Laminitis and Ventipulmin (with a side of box rest ideas?)

TPO

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Anyone any experience of giving a lami horse ventipulmin or any contradictions to doing so?

My horse just went suddenly pottery so vet out and lami diagnosed. No obvious cause or trigger for it, no heat or pulses.

Horse to be box rested for 2wks then vet back out to do TRH test and glucose challenge and possibly another week of box rest. Vets best guess is that horse has some form of insulin disregulation going on but as he's only 9 he's quite young for it (although he's seen it in younger horses).

Horse has mild asthma and was stabled overnight. He was getting approx 1/4 scoop of ventipulmin as maintenance. Being in 24/7 will trigger his asthma. He already has dust extracted bedding, dampened hay and he's stabled beside barn doors which will be left open while he's in, barn also has ventilated cladding on both long sides. Vet said because we don't know what has caused the lami he's unsure if I should continue with ventipulmin right now.

Obviously I'll see how horse fares and will contact vet with any concerns but was just wondering if anyone had first hand experience of a respiratory compromised horse having lami and medication?

Also any ideas to entertain a lami horse who has never box rested before? My usual involves hiding carrots and snack balls but guessing that's not ideal for a lami horse who may have insulin issues.

TIA
 

alibali

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Sorry I've no experience of ventipulmin and lami.

I was wondering if there was any way the horse could be out on a yard for the day? Would the vet allow it? Even just a very small outside coral? Or a very small area outside the stable so he could stand outside the barn doors and go inside to lie down. Trying to think how to get him more out in the fresh air to reduce need for the ventipulmin. Boots and pads could be used to provide similar support to his feet as a deep bed. I guess it depends on your setup and your vets opinion as to what's possible.

I have a lami prone pony myself so you have my sympathy. Fingers crossed he comes right quickly
 

Pinkvboots

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I don't think the ventipulmin is dangerous to feed to on its own to lami prone its when it's prescribed alongside steroids when it becomes an issue, but I could be wrong?
 

Pinkvboots

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Sorry to hear about that 😞 there is a really good drug they use now for insulin problems in horses, my friend used it for her pony and it literally turned her around from almost pts to being completely sound in a week.
 

TPO

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Sorry I've no experience of ventipulmin and lami.

I was wondering if there was any way the horse could be out on a yard for the day? Would the vet allow it? Even just a very small outside coral? Or a very small area outside the stable so he could stand outside the barn doors and go inside to lie down. Trying to think how to get him more out in the fresh air to reduce need for the ventipulmin. Boots and pads could be used to provide similar support to his feet as a deep bed. I guess it depends on your setup and your vets opinion as to what's possible.

I have a lami prone pony myself so you have my sympathy. Fingers crossed he comes right quickly
Thanks alibali

Already asked vet, and I have boots and pads, but he said no. Horse to be in bedded to the door for two weeks.

I do have an outside passageway from the barn to the gate, that's where he was this morning while waiting so that he could see the other two, so vet has seen that set up. Still a no, he's to be in 😬

I've googled and can't find anything related to contradictions of giving ventipulmin to lami horses. Vet is more concerned because there's seemingly nothing to have triggered this attack so concerned over making anything worse iykwim. The TRH and glucose tests will be in 2-3wks so he's ro be in at least until they are done.

TBH horse gets such a minimal dose normally but I can forsee that increasing while he's in. It's been dry and our hay is stored in the same barn. The double doors at the end and the sliding door beside his stable will all be open to try to help.

Thanks for the replies
 

Red-1

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It was a year after his actual Lami attack, but he was on Ventipulmin as a Lami prone horse and it wasn't an issue.

I would have thought your vet would be able to give quick and free advice on this?

My vet did say that Ventipulmin will become less effective the longer it is used. It then needs a rest before it can be used again.

For a Lami attack, I would contact Simon at Trinity Consultants. I think their L94 made a difference to Rigs.
 

alibali

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Ah that's a shame, it's very difficult balancing two different issues with two very different management requirements. I do see your vets point of view though, the laminitis is the more urgent issue at present. I guess you'll just need to do the best you can ventilation wise and cross the asthma bridge if/when it arises. Best wishes
 

TPO

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It was a year after his actual Lami attack, but he was on Ventipulmin as a Lami prone horse and it wasn't an issue.

I would have thought your vet would be able to give quick and free advice on this?

My vet did say that Ventipulmin will become less effective the longer it is used. It then needs a rest before it can be used again.

For a Lami attack, I would contact Simon at Trinity Consultants. I think their L94 made a difference to Rigs.
I was just searching your posts as I was sure you'd posted about Rigsby having the glucose challenge but I can’t find anything.

I wasn't at the visit because of work/illness and vet is uncontactable currently because he's fully booked all day. I got an emergency appointment so they shuffled things around to get there.

The prescription needed renewed so when I made the appointment I asked if that could be done. Thel vet mentioned something to my mum about being unsure about Ventipulmin while we don't know what triggered this attack but that's all the info I have. Something may have gotten lost in translation, I can't find any links online to Ventipulmin and lami and I've had a new prescription emailed through by the office staff. Hence asking for experiences.

I know that a resistance of sorts can happen with Ventipulmin and horse's breathing is checked at least once a year. He gets a miniscule dose so my usual vet isn't concerned in the slightest. There is plenty of scope to up the dose and if it ever stops being as effective he's a big fan of the flexiair (sp) inhalers.

I'll have a look at Trinity but I'm wary of trying things when we don't know what has triggered this attack. Thanks though
 

Red-1

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I was just searching your posts as I was sure you'd posted about Rigsby having the glucose challenge but I can’t find anything.

I wasn't at the visit because of work/illness and vet is uncontactable currently because he's fully booked all day. I got an emergency appointment so they shuffled things around to get there.

The prescription needed renewed so when I made the appointment I asked if that could be done. Thel vet mentioned something to my mum about being unsure about Ventipulmin while we don't know what triggered this attack but that's all the info I have. Something may have gotten lost in translation, I can't find any links online to Ventipulmin and lami and I've had a new prescription emailed through by the office staff. Hence asking for experiences.

I know that a resistance of sorts can happen with Ventipulmin and horse's breathing is checked at least once a year. He gets a miniscule dose so my usual vet isn't concerned in the slightest. There is plenty of scope to up the dose and if it ever stops being as effective he's a big fan of the flexiair (sp) inhalers.

I'll have a look at Trinity but I'm wary of trying things when we don't know what has triggered this attack. Thanks though
No worries, yes we did the Caro Sugar challenge test. I was bricking it in case it brought on an attack. After 6 months of no sugary feeds, soaked hay and no grass, to deliberately feed him thick sugar syrup was very worrysome.

|I think he had to be proper starved for 6 hours. So, I was in his stable at 3.30am so he could have a net, which was removed for 6.30, so he could be starved until 12.30. The vet said that starving them left a bit of capacity for the sugar not to be so dangerous. He had work after the test, to use up some of the sugar too.

Rigs had Ventipulmin, 2 tubs, and that was enough as his is an allergy type reaction. I actually found antihistamines to be as effective. The vet said that, this year, I should start the antihistamines earlier, before the allergy, to try to stop it coming. It went as soon as it came, although for a while it was bad enough I thought that the asthma would be what saw him off!

We spoke about steroids, it isn't ideal but the vet said it may just have to be a calculated risk if I can't control it otherwise. He thought that inhalers were not totally risk free, but are maybe not as bad as I might think.
 

TPO

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No worries, yes we did the Caro Sugar challenge test. I was bricking it in case it brought on an attack. After 6 months of no sugary feeds, soaked hay and no grass, to deliberately feed him thick sugar syrup was very worrysome.

|I think he had to be proper starved for 6 hours. So, I was in his stable at 3.30am so he could have a net, which was removed for 6.30, so he could be starved until 12.30. The vet said that starving them left a bit of capacity for the sugar not to be so dangerous. He had work after the test, to use up some of the sugar too.

Rigs had Ventipulmin, 2 tubs, and that was enough as his is an allergy type reaction. I actually found antihistamines to be as effective. The vet said that, this year, I should start the antihistamines earlier, before the allergy, to try to stop it coming. It went as soon as it came, although for a while it was bad enough I thought that the asthma would be what saw him off!

We spoke about steroids, it isn't ideal but the vet said it may just have to be a calculated risk if I can't control it otherwise. He thought that inhalers were not totally risk free, but are maybe not as bad as I might think.
Vet offered the Caro Sugar as an option if Chip wouldn't eat the glucose but he's the unfussiest horse ever so we should be OK.

Yes they said about 6hrs starvation too. Apparently a blood sample initially and then 6hrs+ later? So the receptionist is trying to coordinate diaries for 2wks time as there are currently no morning spaces 😬

Chips asthma is the result of being on a yard with infected horses where the owners didn't get a vet (& continued to ride their ill horses). Typical not my luck, despite getting vet ASAP and taking all precautions, Chip was left eith mild asthma. Three tubs last us a year and he can usually come off it in spring and autumn but over winter 1/4, or less, scoop keeps him cough and wheeze free.

In my vets defence when we last spoke about inhalers Chip wasn't a lami risk. Using steroids will be riskier now thst he's had this attack I'm guessing.

I've just spoken to Trinity and ordered L94 🀞
 

nutjob

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I had a horse which had a very bad laminitis attack. He was subsequently given quite a lot of ventipulmin and also inhaled steroids, but they were after he had recovered from the laminitis attack.
 

ihatework

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Theoretically I cannot see how the mechanism of ventapulmin would be linked to laminitis. But never say never. It’s unlikely though.

Quite a few years ago, I had a weird horse. He is actually still going and happy, out on loan as a companion/hack.

To this day I don’t truely understand what was going wrong with him, but suspect it was very much metabolic and I think I was done over buying him.

I got him as a 5yo having passed a vetting with a top vet with zero comments. Shortly after he developed stringhalt. He also over a period of about 18 months had seriously fluctuating energy levels - from depressed/dead as a dodo to cheeky and jolly and pingy, and varieties of inbetween.

At various points in time we did all sorts of things. An initial blood test indicated a worm burden which was dealt with and normalised. A later blood test showed high inflammatory markers which combined with an increased resp rate, trach wash, dynamic scope settled on a diagnosis of mild allergic asthma - treated with ventapulmin and steroid inhaler.
Still not convinced we had solved the issue.
Horse then had an accident on horse walker with orthopaedic consequences that pretty much put paid to any lingering hope of competing. Was turned away.
Come spring had weird fat distribution and started to look borderline laminitic. Barn rested and I insisted (much to vets amusement for a 7yo) he be tested for Cushings. ACTH >150. Non responsive to prascend and continued to rise to over 250. Seriously unhappy horse with huge side effects from prascend.
Took off prascend, gave daily bute, lowered all ridden expectations and he has pottered on reasonably well for about 8 years now.

Complicated and we will probably never really know what is wrong. My gut feel is the acth was a false positive from pain/stress and that he has some sort of IR/PSSM and has some LGL (combined with the accident/orthopaedic)
 

Schollym

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Anyone any experience of giving a lami horse ventipulmin or any contradictions to doing so?

My horse just went suddenly pottery so vet out and lami diagnosed. No obvious cause or trigger for it, no heat or pulses.

Horse to be box rested for 2wks then vet back out to do TRH test and glucose challenge and possibly another week of box rest. Vets best guess is that horse has some form of insulin disregulation going on but as he's only 9 he's quite young for it (although he's seen it in younger horses).

Horse has mild asthma and was stabled overnight. He was getting approx 1/4 scoop of ventipulmin as maintenance. Being in 24/7 will trigger his asthma. He already has dust extracted bedding, dampened hay and he's stabled beside barn doors which will be left open while he's in, barn also has ventilated cladding on both long sides. Vet said because we don't know what has caused the lami he's unsure if I should continue with ventipulmin right now.

Obviously I'll see how horse fares and will contact vet with any concerns but was just wondering if anyone had first hand experience of a respiratory compromised horse having lami and medication?

Also any ideas to entertain a lami horse who has never box rested before? My usual involves hiding carrots and snack balls but guessing that's not ideal for a lami horse who may have insulin issues.

TIA
Do you soak your hay or just spray it with a hose. We jus used to damp it but our vet recommended soaking for 20 minutes for dust/ spores and over half an hour to reduce sugars. We have two that have breathing issues and a fat one so have to work on timings.
 

SEL

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I'm sorry you've got a poorly horse TPO. Is the vet not concerned that doing the glucose test on a horse he believes has laminitis is going to make things worse? I never really understand why they do that test given no one with an at risk horse is going to pump it full of sugar. Pulling bloods an hour after their normal meal is much more realistic. I've had the test myself and my blood glucose levels went through the roof and left me feeling rough for about 48 hours - it isn't pleasant!

Do you have x rays to confirm it is laminitis? Box rest is recommended whilst the pedal bone is unstable but that can only really be confirmed with x rays.

I've fed ventipulmin to two sugar intolerant horses without issues (one has EMS, the other has PSSM and can get elevated insulin levels at times due to a problematic thyroid). In neither case did the vet flag it as a risk, but they did flag the steroid inhalers as a risk for the EMS one who struggles with pollen. I thought it was just an airways dilator, but just been on google and apparently it can mimic a steroid so perhaps that's what your vet is concerned by
https://www.webmd.com/pain-management/what-you-need-to-know-about-clenbuterol-for-bodybuilding
 

TPO

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Do you soak your hay or just spray it with a hose. We jus used to damp it but our vet recommended soaking for 20 minutes for dust/ spores and over half an hour to reduce sugars. We have two that have breathing issues and a fat one so have to work on timings.
It's being soaked in a haycube for 20mins. It was steamed in a haygain before but he improved so I sold it a year or so ago; typical!

I (my mum) has a fat one too so his hay is properly soaked and rinsed.
 

TPO

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I'm sorry you've got a poorly horse TPO. Is the vet not concerned that doing the glucose test on a horse he believes has laminitis is going to make things worse? I never really understand why they do that test given no one with an at risk horse is going to pump it full of sugar. Pulling bloods an hour after their normal meal is much more realistic. I've had the test myself and my blood glucose levels went through the roof and left me feeling rough for about 48 hours - it isn't pleasant!

Do you have x rays to confirm it is laminitis? Box rest is recommended whilst the pedal bone is unstable but that can only really be confirmed with x rays.

I've fed ventipulmin to two sugar intolerant horses without issues (one has EMS, the other has PSSM and can get elevated insulin levels at times due to a problematic thyroid). In neither case did the vet flag it as a risk, but they did flag the steroid inhalers as a risk for the EMS one who struggles with pollen. I thought it was just an airways dilator, but just been on google and apparently it can mimic a steroid so perhaps that's what your vet is concerned by
https://www.webmd.com/pain-management/what-you-need-to-know-about-clenbuterol-for-bodybuilding
I'm presuming that vet isn't concerned because it was him thst instructed the test. Chip isn't a "typical" lami horse so checking insulin seems a logical step. The vet is really stumped as to why this has occurred. It is a very mild case but vet wants to take every precaution and err on the safe side so horse is on box rest until 5 April. The vet is out then for the tests and he'll reassess him then. Obviously if he deteriorates before then the vet will be called straight away.

Horse was comfortable in his stable last night and my mum has phoned to say that he's even better this morning. The horses are at their home so she has been popping out to check on him regularly while the others are out.

The vet didn't take xrays or think thst they were required at this point. Another presumption by me but guessing because its such a mild case and no heat, pulses or any form of reaction to hoof testers. I was thinking that once he gets the "ok" I'll get xrays done for once of mind and to have a record.

I had a lami prone pony when I was younger and lost her due to pedal bone rotation after an acute attack. This was back in the dark ages before IR/EMS was really a thing as she wasn't fed, was in work and was a fit and healthy bodyscore. With hindsight and current knowledge there must have been something else going on other than just "native type ponies get lami".

Chip really isn't bad, he was slightly pottery and as I didn't see him from the description I was assuming abscess. I couldn't get there so called the vet fully expecting them to dig a hole and poultice. Like I said the vet has been a bit flummoxed by the case too. Chip is very (too!) bright in himself and other than that potteriness (new word) there are no other indicators of lami. I think it was more a case of the vet thinking out loud when he said about Ventipulmin and it was only in the mix because I decided to get the most out of the visit and get my prescription renewed while.

Along with my thoughts about xrays I was also thinking thinking that this might limit the options should he ever need something steroidal for his asthma but I'll cross bridges when I get to them. As it stands he only had an initial course of steroids back when this started years ago and its always been plan b to have the inhaler should he ever need it.
 

Hepsibah

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I can't recommend the laminitis site enough: https://www.thelaminitissite.org/
They have the most up to date research from around the world in one place and it was invaluable when Daisy had laminitis with rotation in all four feet and had to be on box rest.
Keeping them busy when in is all about slowing their feeding down so small holed nets or double netting, hanging the net free so they can't pin it down to get the hay out easily, splitting the feeds into several smaller nets and feeding them at intervals through the day. I was concerned about ensuring she had plenty of fibre so would leave a large trug of dampened topchop zero chaff for her to eat overnight. She didn't like it and would only eat it if she was ravenous but it was low calorie enough to be considered negligable in terms of her diet and kept her belly happy.
 

laura_nash

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My vet was happy for mine to have ventipulmin with suspected lami. Said the anti inflammatory affect might be helpful if anything, and we really didn't need another issue with his breathing. It turned out to be a hoof injury rather than lami with him though. For box rest I also used lots of Top Chop zero (it wasn't lami, but he was still a risk for it so was careful with diet).
 

ycbm

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. She didn't like it and would only eat it if she was ravenous but it was low calorie enough to be considered negligable in terms of her diet and kept her belly happy.

Just in case other people want to try Top Chop Zero, I gave my fatty mare a trug of it to pick at. The first night she hardly touched it and I was pleased I'd found an easy answer to feeding her. The next night she ate 5 kilos of it, she decided she loved it!
.
 
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I'm Dun

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try a hay ball, they tend to either love them or ignore them, but it does give them a bit more stimulation than a haynet, and slows their eating right down as well
 

Hepsibah

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Just in case other people want to try Top Chop Zero, I gave my fatty mare a trug of it to pick at. The first night she hardly touched it and I was pleased I'd found an easy answer to feeding her. The next night she ate 5 kilos of it, she decided she loved it!
.
There's always one isn't there! Still, with 4mj of digestable energy per kg, it's a full belly with hardly any calories even compared with soaked hay.
 

TPO

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Thanks for the replies.

He has a haycube with soaked hay (for dust mainly), I have a hayball but not tried that in the stable yet and he gets one of the "diet" halleys blox in a wee blox net too.

His feed has already been changed to just a tiny sprinkling of Fast Fibre and Pink Mash pellets to get his bute and ventipulmin. His chaff has been swapped to Fat Cobs Top Chop zero too.

His breathing has gotten worse and he has started coughing. He was on 1/4 scoop of ventipulmin a day but he's now getting it twice a day and dose has increased. He coughed for an hour solid on Monday night πŸ˜₯

I laid a matted trail from his stable to field gate on Sunday. The horse half of the shed is all rubber matted so I walked him up the mats into an empty stable to muck out. He was completely comfortable on his feet so I lead him outside on the mats. He had just over an hour tied outside on the mats to get some fresh air.

Anyway I spoke to the vet yesterday about the coughing and he has said that if Chip is comfortable he can have a section the same size as his stable in the walkway from the shed to the field to be outside in the fresh air. As he's fine on his feet the issue is now his asthma.

I had him out in the arrangement for an hour last night but the eejits insisted in playing the face biting game over the gate πŸ™„ I need to rethink how to go about it tonight.

So he was sound and comfortable, albeit always on rubber matting, excluding the face biting larking about resulting in some off mat moments 😬

The vet was saying he still doesn't know or understand why Chip was sore on his front feet. He was better in a couple of days but he has been on bute; 2 a day for 4 days and now onto 1 a day for ten days. However the vet doesn't want Chip moving because of the damage that could cause the laminae...but if it isn't laminitis then there is no weakening or damage?

Vet out Tuesday 5th to do the glucose and RTH tests so we should know something more definite once those results are in.

Daft question but would xrays show if laminae were damaged even if no pedal bone movement?
 

TPO

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I don't think so - I've just had hoof x rays for another reason and you can't see the laminae on them, just the position of the bones.
That's what I was thinking.

The white line looks tight and there's never been sensitivity in his hooves (other than being pottery; no reaction to hoof testers or heat). I know it might take a while for bruising to show or come out in the hoof.

Just wondering how to tell if there is any internal damage if it is/was lami and if it wasn't lami what the flip it was πŸ€”

Also worried if it wasn't lami that it's still recorded as lami and might after drug options should his asthma worsen and/or ventipulmin stops being affective 😬
 

GoldenWillow

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My mare developed acute laminitis when on oral steroids for asthma, so you have all my sympathy in managing the two together. In her case it was clear cut both that it was laminitis and the cause. She was treated with ventipulmin both during laminitis and afterwards with no problems although it effectiveness decreased noticeably after a few years. Her breathing was also managed with steroid inhalers with no further laminitis episodes, had flexinebs been available then I would have used them. This was 16 years ago.
 

ycbm

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Daft question but would xrays show if laminae were damaged even if no pedal bone movement?
Not daft I don't think. They might show if they are dead and missing in patches or creating gas from decaying. Most likely at the toe, like this seems to be showing.


. Screenshot_20220330-205527_Chrome.jpg
 

TPO

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I think, if it is lami, it was so mild that there more than likely wouldn't be a rotation...not that I have xray eyes.

Also probably clutching at straws but tonight I found a crusty hole on the top of his off fore lateral heel bulb. It was out the hairy bit at the top (technical terminology) well above the cornet band. Could that be an abscess exit point?

I've had a horse burst out of that area several times but he had a chronic abscessing problem. I know that they usually exit the path of least resistance and it is odd to pop out sort upwards.

It would tie in with being lame off fore originally and no reaction to hoof testers? Then bilaterally lame if compensating 12hrs later? I didn't see the lameness at all and mum only managed to send once rubbish video with her filming and leading. He was sore in it but was also walking over a surface with loose stones on top of haed ground so not ideal.

He's pretty stoic about abscesses and I've only ever noticed them after they've burst. Just a slit in a heel bulb or once a tiny hole in his sole that th trimmer found. In nearly 8yrs of owning him I think that's happened 3x max.

Also vet said that he had thin soles. He's been barefoot his whole life and trimmers have always commented on how good his hooves are. Current farrier says nothing (at all hoof related) but I'd hope he would if there was an issue, I'll make a point to ask him next visit. Just seems strange that Chip had always been sound and hasn't needed boots, plus zero reaction to hoof testers, yet he apparently has thin soles. Not the best measure but I can't get any flex pressing on them and zero reaction from him.

Now I'm wondering if I should proceed with TRH test and glucose challenge.

He came in lame late Monday night, off fore according to mum but she's not the best at spotting lameness, and ten both fronts Tuesday am so I called vets when they opened at 8. I didn't go over Monday night because I was ill and I was working Tuesday so called vet rather than look myself. So other than that one bad video I haven't seen him lame. Tuesday night he was maybe slightly short in thr stable but he'd also had a painkiller jag am and a bute pm. He's been totally comfortable since Wednesday of last week but he has been, and still is, getting bute.
 
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