First-time concussive laminitis - why? and help!

[Holtons Hollywood]

Hi everyone,

Right, so my little Holly was diagnosed last Tue (8th) with low-grade concussive laminitis all round after coming in the day before from the field looking distinctly short in her action. She has been on box-rest on a deep bed and bute since then. She was still looking like a cat on a hot tin roof on hard ground on Friday, but was totally sound on the soft. Vet said to leave her in again and re-assess on Wednesday.

My questions are, why has this happened, and what can I do to prevent it happening again?

Holly's background:-
10 year old 13.3hh New Forest mare.
Barefoot, always kept at a very good weight.
Usually works 3-4 times a week for a total of 4-5hrs with a mixture of jumping, schooling and hacking (during which there are long stretches on the road). I'll add in work on the horse walker should I need to up her exercise.
Never been unsound in her adult life (I've owned her since she was 6 months old).
Good conformation in the main, except her feet, which are naturally small and tending to upright, although my HPT barefoot farrier has got them as 'normal' looking as possible over her years of trimming Holly.
Until this winter Holly lived out 24/7 on clay soil. We moved in July of last year to another clay soil yard where she lives out mid-April to mid-Nov, and is in at night min-Nov to mid-April. So she was out 24/7 when this happened.

At the mo my reasoning is the massively prolonged, VERY wet spell we've had has softened up her already small and upright feet to the point where they simply couldn't cope with the concussion of being on the roads, and led to laminitis. Could I be right??? If not, please give any other ideas and advice because I'm loathe to put shoes on her (as my vet is suggesting) when she's gone 10 years without needing them!

Thanks for reading through all my babble!!!!!

 

[LucyPriory]

why concussive lami - why not your regular vanilla eaten too much grass type? have you been doing anything which might lead the vet to think former rather than latter?

 

[Holtons Hollywood]

LucyPriory - She's way too slim for it to be carbohydrate overload laminitis, and the grazing isn't lush by any means, which is why the vet said concussive I believe. Plus she was a bit sore after the hack before last, and then as described after the most recent hack, so it seemed that it was linked to the hacking.
As she is hacked every week, and has done so for years incl on roads, there must be a reason why it is now affecting her, hence my theory about all the wet weather having softened up her feet too much. Although I could be going in totally the wrong direction with my thinking!

 

[vanessarimmer]

I had my mare barefoot for two years and thought it was brilliant until she got concussive laminitis. She required 3 lots of plastic shoes and months of box rest to get her sound. My vet warned me that she might go lame again when brought back into work. She has had 4 attacks of laminitis since and is currently on box rest with plastic shoes as she can't even tolerate having shoes nailed on.

I can honestly say that I wish I had never had her barefoot. Apparently my friends farrier told her at the time that I was asking for trouble and how right he was. Barefoot is great for horses doing very little or no work but other than that most horses need shoes.

I was born without shoes but I would be crippled if I ran round barefoot all day. Why do people think horses are any different.

 

[Holtons Hollywood]

Hi Vanessarimmer - Sorry to hear of the issues experienced with your mare Holly has been barefoot all her life, doing plenty of roadwork, jumping, cross-country etc and has never had issues until now though.
Personally, I'm of the horses evolved for millions of years to be barefoot, who are we to alter their way of going by the application of heavy, unflexible shoes? But that's a debate for another day!

 

[be positive]

Putting shoes on will not prevent concussion, it is actually more likely that they will suffer from concussion but the early symptoms will be masked by the shoes.

My farrier would rather rehab laminitics with no shoes, it is better for the feet long term and with the need for really keeping on top of the balance and trimming they can be trimmed every 3 or 4 weeks without having to keep putting nails back in.

I would think it possible that the wet ground has allowed the white line to become a little open, then the laminae are put under stress, hence laminitis,

Once she can go back out it may be a good idea to keep her in each day so the feet can dry out, a look at diet would be worth doing, the change of land may mean there is an inbalance. The quality of her frogs may be not so good in the wet either which would reduce her ability to absorb the concussion when exercised.

 

[LucyPriory]

LucyPriory - She's way too slim for it to be carbohydrate overload laminitis, and the grazing isn't lush by any means, which is why the vet said concussive I believe. Plus she was a bit sore after the hack before last, and then as described after the most recent hack, so it seemed that it was linked to the hacking.
As she is hacked every week, and has done so for years incl on roads, there must be a reason why it is now affecting her, hence my theory about all the wet weather having softened up her feet too much. Although I could be going in totally the wrong direction with my thinking!

Being slim does not prevent carb overload lami. For example latter stage symptoms of IR are muscle loss/inability to maintain weight, these horses still get lami.

But sorry I didn't see in your first post any mention of being sore after a hack - I must have missed it. I only saw the bit about being sore after coming in, which I interpreted as coming in post grazing, not hacking.

But many horses hack many miles every week unshod and don't get lami, nor do horses living in very wet conditions automatically get soft soles, there is usually something else going on. It is your vet's job to find out what that is.

If you want to shoe to help you manage your horse so be it, but your vet should sort the problem first.

 

[Holtons Hollywood]

LucyPriory - you're right, I didn't mention the hacking bit, doh! Basically Sun 29th I hacked, Mon 30th she looked a little sore, had 1 day box-rest and was sound the next day. Rode several times in the sand school that week without issues. Sun 5th I hacked again, Mon 7th she looked rather sore, and was not sound after 1 day box-rest again, so I called the vet out.

Be Positive & LucyPriory - my farrier did suggest that maybe there was a vitamin/mineral imbalance. I feed the NAF GP supplement each day, but it might not be enough if there is a specific lack. I did suggest this to my vet, but he seemed to dismiss the idea. He did blood test her at the time, because he thought azoturia was a possible reason for her short action, but found nothing except a borderline low protein level.

 

[LucyPriory]

bearing in mind that there it is very common for uk forage to be short of copper, zinc, magnesium,selenium and lysine among other things it may well be worth pursuing your farrier's thinking. Personally I am underwhelmed by the NAF product - just check out the analysis.

 

[LucyPriory]

and consider that long term low grade lami's can get soft soles.

 

[ILuvCowparsely]

Yasandcrystal are going through this,

we just have plain old laminitis

 

[Oberon]

I would question why the laminae was weak in the first place. It doesn't just separate without reason - it's designed to hold strong.

It would be interesting to have pictures (side view from the ground and sole view).

Otherwise you could investigate if there is anything funky going on with your grazing via an analysis - or you may consider a recommended mineral supplement.

Is there any chance she may have a metabolic issue?

I like this video (from 1.30 onwards) for info on the pathophysiology of laminitis.
[YOUTUBE]KOMDzlLKtP0[/YOUTUBE]

 

[Rosehip]

My old girl got concussive lami last year in the summer when it was very dry and hot, she was also tested for IR and came back borderline. I lookedd at her diet, forage and grazing, and made a few changes to the way she grazes and how she is fed (she is retired and a porker) and it seems to have worked, however it was slightly different to your girl as it was absolutely concussive, and couldnt have been any other.
I too am less that impressed with the Naf GP supplement (I do like other products of theirs though) and stick with Equivite Original which never fails to improve anything I feed it to. Might be worth a try x

 

[cptrayes]

I had my mare barefoot for two years and thought it was brilliant until she got concussive laminitis.

....


I can honestly say that I wish I had never had her barefoot. Apparently my friends farrier told her at the time that I was asking for trouble and how right he was. Barefoot is great for horses doing very little or no work but other than that most horses need shoes.

I was born without shoes but I would be crippled if I ran round barefoot all day. Why do people think horses are any different.

Horses wearing shoes have more concussion than barefoot ones. Whatever caused concussion to hurt your mare's feet it can't, in my opinion, have been that she didn't have metal nailed to her feet.

Kids in Africa are born without shoes and run around all day without them on without being crippled. So would you have done if your mother had never put shoes on you.

If your mare is still having so much trouble, has she been tested for IR, EPSM and Cushings?

 

[cptrayes]

My old girl got concussive lami last year in the summer when it was very dry and hot, she was also tested for IR and came back borderline. I lookedd at her diet, forage and grazing, and made a few changes to the way she grazes and how she is fed (she is retired and a porker) and it seems to have worked, however it was slightly different to your girl as it was absolutely concussive, and couldnt have been any other.

Um ..... have I understood you right? Your horse's problems were "absolutely concussive" yet you made changes to her diet and resolved her problems?

 

[cptrayes]

LucyPriory - you're right, I didn't mention the hacking bit, doh! Basically Sun 29th I hacked, Mon 30th she looked a little sore, had 1 day box-rest and was sound the next day. Rode several times in the sand school that week without issues. Sun 5th I hacked again, Mon 7th she looked rather sore, and was not sound after 1 day box-rest again, so I called the vet out.

Be Positive & LucyPriory - my farrier did suggest that maybe there was a vitamin/mineral imbalance. I feed the NAF GP supplement each day, but it might not be enough if there is a specific lack. I did suggest this to my vet, but he seemed to dismiss the idea. He did blood test her at the time, because he thought azoturia was a possible reason for her short action, but found nothing except a borderline low protein level.

I have another proposition which fits your two posts HH

Your mare has been affected by 24/7 grazing on different land than last year in spring. It may be too rich, or unbalanced somehow, low copper being a very common one which will affect feet badly.

This has weakened her laminae slightly but not enough to make it clear that she has dietary laminitis.

You take her out for a hack and the weak laminae get very stressed from the hard surfaces.

This gives you a diagnosis of concussion laminitis when in fact the problem is really dietary laminitis.

Even if your mare does "just" have concussion laminitis how on earth does your vet think increasing the concussion by nailing steel to her feet will help?

 

[muff747]

LucyPriory - you're right, I didn't mention the hacking bit, doh! Basically Sun 29th I hacked, Mon 30th she looked a little sore, had 1 day box-rest and was sound the next day. Rode several times in the sand school that week without issues. Sun 5th I hacked again, Mon 7th she looked rather sore, and was not sound after 1 day box-rest again, so I called the vet out.QUOTE]

I can see this another way around though, JMO, maybe she was already suffering some slight hoof pain due to the different grazing hours and the hacking made it worse. You keep her off the grass for 24 hours and that reverses the pain. The weather lately has been wet and would be causing the grass to grow faster on the subsequent days, could explain why she was ok for a few days and then off again.
Is the land very waterlogged? The grass would be lacking in magnesium as a result perhaps - just my angle on what I've read???
And your vet sounds anti barefoot to me, so he would be more likely to think concussion than a pro vet???
Has she had x-rays to back up the lami diagnosis?

 

[muff747]

Sorry, I hadn't read cptrayes post first, bit similar thinking.

 

[Goldenstar]

Shoes don't reduce concussion but they will raise the soles off the ground and I suppose you could say they reduce direct concussion to the sole .
Why don't you suggest boots and pads to the vet as a alternative to shoes.

 

[Goldenstar]

I had my mare barefoot for two years and thought it was brilliant until she got concussive laminitis. She required 3 lots of plastic shoes and months of box rest to get her sound. My vet warned me that she might go lame again when brought back into work. She has had 4 attacks of laminitis since and is currently on box rest with plastic shoes as she can't even tolerate having shoes nailed on.

I can honestly say that I wish I had never had her barefoot. Apparently my friends farrier told her at the time that I was asking for trouble and how right he was. Barefoot is great for horses doing very little or no work but other than that most horses need shoes.

I was born without shoes but I would be crippled if I ran round barefoot all day. Why do people think horses are any different.

For a start people and horses are different one of my horses works quite happily one hour a day six days a week with no shoes.
A proportion of horses get laminitis some will be shod some not its difficult to say that the lami is caused by the BF you don't say that every horse with shoes who gets lami has it caused by the shoes and more horses will get lami with shoes on as more horses have shoes.
I had a horse get concussive lami years ago she escaped the field went running about on the road ended up with a concussive lami did we blame her shoes no its too simple to say that lami in a BF horse is caused by having no shoes but one thing is for sure there's no where to hide BF, shoes are like metal bute they mask the lami symptoms as the sole is off the ground.

 

[alsiola]

Is there any chance she may have a metabolic issue

10 year old 13.3hh New Forest mare.

OP: I would be willing to stake that your pony has underlying insulin resistance issues. (Some would even consider that a degree of insulin resistance is normal for a native breed.) Most likely due to Equine Metabolic Syndrome, but Cushings Disease cannot be ruled out. I would be testing for both as a priority - it is my experience that no matter what is done with the feet, one is fighting a losing battle until any metabolic issue is resolved.

In the meantime I think the most important management point is to have her on soaked hay at 1.5-2% bodyweight daily. Soaked for 12 hours minimum followed by rinsing is best. A vitamin/mineral supplement is important when soaking forage, and you may need to use some unmolassed chaff to ease bute administration.

 

[LucyPriory]

OP: I would be willing to stake that your pony has underlying insulin resistance issues. (Some would even consider that a degree of insulin resistance is normal for a native breed.) Most likely due to Equine Metabolic Syndrome, but Cushings Disease cannot be ruled out. I would be testing for both as a priority - it is my experience that no matter what is done with the feet, one is fighting a losing battle until any metabolic issue is resolved.

In the meantime I think the most important management point is to have her on soaked hay at 1.5-2% bodyweight daily. Soaked for 12 hours minimum followed by rinsing is best. A vitamin/mineral supplement is important when soaking forage, and you may need to use some unmolassed chaff to ease bute administration.

second this ^^^

 

[cptrayes]

OP: I would be willing to stake that your pony has underlying insulin resistance issues. (Some would even consider that a degree of insulin resistance is normal for a native breed.) Most likely due to Equine Metabolic Syndrome, but Cushings Disease cannot be ruled out. I would be testing for both as a priority - it is my experience that no matter what is done with the feet, one is fighting a losing battle until any metabolic issue is resolved.

In the meantime I think the most important management point is to have her on soaked hay at 1.5-2% bodyweight daily. Soaked for 12 hours minimum followed by rinsing is best. A vitamin/mineral supplement is important when soaking forage, and you may need to use some unmolassed chaff to ease bute administration.

OP please listen to this. Not only is Alsiola a vet, but she's an enquiring and open-minded vet. She's worth listening to!

 

[Holtons Hollywood]

I have another proposition which fits your two posts HH

Your mare has been affected by 24/7 grazing on different land than last year in spring. It may be too rich, or unbalanced somehow, low copper being a very common one which will affect feet badly.

This has weakened her laminae slightly but not enough to make it clear that she has dietary laminitis.

You take her out for a hack and the weak laminae get very stressed from the hard surfaces.

This gives you a diagnosis of concussion laminitis when in fact the problem is really dietary laminitis.

Even if your mare does "just" have concussion laminitis how on earth does your vet think increasing the concussion by nailing steel to her feet will help?

Thanks for all the posts guys! I'll answer you one at a time so I can keep my thinking straight....
Cptrayes - I was thinking this morning that in the last few weeks Holly has been coming in from the field at brekkie & dinner time VERY hungry. I'd been upping her hay accordingly. Obviously grass is coming through, but with all this wet weather perhaps more of it is being turned into mud that is available to eat, hence the hunger. I'm presuming therefore that the lack of grass could have led to a dietary imbalance....
Following that thinking, what is it better to get tested first - Holly's blood, or the soil?

 

[Holtons Hollywood]

OP: I would be willing to stake that your pony has underlying insulin resistance issues. (Some would even consider that a degree of insulin resistance is normal for a native breed.) Most likely due to Equine Metabolic Syndrome, but Cushings Disease cannot be ruled out. I would be testing for both as a priority - it is my experience that no matter what is done with the feet, one is fighting a losing battle until any metabolic issue is resolved.

In the meantime I think the most important management point is to have her on soaked hay at 1.5-2% bodyweight daily. Soaked for 12 hours minimum followed by rinsing is best. A vitamin/mineral supplement is important when soaking forage, and you may need to use some unmolassed chaff to ease bute administration.

Sorry, being dense here - is the OP comment directed at me/Holly? If so, regarding the hay soaking, I was always told at uni (only Equine Science honours degree, not veterinary!) that soaking hay for that long would leach out basically all the goodness from the hay into the water - or is that the point?

 

[Holtons Hollywood]

Muff747 - hmmm, no, it's not massively waterlogged. Definitely better than the pasture she was on at the last yard! That was just a sea of mud every winter! Yeah, I kinda got the impression the vet may have been anti barefoot, and nope, he didn't take any x-rays.

 

[Pasha]

I second cptrayes in that you should listen to alsiola!

Also take a look at this site: http://www.talkaboutlaminitis.co.uk/ It is very informative.

I would also add that blood tests are not 100% accurate and lots of ponies come back 'boarderline' EMS or Cushings... in my experience, having had 2 boarderlines, they DO have EMS or Cushings and will test 100% positive a year or so later! Don't wait for another Lami attack before you treat as EMS or Cushings, the sooner diet and management is changed the better for the horse and owner! Good luck, I hope your pony is back to her old self!

P.S. Increased hunger/appetite is one of the symptoms of EMS as is excessive weeing and drinking... also look at the hollows above the eyes - when they are flat or filled in, that is also a tell tale sign something metabolic is going on

 

[be positive]

Sorry, being dense here - is the OP comment directed at me/Holly? If so, regarding the hay soaking, I was always told at uni (only Equine Science honours degree, not veterinary!) that soaking hay for that long would leach out basically all the goodness from the hay into the water - or is that the point?

I will answer this in case the poster is not around for a while, yes that is the point, you soak to remove as much sugar and goodness as possible, then replace the vits/mins with a supplement, that way you are feeding plenty of fibre with far less goodness in it, you can then in theory feed more quantity less quality.
I soak for up to 20 hours, a bit less when it is hot as it can start to ferment, then rinse thoroughly before draining and feeding.

 

[Holtons Hollywood]

I second cptrayes in that you should listen to alsiola!

Also take a look at this site: http://www.talkaboutlaminitis.co.uk/ It is very informative.

I would also add that blood tests are not 100% accurate and lots of ponies come back 'boarderline' EMS or Cushings... in my experience, having had 2 boarderlines, they DO have EMS or Cushings and will test 100% positive a year or so later! Don't wait for another Lami attack before you treat as EMS or Cushings, the sooner diet and management is changed the better for the horse and owner! Good luck, I hope your pony is back to her old self!

P.S. Increased hunger/appetite is one of the symptoms of EMS as is excessive weeing and drinking... also look at the hollows above the eyes - when they are flat or filled in, that is also a tell tale sign something metabolic is going on

I won't start panicking yet, although I will ask my vet about a blood test, as Holly def doesn't meet all the symptoms. She has none of the fatty deposits/cresty neck I always hear about. She is losing her winter coat in her normal way. The hollows above her eyes are perfectly normal. She is most definitely not excessively weeing, in fact it is a little under average for her. Her water intake is slightly up, but I am attributing that to the fact she is eating hay and not grass at the mo. But yes, her appetite at the moment is increased.

 

[YasandCrystal]

My mare has concussive laminitis. Just for interest I will detail her case. She is now on her 5th week of box rest and still very sore. She has been blood tested for Cushings and EMS and the results were negative. She has always been bf behind and I tried to go bf infront with her last year, but she was so footsore on the stoney track outside my paddocks that I gave up and reverted to shoes. She does have sensitive soles and I concur that this could be due to an imbalance in her.

I tried to go bf with my mare this year and for the transition we were using hoof boots and I was also applying Keratex hoof hardener on her soles. I always feed additional magnesium oxide and all of mine are on adlib hay and short feeds including carob which is full of nutrients and calcium. My mare was also getting A & P's veteran vitality and Pernamax for joints (she is 17 years old). I have almost a paddock paradise system with a track running around the perimeter of my paddocks and hay and water up the top of a hill and hedgerows available for foraging. The only thing I don't have is the shingle area. There are a couple of Red Rock mineral stones available too. I thought hat the horses diet was good - I do fertilise my grazing as it is just natural grass (nothing was ever seeded) with an overseed of herbs a couple of years ago. I offer mine dandelion and dried rosehips by hand over the winter months. I have a pony and a WB both bf and never sore.

I am now giving my mare a diet of ground carob and alfalfa and a little of a high fibre laminitic mix. As supplements I am adding (with the vet's agreement) the following: an Amino Acid gut supplement, a Probiotic, Charcoal to remove toxins, bute, Aloe Vera, Equimins Flexijoint (newly started)and magnesium oxide. She is having Sedalin twice daily and I have just started her on 20 paracetomol a day. She is also on soaked hay. She is a 16.3hh ID x not the usual candidate for lami. She is not overweight nor has she ever been and she is not a greedy mare either. She has no heat in her feet nor any raised pulse at the moment. Her feet are convex - she will surely have had some rotation. I can't xray at the moment as there is no power at the paddocks and I won't move her until I see some improvement. We tried pads, but these seemed to cause her further discomfort. She has shoes on, which as a next step we will remove and try pads again. We have glue on shoes should she need them. I do wonder if she maybe has some navicular changes - she has a strange gait at canter (always has).
I hope to xray her as soon as she can travel.