Equine Metabolic Syndrome / laminitis - pls help

[Stasha22]

Can anyone offer any help or advise on the above?

Brief history... My 8yo TB mare came in from the field lame on her right fore on boxing day. She had her front shoes removed about 3 weeks ago so it was assumed she was just a bit foot sore as we had hard frozen ground.

She has been lame on and off since then. The farrier came to look at her on Wednesday and told me her feet were fine and its nothing. Friday morning I lunged her on a circle to check her soundness and she was sound. Friday afternoon when I brought her in from the field she was crippled lame on the right fore with a lot of heat and a very strong pulse.

Called the vet immediately and he had a good look at her foot and couldn't find anything except for a tiny bit of bruising on her toe. Gave her IV pain relief and said to see what she was like in the morning. She was no better this morning.

Tonight she is in a bad way. Crippled lame with a pulse in every foot. She can hardly walk and is weight shifting constantly. Vet came back and said he thinks it may be laminitis or equine metabolic syndrome. He has taken blood for testing for EMS.

Obviously I am devastated by all this and can't bear to see my horse suffering so much. The vet has given her IV pain relief and ACP and strict box rest with no feed except for half a slice of soaked hay. I've been told to give her a sachet of Danillon in a handful of chaff twice a day along with an IM injection of ACP twice daily and a tube of Gastrogard.

I have no idea how this can be happening. She is not overweight, we have no grass and she has little hard feed (scoop of leisure mix, scoop of ready grass and half a scoop of Speedi-beet). Her routine has not changed and she has not been stressed.

A further complication is that she has suffered from severe gastric ulcers in the past so she is on GastroGard as of now as a precaution but I am really anxious that they will return.

Can anyone offer me any advise or any positive stories? I am devastated and so worried about her.

 

[PeterNatt]

Laminitis can be caused by a number of different things such as diet, stress, emerging encysted red worms, Cushings Disease etc.

Where the horse is in a lot of pain Finodyne is better for pain relief than bute. Your vet should also fit frog supports as quickly as possible so as to avoid permanent rotation or sinking of the pedal bone.

Take a look at the www.laminitisclinic.org web site.

 

[Eaglestone]

Hi
Presume you have seen this post http://www.horseandhound.co.uk/forums/showflat.php/Cat/0/Number/2646165/an/0/page/0#2646165 as this poster may be able to give you some support ..
Please keep us all informed on your Mares progress as I for one care .... however I only have knowledge of Cushings not the EMS
<<< hugs >>>

 

[Flame_]

The driving pony I look after who was diagnosed with cushings a couple of years ago is still with us, working and naughty as ever! On his worst attack of laminitis he was on his autumn holiday and there was a sudden drop in temperature one night. My OH found him in the field at 6.45am sort of sat down, trying to stand but every time he tried to stand he collapsed back down again because the pain when he tried putting weight on his feet was so bad. It took the an injection from the vet, frog supports and three of us pushing him just to get him to his stable.

After much box rest, treatment and then controlled exercise he returned to work. However that summer he had another, less severe but still horrible, attack of laminitis and that was when cushings was investigated. I don't know if there is a treatment for EMS but there are drugs that work to treat cushings and they have been successful with this pony. I thought it might be the end of him that day we found him in the field, needless to say he's NEVER out at night anymore and doesn't go out if there's a frost.

Im not sure what the difference is between EMS and cushings but the symptoms sound very similar. If my little lad can come back from that sort of pain at 13 I'm sure your horse will at her age. Try not to worry, it sounds like you've got a good vet at hand.

 

[Llwyncwn]

So sorry to hear about your horse. My mare had terrible trouble with ulcers a few years ago which was apparently bought on by Fynadine which is known can cause ulcers in dogs and horses.

Has she been out on frosty grass at all?

 

[Stasha22]

Thanks for all your replies.

She had Finodyne on Friday night and again tonight on top of 2 sachets of Danillon but so far it doesn't seem to be helping.

I have ben looking at the Laminitis Trust website and will be calling them on Monday morning. Worryingly I have read that Laminitis related to EMS has a guarded prognosis and horses often don't respond to treatment and have to be PTS. God I hope this is not the case for Lottie.

Vet has not mentioned frog supports yet but I will ask him tomorrow.

Just feel like we should be doing more for her but I don't know what.

 

[Stasha22]

Yes, we had a frost a few weeks ago which she was turned out on. Hasn't been one recently though.

 

[bluehorse]

Hi I put a post on a few days ago...EMS is soooo difficult as it seems to be invisible to the eye. I'm interested in your girl as she's a TB too, don't know how to put a link on to my post but sure you will find it...get in touch... :

 

[Stasha22]

Also, can anyone offer any advice on if she should be starved or not?

My vet has said she has to be starved except for half a slice of soaked hay in the morning and the same again for the evening, but the Laminitis Trust says not to starve them. I would rather she wasn't starved, especially given the Ulcer situation but obviously I am anxious to do whatever is best for her. Any thoughts please?

 

[Llwyncwn]

I have to agree with you on this one, with a laminitic especially they should have access to low quality hay (or unfertilised) to keep the gut ticking over.

I dont know much about EMS so above advice may be wrong in this case???

Do you feed her on a mix or cubes - I found Spillers seemed to be the only people who knew anything about ulcers when I needed advice (ten years ago) and were of great help.

What is her dung like? Have you considered trying Coligone?

 

[bluehorse]

Recommend don't starve, a big hi-fibre diet is needed - one of the symptoms of EMS is permanent hunger, my boy stuffs his food faster than anything. If you are worried about the amount he amount of nutrients he is getting soak his hay for hours so there is nothing left except fibre..

 

[Stasha22]

She was on Dodson & Horrell Leisure mix but the vet has said no hard feed at all so I guess she wont be on it anymore!

The ulcers haven't been an issue for about a year and a half, she had made a total recovery, but now that she is on masses of painkillers, stressed and in a lot of pain both me and the vet are concerned that they will return, hence he has put her on Gastrogard straight away as a precaution.

I can cope with ulcers but I'm not so sure about the laminities/ESM.

 

[Llwyncwn]

I am surprised that more people havn't offered advice here considering the desperate circumstances.

There is a forum member called Greedyguts (was on here lastnight) who seems to be very knowledgeable, maybe a clinitician. If I were in a state of not knowing where to turn, I would badger Greedyguts and all the forum vets. You could also try Star (she is a small animal vet) and Ann-Jen.

 

[Stasha22]

Interestingly Lottie doesn't have a big appetite, she is a pretty poor eater at the best of times.

EMS has not been confirmed as of yet, the vet suggested it was a possibility and that it might be the cause of the laminitis. Although again, he is not 100% sure it is laminitis either, although all the signs are indicating that it is at this stage. Guess I will know more over the next few days and when the blood results come back.

 

[Eaglestone]

As I said in my previous reply I can only comment on Cushings ... and the Laminitis caused by that condition...

I was never told to starve my horse, but it was stressed that the hay must be soaked. I started soaking for 10 mins then 1/2 hour but now do so during the day for the night time net and overnight for the days net. He was on 2005 hay until recently, but is now on last years. It may be that the Vet has specific reasons to starve your horse, so you must talk to the Vet again, for your own peace of mind.

My old boy is turned out in his own wood chippings paddock with a Field Shelter, next to his stable mate, where he can cuddle him if necessary, with limited grass, or no grass depending what the season is. He is a very happy chappie so I have no worries about him being on his own ... to be honest, my other horse would pester him, if they were out together, so it is in fact better this way!

It was suggested by my Vet in December 2005 that I had my old boy PTS as the prognosis was bad, and his Pedal Bones had rotate 10 degrees, however I was not going to loose him so carried on, he was on 5 months box rest so it was a very long struggle, however my chap was so so so very good throughout it all and took everything in his stride (excuse the pun, sorry!) and now over 2 years later he is being ridden regularly and even today was doing his old 'Hackney Trot' and all I could see was his fluffy knees coming up to hit me

.... what I am saying is that although you may be told the worst, there are happy endings, but it is hard work, takes all your time and alot of your finances, but I for one would not have done it any other way. I was also fortunate to have a very good farrier, who was equally determind to get us all through it.

I, like many others on here, and now you, have been through hell and back, but our determination and love for our ponios is what brings them through .... the Vet is there for advise, support and medication, but it's you that does all the work.

Please let us know how you are getting on <<< hugs >>>>

 

[Llwyncwn]

I can help you with feed and suppliments/alternative drugs for ulcers as can many people on here. Mixes arn't entirely suitable for ulcers as they dont digest as easily in the hind gut as a cube would. If you need help on this side of things, feel free to PM me.

 

[bluehorse]

That is interesting, Blue is totally gutsy - I've had him for 8 years but I never considered him to be anything other than easy to please with food until I realised he was completely desperate for any passing wisp of hay that went his way. Please let me know what happens when the blood tests come back - i dont know of anybody else with a TB with this problem....

 

[_Libby_]

QR- Sorry I cant offer any advice but sending healing vibes and thoughts for you and your horse x

 

[susannita]

Oh crikey! Firstly huge hug! You are currently living the my nightmare from almost a year to the day with my fit hunter..... he is still with us but it has been one hell of a journey.

He was the same, sore on one front foot, about 3 weeks after his annual vaccinations. presumed it was an abcess and poulticed, but when it went on for a few days called the vet who dug around far more than i would have liked but continued to turn him out in order to assist the abcess to blow. Nothing came out. the about 10 days later went out to do a late check to find him having a full blown laminitis attack, heart rate and breathing through the roof and the classic stance. vet came out and confirmed laminitis. He took his shoes off and put frog supports on all 4 feet, and gave him his pain killers and anti-inflamatory injections and took bloods. He was already on a shavings bed and 34mm EVA stable mats but we still needed the bed to be a foot deep to support the foot. he didn't leave his box -AT ALL - for over 3 months. the mats provide the most cushioning possible - rubber mats just don't compare - they have paid for themselves many times over in the shavings I saved over the period of the box rest. I am usually really anti box rest but this is one of the few exceptions. I was really strict and followed the laminitis trust recomendation of leaving them in for a full month AFTER they are sound (no pulses etc) without drugs. It paid off.

His initiaql bloods came back with an insulin level of 240, the normal is under 20!!!!! His Cortisol levels were also very high, but there was no sign of a pituitary problem as a tumour of the pituitory gland could havebeen a cause. His attack happened during a period where the temperature had been fluctuating wildly between -10 and +10C on the same day. We had a dodgy batch of haylage and some mouldy feed (found at the bottom of the bag after the rest had been used) All of which and the vaccination could have been possible triggers - we still have no idea what the actual cause was but the combination seems to have been a factor. It is a change in the hind gut which causes toxic laminitis, and foot imbalance causes mechanical. I can safely say it doesn't sound as though it has been carbohydrate induced laminitis (the "normal" fat pony one)

We xrayed all round after about a week , then a month, then 3 to keep an eye on what was happening. We did an ACTH test for cushings which came back negative. It was a very slow reintroduction to grass in a very bare small paddock for just 10 minutes to begin with building up. The only "blips" we have had have been when the farrier has been - mechanically related. He went back in the box as soon as it happened but only needed a couple of days of drugs. He still has no shoes on as I have had issues with remedial farriery in the past which caused more problems than they solved (not with current farrier) and definitely made the right choice keeping the shoes off. His feet have healed really well, he has bars which he has never had in shoes, it has just been a very slow painstaking progress to get him better! We xrayed last week and we are 95% there, (which i could have told you by the event line on his feet)

BUT he has been ridden for the last 2 months and is sound on soft surfaces - bit footy on gravel but he still have very thin (but thankfully concrete) soles, have just bought some hoof boots to start riding him on the roads etc. His bloods came back last week with normal cortisol, and an insulin level of 15!!! (under 20 normal!!) So looks like we have got his diet well and truly under control! Just waiting for the feet to catch up!

I would highly recommend you use a weigh tape to keep an eye on your horses weight and you will need a spring balance for your hay and scales for your feed. I am somewhat concerned by your vet recomending only 1/2 a slice of soaked hay. Even old fashioned thinking is 1% of the horses body weight in fibre per day. My horse was 540 kilos and so actually had about 6kgs per day, my vet actually wanted him to have 2% but to be honest even add-lib he never ate much more than 7kgs. He also had speedibeet and hifi lite - actually more than he was getting in his previous feeds (that was what he was fed already!)

Ok what to do, contact the laminitis trust - http://www.laminitis.org - be warned though - it is a £1 a minute!! they will give you a suitable diet and advice. Whatever the cause of the attack - it is the laminitis you need to get under control before you start worrying about EMS. Drugs wise - ask your vet why he has not given you bute - i understand your issue re ulcers but the bute is metabolised differently to danilon and is recomended in the initiasl stages. She should also be on aspirin and acp (sedalin is the same as acp just different form) if she stops eating her drugs I had to crush all the pills with a pestle and mortar and then mix with golden syrup and then syringe! You should get your hay checked for sugar levels (dodson and horrel offer this service for £5 per sample) and NSC. You may find she is sensitive to changes in hay supply so if you get some that suits buy as much as you can. You cannot EVER feed her haylage if she does have ems.

I also used bioflow magnetic boots; a homeopathic remedy from www.crossgatesfarm.co.uk; I also used a feed supplement from trinity consulatants www.justbespoke.com, he is a wealth of information. I actually used distance reiki healing for him and that seemed to make a huge difference (again not something i had ever considered before and was somewhat sceptical). there is a super yahoo support group called the metabolic horse which has all the help and information you would ever need.

BUT I had worst case scenario, on the scale of 1-5 with 5 being put down he was a 4.75. The vet has been amazed at his progress (to be honest I have only used the vet for drugs and xrays but that is how I deal with my horses anyway) - I have lots of experience and have access and inclination towrds whatever research i should want) Keeping the shoes off has enabled his feet to actually heel rather than masking a potential issue - particularly as yours coincided with the farrier trimming her feet.

Keep positive and if there is any advice or help you need don't hesitate to PM me. Sorry this turned into a mammoth essay but I could keep going ad infinum!!

 

[Happytohack]

So sorry to hear about your horse. I replied to Bluehorse's post about EMS. My pony is being tested for it next week after having an equivocal negative result to Cushings. He has been in for the best part of 5 months and has had chronic low-grade laminitis for this period. Today my farrier fitted Imprint shoes which have brought about fairly instant relief. Obviously your horse is in the midst of an acute attack. My other laminitic has Cushings which was diagnosed two years ago after an acute attack of laminitis. He was pitifully lame - lying down most of the time and could hardly walk to his water bucket in his stable. My vet fitted frog supports, but it was the imprint shoes that my farrier fitted that were the turning point. He was on 10 weeks total box rest, with bute and ACP and on rubber mats with a deep shavings bed on the top. Like others on here, I would be concerned about your vet's advice regarding the amount of hay to give your horse, especially in view of the history of gastric ulcers. I have fed both of my laminitics poor quality hay and a feed recommended by the Laminitis Trust. It is awful to see your much loved horse in the middle of an acute attack of laminitis, but many horses make a full recovery and with careful management the outlook is good. So many things can trigger an attack, but the frosty grass is quite often the culprit this time of year. Please let us know how you get on and good luck.

 

[pottamus]

I am so sorry to hear this and can offer no real advice but just wanted you to know I am thinking of you and your horse.
My horse had a small lami problem for the first time ever this year and I was totally devastated to see him in pain, even though it was only a twinge. So I cannot imagine what you are going through, take care and best of luck.

 

[MagicMelon]

[ QUOTE ]
I am surprised that more people havn't offered advice here considering the desperate circumstances.

[/ QUOTE ]

I think a lot of us don't know enough about EMS to comment! I know about laminitis but not EMS. I'd question why she was being starved though as this could cause more problems. With lami cases, they should never be starved (although some still seem to think this). Is it different with EMS?

Im sorry I cant give any useful advice, I really dont know enough about it. All I can say is that one of my ponies got concussive laminitis about 15 years ago. It was touch and go as to if the decision would have to be made. It took a year of corrective shoeing by our amazing farrier and many vet visits. I do wonder if I should have put my pony through that however he made a full recovery (even returning to BSJA a few years ago!) and is still with us age 20! It's awful thinking you're going to lose a horse, but there is always hope. Just try to give him your best shot and that's all you can do. x

 

[Stasha22]

Bluehorse I will let you know the results of the blood test when they come back. Hopefully they wont take too long....

 

[Stasha22]

God what happened to your horse is incredibly similar to what is going on with Lottie.

As she is now at the vets I don't really have much control on the feeding side of things at the moment but I will certainly be calling the Laminitis Trust tomorrow morning and looking into everything you have suggested. The vet said he chose danillon over normal bute as he feels it is safer for her stomach.

At home she has 28mm Equimats and about a foot deep bed of shavings. At the vets they have the same mats and the vet has put down a massive shavings bed for her so hopefully that will be ok.

Whilst it gives me hope that your horse has come through this it really worries me to death as I don't think Lottie could. She wont be able to cope with all the box rest (simply cannot bear it, even with sedation daily she gives herself spasmodic colic) and medication (because of the ulcers). She is already retired due to severe kissing spine and she lives for being in the field with her friends. If she can't have that the I really would have to question what quality of life she will have.

God, I can't bear to even think about it anymore. She is my world and I will do everything to make her better but I don't think I could put her through months of box rest. I think it would finish her off.

 

[measles]

So sorry to hear about your horse and will be keeping my fingers crossed for you both.

 

[mystiandsunny]

I had almost the exact same thing happen to me last winter in February, including the time wasted by farrier saying all was ok etc.

Some things I found worked/helped, in case they are of any use

- Timothy horsehage has worked even better than soaked hay for my horse, who still cannot tolerate grass. She recovered mostly on soaked hay, but only really came right after the hay was eliminated and she just had the horsehage. Some hays have still quite a lot of sugar even after soaking for 12 hours.

- For the boredom of being in for ages, Spillers High Fibre cubes in a snak-a-ball are really good. They're ok for laminitics.

- The laminitis trust advice is ok, but parts of it don't work. What they will tell you isn't much different from what your vet will but they'll charge you serious ££££ for it.
The most important part of their advice is to keep your horse in for at least a month AFTER she is sound.
Now I've tried the rest of their advice (turn out after that month, slowly increasing time until all day, only then starting riding), and for us and for others I've spoken to, it didn't work. My girl had several relapses before I gave up on trying to re-introduce her to grass, and from those I found that the vet's advice (get her out and moving on a soft surface after she's sound, trot after she's been sound for a month), before even trying turnout, led to the fastest recovery.

- Some horses take a long time to heal and cannot tolerate grass/sugary foods for quite some time after the initial attack. My horse was mistakenly fed a handful of coarse mix two months ago. Almost instant laminitis.

- Laminitis does muck up your horse's gut. I found Gastri-X from Hilton Herbs helped my girl significantly. It's designed to stop ulcers too and is definitely ok for laminitics.

 

[JackieJATaylor]

No, you definately do not ever want to starve a laminitic. If she is not fat I would feed her 2% of her bodyweight in meadow hay per day, but soak it for several hours to ensure it does not contain high levels of sugar. I have a diet sheet I can email you for future reference, or you'll find it on the Yahoo group:
http://groups.yahoo.com/group/TheMetabolicHorse

Make sure she is on a foot or more of shavings, and right up to the door (you can nail a plank across to make sure it does not get thin where she stands).

Jackie