Laminitis - Still lame - hoof pictures

Wagtail

Wagtail

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My girl is still happy and perky but is footy. Especially her left fore. In the past she has always had laminitis primarily in her right fore. Now that is virtually rock crunching, but she has it in her left. I poultice it for 24 hours, but no puss came out and didn't want to soften up the hoof too much so stopped.

She has bruising on her heel from the hoof boots she was wearing. So I have stopped using them for now, until I can get some pastern wraps to protect them.

Anyway, is there anything you can see with her foot that would point to any issues? As you can see, she is very lean. The vet was very pleased with her weight. Her Cushings is under control (levels are 19.5), she is on one prascend a day, and 20 metformin. Vet is stumped as to why she still has symptoms.







You can see some bruising here:





 
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Firsty, she looks fab! I real credit to you and all your hard work.

Secondly, could she still be suffering from a slight bit of lami? how long has she been better? if i remember rightly my boy was 'sore' for about 7-8 months after orginally getting lami and that was with no rotation. The vet said he had very little pain threshold for such a big horse, but atleast he let me know when he was uncomfy. If shes happy enough then I wouldnt be too worried, I would keep her on a nice soft surface and let her heal.
 
BlackVelvet said:
Firsty, she looks fab! I real credit to you and all your hard work.

Secondly, could she still be suffering from a slight bit of lami? how long has she been better? if i remember rightly my boy was 'sore' for about 7-8 months after orginally getting lami and that was with no rotation. The vet said he had very little pain threshold for such a big horse, but atleast he let me know when he was uncomfy. If shes happy enough then I wouldnt be too worried, I would keep her on a nice soft surface and let her heal.
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Thank you. I think that she still has LGL as there are faint pulses in her left fore and intermittently in her right. Since getting acute laminitis for the first time 18 months ago, she has had two other major bouts of it (though not as bad as the first) and has been sound inbetween. I was hoping this footiness was her hoof just needing to grow down well connected, but I fear ther is another ring appearing at the top which means that she has had another bout of LGL. I am keeping her primarily in the sand turnout, with a few hours a day out in a small paddock with a grazing muzzle (which she has learnt to get off! :mad:).
 
Can't really comment on the hoof pics except to ask, how deep is the frog central cleft if your put you hoof pic in gently? If it goes in I would treat with some anti bacterial and anti fungal cream deep in there.

Are you still using haylage? Sorry if I've got you mixed up with another poster. If you are using any haylage I would switch to well soaked and rinsed hay if you are and no grazing and see the response in 3-7 days. My pony, I have learned to her cost sadly, cannot tolerate any haylage or more than yard pickings of grass.
Perhaps look at mineral, amino acid and vitamin E intake, perhaps something needs increasing.

In the pic you can see she is standing with her left hoof back and only weighting her right one fully.

Just some suggestions. She looks fab btw. x
 
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Could it be abit of bruising/soreness from putting more pressure on the good hoof because it has always been the right one which is hurting the most? So now the right is okay she is feeling the other more as she used to favour it? This is only from my experience of my old girl, she had some soreness in her heel of her right fore(less rotation in it and was abscess free) as over the months she had used that one more than the left with more rotation.
 
If you grasp the heel bulbs, can you wiggle them independently of each other? Try gently, if she's sore.

It looks like you may have a fungal problem. If the heels move readily independently then that suggests a sheared heel, meaning the infection is quite deep in the central sulcus. If this is the case, the laminitis may be a red herring as far as the current discomfort goes. Even just normal thrush could be the cause, though.
 
ATrueClassAct said:
Could it be abit of bruising/soreness from putting more pressure on the good hoof because it has always been the right one which is hurting the most? So now the right is okay she is feeling the other more as she used to favour it? This is only from my experience of my old girl, she had some soreness in her heel of her right fore(less rotation in it and was abscess free) as over the months she had used that one more than the left with more rotation.
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You could well be right. Her right fore flattened and bore the brunt of the initial laminitis because of her left shoulder injury over three years ago. Now the left has been doing more work.

TwoStroke said:
If you grasp the heel bulbs, can you wiggle them independently of each other? Try gently, if she's sore.

It looks like you may have a fungal problem. If the heels move readily independently then that suggests a sheared heel, meaning the infection is quite deep in the central sulcus. If this is the case, the laminitis may be a red herring as far as the current discomfort goes. Even just normal thrush could be the cause, though.
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I did wonder about thrush. Could it cause pulses though? I will take a closer look at her heels later. I agree, they don't look healthy.
 
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amandap said:
Can't really comment on the hoof pics except to ask, how deep is the frog central cleft if your put you hoof pic in gently? If it goes in I would treat with some anti bacterial and anti fungal cream deep in there.

Are you still using haylage? Sorry if I've got you mixed up with another poster. If you are using any haylage I would switch to well soaked and rinsed hay if you are and no grazing and see the response in 3-7 days. My pony, I have learned to her cost sadly, cannot tolerate any haylage or more than yard pickings of grass.
Perhaps look at mineral, amino acid and vitamin E intake, perhaps something needs increasing.

In the pic you can see she is standing with her left hoof back and only weighting her right one fully.

Just some suggestions. She looks fab btw. x
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Thank you.

I will have a look at her frogs later. She actually does better on Marksway hi fibre haylage than soaked hay. But she is on some dry haylage at present that is less than 3% sugars (tested) and only 18% moisture which is the maximum moisture for hay. I do wonder if she can't tolerate the grass though even with her muzzle on and very sparse grazing as she does seem to have a flare up in her footiness if it has just rained.
 
Is the pulse in one foot, or all?

Ime, the presence of pulses doesn't necessarily mean laminitis; it depends how strong the pulse is, and what's normal for the horse.
 
TwoStroke said:
Is the pulse in one foot, or all?

Ime, the presence of pulses doesn't necessarily mean laminitis; it depends how strong the pulse is, and what's normal for the horse.
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There is a very noticeable pulse in the left foot, though not like it was when she had acute laminitis. There is a very faint, hard to find pulse in the other front, and none detectable in the hinds. It is not a fast pulse like it is when she is in severe pain with laminitis, when it gets up to around 60 beats a minute. It is normal speed.
 
Wagtail said:
There is a very noticeable pulse in the left foot, though not like it was when she had acute laminitis. There is a very faint, hard to find pulse in the other front, and none detectable in the hinds. It is not a fast pulse like it is when she is in severe pain with laminitis, when it gets up to around 60 beats a minute. It is normal speed.
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Have you ever monitored her pulses when she's rock crunching? They can vary at different times of the day, different temps etc.

It *could* indicate low grade laminitis, but I wouldn't take it as a proof, especially if she's not responding as normal to a laminitic diet/management.

A gentle thrush treatment programme certainly won't hurt ime.
 
Yes, I will get her in in a bit and treat her for thrush in any case. I think she could well have it as her hoof boots smell a bit and there is black debris even after her feet have been cleaned. She has very deep grooves and tall heels in that foot and has suffered from thrush in the past. I think I have been so focussed on the laminitis, I have neglected to think of other possibilities.
 
Twostroke: Her heel bulbs are very rigid and do not move independently. She was a lot sounder when I brought her in today even though she was completely barefoot. So I wonder if the boots were actually making her sore. :confused: She looks completely level and sound in the sand (in walk as I haven't seen her trot today). But the pulses are up more now in the right fore. :confused:

Anyway, she was uncomfortable when I was digging out her grooves with the hoof knife, and slightly sore when I pushed my thumb against the rear of the frog. The hooves, now that they have been 24 hours dry after the poultice look very clean, firm and dry, but digging down, they were softer. So I sprayed with teramycin for now. This has usually cleared her thrush very quickly (even though I know it isn't a fungicide, I think it kills the bacteria on which the thrush feeds and creates an unfriendly environment for it.
 
Sounds like no sheared heel at least :), but a little sore in thrushy hot spots? Hopefully that'll clear up easily & may help her comfort levels.

Sounds like the boots may rub a little? Does she have pads in them? Either way, if she's happier without, maybe leave her for a bit to see how she goes.

Afternoon is when pulses tend to be up a bit more, I find, possibly because the sugar in the grass peaks in the afternoon. If treating the thrush doesn't sort things, the only other thing I can think of off hand is the obvious - no grass at all. It's bit of a last resort unless you have the facilities for grass free turn out though.

Fingers crossed its just thrush!
 
TwoStroke said:
Sounds like no sheared heel at least :), but a little sore in thrushy hot spots? Hopefully that'll clear up easily & may help her comfort levels.

Sounds like the boots may rub a little? Does she have pads in them? Either way, if she's happier without, maybe leave her for a bit to see how she goes.

Afternoon is when pulses tend to be up a bit more, I find, possibly because the sugar in the grass peaks in the afternoon. If treating the thrush doesn't sort things, the only other thing I can think of off hand is the obvious - no grass at all. It's bit of a last resort unless you have the facilities for grass free turn out though.

Fingers crossed its just thrush!
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At the moment she has the thick Styrofoam pads in her boots. I think that maybe these raise her already high heel too much? I have ordered the Old Macs gaiters to put in them to hopefully stop the rubbing.
 
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