Advice please

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Emmahi

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Hello I am new here so please be kind and patient! Need some advice. My daughters 21 year old 14.2 cob is having real problems. Last summer her feet were in such bad condition her shoes kept being sucked off, hence lots of nail rips and splits. My horse has always been bare foot so after speaking to vet and barefoot trimmer decided to take off ponies shoes and let feet grow out,with just trimming.
6 months later all nail holes have grown out but wasn't happy with her soundness. Had X-rays done, pedal bone rotated, no laminitis, vet said her feet now need heart bar shoes. She has had other health issues all of which have come to a £600 plus vet bill!! This bill is just going to keep going up.

The question is at what point do we retire her, do we keep going with corrective shoeing etc etc or do we call it a day? She is a very much loved pony,happy hacker,fun rides etc. just want to do what's best for pony.

Sorry to waffle on!!
 
Photos please it really helps.

Can you ask your vet to explain how the pedal bone has rotated without laminitis? Or is this negative rotation?

Heart bars besides being costly do damage the caudal hoof so are not an option to be taken lightly.

Whether rotation from laminitis or negative rotation from a poor caudal hoof there are many examples of horses who have recovered whilst either being taken barefoot or remaining bare.
 
My tb has reverse rotated pedal bones in his hinds, he had low grade laminitis ( hinds only ) which was diagnosed as something else and has secondary PSD, he's now 6. Neither vet nor farrier picked up on the laminitis, and both were adamant he didn't have it.

He went in for a full lameness work up in October and x-rays showed the reverse rotation and scans showed PSD, the vet recommended remedial shoeing. I went with this as I felt at the time he was very uncomfortable but the horse hated the heart bars in front, these were changed to normal shoes with a rolled toe, still not sound in front shoes so I had them taken off, consequently sound in front! Have now recently taken off the hinds and he's started walking, he's very slightly unlevel behind in trot on concrete but he has improved so much, this horse I was expecting to have to have him pts because he was lame and he was miserable.

I changed diet to low sugar / high minerals last september, I use pro hoof and also micronised linseed. The changes to the foot have been remarkable.

Just finished reading "Feet First" which is a good guide to feet and the info on here is always very helpful.
 
We think she has had laminitis in the past, not the previous 4 years we've had her though. She is sound, just very unhappy walking on uneven hard surfaces. Her feet are a strange shape, with very slow growth, despite feeding supplements recommended. Vet recommends heart bars,4 weeks box rest ( to make sure shoes stay on) then more X-rays before we can think about riding her again.not a problem if I think a) it's fair on horse and b) after the expense she will be sound.

I just don't know how far to keep pushing her or when to say enough is enough. I think she would love retirement, not sure about my daughter though.
 
If not done already, I'd ask the vet to test her ACTH for Cushing's (and they'll probably do glucose/insulin at the same time to check for insulin resistance), both of which can cause laminitis and may account for the odd shaped feet and particularly for her being more uncomfortable on uneven surfaces.

At her age, I wouldn't be surprised if it was Cushing's creeping in, and in which case it may help to have her on pergolide.

If that's the scenario, I think I'd be tempted to try her in shoes again for a few shoeing cycles to try and get some good wall growth coming down again whilst keeping her a bit more comfortable, and then try again without shoes.

If it is Cushing's and you can control the changes in the feet, then hopefully she'll be able to carry on working. It's certainly worth a go.

Sarah
 
Did the vet give you a full copy of the blood report(s)? If not, it's definitely worth asking for a copy (and of any future bloods).

What test did she have done for Cushing's? What time of year was the test done? What was her actual level, and what was the lab's reference for "normal"?

These are all the sort of questions I'd ask myself if it was my horse. The reference levels change at different times of the year, to take account of a natural increase in ACTH in the late summer/autumn. A result might be just within normal range, but that might not mean the horse is truly normal - in other words, if it's borderline you might choose to put on pergolide as a trial and see how much difference (if any) it made. Also, there is another test, where they inject TRH and take a blood and test it for ACTH after 10 minutes - that test can be helpful in picking up borderline cases that don't show with just the baseline ACTH test.

Of course it may still not be Cushing's, but I honestly wouldn't exclude that unless you have seen the full results. This article from Liphook is quite interesting:

http://www.thelaminitissite.org/news.html

Also, this one shows a simple graph of how ACTH levels vary through the year:

http://liphookequinehospital.co.uk/wp-content/uploads/2012/03/PituitaryParsIntermediaDysfunction.pdf

Hope you manage to get to the bottom of things, whatever it is.

Sarah
 
Emmahi said:
We think she has had laminitis in the past, not the previous 4 years we've had her though. She is sound, just very unhappy walking on uneven hard surfaces. Her feet are a strange shape, with very slow growth, despite feeding supplements recommended. Vet recommends heart bars,4 weeks box rest ( to make sure shoes stay on) then more X-rays before we can think about riding her again.not a problem if I think a) it's fair on horse and b) after the expense she will be sound.

I just don't know how far to keep pushing her or when to say enough is enough. I think she would love retirement, not sure about my daughter though.
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It is great that you want the best for your horse - TG for people like you.

Bear in mind hooves are a reflection of horse health. If the feet aren't great then something is wrong, somewhere.

As FF suggests it is a good idea to follow up the bloodwork. If at the upper end of the 'norm' for PPID then you may want to discuss a Prascend trial. I know a number of people who were told their horse did not have Cushings but were at the upper end. The trial has sorted things for them, although it did take time. (months rather than weeks)

A horse is unhappy walking on uneven surfaces for a reason. Often it is subclinical lami (LGL), but it may be poor caudal hoof development or thrush or a mix. Sometimes it can be something else such as pain in the shoulder or arthritis often in the lower limb.

Can you describe 'strange shape' or better still post photos. Strange shape doesn't always mean 'bad shape'. I have worked on many 'strange shape' hooves that were perfectly sound.
 
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