Chronic Laminitis...What to do next.

[Carlosmum]

15 yo NF gelding, tested positive for PPID last autumn. Levels 'normal' after 6 weeks on Prascend. However, began working again in January after nearly 3 months off ( life got in the way). Presented as lame, but no usual signs of laminitis, however vet x-rayed and confirmed laminitis and a little rotation in both forefeet. Fast forward 9 weeks box rest, during that time I have removed alfalfa from his diet, all molasses etc amd on soaked/ rinsed hay he has had heart bar shoes fitted. He is also on 1x bute per day. I am not seeing any further improvement. He is still walking heel first and sore on turning corners. Do you think he still has inflammation in his laminae or would the lameness be caused by the rotation of his pedal bone. Should I now be thinking of removing his shoes and using pads and boots? There is no obvious digital pulse that I can find.
After discussion with the vet we realised this has probably been going on for several years at an undetectable level, so he has probably been uncomfortable for a long time. She wanted him left in until he was sound off bute. Do I carry on with the box rest assuming any movement will cause more rotataion? Do we pad him up so he can at least come out for a walk? When should I call it a day? He is perfectly happy in himself though fed up with being in all he time. I will be getting the vet back in 2 weeks around the time the farrier is due again, but does anyone have any suggestions something I might not have though about.

 

[Highmileagecob]

If PPID is involved, things do not often go to plan. Symptoms are low or absent, pain levels go through the roof, pain relief is often not effective and the normal course of a bout of laminitis/coughing/EMS or whatever just doesn't follow the usual pattern. I would liaise closely with your vet, pad him up and continue box rest, do not walk out. Take your farrier's advice about whether to remove shoes or not, and do not be pushed into heart bar shoes if your farrier can make him comfortable with pads and boots. This all comes from personal experience, but unfortunately, I didn't have a happy ending. Good luck, I hope you get through.

 

[meleeka]

I’d have a chat about pads under shoes and get him moving gently if he were mine. By gently i mean an amble round the yard just to loosen his joints. If there’s no bounding pulse (assuming there was before) then active laminits seems unlikely. How often is he shod? It needs to be between 4-6 weeks ideally while you are trying to stabilise rbinfe

 

[holeymoley]

Rotation normally only occurs when there’s active inflammation, think bounding pulses, sore to move/turn. However if been going on for a while undetected as it can, the rotation may have been gradual over time. Has there been any realignment done of his hooves or were heartbars just put on? Did he have pads and frog supports initally or were the heartbars put straight on? I’d be inclined to think with ppid in the mix that levels aren’t correct. Has he had more bloods? Hooves can also abscess quite deeply after rotation but this depends on severity of damage. What was his rotation? What is he fed at the moment? There are so many factors to consider.