Laminitis and the long run

dust100

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Hi all,

wondering if any of you have struggled with laminitis in the past and whether your horse made a full recovery and how long this took?

My pony had it last year he had foundered and was quite lame.... after around 8 months of treatment he returned to a normal shoeing plan however recently seems to be intermittantly lame with no real cause showing.

No xrays were conducted with his laminitis so it is hard to grasp whether he had rotated and if so to what degree however he went through a full medical shoeing plan and did return to soundness.

Just wondering whether any further symptoms have occured in the long run or if the pony is prone to suffer with other ailments...

Any input welcome :)
 
Yes, I'd be suspecting laminitis again too. Best to be safe and get him off the grass and feed some soaked hay instead, and see how he moves after a few days.

One of the problems with shoeing a laminitic (or any horse) is that it masks some early signs of lameness, so by the time you see a lame horse it can have been that way for a while.

Personally, I would opt for shoes off and a good regular trim to keep the breakover well back, and blood tests to check the glucose and insulin levels to see if he's insulin resistant as this may be contributing to the susceptibility to laminitis.

Also if he's 12 or over, I'd have him tested for Cushing's too, using the ACTH test.

At least with those two tests done, you'll have an idea of whether it's hormones causing the laminitis, and will better be able to determine how to keep him sound.

I keep copying this link to different threads, but there's a graph half way down the page which shows how ACTH (a hormone) levels rise during August, September and October in all horses, but most dramatically in Cushing's horses. So this time of year can show very clearly which horses are Cushing's if you blood test them. It's also the time of year when they are most likely to have their first attack of laminitis.

http://www.liphookequinehosp.co.uk/documents/PituitaryParsIntermediaDysfunction.pdf

Of course it might be something else altogether....

Hope he's soon OK.

Sarah
 
I second getting a cushings test as it will completely dictate how you deal with it.

If it is not cushings but long term laminitis then it is normally possible to control it long term but you have to revisit all your horse management - lots of great experiences if you do a search on here! But weight, access to grass are key and also may be worth taking magnesium oxide supplement?
 
Sadly, Septemebr is the month when the highest cases of laminitis are diagnosed, worse than spring. I hope it's not this.

I wonder if that is just because people associate laminitis with the spring and are more aware?

OP, fingers crossed for your pony and ditto what the others have said.
 
Ditto all of Te above - especially getting the shoes off made a big difference for us - I can pick up warning signs and take action before it gets worse.
 
My pony suffered a severe bout of laminitis 3 years and after around 6 months made a full recovery - she was x-rayed 3 times during her treatment and on the last x-ray the pedal bone had returned to normal position. She is carefully managed ie restricted grazing with muzzle in Spring to Autumn months and stabled at night and she is back to normal work (careful not to do to much on hard ground). However her soles are still sensitive so I have had to go back to natural balance shoes after normal shoeing for around 2 years. It is hard work keeping laminitics sound but it is possible and you need to stay positive as you have come this far. Every case is different but you really need to consider x-rays as this is the only way you will know if the pedal bone has rotated and the future for your horse. If in doubt about lameness in a laminitic prone horse I would go for immediate box rest and book your vet or farrier. Good luck.:)
 
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In essence after an acute attack of laminitis where the hoof has broken down and pedal bone rotation is the result, the horse has to grow itself a new foot, as it does from the coronet band down, allowing the realinement of the pedal bone.

In order to do this in the shortest possible time, the hoof needs an adequate blood flow to regenerate lamina, and little suppression of the enzyme cascade cox1 and cox2.

Therefore horses without shoes have an advantage in this respect as they do not have a retricted blood flow to the hoof caused by the shoe.

Also restricted use of Nsaid's of which phenylbutazone, or bute is the most commonly prescribed, suppress the enzyme cascade in attempting to control the inflamation. Doubt has now been cast on the benefits of supressing the inflamation, which may lead to more damage and a longer recovery period.

The analgesic, effect of bute, of limited effect in this regard, may also be counter productive in enhancing successful and swift recovery.

Therefore, the best recovery results tend to be where horses are unshod and bute is kept to a minimum.
 
just to make you aware that if you are testing for cushings this time of year is not the best time to do as horses and ponies have a natural biorhythm that can false negative the test for cushings - but i would agree that getting your animal tested for cushings is a good idea just not in the next two months
 
Horses4coursies,

please would you provide a reference source to support your comment that now is not the best time of year to test for Cushing's please?

It just seems to directly contradict what vet Andy Durham of Liphook Equine Hospital has recently said on a webinar (which can be viewed free through the Prascend website), and also goes directly against a graph showing ACTH levels in Cushing's horses seasonally compared to non-Cushing's horses, the link for which is here:

http://www.liphookequinehosp.co.uk/documents/PituitaryParsIntermediaDysfunction.pdf

Look half way down the first page for the graph I'm referring to.

It's interesting to hear Andy Durham saying that actually it is very much this time of year that gives the clearest difference between Cushing's and non-Cushing's horses, although he says there is a significant difference between the two groups in any month of the year.

So if there is contradictory research out there, I would be very keen to read up on it.

Many thanks.

Sarah
 
my Nf pony had bad laminitis a few years ago, resulting in resection of dorsal hoof wall due to seedy toe. She ended up being out of work for nearly 1yr.

She had bouts of relapse until I discovered she can't tolerate alfalfa, which is common in alot of laminitic feeds, also rye grass stalks has a habit of making her footy.

Along with the suggestions for testing for Cushings, I would recommend you look at your pony's diet and try to eliminate alfalfa for at least a month to see if things improve. D& H do a alfalfa free feed - Safe & Sound.

I would also suggest having the pony's feet xrayed to see if anything is going on and check the balance of the trim / shoeing. I have my pony's feet xrayed every year and I have subsequently found out she has arthritic changes in the pedal bone of the worst effected laminitic foot.
 
hi flintfootfilly

have always been told this by vets that the autumn months sept/oct are a bad time to test. I think in my last post i said that it was due to false negative tests but in fact i meant to say false positives. A friend of mine has just completed veterinary medicine degree and this was what they were taught also at Liverpool - so i assume this is current teaching across the boards at present. Having done a 5 minute google search i came across the following:

www.equisearch.com/horses_care/health/illnesses_injuries/cushings_tests_092308/

www.thehorse.com/ViewArticle.aspx?ID=12754

now whilst these are not scientific papers and having read the doc you posted here today i am very interested to see that this has been established by liphook.
 
I can only view first one on The mobile.

If you read a little further down, it states horses have elevated ACTH levels in autumn which is why dex suppression test produces skewed results.

That said, afaik dex suppression test isn't the usual test over here - it's just a blood test and ACTH levels are compared to the "norms" data collected. There are labs which allow for seasonal differences so it shouldn't really matter what season it is sampled in... In theory
 
Thanks H4C. Have just had a look at those 2 articles, and I think it sounds as though that may have been what Andy Durham was alluding to when he said something to the effect that if there are too many false positives due to seasonal variations in hormone levels, then the reference range for "normal" must be wrong. Hence why he advocates a seasonally adjusted reference range, even though he ways cushing's and noncushing's horses are distinct with the basal ACTH test during any month.

Interesting about Liverpool vet school there. They have Cathy McGowan there who is pretty hot on laminitis/cushing's etc so I'd be quite interested to find out what her views are. Must remember to ask when I next get chance to go to another of her talks.

Thanks again.

Sarah
 
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