence the frog plate.

It sounds to me by your descriptions that the laminitis may have been triggered by trauma perhaps as a result of long flared toes and or flat soles, ref. your vets description of torn laminae and request to have the toes shortened and [ QUOTE ]
it was her soles making her uncomfortable

[/ QUOTE ]. Ask your vet regarding exercise as this can be problematic particularly if she is on painkillers. I'm sure if you talk to your farrier you will be able to find the best long term management of her feet Without seeing the feet it is difficult to suggest anything in particular.

Looking forward to the next update

 

[miss_tipsy]

Hi Everyone,

Kim is going to be fine!!!!!

Kim had her x rays this morning, I felt worse when they had been done than before as I knew I was going to find out one way or the other. The were done with the mobile machine so I had to wait for the verdict, it came at 2pm and is was good. Both the vet and the farrier have looked at them and they both agree that her feet are perfect! It looks like it was bad bruising all the time and having her shod inflamed it again. The vet is coming back on wednesday to see her and we can discuss where to go from here.

Thank you all for your support and advice, I will keep you updated.

 

[Spot1]

Thanks for keeping us all informed. Glad to here things are looking up

and its FRIDAY as well