Laminitis 😔

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Hi all, this is my first post on this forum. Sorry if it’s a long one.
My boy who 17 yrs old and a 16.1 ID x cob, heavy set with enormous feet came in with laminitis in June, he wasn’t particularly overweight at the time. Vet came out and said it was a very mild attack so box rest, bute and soaked hay until digital pulses had disappeared and then stand in for 30 days on a deep bed. He was getting a handful of non mollassed happy hoof, top spec light and magnesium. Vet said I was doing everything right. No need to X-ray at that point as it was mild. He sprung two abscesses when he was in also, which were treated and cleared up.

I followed all the advice and gradually reintroduced him to grass with a grazing muzzle. He was out for half an hour every second day gradually building it up to out everyday for 2 hours.

A fortnight ago he came in absolutely crippled, still had grazing muzzle on. Vet came out and tested for cushings which came back clear, he showed no pain with hoof testers and vet says he has really good thick soles and good strong feet, feet X-rays show that he has 10 degrees rotation on nr side and 15 degrees on offside.

He’s been fitted with heart bar shoes as he’s never not worn shoes. Vet gave me a 50/50 diagnosis and told me that if there was no change after being shod twice then there wasn’t much point in keeping him going, because he’s so big and his conformation means all his weight is in his fronts.

My farrier says his feet are in fantastic condition and to keep doing what I’m doing, so again he’s on complete box rest with the same feed and supplements and soaked hay. I suppose what I’m asking is has anyone else managed to get a horse back from this far gone?

X ray pictures included and a picture of my gorgeous boy

Thank you to anyone who takes the time to read this or reply, any input gratefully received xx
 

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31 October 2018
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Oh I must also add when he was on turnout I was checking digital pulses daily before and after he went out. There were none present on the day he came in crippled.
 
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Sorry that your lovely boy is suffering with laminitis at the moment. My 16 year old cob is just recovering from a prolonged period of laminitis caused in her case by EMS. She had rotation in both fronts although not quite as much as your boy. Does your boy show any EMS signs like cresty neck or fat pads? I personally would drop the Happy Hoof and swop the Top Spec Lite to Top Spec Zero as the Lite seems to have alfalfa in it and the Zero is just oat straw. Fingers crossed that your boy improves.
 

meleeka

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I think your vet sounds unnecessarily pessimistic and it’s certainly possible to come back from that with regular shoeing and xrays.

Did you have the normal cushings test where it’s just a case of blood being taken? If so, ask for the TRH test. There are many cases of horses testing negative to the normal one, but that doesn’t mean they don’t have it. Have a look at the Equine Cushings group on FB and you’ll read about lots of cases like this.

If there’s an underlying reason for him getting laminitis, you aren’t going to get anywhere until you find out what it is.
 

skint1

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Sorry to hear about what you and your gorgeous boy have gone through.
Last year my horse had a long period of various degrees of lameness, some of the time he seemed laminitic, even when not on grass. I thought it was all kinds of things. In the end in desperation I asked for the senior vet at our practie to see him, nerve blocking had isolated cause of pain to his hoof, I wanted scans of the hoof done after x-rays had revealed nothing we hadn't already accounted for and the vets felt that wasn't necessary and I was getting a bit arsey about it all. Anyway, she tested him for PPID/EMS and he did need Prascend, he's now on 1 a day and doing really well (knock wood). Might be worth a try with your boy? I hhope it all works out xx
 

ester

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I'm curious that the vet has said he has thick soles, as they don't look particularly so on xray but that might be the shoe skewing the view.
Hooves are great with healing but to correct the rotation you are waiting for a better connection to grow down and it does seem harder/more complications with the bigger horses.
Has testing for other metabolic issues been suggested?
As it stands it would seem to me that as he was still muzzled there is something going on that means he is potentially going to need grass free turnout in the future.
I'd switch out the topspec, can you feed a powder or do you need a nut?
I wouldn't feed happy hoof to mine either, I find weisencobs by agrobs an excellent carrier for a vit/min supplement and anything else that is required.

Is he currently comfortable on the heartbars? I only ask because if mine wasn't I'd have imprints put on if I could as opposed to nail ons.
 

Nari

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Like ester I'm not seeing thick soles here, in fact I can hardly see any sole depth. Has your farrier seen these x-rays & what does he think of them?

I think your vet is being very pessimistic, and to say if two shoeings doesn't do the trick it isn't going to work is, to me, ridiculous when looking at something this severe. You're looking at a very lengthy period of box rest to regrow foot, probably more x-rays so your farrier can keep the trim spot on & so relieve pressure & further damage, and a fair dose of luck BUT if you are lucky it can be done. You're probably always looking at a horse that will need careful management & good footcare though. I'd also want tests for metabolic issues & even though the PPID test came back clear I'd be asking for a prascend trial to see if that helped. I'd also be wondering if this is all new rotation or if the majority of it is from the so called mild attack that your vet said didn't merit x-rays & what you have now is maybe a little bit more rotation and/or bruising on low & rotated pedal bones.
 

ester

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Yes I forgot about the two shoeings things, you're waiting for the hoof to grow down, that doesn't happen in two shoeings.
 
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Thank you to all who replied, I asked the vet about further tests and she said that as he has improved from losing a bit of weight that she doesn’t feel it’s necessary. He doesn’t have any particular fat pads and he’s never been cresty. She talked about cushings tests and said all cane back clear. Will phone and ask what she tested for.

We have had an unusually hot summer up here and vet says that it’s probably been a flush of grass that’s caused it, plus the big bugger had worked out how to get maximum grass with his muzzle on.

He seems very comfortable with his heart bars, I’d say he’s improved if I’m honest. He’s due to come down to one bute a day on Wednesday. So will see what he is like then.

The only other thing that springs to mind that may have brought on the second attack is the fact the he hadn’t had any magnesium for approximately 4 days prior as I’d run out.

My farrier has seen xrays and discussed with vet about shoeing and releasing pressure in his foot. He’s due to come back in four weeks. I asked if sooner would help and he said that the foot wouldn’t have grown enough.

Will get different feed and wean him across as I wasn’t sure what to give him.

I’ll speak to the vet about different metabolic tests as I want to give him every chance possible.

The vet did say even if there was a even a slight degree improvement in 15 weeks it was worth continuing with him.

I’m prepared to keep him in a bare paddock with hay for the rest of his life if that’s what it takes.

The saddest thing for me is that he’s standing in his stable the picture of health, his coat is shiny, he’s alert and interested in everything going on. You wouldn’t know there was anything wrong to look at him.

He barely has a digital pulse at the moment in comparison to when he first was lame so I suppose that’s a positive.

Thanks again to everyone. Will definitely call vet for a chat and see what else I can do for him.
 

Carrottom

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Yes I forgot about the two shoeings things, you're waiting for the hoof to grow down, that doesn't happen in two shoeings.
I agree that 2 shoe cycles is unlikely to fix things but improvement could be shown, maybe this is what the vet meant. Mine had heartbars fitted and redone twice (5 week intervals) and ex-ray showed significant improvement.
 
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Yes I think this is what the vet was getting at, she said it could go either way. I’ve got the winter on my side as my horses will likely be in now till at least the end of April possibly may depending on weather.

My plan is to keep on with shoeing with xrays every so often till then and see where we end up.
 

Pinkvboots

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Yes I think this is what the vet was getting at, she said it could go either way. I’ve got the winter on my side as my horses will likely be in now till at least the end of April possibly may depending on weather.

My plan is to keep on with shoeing with xrays every so often till then and see where we end up.
Will your horses have no turnout at all until April?
 

Nari

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I think it's the trim that will make the degree of rotation look less, the rotation itself doesn't really reverse. I can remember seeing x-rays of one of mine & I thought there was no hope there was so much rotation, the farrier was also there & trimmed him to the x-rays then we took more x-rays to see if the trim was optimal or more could be taken. The after x-rays were incredible, it was hard to believe there was so little time between them. No rotation had been reversed, but the hoof wall had been realigned to the pedal bone to alleviate pressures & that made a huge difference. The horse was not badly trimmed before, it wasn't like we were working with a neglected or badly cared for foot, but a correct looking foot was no longer correct for that horse. @Setterali if you can have your farrier there when x-rays are taken so that he can trim with them in front of him, then take more x-rays & if needs be adjust his trim further then you have the best chance of helping your horse. Try to get your vet & farrier working together if you can, both of them have a valuable role too play in his recovery.
 
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Will your horses have no turnout at all until April?
Sorry I never made myself clear.
I’ve got 9 acres for my two horses, they are generally out all year round!
I was trying to say that this year I’ll keep them in at night and my lami boy can stay in on box rest for as long as is needed until April to give my lami boy a chance to improve.

My older boy chooses to go out if he wants, some days he’s only out for half an hour others three hours.

I’ve got a dry paddock that the lami boy can go into if and when the vet says it’s ok.[/QUOTE]
 
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I think it's the trim that will make the degree of rotation look less, the rotation itself doesn't really reverse. I can remember seeing x-rays of one of mine & I thought there was no hope there was so much rotation, the farrier was also there & trimmed him to the x-rays then we took more x-rays to see if the trim was optimal or more could be taken. The after x-rays were incredible, it was hard to believe there was so little time between them. No rotation had been reversed, but the hoof wall had been realigned to the pedal bone to alleviate pressures & that made a huge difference. The horse was not badly trimmed before, it wasn't like we were working with a neglected or badly cared for foot, but a correct looking foot was no longer correct for that horse. @Setterali if you can have your farrier there when x-rays are taken so that he can trim with them in front of him, then take more x-rays & if needs be adjust his trim further then you have the best chance of helping your horse. Try to get your vet & farrier working together if you can, both of them have a valuable role too play in his recovery.

Yes I discussed this with my farrier and that’s what we decided, so just before the third shoeing I’ll arrange them both for the same time and we can see where we go from there x
 

Nari

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Yes I discussed this with my farrier and that’s what we decided, so just before the third shoeing I’ll arrange them both for the same time and we can see where we go from there x
Is he still on his first set at the moment? If so I'd try to get the vet & farrier together for x-rays for when the second set go on rather than wait for the third. Getting the trim spot on can make a huge difference to how comfortable they are and also help to minimise ongoing damage so the sooner the better really.
 
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Is he still on his first set at the moment? If so I'd try to get the vet & farrier together for x-rays for when the second set go on rather than wait for the third. Getting the trim spot on can make a huge difference to how comfortable they are and also help to minimise ongoing damage so the sooner the better really.
Right ok I never thought of that, will organise vet and farrier for next time and see how things are going x
 
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Sorry to hear about your horse.Please ask your vet about doing an EMS test.My Sec D was fully fit,just done the regionals and came down with Laminitis.Vet was shocked as he had absolutely no signs,did Cushing Test-negative,she wasn’t convinced it wasn’t something underlying as I was very strict regarding Lami precautions.Ended up doing the glucose test,vet arrived late but he was still over 200-should Be below about 40.Sorted him out and kept him right through diet and soaked hay for last 3 years.He started getting recurring abscesses and slight lameness on and off.I got the vet in,we re tested for Cushings again which was negative again. She took a resting blood which also has a new one which tests for something else-apologies cannot remember the name-apparently If this one thing is low that shows EMS, if it’s high then it’s not.His came back low.He was getting a permanent low grade Laminitis with the abscesses. He was muzzled and took every precaution,no turn out on frost etc....He started on metformin and was sound within 4 days with no abscesses now for 6 months.I still control diet etc but he leads a normal life. Sadly sometimes it is just genetics that can cause it but would definetly look into other causes metabolically- it was only because the vet I had was very knowledgeable on it all that she pushed to find out what could be causing it as in her words-on paper-you are doing absolutely nothing wrong.Good luck and I am sure yours will be absolutely fine.
 

pippixox

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Hows he doing?
I agree with ems test. My friend was unlucky: had a loan pony who would go laminitic even without grass (on woodchip pen all winter) so tested and she had ems... once on metaformin tablets she could actually cope with grass.
She also had a huge warm blood who was on box rest after an injury and managed to get laminitis! Again tested positive for ems
 
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Hiya, quick update on Sebastian!
He’s doing really well down to one bute a day and very comfortable. Digital pulses are negligable for the moment which is positive. Vet has glucose tested, which came back fine and the cushings test also came back clear. I’ve discussed medicating him but vet says no need as he is improving with the measures taken for the moment. She has recommended testing again after next set of xrays xx
 
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Hiya
Sebastian presented hopping lame yesterday morning. He hasn't been on any bute for weeks, had no digital pulses at all until yesterday morning. I thought it was the end of the line however, vet and farrier came out. I was hoping for a whopper of an abscess.

Farrier took his heartbars off and mentioned bruising on his sole where pedal bone is pressing. Vet xrayed to see what was going on inside.
There doesn't appear to have been anymore rotation 15 degrees on offside front however the vet commented that pedal bone has dropped slightly. She also said there looks to be a build up of fluid on his wall that would cause similar pain to an abscess. This would account for overnight lameness. His near fore 9 degrees rotation has had no changes what so ever.
Vet has said she thinks he's got a fighting chance however there isn't much room for the pedal bone to drop before it comes through his sole.

I don't know what to do. My heart is telling me to stick with it but my head is saying it's time to call it a day. I keep my horses at home so can set up a track system for grazing or can have Sebastian on a postage stamp paddock. Realistically is this enough for a horse who has spent his entire life living outside?
Vet said she believes I'll do the right thing by him whatever decision I come to.
I think I'll give him another couple of months and see where we go from there.

He's getting very very stressed now when my old boy goes out, which isn't helping.
He's a happy boy other than that and shouts for his morning hay, demands attention and loves his grooming time.

Sorry for going on but I'm all over the place and don't have a clue what's the best thing to do.
Bloody phone won't let me upload xrays. Will keep trying.

Thanks to anyone who reads this and can offer advice x
 

Pinkvboots

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So sorry you have had a set back and it makes you feel so crap I know, but I think in your situation I would seriously consider calling it a day, if the pedal bone is that close it must be so painful, I'm so sorry I hate laminitis I lost my mare 2 years ago to it she also had a set back and was doing so well, then out the blue she become extremely lame even on 6 Bute in 24 hours so I made the decision to let her go the next day.

I know exactly how you feel it's horrible but I actually felt a sense of relief afterwards knowing she was no longer in pain, again I am so sorry if you want to talk to someone about it I am happy to talk or try and help you just message me xx
 

Leo Walker

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I carried on with mine until the pedal bone was at risk of coming through his sole and then I decided enough was enough and he was PTS the next day. The stats for recovery once the pedal bone starts sinking are pretty bleak, especially in these big cobby types. How close are we talking? It was less than 5mm in my case. There was a chance we could have brought him back from that but it would have been months of recovery and then a life of never touching grass again. I was heart broken and agonised over it, but looking back now I 100% did the right thing and if it ever happens again and theres sinking I'm going to PTS at that point rather than drag it out.
 

Leo Walker

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I think the problem is every one assumes horses recover from lammi. I did. I knew it wasnt nice but genuinely thought treated properly he would recover. Other peoples horses recover. I almost couldn't believe it when he didnt. I thought I must be doing something wrong, or that something was happening that I wasnt aware of. I even sent him to a special rehab yard so they could give him tiny amounts of hay hourly and all sorts of stuff. Made zero difference, other than me knowing he was getting brilliant care. So dont feel you have failed him in anyway. Laminitis is a god awful thing and sometimes they cant be saved.
 

holeymoley

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I’m going through almost the same as you just now. You’ve both come so far so I wouldn’t give up just yet. Mine has 11 and 15 degree roatation and has had heartbars on for 2 weeks. Thankfully he didn’t have any sinking but can understand if you decide to pts x
 

equi

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Im so sorry you are going through this. There is a point in these situations you have to decide quality of life in the long term. If he is getting an attack in the middle of winter with no grass is very worrisome. Do you really feel comfortable keeping your horse in a stable/off grass only being allowed to eat barely anything for the rest of his life? You also have to consider your own situation..the stress im sure you feel every morning when you walk in and touch his leg (which im sure has become almost like an OCD thing) and in constant worry of any sort of pulse/heat/limp?

Could he come back? Yes, but i doubt he will ever be 100% able to be a normal horse again. If money is not really an issue you could maybe talk to Rockley and see how they feel.

We will support you whatever you decide to do though.
 
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I'm struggling as the vet is unable to tell me if it's a lami attack or the fluid in the hoof wall that's causing the lameness. My farrier said pressure of fluid would present like an abscess and that probably why he went lame overnight, he opened up the wall and said the fluid would seep out over the next day or two. Sebastian is comfortable walking around his stable on two bute a day. Farrier didn't reshoe yesterday as he said he thought it better to give him a day or two to see if lameness subsided.
 
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