Lameness lami? vs heel pain??

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jessieblue

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Following on from my previous posts about my horses soreness when turning on left fore, heat in hoof (now heat has gone) Then farrier replaced shoe with a pad and horse went hopping lame, so removed shoe he was much better. Poulticed, nothing, reshod with pads looking much better but still scratchy on the turn. 2 weeks on still the same, sore to turn left and now right. Only on tarmac, he is fine on field and in the burn where the surface is hard but very smooth!! Wierd one I know, but need some help from anyone that has experience of knowledge. My vet and farrier ruled out lami although 3 months ago he had what was believed to be lami from a peritonitis followed by treatment by penicillin which gave him abcessess on hind quarter. Loads antibiotics during this time he did exactly the same started to show slight soreness when turning or going up or down hard slope on turn. When treatment finished he actually went properly lame, only mildly but noticeable on lunge. Farrier agreed laminitis very mild and so did vet. Heat in hooves DP both fore limbs. We assumed it was very low grade due to concussion/toxaemia/stress, who knows. Treated with reduced sugars etc and resolved quickly. Shod with heartbars remained sound for 2 months. Then this time, similar symptoms but a little different. He has very subtle symptoms and I have pushed with my vet that I think it could be lami. He was going to nerve block to look for causes today, but on my concerns has decided to test for Insulin resistance before nerve blocking as the nerve block could aggrevate lami if thats what it is. So before nerve blocks we need to rule out IR.

Now what I am desperate to find out is, does my horse have to be positive IR to have low grade/subclinical lami??? He isnt the typical type of IR horse. He is TB weatherby passport/WB, medium weight, no cresty neck, no fat deposits, not overweight (he was weighed while at RVC 600kg he is 16.3). We xrayed 3 months ago for pedal rotation and none was found. I have requested we x ray again to be safe. So could he have sub clinical lami without IR? Could it have been caused by his previous stressful event and now he has a suceptibility maybe caused by too much rich grass or by concussion as I had recently started jumping him again. I have heard people refer to horses getting "footy" from certain feeds or grass etc is this the same thing as low grade lami really?? I think the vet is suggesting that if the test is normal this will mean he definitely doesnt have laminitis, is this the case. He previously tested negative for cushings.

I know ideally I need to box rest to get over the lami flare, but I need to investigate this further as if it is a second bout of lami I need to know so I can plan for the future/medicate or whatever.

If anyone can help before I rush into too many diagnostics that would be great. Basically he has been like this for 2 weeks with little change. He was slighly better one day then slighly worse again, but fairly much the same. Trots up sound, not stiff or shortstrided. Vet and farrier said sound too. Landing hee first just!! But is shod so apparenly as good as it gets in shoes. He was pointing to start with and literally lifting the worse foot up. That was only the first day since then seems comfortable in every way as long as I dont turn him!
 
My then 5yo tb had low grade laminitis last year, he tested negative for insulin resistance but he's very sensitive to sugar in his diet. He is living in and has restricted turn out on a barefoot diet.

Mine was diagnosed with reverse angle pedal bones in hinds and scans showed evidence of PSD in all 4 legs ( though he was only 1 to 2 tenths lame on off hind trotting in a straight line, he was lame on all 4 legs on a circle at the vets ).

Mine is currently sound, and actually the vet said surprised, he's even sound on a tight turn.

Tbs are more sensitive to sugar than most people think, and I have been told low grade laminitis is common in tbs.
 
Thanks for replying pinklilly. How did they come about diagnosing the laminitis in the end?? Was the lameness investigated from the laminitis or from the PSD?? Was the pedal bone rotation found in the fronts too? Was your horse having laminitic sypmtoms for long?? My horses forelegs were x rayed 3 months ago but were normal then, hindlegs werent done as no reason to suspect they are a problem at this point, but who knows??
 
After going through a number of weeks with what my vet said was Heel Pain (later diagnosed with Navicular) and then a number of months with first Eggbar shoes on their own and then with wedges, later on I took the wedges out as it made her worse I have now gone down the route of Barefoot.

Yesterday I took some videos of her walking and then trotting. The first thing I noticed was that she was placing her toe down first and not her heel. I now realize that the Eggbar shoes and also when there were wedges in made her place her toes down even more. This is not correct as it should be heel first and as she moves forward she hen rols onto her toes ie the breakover.

As long as she can cope barefoot she will stay like that as it can only be better for her.

As an Athletic coach I have watched many a runner and the really good ones propel from the heel through the ball of the foot onto the toe.

my belief in horses is that the heel can not work properly if it can not touch the ground
 
jessieblue said:
Now what I am desperate to find out is, does my horse have to be positive IR to have low grade/subclinical lami???

Hi

No your horse does not have to be IR to have LGL.

My horse has been tested for IR- negative and also still negative bloods after a challenge test 250g of glucosamine, tests were 2 weeks apart and my horse can not handle more then 4 hours daily on fertilised grass.

I know you did not ask but I would not be happy with the lack of heel support on that "remedial shoe".

I have been that route and my horse is now unshod.

Best luck
Click to expand...
 
I had Ari's forelegs fully scanned in January last year after about 20 months off after I bought him unwittingly after he failed to stay sound in racing yard, he'd actually always been sound and the scans showed a minor mid suspensory injury which had healed and I was advised he was fit to do any job including eventing. I started doing some long reining and hacked out at walk a handful of times then he went was roughed off and went on grass livery as I'd just moved house and was waiting for a livery place to come up.

In April i started him and he promptly developed sarcoids on his girth and a couple elsewhere and carried on groundwork but then I had a niggle that something wasn't quite right behind. I had the vet who did flexions and he was unsound on his off hind and slightly on his off fore and was unlevel behind on a normal trot up. The vet said he had heel pain and thrushy feet and said shoe behind and to rest him. He was more comfortable with shoes on but still not right. The vet notes I have said he reacted to hoof testers, had a digital pulse and feet were warm ( hinds only ). Though the vet said he did not have laminitis at the time I'm fairly sure he did.

Basically stayed the same until I moved him to livery yard, I wasn't happy with his stance ( hindlegs tucked underneath him ) and his general demeanor wasn't right and I suggested that he was suffering mild laminitis to which the vet agreed and he was box rested. He was also treated for the second time with liverpool cream for sarcoids.

No real change in the off hind lameness, still trotting up one to 2 tenths lame so in October he went into the vets for a full work up. I'd already put him on a barefoot diet at this stage.

On a circle he was 3 tenths lame in both off fore and off hind and one tenth lame on near fore and near hind, nerve blocks to the off hind foot improved soundness.

All four feet were ex-rayed, fronts were normal and hinds showed reverse angle pedal bones, scans of the suspensories in all four showed signs of PSD in all 4.

Heart bars all round with wedges behind were prescribed but he immediately looked worse in front, pottery, but there was a massive improvement behind, he promptly pulled a front shoe off and had severe bruising to the foot so was box rested for 10 days then he went very lame in both fronts, at this point I was considering pts as he was unhappy in himself, he had a lot of problems and a poor prognosis. Vet came and told me some horses don't like heart bars so I asked him to take them off and the horse almost breathed a sigh of relief, the swelling in the forelegs and lameness subsided immediately.

The farrier came and put normal shoes with a rolled toe on and he much better almost sound but not quite, second shoeing and he got worse, just pottery, then he got worse, lameness was inconsistent day to day, pottery, trying to land on toe, tripping, forelegs standing behind the vertical. He pulled a shoe in the field not long after shoeing and I asked the farrier to take off the other front and to start reducing the wedges behind as I wished to permanently retire him, and since the front shoes came off which has been 4 months now he has been sound since.

The hinds have been reduced down to a normal shoe with a slight deviation to the toe to make it into a small wedge, I did have the hinds off for a while but he was still slightly uncomfortable and with a view to bringing him into work had the hind shoes back on. The barefoot trimmer has also advised leaving the hinds on whilst he's being rehabbed.
 
Sorry you are having troubles.

They are not the healthiest looking feet so i would be looking at your horses diet to start.

Best way to diagnose lami is to treat for it and see if they respond. So box rest on thick shavings bed, soaked hay and water, if supplements are needed then can be given in speedibeet but as little as possible sugar and starch and no grass.

My horse suffers with low grade lami and if she gets a bit sore then usually 48 hours off grass is more than enough to get her back on track.

http://www.thelaminitissite.org/index.html

This site is usefull.

If you confirm lami then I would blood test for IR and PPID.

My horse turned out to have PPID and is now on treatment.
 
Hi and thank you for all the input. Can you tell me what PPID is please? He has been tested for cushings and tomorrow for IR. I suspect this may come back normal but I still mildly suspect it may be LGL! I will have a hard time convincing my vet as he seems to think this will rule in or rule out lami. My horse did have what looked like (as far as we can tell) a low grade lami episode but he wasnt on grass at all at the time. In stable pretty much all the time then as he had been really poorly. We suspected the lami was a secondary to toxeamia or concussion or stress. Obviously this time he has had not stress/toxaemia, he is as happy as can be! So the only factor is grass, the grass is very rich and my other horse has the runs from it at the moment too as do most a lot of other horses. My lami horse is on gastrogard for stomach ulcers too and the fields were fertilised a couple days before our horses went out to grass, so there may be a nitrogen element here maybe??

I have been told his feet are not a good shape, previously on the forum, so I have him on happy hoof now. I am not really in a position to go barefoot until I know what is wrong really, so currently he has the shoes with a pad. I didnt feel there was much heel support, although these shoes are a lot better than the ones he was in 8 weeks ago, they were even shorter on the heel, which worried me at the time! When he went lame before he was shod with heartbars, but this time around the farrier said he didnt need them. He stayed sound in the heartbars! In fact the farrier said the shoes with pads were the same as wearing a heartbar. Im at a loss for what to do re the farrier as I dont feel his feet are going in the right direction at the moment!

My horse seemed fine last year and all previous years with previous owner, I dont know if this is LGL or not but really want to find out what is wrong so I can see if there is anything I can do to get him right or whether we are looking at retirement.
 
Some vets think of laminitis as on or off. If your horse is 'footy' this can often be down to low grade laminitis, which some vets are excellent at spotting and others not so much. I agree the hooves in the photos do show signs which can mean the horse is not coping with dietary or other issues.

The horse does not have to have IR, EMS or Cushings to get laminitis.

I would not feed Happy Hoof it is a triumph of marketing but has been known to cause footiness in some. Do not trust the Laminitis Trust logo.

A good source of information is www.ecirhorse.com
 
Oh Gosh Lucy! I thought I was helping with the happy hoof!! What about molasses free dengie hi fi? I know my yard stock that too! Or can you recommend?? Am happy for any help on this.
 
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