Laminitis set back :-(

RubysGold

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For those following mine and Roos progress. She has been doing so well. Over the past six weeks we were able to build her up to two hours turnout a day. Taken it really steady.

But today she has pulses and is a bit slower in her walk :-( Im not sure what I've done wrong. She still has a big deep bed, soaked hay. Muzzle on for her daily turnout. Prascend tablet every day. Ive gone by the book.

So I'll keep her in for the next few days and hope that the pulse goes down again.
So frustrating :-(
 
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Crackerz

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Oh no :( So upsetting for you

It may well be not enough box rest? Not sure how much you've done. The lami clinic advises 6-8 weeks solitary box rest which some people think WHOA at but more often than not it's what's needed ime (not read up on your story, will go look now) (edited to add - seems like you done plenty of box rest!! it's just one of those things :( )

How did the latest set of xrays look?
 
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Tyssandi

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Oh no

following Ruby's story

My boy is on box rest for his first bout of lami - vet tomorrow.


Wishing Ruby well

Have you thought of breaking that into small amounts if poss, 1/2 hr then in one hour etc or 1 hour then in 2 hours and out 1 hr???

Also soak her hay 24 hrs as when she is out she is eating loads rich grass, it is what I will do for my boy now in summer soaked hay so when he is in he is not getting protein from hay.


So ruby wont get sugars as well from the hay after being out for her 2 hrs
 

Wagtail

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You are doing nothing wrong. It is a hellish thing to deal with. My poor mare fought it for three years before we finally had to give up our fight. She went from 620kg to 470kg and was a 2 condition score but still the lami continued. Poor lass.
 

WandaMare

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I'm sure you haven't done anything wrong, this is quite typical of lami so don't get too disheartened. The reasons I found my pony's lami might flare up again even though his regime wasn't changing was usually because of a difference in the hay. Not all bales are the same in terms of their sugar content so you only need to get a slight uplift in the sugars to cause a problem, even though you are soaking for the same time. So I would then soak for longer ( I read in H&H that 16 hours at 16 degrees was the best although I know a lot of people have different ideas, but anyway I used this as a guide). So if nothing else has changed, try soaking the hay for a few hours longer. Also, I found he got pulses again in winter when the temp dropped because the hay didn't soak as effectively when the water was cold so its worth watching out for this too.

Another thing I didn't realise until I went to an evening talk at my vets on lami, was that little flare ups of lami after the main attack aren't necessarily caused by the same thing which triggered it in the first place. Because the laminae have been damaged by the first attack, they are weakened and inflamed, a bit like a sore that has healed but then gets mechanically aggrevated again. So a particularly energetic run around in the field on a bit of hard ground or a bucking spree in the arena might be enough to aggrevate the feet until the laminae are nice and healthy again, and this will take months, not weeks. So what I did with my pony was to build him a woodchip pen on my yard where he was still close to his friends, but I found that this stopped what I had thought were further attacks of lami. The reason was because his feet were on soft ground so the laminae were able to recover properly.

Is she on Metformin, I found this helped too. I was able to keep my boy sound and stop him getting lami at all eventually but only after a good year of experimenting and learning about his triggers. I know your horses triggers might be different but I thought I would share this anyway in case any of it helps.
 

MrsNorris

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Can you turn out very early in the morning? Mine is going out muzzled at 5:30am and back in between 9 and 10. The sugar levels in the grass are at their lowest then.
 

BlackVelvet

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Chances are she is just sensitive to changes in the grass, mine was always super sensitive to sugary grass so we always went back to basics, off the grass then build the time up gradually again.

Have you had her tested for EMS?
 

eggs

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I had a 17 hand horse get stress laminitis after his feet were trimmed too short. It was a real roller coaster ride with many setbacks even during his 12 weeks of complete box rest. He did finally make a full recovery.
 

Crackerz

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Oh no

following Ruby's story

My boy is on box rest for his first bout of lami - vet tomorrow.


Wishing Ruby well

Have you thought of breaking that into small amounts if poss, 1/2 hr then in one hour etc or 1 hour then in 2 hours and out 1 hr???

Also soak her hay 24 hrs as when she is out she is eating loads rich grass, it is what I will do for my boy now in summer soaked hay so when he is in he is not getting protein from hay.


So ruby wont get sugars as well from the hay after being out for her 2 hrs

The Lami clinic themselves tell you 30 mins to soak hay for a laminitic, very maximum an hour as the fermentation process kicks in much quicker than people first thought.
 

WandaMare

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The Lami clinic themselves tell you 30 mins to soak hay for a laminitic, very maximum an hour as the fermentation process kicks in much quicker than people first thought.

Yes I heard that too but having soaked hay for much longer than that for years and seen the difference that the extra time soaking makes to a laminitic that is proving very difficult to stabilise, I don't know what else people can do. I soaked hay for a COPD horse for over 10 years and the fermentation never did her any harm, she lived well into her 30's. Do you know what the risks of the fermentation are, I would be interested to know. I've always run another tub of clean water to dip my soaked hay in before feeding so that its clean of any dirty water, wonder if this eliminates any potential negative effects
 

Christmas Crumpet

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Yes I heard that too but having soaked hay for much longer than that for years and seen the difference that the extra time soaking makes to a laminitic that is proving very difficult to stabilise, I don't know what else people can do. I soaked hay for a COPD horse for over 10 years and the fermentation never did her any harm, she lived well into her 30's. Do you know what the risks of the fermentation are, I would be interested to know. I've always run another tub of clean water to dip my soaked hay in before feeding so that its clean of any dirty water, wonder if this eliminates any potential negative effects

I always drain my hay, hang it up and then pour buckets of fresh water over the top of it. I only stop rinsing it when the water coming out of the bottom of the haynet is clear as opposed to that sort of browny colour.
 

Tyssandi

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I just had the vet out to my boy as last week he had a pulse in all 4 feet so called the vet. Who came down and said Lami as pulse in all 4 feet and heat.

1 week box rest soaked 24 hr hay 11 pounds in total for the whole day bute and cold hosing.

Today's vet said feet are cool no pulse and he can go out 2 hours in the ponies starvation paddock for the next week.

Try different regime, tweaking things can really make a difference
 

WandaMare

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I always drain my hay, hang it up and then pour buckets of fresh water over the top of it. I only stop rinsing it when the water coming out of the bottom of the haynet is clear as opposed to that sort of browny colour.

Yes maybe thats what makes the difference. Also haylage is fermented isn't it and they eat that ok, I would like to understand more about the fermentation risks
 

JillA

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If she is on a deep bed, do her feet have any support when she is out in her paddock? Hoof boots with decent pads are really important to support the pedal bone when the bed can't http://hoofrehab.com/BootArticle.htm
I have Easyboot Transitions plus the green thick pads for mine and it has meant he can move and stimulate hoof growth while still having the essential support. Lots of information on The Laminitis Site too.
Much depends on whether she still has inflammation of the laminae (active laminitis) or the pedal bones are at risk because the laminae are damaged and not supporting it.
 

RubysGold

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Thanks for all your replies
I felt Roos pulses today and could only find one very very lightly, not sure whether it was a 'normal' pulse as so light. kept her in and will see if I can feel it tonight and tomorrow.
Thinking about it, it is probably my fault :( She had slowly built up to one and a half hours turnout in the morning, so I thought it would be good for her to go out in the afternnoons as well so I introduced 30 minutes at night. I think that was possibly the reason :/

crackerz she was on box rest for three months and sound for at least 30 days before turnout
Tyssandi sorry to hear you have one with lami :( Its an awful thing!
wandamare no she doesn't have the metformin but she does have prascend. I soak most of her hay for one hour, and some of it all day so she can have hay when I arrive in the evening. And I always run the hose over it to get rid of the nasty water
Ester Is that the cushings blood test? She had the one at the end of March and the vet said she would do another in 6 months. So September.
JillA she has really lightweight heart bar shoes on so has support at all times
 

RubysGold

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Yes quite possibly

It may be irrelevant but she was silly when I rode the other day, chin touching chest and bouncing sideways instead of just walking so maybe that didn't help. The pulse is near enough gone today and I haven't led her out so not sure on her walking
 

Tyssandi

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Thanks for all your replies
I felt Roos pulses today and could only find one very very lightly, not sure whether it was a 'normal' pulse as so light. kept her in and will see if I can feel it tonight and tomorrow.
Thinking about it, it is probably my fault :( She had slowly built up to one and a half hours turnout in the morning, so I thought it would be good for her to go out in the afternnoons as well so I introduced 30 minutes at night. I think that was possibly the reason :/

crackerz she was on box rest for three months and sound for at least 30 days before turnout
Tyssandi sorry to hear you have one with lami :( Its an awful thing!
wandamare no she doesn't have the metformin but she does have prascend. I soak most of her hay for one hour, and some of it all day so she can have hay when I arrive in the evening. And I always run the hose over it to get rid of the nasty water
Ester Is that the cushings blood test? She had the one at the end of March and the vet said she would do another in 6 months. So September.
JillA she has really lightweight heart bar shoes on so has support at all times


Well vet out today and no pulse no heat in feet and gone out on the ponys starvation paddock. 2 hrs for this week then move into the back fields which are being eaten down by the others and build up to max 4 hours.


Vet said max 4 hours and keep hay soaked I will watch him like a hawk
 

RubysGold

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Checked pulses this morning. They weren't there so I let her out for one hour. She walked absolutely fine. Brought her in and could feel the pulses again so it's definitely there.
Going to ring the vet on Monday but for now will just keep her in on soaked hay.

Tyssandi that sounds good for your horse. Is the maximum four hours forever? I don't know what Roo will be allowed to have long term
 

ester

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I really would get her levels tested again, and if they are ok query whether it is just cushings or whether she has EMS/IR going on too.
 

_HP_

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If she has laminitis, she has EMS
I would be looking at getting tested for that as well as rechecking her acth levels. This will give you a guide as to how sensitive to the grass she is and help you to work out how much she can cope with.
 

RubysGold

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Can they test both things with one blood sample or will that take two tests? I will definitely speak to my vet and ask her to test her
I thought losing weight would make her less insulin resistant? But maybe that's just a rumour I heard.
If she does have ems, then what? Is that when the metformin comes into play? Seen that drug mentioned a lot.
 

Crackerz

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Can they test both things with one blood sample or will that take two tests? I will definitely speak to my vet and ask her to test her
I thought losing weight would make her less insulin resistant? But maybe that's just a rumour I heard.
If she does have ems, then what? Is that when the metformin comes into play? Seen that drug mentioned a lot.

Even lean fit horses can be insulin resistant, it's not all to do with weight. Just like humans, the only diabetic people i know have been slim all their lives :)
If it's EMS then yes, Metformin is used - it's more tablets than Prascend normally, i think my friends pony has 8 a day! Not sure on costs though.

I believe you would need 2 different blood tests though, but someone might correct me :)
 

_HP_

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Metformin can be used but it's really only useful if your horse can't be exercised ie on box rest with laminitis.
Diet and exercise is the best way to go.


Taken from The Laminitis Site:

What is the difference between EMS and PPID?
Horses with both EMS and PPID can have regional adiposity, hyperinsulinaemia and laminitis. Horses with PPID are often, but not always, insulin resistant. With PPID, it is the loss of dopamine producing neurons that ultimately leads to hyperinsulinaemia. With EMS, it is likely that obesity, lack of exercise, genetics and diet can all lead to hyperinsulinaemia. Testing for PPID using the resting ACTH concentration should differentiate between a horse with EMS only and a horse with PPID (although tests are not 100% accurate). This is important because a horse with unrecognised PPID that is being treated only for EMS is unlikely to improve significantly without pergolide. There is currently no reason to think that a horse will benefit from pergolide if it has EMS but does not have PPID.
http://www.thelaminitissite.org/irems.html
 
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