Laminitis and turnout

[Wagtail]

Was just wondering what others believe is the right thing to do regarding turning out horses with active laminitis or recovering from laminitis.There appears to be two schools of thought. The traditional method followed by most vets is strict box rest until three weeks after the horse has come sound without bute. Whereas the 'barefoot' people tend (not always) to advocate encouraging blood circulation with a limited amount of turnout in a sand paddock or gravel surface. I personally have had great success in the past with the use of a sand paddock. So what do others think? At the moment I can't use the sand paddock for my mare as the other horses are using it in winter and so she is on box rest. My plan is to keep her on box rest until she is sound without bute and then turn out for an hour (gradually lengthen time) on her own in the arena. She will be next to the others in the sand paddock but I don't want her in with them as she spends too much time chasing around. Thanks.

 

[Shysmum]

I followed the first option, but Shy wasn't acute, just "on the cusp", and he was in for about 2 weeks. The vet was great, and hopefully that will be the last episode.

 

[joeanne]

I think you have to do whatever works for you.
Sand is good as it packs into the hoof and gives support to the sole. I have a friend who uses this method with her lami prone mare and she is happier than being constantly boxed although she is only given a 20x20 area to prevent hooning which her mare is prone to.

 

[ihatework]

In the acute phase and while the horse is still in discomfort then strict box rest for me. The forces put on the laminae during movement just cause a higher risk of further damage and pedal bone rotation, so although I do agree that some movement for blood flow is theoretically a good thing, Im afraid the risk of further damage outweighs the benefit for me.

As soon as the horse is comfortable without bute I'd probably consider short periods of turnout on sand, building up gradually over the course of time and any sign of discomfort back on box rest.

 

[Wagtail]

Thanks. It is such a frustrating condition. I have found that usually the first episode of laminitis, if caught early enough is pretty quick to resolve. Sadly, IME the more flare ups a horse has, the longer it seems to take to recover.

 

[Wagtail]

Any more?

 

[PandorasJar]

Last yard we ran purely 24/7 turn out with emergency stables.

Had plenty of lamanitics on site (from previous yards not ours) and none on our management ever had it again once out 24/7. Some were on smaller patches (greedy dinky ponies), mostly were out in a suitable paddock which was brought in and strip grazed out til suitable if lush grass. Hay was provided for little ponies all year and for temporary/starvation patched ones to keep through their system. One donkey had laminitus (emergency stabled for a day and then patched and then owner let back onto lush grass not maintained how we would at all) and one caught just before (let out on 5 lush acres against recommendation).

So if they actually had it, stable for a few days and then turned out onto bare/starvation paddock which horses would be run through for a day first. If just before, then into starvation paddock.

Sorry this is based on early stages and not with pain/discomfort needing pain management. I've never had one go further than nearing it with me.

Donkey was different as they hide signs and pain and so much harder to manage.

 

[seoirse]

I lost my horse last year because he had an acute attack of laminitis, which settled after a few days (his first ever attack aged 12), however as he was used to living out, he was unhappy in. I kept him in though, as I believed it was the right thing to do, he box walked and caused himself to prolapse in a very short time in both front feet so he was pts. With hindsight he should either have been turned out in a small pen, or sedated to keep him quieter in the box. Either way, the walking is what killed him. I don't think the vet handled it very well as I was on the phone to him constantly telling him my horse was box walking but he kept telling me he wouldnt be doing it if he wasn't up to it.
So the answer really has to be what works for you, and what keeps the horse quietest. I would always try and box rest for as long as possible, but only if the horse tolerated it.

 

[TigerTail]

Id be wanting some movement as to stand still is so unnatural for a horse it prevents the toxins being circulated and therefore excreted.

Thinking about the facilities Ive got to hand right now, which is an 18 x 12 field shelter I can shut the gate on with about 8 feet of rubber matting outside Id probably fence around the rubber matting, bed the shelter up and leave them that. Then once less crippled Id put them on bare mud track I think.

When mine had an abscess last year and was on 3 legs I made an electric fence pen for her so she was out of the way of her rough field mates, she could move around if she wanted to, she could lay down on the mat which i put shavings on or could stand still. Her choice

 

[Wagtail]

I lost my horse last year because he had an acute attack of laminitis, which settled after a few days (his first ever attack aged 12), however as he was used to living out, he was unhappy in. I kept him in though, as I believed it was the right thing to do, he box walked and caused himself to prolapse in a very short time in both front feet so he has pts. With hindsight he should either have been turned out in a small pen, or sedated to keep him quieter in the box. Either way, the walking is what killed him. I don't think the vet handled it very well as I was on the phone to him constantly telling him my horse was box walking but he kept telling me he wouldnt be doing it if he wasn't up to it.
So the answer really has to be what works for you, and what keeps the horse quietest. I would always try and box rest for as long as possible, but only if the horse tolerated it.

Oh that is just awful! Poor boy, and poor you. You make a very valid point and it is certainly something which owners and vets should consider. I have found that vets are very inflexible when they prescribe box rest and often don't take owners concerns seriously. I think if a horse cannot have company next door to them in a stable, that ot is often best for them to be turned out in a restricted area of the paddock.

 

[seoirse]

Oh that is just awful! Poor boy, and poor you. You make a very valid point and it is certainly something which owners and vets should consider. I have found that vets are very inflexible when they prescribe box rest and often don't take owners concerns seriously. I think if a horse cannot have company next door to them in a stable, that ot is often best for them to be turned out in a restricted area of the paddock.

Yes it was all pretty awful, he was an amazing horse, I always knew he'd never make old bones as he was a nutcase but I never for a moment thought he'd go with prolapsed pedal bones. Very traumatic for everyone concerned.
You are right, vets are not always very flexible and in this case whilst he was supposedly the best vet in the practice, a senior partner in fact, his methods were a bit out of date and we disgreed on a lot of things, I wish now I'd got a second opinion but it all happened so fast and I trusted him as he was supposed to be 'the best'.

The main thing is to control how much the horse moves about and if you have to keep it out in order to do that then it's got to be preferable than what happened to me.

 

[ihatework]

The main thing is to control how much the horse moves about and if you have to keep it out in order to do that then it's got to be preferable than what happened to me.

Seorise I'm sorry to hear about your horse
Your statement above is the critical one ....

Yes it's not natural for a horse not to be moving, yes in an ideal world we wouldn't have to restrict this.
Ideally box rest - use dope or cross tye if needed. Only in exceptional circumstances would I turn out in the acute phase.

The reason for restricting it isn't primarily down to the horses pain/discomfort (although that is a factor). The KEY reason for limiting movement during the acute phase is that the laminae are inflamed and very weak. The laminae hold the pedal bone in position. Move the horse and that action puts far more leverage on the foot and increases the chance of laminae damage and pedal rotation.

 

[seoirse]

Agree 100% ihatework. I think its all too easy to underestimate the forces placed on the column of bones in the horses leg and the damage that can be done when the structures holding it all together are compromised and not given time to heal.

 

[Grumpymoo]

Mine was meant to be on box rest but was doing more damage trying to get out so I turned him out on a small bare patch for two weeks with a Shetland for company and soaked hay. He was completely sound without bute within a week. After the two weeks I moved the fence a little to let him have some grass then after a further week he was out at night and in his bare patch during the day. He is now out 24/7 on his summer field still as I am too scared to let him back on the winter fields untill they have been eaten down a little more.

 

[MagicMelon]

I think you have to do whatever works for you.
Sand is good as it packs into the hoof and gives support to the sole.

Ditto this. IMO I think this is the best situation (if you have access to it). With my lami-prone shetland, she's out in a very small bare paddock at night and in my hardcored yard during the day (with hay), works great for her.

 

[BlackRider]

You do need them to have time for the laminae to recover, as too much movement when these are weak will mean that they can't support the pedal bone.

Will the vet give you ACP to help keep her calm?

It might also be worth trying either restore or D Tox to try and help the body deal with the toxins.

Wishing a speedy recovery x

 

[noblesteed]

My farrier had some interesting ideas about turnout with laminitics. Mine was caught in the very early phases, farrier said initially to box rest, as did vet. However both were keen for the horse to be out (obviously restricted grazing) even before he was completely sound. Farrier said the soft ground (it was muddy in spring) would also offer plenty of support, and the toxins would clear quicker with movement.
He also talked about 'old fashioned' methods of turning lamis out in cow-byres - the heat from the cow-muck would warm the feet and speed up recovery!

 

[misst]

Our old mare was out 24/7 and was very very stressed if brought in. When she got her first and only bout of laminitis at aged 28 (cushings related) we compromised by locking her into a 12 x 16ft field shelter with a tiny bare area in front that was soft mud. Vet then suggested we "muck out" the shelter onto this area to keep it soft. There was a huge shavings bed in the shelter. She was able to touch her fieldmate over the electric fencing and was in her familiar field. Vet felt this was a good compromise between traditional management and her mental welfare.

Sadly after 3 weeks she suddenly got worse and it was clear she would never be able to rejoin her friends on the grass and we made the very hard (but I believe right) decision to PTS. She had a very happy couple of hours back on the grass before the vet came

 

[minime22]

My miniature is prone to laminitic outbreaks. At the moment he is going out in the day with grazing muzzle on and in at night with hay. The grass is fairly long and yellow and it is winter. The people who own the fields say the grass has no nutritional value and he doesn't need to wear the muzzle on it? Is that right? Thanks

 

[Oberon]

He also talked about 'old fashioned' methods of turning lamis out in cow-byres - the heat from the cow-muck would warm the feet and speed up recovery!

Whereas the research now recommends cryotherapy for the first 48 - 72 hours or as a prophylaxis post surgery

http://www.ivis.org/proceedings/aaep/2006/pdf/z9100106000538.pdf

 

[Oberon]

The emergency treatment for acute lami is to prevent further damage to the internal structures.

How that is achieved should reflect the individual needs of the horse.

Usually box rest on a soft surface is the best option (in the acute phase only) - but it's important to have another option when that's not going to work for the horse.

It's also important to treat the cause of the lami - it's a symptom of something else at play.

Also getting the mechanics of the hoof right is as important as any treatment.

 

[Sophstar]

I have managed to catch my cushings pony right before a full blown lami attack. First time when he was diagnosed he was quiet and sore enough to stay locked in a stable for a couple of days but after the third night of rearing over the door he went out in a mud patch with 3 ponies taking it in turns to babysit him. Much happier and far less stressed with the herd right next door. Second time the vet agreed it was best for him to stay out as he was beyond settling when left in. He had his own private paddock right next to the herd and was content being on his own through the day and then my cob spending the night with him. Two weeks of soaked hay, nettles and playing hunt the pony nut game, i was able to wean him back out with his muzzle half taped off.

Depending on the severity, i much prefer to keep them quietly moving. If mine ever got lami that HAD to be box rested, i would consider pts as they both despise and get so stressed about long periods in a
stable.

 

[Wagtail]

The emergency treatment for acute lami is to prevent further damage to the internal structures.

How that is achieved should reflect the individual needs of the horse.

Usually box rest on a soft surface is the best option (in the acute phase only) - but it's important to have another option when that's not going to work for the horse.

It's also important to treat the cause of the lami - it's a symptom of something else at play.

Also getting the mechanics of the hoof right is as important as any treatment.

When would you say the acute phase is over, Oberon? My girl is now sound without bute in her boots, but still lame on her right front on hard or stoney ground without her boots. I was wondering whether to turn her out for half an hour in the arena tomorrow. But I know she will hoon about a bit.

 

[Wagtail]

I have managed to catch my cushings pony right before a full blown lami attack. First time when he was diagnosed he was quiet and sore enough to stay locked in a stable for a couple of days but after the third night of rearing over the door he went out in a mud patch with 3 ponies taking it in turns to babysit him. Much happier and far less stressed with the herd right next door. Second time the vet agreed it was best for him to stay out as he was beyond settling when left in. He had his own private paddock right next to the herd and was content being on his own through the day and then my cob spending the night with him. Two weeks of soaked hay, nettles and playing hunt the pony nut game, i was able to wean him back out with his muzzle half taped off.

Depending on the severity, i much prefer to keep them quietly moving. If mine ever got lami that HAD to be box rested, i would consider pts as they both despise and get so stressed about long periods in a
stable.

I use the sand paddock for the two laminitics if they get an attack in the summer. This means they are next to the other horses and it usually clears in a few days. In the winter, the gelding doesn't ever get it as he is on a strict diet, but he only needs an hour on good grass in the spring or summer to be like a cat on a hot tin roof. But it passes really quickly. My girl's lami is cushings related and haylage will bring it on, or grass. She takes longer to recover, but does not seem in as much pain as the gelding. Next year I am intending to turn these two out together which will make their management much easier.

In the winter, I manage the lami with box rest in a deep shavings bed. This is usually tolerated really well because there are always other horses in at any one time.

 

[Equilibrium Ireland]

In America they recommend "ice" beds but obviously in most places and not during winter, it will melt. But layer of peat moss quite thick. Add ice all through the bed. Let melt a little and then top with shavings. Add horse. Keeps the feet cold and to bring down the swelling. As most of the time attacks will be occurring in spring and fall the bed won't be in danger of freezing. Keep ice going for the first 48 hours. Alternatives of course is ice in a tub done throughout the day.

I also agree management should be what best suits a horse. A couple of years ago Stella got a really bad stone bruise. In fact vet thought maybe it was in the coffin joint. Well the joint had been infected. So we gave her a huge padded boot. The layers on that thing were unreal. Huge doses of antibiotics. As it was the only nice dry period of the summer he suggested I make her a pen in the hardcore of one of my paddocks. She had her hay and water out there. It worked brilliantly. She was happy and thankfully no infection in the coffin joint.

Terri

 

[Oberon]

When would you say the acute phase is over, Oberon? My girl is now sound without bute in her boots, but still lame on her right front on hard or stoney ground without her boots. I was wondering whether to turn her out for half an hour in the arena tomorrow. But I know she will hoon about a bit.

It depends on the primary cause of the lami as to how long the danger period is.

If a horse has a lami attack due to systemic inflammatory disease (such as grain bin incident) and no other factors - then I would expect the acute phase to last 48 - 72 hours.

If a horse suffers from hyperinsulinaemia and the horse is still on grass and sweet feed - then I would expect the problem to linger.......

 

[Beatrice5]

Sorry to drag up an old thread but have found this really useful as pony has gone footy with this flush of grass Not lame but not striding out so I am sure we have caught this very early ( fingers crossed )

So hay is soaking tonight and he is out tonight in bare paddock as I don't want him in the corral with the mares and eating dry hay so I thought the bare paddock the lesser of two evils.

The plan is to have him in the hardcored coral tomorrow with small haynets that are soaking tonight split up over the day then out again in bare paddock at night - Do you agree with this or have any other suggestions ?

He is rounder than I would like but not an apple shape, cresty which I struggle to manage to erradicate totally even naked in the worst of winter and barefoot. Feet are warm to touch but not able to feel a pulse ( tips on finding a foot pulse appreciated)

As a kid we had a lami pony but it was a different situation as we had stables and pens as it was on a proper yard. I am trying to juggle 2 horses and a pony at home with only 1 corral, a few acres and no stables so compromise is the word of the day. If I had facilities I would bring him in penned 24/7 until he is striding out better.

Advice and management tips appreciated.

 

[khalswitz]

As we always grass-keep our horses year round, I find box-rest gets everyone very stressed. With lamis, I have always gone a half-way house - I electric tape a 12x12 of sand/bare earth in view of other horses in nearby fields, with soaked hay/happy hoof. Stops too much movement in the acute stages, but horse is still out and not stuck inside. I then make the 'pen' bigger as foot can cope with more movement, and keep them off grass entirely until flare-up is over, then onto starvation paddock.

 

[Pearlsasinger]

Someone I know manages her laminitis-prone, possibly Cushingoid pony with magnet leg-wraps, as well as the other obvious measures.

 

[holeymoley]

Likewise mine had just the start of it but was sore . He got Bute the first night and left on box rest for two weeks on a good deep bed. He went into a spare stable while mucking out and had a wee wander around the arena purely for his sanity but he was happy to stay in. When he was ready to go on grass again , he was on a strip the size of a stable and then that gradually increased .