Laminitis time scales? (Long, desperate)

blackcob

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Three weeks ago now B became quite suddenly lame on one or both front feet - she was shod on the Friday and the farrier thought she was a tad sensitive but nothing to be concerned about, a tad pottery on a circle on Saturday and obviously lame by Sunday. Vet nerve blocked the off fore foot and she appeared pretty much sound, dismissed any lameness in the other front foot and advised box rest and bute for a week.

We called him back 48 hours later as she was very lame, reluctant to move at all, alternately resting front feet and rocking back. Still reluctant to diagnose laminitis as she had not had a blade of grass (no winter grass turnout, only on a bare concrete paddock with hay, stabled at night), was not overweight, no change in feed or management, no bounding digital pulse, no reaction to hoof testers etc. and appeared significantly worse on one foot. We took her to the clinic for x-rays to rule out a pedal bone fracture. X-rays were clear, no fracture, no movement of pedal bone.

Advised to poultice and treat as if a very deep seated abscess. Very small amount of pus came out two days later. Farrier came back to put the shoe back on (it had to come off for x-ray and poulticing) as she is very flat footed and vet advised it went back on as soon as possible. Next 72 hours she improved greatly, happy to mooch around the yard, sound in a straight line, only a little lame on a circle.

I arrive on the following Monday - so two weeks after initial lameness - to find her suddenly barely able to walk again. At this point vet confirms laminitis. We swap deep straw bed for even deeper shavings, continue bute and add ACP. Hay now weighed and fed in small holed net, what little feed she did get (half a scoop to come into the stable at night) is swapped in favour of a minimum amount of sugarbeet in which to take her medication.

She is tested for Cushings, EMS etc. but all come back negative (we were expecting positive EMS, she is a native pony who has previously been overweight, gets fat on fresh air etc). Still no idea what the trigger for the attack was.

One week on from there she is still very, very uncomfortable despite the painkiller and sedative. She is lying down for several hours during the day (and by god didn't that make me cry the first time I saw it :(). Vet suggested that the relapse may have been triggered by the shoe going back on (on the understanding that laminitic symptoms occur as a result of input approx 48-72 hours earlier).

He is now very keen to have heart bar shoes on and farrier (who has been excellent throughout) is coming out tomorrow to do this. I am terrified, however, that another stress on her poor feet is going to result in even more pain. Everything I'm reading says not to mess about while the horse is still in extreme discomfort but, obviously, we are now concerned that with the length of time this has been going on the probability of rotation or sinking is becoming higher. Vet has advised further x-rays after heart bars have been on for a while.

I don't know what to do. :( Everything I read says 4-6 weeks before rotation or founder is pretty much inevitable and there has just been no improvement at all since the second attack.
 
Oh is a farrier and regularly fits heart bars on veterinary request. They will provide the support needed if fitted correctly. Good luck. It's a horrible illness.
 
I would not put shoes on. Get some styrofoam pads instead. The problem with heatbar shoes is that although they are fine to begin with, as the hoof wall grows, the support they give to the frog deminishes. Also, you have the trauma/pain of putting them on. Has she been tested for insulin resistance where she has to be starved for 12 hours before hand? Do the hollows above her eyes still look like hollows or are they puffy/filled in? Make sure she is on soaked, late cut hay. I had not heard of the 4 - 6 week rule for pedal bone rotation.
 
Consult another vet as you are clearly unhappy with what has been said (as would I be) and also contact the laminitis clinic for advice.
 
My farrier and vet worked together with our pony who got laminitis last Spring (2011). He was kept in on a very deep bed with lilypads and wraps for a few weeks and had a lot of Danilon which I was told would help bring down the swelling and ease his pain. Then he graduated to heart bars which he wore for many months, he's gradually being bought back into work and so far so good. Just need to find a little rider for him, hopefully it will be the same for your pony. It is heartbreaking to see them and it must be such a worry for you.
 
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we used Bathroom sponges and gaffa tape for our girl who had cushing lami and was in foal and then after she foaled it worked ver well and eased her pain good luck with your girl
 
Sorry to hear this. Laminitis is very distressing - both for horse and owner. I would def not have nail on shoes. The nailing on of shoes on very sore feet can make matters worse. I would go for Imprints. These need to be put on by a farrier who can fit them, but they can bring pretty much instant relief to a laminitic. They aren't cheap (approx £100 - £130 for two shoes), but can be a life-saver. I was in the same position as you 8 years ago - frog supports and heart bars made my pony much worse. Imprints probably saved his life. He is still with me - so don't despair!
 
The most important thing is to diagnose what caused the Laminitis?
It could be a number of different things from concushion, an infection, stress, Cushings Disease, emerging encysted small red worms (which do not show up on a worm count only on bloods) etc.
Keep your horse on a very thick bed and fit frog supports (take a look at the Laminitis Clinic Web Site).
Finadyne is a stronger pain killer than Bute.
Also agree with the Imprint shoes.
 
My boy got lami last summer, after breaking into our feed area, unscrewing our feed bins and eating an entire bag of baileys number 17- however we had it diagnosed within 24 hours (he couldn't walk the day after) he was on box rest with bute and sedalin until he was sound for 3 days without. He was chronically lame on all 4, but came away negative to all tests and no rotation. We were very lucky- he is now back in full work as before and on careful management- but kept him barefoot till he was back in work to save him the pain! ( He had shoes off about a week after when he could bear weight on his Legs) he only had padding and gaffa too :) x fingers crossed you get everything sorted soon! Since my incident I have much sympathy for anyone who has to experience it :( x
 
Did the vet say why he wanted heart bars and what he wants to achieve by applying them?

If is it to support the back of the hoof - do you know what does that even better?

The ground.

The laminae will be weak and compromised.
The hoof wall wasn't designed to be entirely weight bearing.
The shoe is making the horse bear it's entire weight on the wall and that weak and compromised laminae.

Nature didn't put anything on the bottom of the hoof that wasn't meant to bear weight in a pressure AND release way. The heels, frog, sole AND wall are all supposed to work together to bear weight. Unfortunately the shoes are preventing this from happening and you are suspending the horse from a damaged laminae at the moment.

There are plenty of ways to protect the hoof and a thin sole while allowing the horse to engage the hoof mechanism as it's meant to be.

Hoof boots and pads
Styrofoam pads
Deep bedding
Mud
Hoof casts and pads
Epoxy as dare.to.go.bare suggests.

Shoes are not the only option.
 
Will try to respond in turn...

Yes she's had the fasting test for insulin resistance, no issues shown. Hollows above eyes normal. She will *not* eat soaked hay or straw, is on measured amounts of hay in a small holed net. She's only being fed a minimum of soaked sugar beet and a lo-cal balancer, enough to have the painkillers in.

There was no discernable cause - can rule out concussion, worms, cushings, infection in addition to grass, weight, feed. No stress that I can think of, nothing's changed in months.

She's on a very deep, clean and dry shavings bed 24/7.

I don't know what to think about shoes, heart bar or otherwise - everything I read is contradictory. :( She normally has excellent feet, no issues to speak of, small neat feet with a short toe, just a fairly flat sole.
 
My lami had stiro pads on for two months then had imprint shoes as vet didnt want to aggravate the lami ( had 13 and 12 degree rotation in boyh feont hooves) the imprints are glued on and helped alot then after three sets of these at 5 week changes he went to heart bars.

Id get her retested and make sure she is starved for 12 hour before hand. My boy was on box rest for 9 months before we could start walking out in hand and a total of 11 months before he was back into full work and goong out into the feild for 6 hours a day.

Sending lots of hugs

Xxx
 
Really sorry to hear this. Laminitis is awful! Have you looked at hoof boots? Some come with supportive pads.

Also. In term of feed, I won't let anything past my Sec A's mouth which doesn't have the 'Laminitis Trust' mark stamped on the bag. I suppose it depends on what your pony was getting before, but even half a scoop of some feeds could cause laminitis in those which are really prone. Instead of a balancer (as even the lo-cal ones don't have the Laminitis Trust mark), I use Top Spec powdered supplement and I use speedi-beet instead of standard sugar beet as it's approved by the Laminitis Trust. I'm really obsessive with this!!

Don't know if any of that's useful at all. Really hope your pony gets better soon.
 
I find it suspicious that if a horse is diagnosed with navicular, laminitis, tendon issues, ligament issues etc etc then the magic heart bars are trotted out......

How can all these different problems be fixed with the same shoe?

The thin sole is a by-product of diet, excessive paring and lack of stimulation. A flat and thin sole is not natural or healthy on a hoof.

But it IS fixable.

There are plenty of thin soled horses who've come good. Here is just one of them
http://rockleyfarm.blogspot.co.uk/2011/10/further-adventures-of-horse-with-thin.html

The 'Emergency Diet' as recommended by the Cushings and Insulin Resistance Yahoo Group is on here
http://phoenixhorse.myfastforum.org/about25.html

At the very least I would drop the LoCal and get some magnesium and Yea-Sacc in there instead.
I hope the sugar beet is unmolassed. I would also rinse, soak and rinse until the water runs clear too.
 
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My lami had stiro pads on for two months then had imprint shoes as vet didnt want to aggravate the lami ( had 13 and 12 degree rotation in boyh feont hooves) the imprints are glued on and helped alot then after three sets of these at 5 week changes he went to heart bars.

Id get her retested and make sure she is starved for 12 hour before hand. My boy was on box rest for 9 months before we could start walking out in hand and a total of 11 months before he was back into full work and goong out into the feild for 6 hours a day.

Sending lots of hugs

Xxx

Don't they recommend not starving now but only feeding soaked hay instead?
 
My vet said nothing to eat after 10pm and he did the jab at half 8 the next morning and it showed up he was badly insulin resistant. While he was on box rest he was having nothing but soaked hay and happy hoof to have the metformin in, 15 tabs twice aday which he is still on, and he graduallu worked up to having dry hay before winter set in as you cant feed it when its frosty and snowy. But as the green stuff is coming through im soaking some again as a panif just in case even though his last bloods came back perfect.

Xx
 
BC so sorry to read this about your lovely girl :( they don't half like to make us worry.

In my head and if mine I don't think I would be rushing to whack heart bars on, particularly after the second flare up after putting the other shoe back on. I would be more inclined to use pads/imprints but I don't know enough about them to advise :(.
 
The 'Emergency Diet' as recommended by the Cushings and Insulin Resistance Yahoo Group is on here
This horse wont eat soaked hay.

She will *not* eat soaked hay or straw, is on measured amounts of hay in a small holed net.


I'm afraid feeding a low sugar/starch forage is vital and the gut needs roughage going through it. As she isn't improving and wont eat soaked hay I am wondering if one of the Marksway haylages such as the High fibre one might be a better option. Some hays can be scarily high in sugars and not being able to soak and therefore limiting intake is imo risky. Apologies if I sound blunt but low sugar/starch and adequate intake of forage is critically important in laminitis.
http://www.horsehage.co.uk/analysis.htmlhttp://www.laminitis.org/emergency treatment.html

I suggest you join the ECIR Yahoo group and ask for advice on there for forage replacers.

ps. Oberon, the Laminitis trust still don't recommend soaked hay and advise limiting it! Groans. http://www.laminitis.org/emergency treatment.html
 
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I agree that if the animal in question will definitely not eat soaked hay, then you need to find an alternative that is low in soluble carbohydrates (sugars/starches). Get your hay analysed (I know Dodson & Horrell do a very cost-effective analysis service) and if the soluble carb content is too high for a laminitic then look for analysed forage replacements, or source some other local hays and get them analysed to see if they are more suitable.
 
ps. Oberon, the Laminitis trust still don't recommend soaked hay and advise limiting it! Groans. http://www.laminitis.org/emergency treatment.html

How very 1980s of them.
banghead.gif
 
Thanks for all comments so far.

It's Kwik Beet, unmolassed. She absolutely needs something, she wasn't overweight to begin with and is now losing weight on the box rest. She's allergic to alfalfa so can't have most of the other Laminitis Trust approved feeds or alternative forages.

My heart is also saying don't mess with the shoes any more than we already have had to. Her poor sore feet. :(

The vet was quite dismissive about forage analysis but I can absolutely have this done, tomorrow if necessary.
 
Huge hugs, laminitis was one of the worst things I've ever been through with my ponies. It's made so much worse by the fact you can't see what's going on inside the hoof :(
I very suddenly found my pony unable to walk in the field after moving into a new field. Looking back I missed the subtle signs something wasn't right her sweating (put that down to the heat) a bit footy on the hard ground ect.
She looked absolutely terrible, the vets face literally fell when she checked her over and confirmed it was laminitis in all 4 feet. She was instantly put in a deep bed of shavings, soaked hay and a handful of Hifi lite for the danilon and sedaline. Her stable is fairly small so she wasn't able to pace and luckily didn't stress as she hated being kept in. Honestly in 2 weeks it was like a miracle she wasn't sound but she was comfortable, barging me out the stable and back to her normal cheeky self :) within 2 months she was out for 2 hours a day in a pen, sound (apart from a slipping stifle which was because of the box rest) and managed to avoid any rotations. This was all without shoes/pads :)
She's okay now, very sensitive to grass so only out for a few hours, lunged everyday and pulses/heat in her hooves checked at least once a day as I know she had a incredibly lucky escape last year.
Good luck with your horse!
 
It can take weeks to come sound completely sound after a bout of laminitis so don't panic too much that he hasn't recovered yet!

My mare was finally diagnosed as cushings after nearly 2 months of laminitis and very nearly being PTS. She had rotation and dropping in all feet but is now as sound as a pound and enjoying life once again :)

Re the causes, mine has cushings, but another horse of mine years ago went down with it after rolling and getting stuck under the post and rails. So basically stress. And a 3rd turned out to have an underactive thyroid and ended up having 27 dog thyroid pills a day. She first got it when not having any grazing at all due to flooding... so grass was not the cause of any of them.

Personally I wouldn't be replacing shoes at this point, heart bar or otherwise. You can get frog supports that can fit within the current shoe to provide supports. Or other supports as others suggest. Might be worth asking your vet

Good luck and hugs from me, I know just how awful it is!

PS mine went on hunger strike when presented with soaked hay, but caved in eventually and now actually prefers it! So worth persevering on that one. Or get your hay tested to make sure its not to rich. If it is unsuitable then blue horsehage is fine for laminitics and very palatable
 
bc I would enquire how long an analysis would take, I think it was a couple of weeks last time I looked so I'd give them a ring tomorrow perhaps and feed blue horsehage in the meantime?
 
Thanks for all comments so far.

It's Kwik Beet, unmolassed. She absolutely needs something, she wasn't overweight to begin with and is now losing weight on the box rest. She's allergic to alfalfa so can't have most of the other Laminitis Trust approved feeds or alternative forages.
She needs more low sugar forage. I don't mean to be rude but forget the laminitis trust feeds and please put her on the ECIR emergency diet. Kwik beet is fine instead of speedibeet. Some horses wont eat soaked hay at first as they have what I call a sweet tooth and need to lose this by limiting any sugars as far as possible. You could try mixing well soaked and unsoaked and over three to four days increase the soaked until she has moved over.

There are ways to pull shoes carefully and without banging.

ps.Rinse the Kwik beet well and increase her portion. Add magnesium, salt, vitamin E and micronized linseed as per ECIR emergency diet
 
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Hope things look up soon :). From someone who's had unexplained lami, with then severe sugar intolerance that lasted years, I found things that worked, and kept my girl with me, where other horses with similar symptoms lost their battle. I can tell you what that was, and you can try it if you wish. If not, I hope you find another solution.

My horse couldn't even have half a tiny slice of hay in a whole day, or she got worse. Soaked, she didn't get worse, but didn't get better either. What worked, was the Timothy Horsehage. Not cheap, no, but she ate it, and it was the ONLY forage on which she improved. When she was improving well, straw seemed ok in small quantities too to bulk it out a little. We then found 'hard' feeds we could add to it - speedibeet, Spillers High Fibre cubes. Yeast helped hugely, making the improvement faster. Anything with any alfalfa, even low starch/sugar stuff, made her more sensitive to sugar and set us back - so no chaff, even low sugar, as they nearly all have alfalfa in them.

I lost count of the times someone would put hay over her door 'cause she'd run out, and I'd find her footy again after just a few handfuls, or the times she was fed someone else's breakfast (shetland sized - normal sugar beet plus literally a handful of mix!) and she was lame for two weeks. But finally everyone on the yard understood. Our YO was fab, we were allowed a little bare paddock in which we hung nets of horsehage and she went out there during the day with a companion. That lasted years, with her coming back into full work and being healthy and fit on this diet - but still she couldn't come off it.

The most wonderful end to all this, is that after years of no exposure to more sugar than she could handle, and no alfalfa, her system has re-set itself. She's now able to eat hay again, and to go out on poor (long, woody) grazing - even living out last summer. There is hope.
 
Sorry to hear this. Laminitis is very distressing - both for horse and owner. I would def not have nail on shoes. The nailing on of shoes on very sore feet can make matters worse. I would go for Imprints. These need to be put on by a farrier who can fit them, but they can bring pretty much instant relief to a laminitic. They aren't cheap (approx £100 - £130 for two shoes), but can be a life-saver. I was in the same position as you 8 years ago - frog supports and heart bars made my pony much worse. Imprints probably saved his life. He is still with me - so don't despair!

Sorry not read all responses, but this is the correct course of action.
I know 2 friends who were in similar position to you.

Friend 1 had imprints and also installed a small "sand pit" for want of a better description for pony to be turned out onto. All his hay was soaked, he had a radical change of diet - ring Simple Systems, their products are marvellous. He was back in work within a few months, and he was close to being put down.


Friend 2 went down the heart bar route, over a year later pony is still in discomfort.

I can't recommend the imprints enough and in the long run they could saveyou money despite the cost as the pony should recover much more quickly so less medicine required in the long run.

Good luck hope pony improves soon.
 
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