EMS, Lami and Side Bone - Quality of Life Dilemma!

cblover

cblover

Well-Known Member
Joined
1 October 2009
Messages
1,887
Visit site
Some of you will know that my HW cob mare, who is 15, came down with EMS and lami at the end of May. Previous to that she had been diagnosed with side bone in both hind legs about 2 month ago.

She's on box rest and we're now into her 4th week and although she's brighter in herself, she is still terribly lame. I'm giving her 2 butes x 2 daily, with sedalin, 24 metformin tablets and 8 aspirin. Bloods are due to be taken again next week to check her insulin levels. Farrier is coming on Sunday and xrays have shown back feet to be ok and front to have rotated pedal bone but not dropped. One of them in particular is really bad vet says.

She needs movement for the side bone and rest for the lami. I thought she'd of improved more than she has by this stage. She's a mare that is used to being out and seeing her like this is awful. Even if we come through this stage, what will her life be like? Vet has already said she will be severely restricted with turnout and never live as free as she has done before. Plus with the side bone, I won't be riding her. She's my one in a million but I can't put her through all of this if the end result doesn't give her freedom to move, socialise, graze and generally be a horse.
 
I'm afraid I would cut my losses now, give her max bute and turn her out on some good grass for an hour then PTS. I also accept that I am considered cold blooded and hard by some. I had my sons pony, who we all worshipped, PTS with the same issues and I am still sad about it (6 years ago) but was better for her, just not for us.
 
I am usually one for saying PTS however I think its early days. once the lami and its associated EMS is under control there is no reason why the horse cant live a good life. do you have suitable turnout for a lami prone horse? ie very bare paddock and the ability to feed the horse soaked hay only? [with a vit/min supplement]? if so then the horse can spends most of its time out consider setting up a paddock paradise system too.
 
This will probably be my mare's last summer, she has cushings/ems and also ringbone. At the moment she is field sound, but is starting to suffer from intermittent lameness. If a horse wasn't comfortable after 4 weeks on bute I think I'd be thinking long and hard about her future.

I've managed mine well with a track system for years now, but at 22 I think it has reached a point where everything is just going to go downhill. I know yours is a bit younger, but quality of life is paramount, and if they can't have that then it's unfair to keep them going imo.
 
Difficult one. If you have the facilities to manage her and you can keep her happy and comfortable, then thats one thing. On the other hand, if you are going to struggle with the management side and you know her happiness is being compromised then I think PTS is the kinder option. It does sound like a lot of drugs going in, with limited results for the time being at least. I suppose, that like Clodagh, some would consider me a little harsh and cold hearted; but I honestly think it is better for the animal to pts in a safe environment that struggle on with limited results for an indeterminate amount of time. Just because we have the medical knowledge to keep them going doesnt always mean it is the right thing to do. You will know what to do x
 
In your situation I'd be assessing quality of life too. For me that is turnout in company - that is what being a horse is all about.
You have a tough choice to make, in your situation I'd be considering pts too.
Hugs :(
 
I think it is early days yet, it is the lami you need to get on top of and that will resolve with time though new lamellar connections need to be made so will take time as the hoof grows.

Sidebone often doesn't cause much of an issue - is it this or the lami that vet says you won't be riding her? Resolve lami wouldn't usually mean that? Chavhorse's spotty on here had huge horns but was in full work barefoot. How is she shod currently? Are you in the position where you could have her on a track system long term?

With regards to EMS, like human type II diabetes many of the issues can be resolved with weight loss. https://admin.imatrixbase.com/clien...ne_topics/Equine_Metabolic_Syndrome_(EMS).pdf
 
I'm sorry to hear about your mare. I went through this with my gelding a few years back. He was on boxrest for months before he came sound but he did get there so please don't be too disheartened. Although he was always incredibly difficult to manage after this, he was extremely sensitive to changes in the grass and we had to watch him like a hawk. I can honestly say i worried about him 24/7! We did end up restricting his grass/turnout and upping his daily exercise as this was the only way to manage him. I was extremely lucky that he didn't mind being stabled and i always went to ride/bath etc after work. He lost all his fat pads etc and we got his weight under control (he was still sensitive to grass though) I had one last full summer with him before he sadly passed away following old age related colic and heart failure. I would not change keeping him going through the lami and EMS, i tried and thats all you can do. Every horse is different, yours might cope fine after recovery, atleast you can say you tried. Please keep us updated as its a subject that is fairly close to my heart!
 
Its a tough choice but after 4 weeks with little improvement and a quality of life likely to be that restricted i would probably pts too, sorry :(
 
For me if they have lami with rotation and are lame that's a one way - you will spend a long time with a sore horse who has no quality of life to end up with a slightly less sore horse.. possibly. I would pts
 
Essentially if you can't manage her weight to help resolve the EMS long term I would PTS.

If you can I would consider the amount of rotation and what support I was currently giving to keep her comfortable.
 
FairyLights said:
I am usually one for saying PTS however I think its early days. once the lami and its associated EMS is under control there is no reason why the horse cant live a good life. do you have suitable turnout for a lami prone horse? ie very bare paddock and the ability to feed the horse soaked hay only? [with a vit/min supplement]? if so then the horse can spends most of its time out consider setting up a paddock paradise system too.
Click to expand...

I can see where you're coming from - but I woud struggle to see my older horse confined to a bare paddock and only able to eat soaked hay. Doesn't sound a very good life to me. I appreciate that laminitics need to be managed carefully, but I feel that sometimes, when its an older horse with multiple unresolvable issues, it's important to consider why we are choosing to keep it going.
 
You're opinions and advice mean a lot, thanks so much. It's a big decision and one I'm struggling to make.
 
Please speak to Andrea from the Laminitis Site before you decide,they also have a fb page for ems and ppid horses,before your farrier comes if possible.
 
My boy had severe laminitis, with rotated pedal bones, EMS and side bone 6 years ago. It took about 3 months box rest to get him stable, and once he was I had a long frank chat with my vet. I told him that I wasn't prepared to have a horse who could only be turned out for limited periods.

Once we had stabilised the EMS, and gig the lammie under control, we started turning out for half an hour at a time. We increased the turnout weekly, as we needed to find out what he could cope with. He surprised us all!

After 6 months I was back hacking him - at all paces including galloping. He even completed a 13 mile sponsored ride. He is now retired at 22, and living out 24 /7.

Don't give up yet. Get her as well as you can, see what she can deal with, and then make a decision.
 
I will be following this thread with interest. I have a 16 year gelding currently on box rest. Severe bout of laminitis. He has never had lami before so I'm new to this. He has been on box rest for a month now with soaked hay that is weighed out. He had sedalin for the first week with 4 bute daily. Sedalin now stopped but bute hasn't been reduced. Vet came last week and said he hasn't deteriorated but there is no improvement. He has been xrayed and has rotation in both front hooves and sinking. Back hooves unaffected. Currently has Hart bars on. Would you expect to see some improvement by now? I'm sorry about your horse, I know first hand how stressful it is .
 
I think it depends on how sensitive to the grass your horse is going to be. A grazing muzzle could be an option to allow more turnout and the chance to be with other horses if you don't have a starvation paddock.

Is your horse overweight as being overweight can also put more pressure on the joints and bone so if she is overweight once she slims down you may find she is more comfortable as her hooves and legs are supporting less weight.
 
ladydoone said:
I will be following this thread with interest. I have a 16 year gelding currently on box rest. Severe bout of laminitis. He has never had lami before so I'm new to this. He has been on box rest for a month now with soaked hay that is weighed out. He had sedalin for the first week with 4 bute daily. Sedalin now stopped but bute hasn't been reduced. Vet came last week and said he hasn't deteriorated but there is no improvement. He has been xrayed and has rotation in both front hooves and sinking. Back hooves unaffected. Currently has Hart bars on. Would you expect to see some improvement by now? I'm sorry about your horse, I know first hand how stressful it is .
Click to expand...

has yours been tested for cushings/ems?
 
He is negative for cushings. The ems test requires him to have a glucose supplement a couple of hours before the vet arrives and as he is so sore she advised not to do that until he improves.
 
I really feel for you, it's so hard to know what to do for best. I have a very elderly horse with cushings and although retired he's never had laminitis. He lives a pretty normal life, I've decided that if he does become laminitic, then I will PTS straightaway as I'm not prepared to keep him going on restricted turnout etc. A pony that we owned but have always kept in touch with was PTS last summer. He was 19, fit and a sensible weight etc and competing regularly. He developed severe laminitis quite suddenly and two weeks in was showing no improvement and was in a lot of pain. He was PTS. I know it was the best thing for him, he was on loan to the daughter of parents who are both senior partners in the specialist vets I use. Everyone who had known him was heartbroken but no-one wanted him to continue suffering. Laminitis is a vile condition. TBH in your situation I would PTS.
 
Auslander said:
I can see where you're coming from - but I woud struggle to see my older horse confined to a bare paddock and only able to eat soaked hay. Doesn't sound a very good life to me. I appreciate that laminitics need to be managed carefully, but I feel that sometimes, when its an older horse with multiple unresolvable issues, it's important to consider why we are choosing to keep it going.
Click to expand...

Very well said; totally agree, sorry OP.
 
Sorry OP I really hope you get a good outcome here.

All I would say is that my sister's horse had very very bad laminitis about 4 years ago when he was a similar age to your girl. (Cushings diagnosed). Pedal bone rotation, but not through the sole, months and months of box rest. Frankly, if he had been my horse I would have had him PTS. But my sister persevered and although he is on prascend and needs careful management, he is sound and well and doing 10 mile rides.

So I guess like others I think this is early days and maybe you don't need to give up just yet. (But like I say I would have done in my sister's situation). xx
 
Hi all, I'm back again with an update and more questions. My mare is now into her 7th week of box rest and coping better than me with it to be fair! But still its not good or fair on her. Anyway...

She is still not sound and needs between 2-4 butes a day. I just manage to get her feeling comfortable, reduce the bute or stop it and she's fine in her stable but the minute I let her out on some scrappy grass for 5 mins, I can guarantee she will be hopping lame again and the bute needs increased. Her insulin levels have reduced dramatically and are now 235, were 900 but need to be under 20. I'm not starving her though and she's getting soaked hay.

I've spoken to the lami trust and they say the pain should be controlled by week two unless I'm not doing something right. My biggest fear is that this is as sound as she'll ever be now.....and thats just not good enough to provide a decent quality of life. I'm waiting for the cushings blood result but I don't think she has that. Her coat is shinning and she's much more alert and responsive (which makes it even harder) but I just can't get her right. Xrays have been done and farrier has seen them and trimmed them to support the findings....more being done this week.

Such a worry!
 
Is she shod? My old boy had acute lami, was in putty pads for weeks. He then went into RX therapy boots & pads for turnout. They are amazing. He was so comfortable in them, and give fabulous support. Bonus is you can wash/replace the pads as required. Easy to manage.
 
I have an elderly pony who was diagnosed with cushings about 5 years ago. he has never had the dull/curly/long coat, so don't discount it as a possibility. His first cushings test gave a false negative too. He started out on just 24hour soaked hay and straw (but lots of it so he was never hungry), and he is now able to live out most of the year (he comes in on hot days as he doesn't like the heat, and he never goes on frosty grass), and is quite happy. Its a long road as Tobiano says, but if you are determined it can be done. R had heart bars, then plastic shoes, and is now unshod - the plastic shoes were fabulous. Best of luck to you both.
 
Personally I think it's very early days yet. Our pony who had chronic Lami. was lame for about 4+ months, (box rest for almost a year) and couldn't stand a lot of the time, she was dull and looked so sad. She was also on four bute a day. Her future looked so, so bleak. I'm sure some people would disagree with what we did, but looking at her now, it was worth it (been completely sound for over two years, looks amazing too, plus she, so, so happy again!). If every horse was sound/ pain free within two weeks, then I wouldn't call it Lami! There's not a horse/ pony I know that was pain-free in 2 weeks.

As I've said on your other thread, she can no longer have any grass, but it really isn't as drastic as it sounds. If your mare really seems to be suffering, then, PTS may well have to be considered, but please don't do anything yet. There are forums & groups for people with Lami. horses (will go and fine the link to the one we joined when Lilly had Lami.). Speak to your vet & farrier, it will be a long, slow, and often tearful recovery, and it's up to you to decide whether you want to put your mare through that.

Hugs & strength, and keep us updated x
 
So sorry to hear about your horse, my mare went down with lami in may she tested positive for ems and cushings for the first two weeks she was on 4 but a day then I got it down to 2 a day she also started on one tablet of pracend a day, she only has slight rotation in one front foot and she is now in heart bar shoes, I nearly had her pts twice in the first two weeks as she is retired from a dft injury so can't be ridden so I did struggle with keeping her alive with so much wrong, but felt she was such a fighter I felt I had to give her the chance, I and the vet are shocked at how she has improved in two months so there is hope, obviously I don't know how she will cope with grass now but I will give it a go and play it by ear.

A few things I would ask you is have they put pads on your horses feet? They made a huge difference and gave immediate relief for my horse.

I also would not bring your horse out of the stable at all at this stage as the pedal bone is unstable and walking on hard ground can make it worse and definitely no grass of any kind.

If your horse has ems and or cushings you have to treat it or you have no chance getting the laminitis under control.
 
I am so sorry for your mare, poor thing. Weighing up the situation from the horse's point of view, pain levels, future quality of life, age of the horse, management challenges and prognosis, if I was in your position I would have already made the decision.
 
You must log in or register to reply here.
Top