Horse sore post laminitis – vet wants to do flexion tests?

seoirse

seoirse

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My horse had a bad attack of laminitis (his first) 10 weeks ago. He was on total box rest for most of those 10 weeks and has started being turned out a little over the last 2 weeks as he started box walking badly. He is still on 1 bute per day, down from 4 at the beginning. He now has heart bars on too. He moves quite well in walk on soft ground and walks ok, if a little slowly on concrete, but doesn’t want to move any faster than a steady walk on any surface, and I’m not going to push him as I think his activity should be kept to a minimum still. He needs more time to recover. He is calm in his little outside pen so we are gradually increasing his time out and it doesn’t seem to be having a negative effect on him and it stops the box walking which has to be a good thing. I hope to reduce the bute but I need to see some more improvement before I can reduce it any more.

However the vet thinks he should be improving quicker. I obviously would like him to be getting better faster and he does seem to have reached a plateau in the last few weeks. Given how severe the attack was though I would expect it to take months to return to normal, though he did only have a small amount of rotation, less than 5 degrees, he was in a great deal of pain for the first week and unable to walk a step other than stagger round his box, so even though the rotation was minimal he must have suffered a lot of trauma and inflammation some of which is still present.

He has some arthritic problems, though they appear worse on an xray than they have ever actually been, he’s never actually been lame or even really very stuiff with arthritis and for the last 2 years we’ve been show jumping, doing dressage and sponsored rides with no problem at all. The vet thinks the bony changes are causing some problem as he seems more lame on the leg that shows changes in the pastern. I do think box rest has aggravated this as he usually lives out 24/7. The vet wants to come and do flexion tests next week to see if the joints are the problem, but the horse is still far too foot sore to be able to trot so I don’t really see how this will work, or show anything cos the laminitis pain will far outweigh any flexion pain! We are only 10 weeks into this so I think the horse just needs more rest, lots more rest. Once again I am baffled by the vet but I have to try and have faith cos he’s got him this far.

Sorry for the essay. I don’t know what to think. I don’t want to go messing about with joints until the lammy is more settled and to me that is very obviously still a big problem as he is still very sore.
 
How do you know if his pain is only from his feet? Perhaps the vet has seen enough improvement in his feet for him to be relatively sound, but as he is not, he may be thinking there is something elsewhere going on?
Just a suggestion, good luck with your horse, you obviously care very much for him.
 
Its just the fact that he is so slow and unwilling to move very fast, even on a soft surface that tells me all his feet still hurt a fair bit. He is usually a very sharp forward going little horse so I know he is still not happy. If it was just the pastern I'd expect to see him lame on that one leg but otherwise still pretty keen to move about.
I'm so sad this has happened to him, he is the most willing horse I've ever sat on and seeing him reduced to this is heartbreaking!
 
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Two things came to mind reading your post OP.
The first is, if your horse has arthritis he has probably stiffened up during the box rest, this could be affecting his movement.
The second comes from something my own vet said to me when my pony was recovering from laminitis last year. He was very sore, although the inflammation had gone, and the vet said this was to be expected: 'if you bruised yourself it would feel sore after the visual signs had gone' - I had to agree.
Your vet may expect your horse to feel better by now but every horse is different - maybe yours has a low pain threshold - does he normally make a fuss if he hurts himself?
 
I have to agree with you re the stiffening up due to being in, especially as he always lives out. I do think there is an element of that and he does look a little freer after he's been out.

I also think you are right about the continued bruising, he makes a fuss if he treads on a stone, poor thing, so his feet obviously do still hurt a lot underneath and having the heartbars on is helping lots by keeping his soles off the ground. He isnt generally the sort to make a fuss about anything though and has been known to gallop about on 3 legs before now when he's been lame (he jumped out of the arena at home a few years ago and I thought he'd broken his leg as he wouldn't weight bear on it, but he happily looned about on the other 3 for weeks while it got better, luckily he didnt do any major damage.). He's not the sorry type, he generally just gets on with it, which has always been part of his problem - getting him to be quiet and calm when he needs time to fix!

He's a fairly low mileage 12 year old so its frustrating that he's got athritic changes, but he's always been passionate about charging about in his field even if no-one else is up for a hoon, so I guess thats where he's done all the damage!

Our vets are doing a talk tonight on colic and lammy, so I'm hoping to be able to collar one of them and discuss this a bit more without the cost of a call out!
 
I agree with Suestowford & I think if he was that bad it's still quite early days. If he was mine there's no way I'd be letting a vet do a flexion test on him at this stage!
 
Well this morning when I put him in his pen for half an hour while I mucked out he trotted off, it was a bit pottery but he volunteered it and its the first glimmer of his old ways I’ve seen for weeks. He also walked out of his box this morning a bit better and he wasn’t so slow and didn’t look worse on the right as he has done. So maybe we are still making progress. If he makes some decent progress between now and next Monday which is when I have to call and update the vet, then that means the vet won’t be so keen to see him and we can just carry on the slow road to recovery hopefully!

He weighs 480kgs which is his target weight and he’s fed on 2kgs of 12 hours soaked, rinsed and dried (he won’t eat it wet! Don’t blame him!) hifibre haylage twice a day and 500g of molasses free hifi twice a day, plus a vitamin and joint supplement. I know haylage is not ideal but he is totally intolerant of hay and has a long history of respiratory problems that its taken me years to get under control so giving him hay would have caused a whole load of other problems and it just wasn’t an option. I am well aware if he won’t come right on haylage I have a major problem on my hands!
 
Having a horse myself who is still recuperating from laminitis 10 weeks does not seem any time at all for recovery.

I am coming up to 7 months but we did have more rotation than you.

My horse has a very high pain threshold and on a number of occasions appeard to be coming sound to only then have a relapse. The vets I was using initially kept telling me to gt him out and slowly build up the length of time, but in our case unfortuantely if his feet didn't hurt to much he would try and run around and cause a relapse. Got a different vet out who said it is mechanical laminitis which he is getting, so complete box rest is the only fix. Now about 7 months later after the initial attack it looks like he is doing ok completely off the bute and I can start doing some very gentle exercise in a few weeks slowly building up (but I'm keeping my fingers crossed this time as I ahve ben here before and then got a relapse). The reason for exercise before turnout is to start building his muscle up strengthening his tendons and doing it all in a controlled environment and then he can start having some turnout.

So the added complication you have is the early arthritic changes so restricted turnout does make sense but from what you have said it does sound like he is still feeling very sore.

Everytime my farrier comes out he goes through and shows me what is happening with the hoof as the problem area grows through. 7 months down the line and last week we saw a cavity between the hoof wall and where the lamini usually is whch is where it was damaged on one of his hooves so even though he is presenting sound and in no pain the damage is still very much in the hoof structure.

I wuld go with your gut instinct, you know your horse far better than the vet. The vet can only go on what they ahve learnt but each case is unique.
 
Thanks bedbug, its always good to hear of others that are coming through it. Good luck with yours, I hope he makes a full recovery.

The thing I have learned with laminitis is that each case is subtley different, but I feel as though the vet is expecting my horse to present according to a textbook, which he isn't and wouldn't do anyway as he always has to be difficult! I do think the athritis is aggrevated at the moment but I want to leave that alone and let the feet recover, and I do think when he is out all day it will help keep him freer. I see where the vet is coming from in that is the joint needs medicating its better to do it sooner rather than later, but I think it would be too complicated at the moment to see how much effect that had as his feet are too sore. My instinct is to try and put the vet off a bit longer and give the horse a bit longer to recover.

I used to have a chronic laminitic driving pony, who sadly ended up having to be pts, even though I always managed to get him sound after each attack, the space between attacks and the intensity was gradually getting worse and worse. I got him from a showing family who had sadly allowed him to get very fat which started it off in the first place. When my horse came down with it 10 weeks ago I expected him to be like the pony but his attack has been totally different and the recovery has been totally different too - mainly in that he is actually getting better!

I just need to work now on devising a management scheme to prevent it coming back. He lives out 24/7 usually, and I only have the box I'm using til Nov 5th as all our stabled lot have to come in from then, so mine really needs to be going out by then. Of course if he needs a stable in the winter I will make sure he has one but he is much happier out and it keeps his arthritis at bay too I have now realised.

Also the haylage is a problem as I am soaking it at present but thats impossible in the winter (if we have another one like last year when water was scarce for WEEKS cos it was all frozen solid!) due to frosts, so I need to wean him back onto unsoaked haylage at some point as I can't rely on being able to soak it, though I am going to leave that for when he is totally better and has been for some time.

We are a long way off all this at the moment but I do need to plan for it. Even when he is better I realise he will need special care for the rest of his days if I am to prevent a reoccurence. It's exhausting just thinking about it!
 
I 'm another who thinks it is far too early to be doing flexion tests after lamintis.

I'd give it a good while yet, some ponies are unsound for months after a laminitis bout.

As for the haylage, I feed unsoaked high fibre haylage to my lamintic and she's actually been better on this than on soaked hay. The sugar in high fibre haylage is pretty low and I think there is a school of thought that says it is possibly the higher acidity that causes problems for some laminitics. I don't think soaking would affect the acidity anyway, so I'm sure your horse will be okay on it.

Fingers crossed for a continued recovery!
 
Its good to know someone else is sucessfully feeding haylage to a laminitic. I do worry about it though he seems fine on it. I am going to try and wean him off soaked hayalge though not sure how to do that as its difficult to reduce the soaking time as I can only soak it for 12 hours or 1 hour! Not sure if I should just mix 12 hours soaked with non soaked and gradually swap over that way?

He is continung to look considerably better, still not good enough for me to feel happy about a flexion test, but the pastern doesnt seem to be bothering him nearly as much now anyway so I am hoping to be able to call the vet on Monday and give him good news so he won't feel the need to come out again for now.
 
I too think 10 weeks is far too early for flexion tests.

My girlie is just coming up to 10 months and we are into our first week of NO BUTE, she is doing really well and fingers crossed we keep going, we have had some bad weeks where we have taken 10 steps backwards, but I can see the light at the end of the tunnel. Vet has advised me to start walking work with her in a soft school, but only 10-15 minutes a time, to get her muscles and tendons working before she is turned out.

I can highly recommend LaminTec5-HT, my girl has been on this for the last three months and I am 100% sure this has help her make progress as to be honest I thought it was curtains for her. Also she has had daily massage (equilibrium massage pad) and magnetic therapy (Boots and Rug)

Good luck.
 
Saiorse - sorry to hear you are still having problems. My two mares are on the road to recovery after developing lami at the end of April. They were both sound after treatment but the older mare became really lame in front again when I was leading them out in hand - they were both still stabled 24/7at this point.

However with her being 21 I reckoned it was more stiffness than the lami at that point. I tried turning them both out in a small section of the paddock (my field has been totally dug up to install drains, and the little grass left has been sprayed with weedkiller as we are going to plough it over and reseed with a lower sugar, more horse friendly grass, along with adding a woodchip area). Anyway my mare is now loads better and much more free in front. It's worth a try turning him out for a while to stretch and roll - do you know anyone with an arena you could borrow for a couple of hours?
 
Well he is coming on quite well and the stiffness is slowly subsiding. He is now out all day in his pen and in at night, aside from a small wobble on Saturday when he got mud packed in his feet after it rained Friday night, he wouldn't walk a single step poor boy, but once I'd picked his feet out he was much happier. A timely reminder I think that he is still very delicate. We are still on one bute a day, which I was going to reduce from Saturday, but after the mud incident I thought I'd wait a couple more days in case that had aggrevated the bruising. He is now turned out with his cavallo boots on, ontop of his shoes! Miraculously they fit!
 
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