Laminitis - Severe Rotation - help and advice please?!

[zoeross0]

Hi, I wrote a post on here a few weeks ago regarding my 7 yr old selle francais x tb mare, who had acute laminitis after receiveing steroid injections for lymphangitis.
She has been on box rest now for 6 weeks and is moving slightly better.
She had x-rays just over 2 weeks ago and they showed some rotation in her right foot, none in her left.
Since then she has had styropads on, bute and sedaline.
Yesterday she was x-rayed again and walked alot better on the yard. Unfortunately the x-rays showed severe rotation now in the left foot (right foot has stabilised which is good) We think she has put a lot of weight on her left foot to cause this rotation whilst the other foot felt so bad.
Vet has said its worryingly near the sole. I havent been that impressed with my vet through all of this, I felt I had to suggest ideas and push for check-ups, we are going to seek a second opinion.
He has now suggested her on metorfin tablets which are meant to help with the metabolic side of laminitis. Ive started her on these last night as we figure we need to do something ASAP. Ive got my farrier up on thursday with the vet to look at x-rays and he has suggested a clog type of shoe put on with impression material.
I am desperate for suggestions as if it gets any worse she will have to be PTS, I am willing to give anything ago, just want to get her out the danger zone! Any advice gratefully received!

 

[karenjj]

Hi, my mare had imprint shoes on about a month ago and these have lifted her foot off the ground and helped with the rotation. I feel the same with my Vet. She's not been very useful at all!! I've ended up just working with other owner's advice and the farrier. Also a book I bought!! Try the shoes, and go with your farrier, they seem much better at helping with these things! Fingers crossed for you xx

 

[TelH]

My little gelding had rotation in both front feet and he had imprints too. Nothing else had worked for him and he too came v.close to being pts. It was a very long road to his recovery (he had 18 months-2 years off) but luckily I had a good vet and farrier and it will be 2 years next month since he started back in work and he has been sound the whole time. Definitely try imprints. Good luck.

 

[zoeross0]

Thank you both for your advice, I think it has got to the point now where I am going to have to make decisions myself and I will mention to my farrier about the imprint shoes, he has suggested clogs, so will see if they have a similar outcome? Im not even worried about rushing a recovery (am 4 months pregnant anyway with 2 other horses to ride!) just want her to be sound and healthy again and feel like we are doing something positive! Ive had her since a foal so she is very special!

 

[MurphysMinder]

Loads of good advice on this site.

http://www.laminitisclinic.org/

I sympathise because I am currently waiting for the vet to come to my Cushings pony who has had yet another laminitis attack

She has been doing well on pergolide and a strict management routine but yesterday was very foot sore so is now in and on bute and we will see what vet says.

 

[sally2008]

Give the Steward clogs a try (I am assuming that's what your farrier is suggesting) as they can bring great results by stabilising the foot which allows time for repair. I'm not a fan of Imprint for laminitis as in my view no plastic shoe is ever going to provide sufficient stability, which the foot needs when the internal structures are on the move as with your horse.

 

[karenjj]

I had to suggest the imprint shoes, the second I said it, my farrier said it was the best route!He said that was the last resort but now but if the vet had been more on the ball (she originally diagnosed Navicular) we would never have got to that stage! It was TheFarrier on here that said about the imprint shoes in the first place which made me ask my farrier. I have been using MSM as well (14.99 for a big tub online) which has really helped, this is something I read about in a book about laminitis! The really expensive stuff the vet gave me didn't work so I think it is all about making your own way through and seeing what's best for your girl! Keep us updated, you can always PM me if you want. Good luck!

 

[Honeypots]

Another vote for Imprints here...really made a difference to my lad with rotation.
Just remember box rest, box rest, box rest...when they are sore and for at least a month after they are sound on no painkillers. Even when they are sound immediately after an attack, the laminae can still be inflammed and weak and so you should still limit movement as this is what can cause more rotation.

Lots of interesting info on here:
http://www.laminitisclinic.org/

 

[zoeross0]

Yes its the Steward Clogs that my farrier is suggesting, ive got him coming on thursday with the vet so she can be sedated (shes not the quietest horse) and also my farrier can then see her sets of x-rays, the one good thing is she has become really used to box rest and doesnt even try and escape now or fuss when the other horses go out, I might give the imprint shoes people a call, see what they say, Im not sure of the pros and cons of clogs v imprints, I have used these clogs on my 30 yr old pony who had laminitis last year, she had them on for 2 months and now back in normal shoes, her laminitis was acute but she got over it within a month.
Thankyou everyone will keep you posted!
Im hoping the metorfin tablets will help too, as they are a human drug I have to get 16 tablets a day down her! Luckily she is fairly greedy and it takes a while but we get it down with speedibeet and apple sauce!

 

[Pasha]

Wishing the best of luck! I know exactly how you feel regarding the vets as I felt the same - My boy was diagnosed with Cushings and put on Pergolide following an acute attack of Lami (his first one last November).... he didn't improve on box rest and normal Lami treatment and the vets seemed happy to leave him like that until in February he had another acute attack and his sole was soo thin they thought the pedal bone was going to come through! Then they put him on Metopirone and he improved dramatically in 2 days! Wish the would have done that sooner!!!

Following the second attack, my boy wore Styrofoam pads for about 3 weeks and I had to push for clogs! However, by the time he had them on the farrier said it was a bit 'after the horse has bolted' (as I think they are for during the acute phase of lami really) and he only had them on for 5 weeks before they had to come off so he could have proper shoes back on and go out! yay!

I would definately call the Laminitis Clinic and I thoroughly recommend their hoof products to help them recover (I use the Formula4Feet and Solution4Feet) - my boy has been out in the field for 4 months now and the vet is even talking about riding him again!

 

[susannita]

I have a laminitic eventer who got toxic laminitis 2 years ago after being poisoned by mouldy feed (didn't realise til we got to the end of the bag the who lot was rotten).

Anyway, had his attack then, vet thought he had broken his pedal bone as he was hunting 2 days a wekk so not exactly prime candidate for laminitis (in january) Followed the laminitis trust to the letter, 7 months in the box in total, frog supports etc then went out and started to ride him in the field (no shoes) farrier wanted to keep the shoes off to give the foot a chance to "heal". X-rays were apprently fine throughout.

fast forward 2 years, another attack (not sure of the trigger) by this point i had already disposed of my previous vets (but had all the xrays(which have since been proven to show that there was rotation last time which they just ignored) This time have a much more switched on vet who is much more willing to treat the individual rather than do enough by the book to treat a "normal" horse which is how i felt the previous vet practise behave. So current vet wanted him out to increase the circulation and thus blood flow under the pedal bone - i wasn't keen but after 3 weeks got him out in a small paddock. (to be honest we had not a lot to lose) The vet had put solepak on his soles and also some liquid plastic to help lower the heels. (xrays taken at the time showed only 1.8 mm of sole) He was also put on 10 metformin a day (I think it is the same stuff you are talking about) (we had also used metacam instead of danilon which he seemed to respond to much better) He had 3 applications of the sole guard and took xrays before and after application (same day) which showed an imediate imrovement with the thickness of the sole (which by the end of 3 months was 7mm thick with rotation reduced from 13% to 4% in one foot.

this horse defies any text book, but this vet prefers to write rather than read the text books so it is helping. unfortunately he is not insured for this but we will get there, like you he is a very very special horse who I will do as much as i can to save (but trust me we have come very very close to making the big decision).

Horses with laminitis which are not carbohydrate induced are incredibly difficult to treat, it is not easy but good luck!

 

[Peter026]

Listen to your Farrier. the clogs have a been a huge sucess world wide.

http://www.equipodiatry.com/article_acute_chronic_laminitis.htm

 

[zoeross0]

Farrier booked with vet to attend Thursday to get these clogs on, hopefully farrier might give vet a kick into action with these sort of cases! I will let you know how it all goes, I agree that all horses are indivudual and once the box rest and bute has been going on for weeks on end, you need other options to try, thanks everyone

 

[Honeypots]

Good luck....pls let us know how you get on

 

[Janesomerset]

My friend's horse had steroid-induced laminitis with some rotation. He has imprint shoes on his front feet and is now being ridden again and doing really well. He is on umpteen tablets a day and she found the best way to get him to eat them was to crush them up, mix the powder into his feed, dampen the feed and then add dried spearmint. (Her vet said spearmint was OK for laminitics.) Works a treat! Just thought I'd mention it in case yours gets awkward about taking them! Wishing you lots of luck.

 

[zoeross0]

Hi everyone, I had the steward clogs fitted yesterday afternoon, we werent sure if she would tolerate them being nailed on so were prepared to glue or screw them on if she wasnt happy, she was sedated and we were able to nail them on no problem. It was hard to see any difference as she was doddery back to her box on all legs due to the sedative. Shes still hobbling round her box this morning but vet and farrier said it might take a few days for her to get use to them and also realise they should be more comfortable as her brain will still be telling her they they hurt anyway. Anyone whos had remedial shoes fitted, how long before you saw some improvement? Vet is popping back to check her today and my farrier is around monday for other horses anyway, I think im being impatient but want to see a little improvement!

 

[sally2008]

I've seen horses show immediate improvement when the clogs are fitted, others take a few days so don't panic if she's not looking better straight away. The important thing to remember is that they allow the optimal conditions for healing to take place so it's up to nature now to do her stuff, with the help of your vet for pain control, your farrier for adjustments as they become necessary and your management routine. I have seen horses with badly rotated pedal bones return to pre-laminitus soundness through the use of clogs at the right time in this critical phase of the disease. Keep us posted on her progress won't you.

 

[zoeross0]

Thanks for your message, in herself she is doing fine and very relaxed now on box rest, so she isnt in any distress and has got quite accustomed to it now! I did notice that she didnt lie down in the night (and she has been lying down every day and night since this) so Im hoping this is a positive sign that the feet arent quite so sore.

Ive just been speaking to Jackie at metabolichorse.co.uk (thank you to those who above who recommended) she has advised getting blood tests for insulin, glucose, blood fats to assess her metabolic status, and ACTH, which is the pituitary hormone at the root of Cushing's. Ive left my vet a voicemail to try and arrange this being carried out.

Will keep you posted

 

[brighteyes]

Jackie is THE person to listen to, so you are in good hands

 

[zoeross0]

Just had vet up to check her after the clog fitting and she wouldnt let him catch her in the box - this is a good sign as this is normal behaviour for her with vet or farrier! I arrived shortly after and caught her, he thinks theres a `mild' improvement, but the clogs will take a few days for her to be use to anyway. Hes also agreed to do blood tests as advised by Jackie at metabolichorse.co.uk and they are being done on Tuesday, thanks everyone for all the advice and im hoping she will improve slightly over the weekend

 

[zoeross0]

Update from weekend - Josie seems bright and due to my incompetence managed to walk out the box yesterday whilst I was mucking out (shes not even tried to escape so far so looking at it like a positive sign!) She only wondered a few steps and I got her back in her box, but she did seem to be walking better, vet checked her saturday and actually wrote minor improvement in her action, only day 4 since the clogs put on so im hoping she is starting to feel a bit more comfortable. Blood tests tomorrow, fingers crossed.

 

[sema01]

Maybe this reference (http://www.laminitis.org/laminitis.html) will be helpful. It discusses frog supports and also the need to ensure that supports are not too thick. Also discusses a number of surgical options --- too complex for me but in your case I think it might be worth plowing through.

In terms of preventing further acute laminitis attacks (which would make the situation worse), some of the stuff in this reference (http://wowhorses.com/laminitis.html) may be of interest.

 

[Eaglestone]

I have just seen this post and am wondering how you are getting on?

I am in West Sussex, down the road from you and am wondering who your Vet and Farrier are?

My horse had 10 degrees of rotation following Cushings Induced Laminitis, nearly 4 years ago and he is doing really well now, thanks to my Vet, Farrier and ME!

Motor had some special high heel type shoes fitted, with the impression type material, however he did not get on with these and so he went bare foot for his box rest, with a really really thick shavings bed ..... it took a long time though

PM me with any info as I don't think it is a good idea to post names of Vets and Farriers on open forum.

<<<< Vibes >>>> coming your way .....

 

[zoeross0]

Dear Eaglestone, I have PM you, a bit new to this so hopefully you got it! Am now wondering if she has an abcess as well, as her coronet band is weeping and has pus coming out of it, she is not happy with me touching it, left a voicemail with my vet so see what he says, hes due out tomorrow anyway.

 

[zoeross0]

Had vet out just now and hes really disappointed, she has abcesses in both front feet and is more uncomfortable than a week ago, so we have taken a big step back, feel really gutted, hes even on about considering PTS if she doesnt pick up, shes got antibiotics for 4 days, has anyone else had this happen?

 

[sally2008]

Whilst unpleasant to deal with and distressing for you and the horse, abcesses are natures way of dealing with the necrotic tissue within the foot that will have been damaged by the rotation of the pedal bone and are a usual feature of laminitis I'm afraid. I don't want to alarm you but I think you need to be prepared for the fact that she may get them repeatedly during the healing process. Look on them as a positive sign that mother nature is doing her stuff to repair the damage.

 

[zoeross0]

Thank you for your reply, Im feeling quite down (doesnt help Im pregnant and hormones all over the place!) just need to hear that its normal and to encourage to keep going, really felt we were getting somewhere last week for the first time and yesterday she started to look more uncomfortable again.
Hopefully the antibiotics will kick in and help her get more comfortable.

 

[sally2008]

I feel for you. You're doing all the right things by having a vet and farrier working together to provide the optimal conditions for healing to take place. Chin up and keep us posted. Sally xx

 

[zoeross0]

Ive just spent half hour on the phone with a really nice lady at the Laminitis Clinic (not getting much work done today!!!) Im going to ask my vet if we can take some more x-rays (last ones done about 3 weeks ago) and send them to Robert Eustace who then liases with my vet, she explained laminitis is so complex that my vet (in the nicest poss way) may need advice too. She said the abcesses are very common and doesnt mean the end! It means they may need a hole cutting to drain it, if they dont clear up.

Anyway my vet is back early tomorrow morning to see her, so Im going to chat with him and ask him to liase with Robert Eustace and send x-rays etc, will let you know how it goes tomorrow, dont want to offend him but my horse is too important!

 

[sally2008]

She's absolutely right. Your farrier might also wish to consult with a specialist laminitis farrier to help him in his treatment plans (David Nicholls at Total Foot Protection, Horsham is an excellent choice). I have everything crossed for you.