Laminitis update

[spotty_pony2]

So as some of you know my boy unfortunately was diagnosed with Laminitis in all four feet which seemed to come out of nowhere. Blood tests for insulin levels were normal and Cushings test was negative so Vet thinks he was just very unlucky and the grass had caused it. Fast forward three weeks and we have cold feet and no pulses, he’s back down to just his usual one Danilon per day and myself and Vet have been very pleased with his progress. He started being being hand walked on the soft arena and being turned out just in front of his stable after about 10 days with Vet agreement. I will admit I have sort of done my own thing since then (I have managed a lot of Laminitis cases successfully in the past so I am relatively experienced) and so I started turning him out in a small starvation paddock with soaked hay about three days ago for around 4- 5 hours per day and this had worked well for him mentally and helped with stiffness as he had arthritis. All is fine and he is very settled to come back in afterwards. I had the farrier today who said he’s in the all clear and doing well but just to be careful with giving any grass still. I understand this and realise I’ve probably moved a bit too fast as it’s only been three weeks but I just feel so bad for him and I know I need to be cruel to be kind but he didn’t understands. Farrier does think he will be able to return to some grazing in time though, I just need to be extra careful now. So for tomorrow I have fenced off the barest area around the gateway that I can find. Unfortunately are grazing is very good and there is practically no areas without any grass so I’ve done my best but there is a little bit along the fence which will be eaten in about 1 minute and a little bit of ‘green’ around the water trough but nothing really there. He cannot stay in the area outside his stable as it’s the main way in and out of the yard and I have to keep taking the fencing up and down and he is only allowed to be there for one hour per day, he can’t be turned out in the arena for long because he’s not allowed hay in there, so I’m a little bit limited. I feel awful because I’ve almost gone back a step and I know he won’t understand why he can’t have grass again.

He will be 27 this year and I’ve owned him for 21 years. I’m just feeling a bit down about it. Am I doing the right thing? Photo of him yesterday in his eaten down postage stamp which is still too much grass at the moment I am told

 

[Pearlsasinger]

I'm so sorry that you and he are in this position. You have done extremely well to get his laminitis under control so quickly but if he were mine, I would want to be assured that he will be able to be turned out on grass in a reasonable length of time, for a reasonable length of time, with other equines to live a 'normal life.
Well done so far!

 

[meleeka]

Which cushings test did he have? A first laminitis at his age would be sounding alarm bells for me. That patch wouldn't look bare to mine. They'd think that was a good covering! Perhaps a muzzle would be something to consider in the future.

 

[Barklands]

Glad to hear your boy is doing better. Sorry to give some tough love here but three weeks is too soon. The rule of thumb is 30 days after last pain relief - yours is still on pain relief.

To put it in perspective, yes box rest isn't natural for a horse but laminitis is life threatening (which I think some forget as it is such a common illness). My mare was put down a few weeks ago from her first ever bout of laminitis as her pedal bone had almost rotated through her foot, we stuck to veterinary advice to the letter and that was still her outcome (another with no EMS and no cushings), and she was only 9.

I know you will feel that you are being kinder by turning out but your boy is 27, and once they have laminitis once, they are much more likely to get it again. The grass isn't the only issue with turning out - the hooves are very unstable after a bout of lami. Did your vet sign off on him being turned out? Reading between the lines it sounds as though your farrier is trying to discourage you from turning out.

Edited to add: it may just be the angle of the photograph but your lovely boy does look like he is standing somewhat camped under

 

[spotty_pony2]

Which cushings test did he have? A first laminitis at his age would be sounding alarm bells for me. That patch wouldn't look bare to mine. They'd think that was a food covering! Perhaps a muzzle would be something to consider in the future.

Yes using a muzzle has been suggested long term and I will look into it. He had the normal blood test for cushings but has had several different ones over the years and all have been negative. He doesn’t have any other cushings symptoms and has started to moult a lot since the test so I really don’t think he has cushings. Apparently with age they develop more allergies and intolerances. I truly believe he’s always been a candidate for it (he has it very mildly in back legs 20 years ago) but I almost managed to reverse it as after that I got him very fit and his metabolism seemed to change. He hunted most of his working life and was one of the fittest on the field. It’s only these past few years since he has slowed down his work life and almost retired that he’s had problems with sensitive soles (now almost certainly this is linked to the Laminitis) and now this year the Laminitis. My mare would also be a candidate for it (being obese when we got her) but I keep her restricted and in plenty of work but retired I think we will have the same issues. I’m just hoping we can get him to the stage he can enjoy restricted turnout again.

 

[spotty_pony2]

Glad to hear your boy is doing better. Sorry to give some tough love here but three weeks is too soon. The rule of thumb is 30 days after last pain relief - yours is still on pain relief.

To put it in perspective, yes box rest isn't natural for a horse but laminitis is life threatening (which I think some forget as it is such a common illness). My mare was put down a few weeks ago from her first ever bout of laminitis as her pedal bone had almost rotated through her foot, we stuck to veterinary advice to the letter and that was still her outcome (another with no EMS and no cushings), and she was only 9.

I know you will feel that you are being kinder by turning out but your boy is 27, and once they have laminitis once, they are much more likely to get it again. The grass isn't the only issue with turning out - the hooves are very unstable after a bout of lami. Did your vet sign off on him being turned out? Reading between the lines it sounds as though your farrier is trying to discourage you from turning out.

Edited to add: it may just be the angle of the photograph but your lovely boy does look like he is standing somewhat camped under

Thank you, I’ve been completely honest in my post and said I have taken his management into my own hands, she has said she is happy with him moving around in a penned area, but not grass turnout no, but if you could see where aive moved the fence too, for today (just behind where I’m standing to take the photo) it is pretty much brown all over as it’s the gateway and there’s a patch where I was feeding my mare hay over the winter which has killed the grass. He will be in there for a reduced amount of time too with soaked hay. It’s the best kind of pen I can do with the options I have. Unfortunately I’m back at work today but my friend will be bringing him back in at lunch for me. Farrier didn’t have any issues with him being ‘out’ just not really on grass.

Also to add - he will never be painkiller free as he’s on one Danilon per day anyway for arthritis.

 

[Hobo2]

I feel for you but it does sound like he has had a great life and owes you nothing and like you say just horrid for him now. I am very much a quaility over quanity sort of person. My old mare when I was still riding her had a laminitis attack but it was confirmed as cushings. She recovered well and had her one tablet a day for the cushings. When I retired her because of joint problems I fully expected for her to have a short retirement get lamintits and be put down . Luckily she is in rude health and covered top to toe in mud which vet was really pleased with ( me not so) He said it showed she was good and healthy enjoying her rolling.
I now have a younger horse who has EMS so is going to be hard work for the rest of her life but I can make it as fun as possible .

Be more patient as three weeks is very short but also think abut what is best for you faithfully old boy long term.

 

[spotty_pony2]

I feel for you but it does sound like he has had a great life and owes you nothing and like you say just horrid for him now. I am very much a quaility over quanity sort of person. My old mare when I was still riding her had a laminitis attack but it was confirmed as cushings. She recovered well and had her one tablet a day for the cushings. When I retired her because of joint problems I fully expected for her to have a short retirement get lamintits and be put down . Luckily she is in rude health and covered top to toe in mud which vet was really pleased with ( me not so) He said it showed she was good and healthy enjoying her rolling.
I now have a younger horse who has EMS so is going to be hard work for the rest of her life but I can make it as fun as possible .

Be more patient as three weeks is very short but also think abut what is best for you faithfully old boy long term.

This morning I feel even more terrible. My friend has rang me (who owns the land and stables) and said it is coming from a good place and she isn’t criticizing me but she really doesn’t think I should put him out I should just hand walk him in the arena. I feel terrible. She said she obviously can’t stop me from turning him out but she doesn’t think it’s a good idea. I hate keeping him locked up in the stable. Luckily he isn’t a stressy sort but what kind of life is that?! She isn’t that experienced either so I guess I usually take what she is saying with a pinch of salt. She has offered to hand walk him at lunch while I’m at work which is kind. I’ve managed tonnes of laminate cases before now but this one is so much harder with him being my boy. There’s too many emotions involved I guess. It’s even worse now because he’s been out the last few days so he will want to go out. I don’t know what to do for the best.

 

[Barklands]

This morning I feel even more terrible. My friend has rang me (who owns the land and stables) and said it is coming from a good place and she isn’t criticizing me but she really doesn’t think I should put him out I should just hand walk him in the arena. I feel terrible. She said she obviously can’t stop me from turning him out but she doesn’t think it’s a good idea. I hate keeping him locked up in the stable. Luckily he isn’t a stressy sort but what kind of life is that?! She isn’t that experienced either so I guess I usually take what she is saying with a pinch of salt. She has offered to hand walk him at lunch while I’m at work which is kind. I’ve managed tonnes of laminate cases before now but this one is so much harder with him being my boy. There’s too many emotions involved I guess. It’s even worse now because he’s been out the last few days so he will want to go out. I don’t know what to do for the best.

I think you really need to speak to your vet to get some professional guidance

 

[Exasperated]

Glad to hear your boy is doing better. Sorry to give some tough love here but three weeks is too soon. The rule of thumb is 30 days after last pain relief - yours is still on pain relief.

To put it in perspective, yes box rest isn't natural for a horse but laminitis is life threatening (which I think some forget as it is such a common illness). My mare was put down a few weeks ago from her first ever bout of laminitis as her pedal bone had almost rotated through her foot, we stuck to veterinary advice to the letter and that was still her outcome (another with no EMS and no cushings), and she was only 9.

I know you will feel that you are being kinder by turning out but your boy is 27, and once they have laminitis once, they are much more likely to get it again. The grass isn't the only issue with turning out - the hooves are very unstable after a bout of lami. Did your vet sign off on him being turned out? Reading between the lines it sounds as though your farrier is trying to discourage you from turning out.

Edited to add: it may just be the angle of the photograph but your lovely boy does look like he is standing somewhat camped under

This is true, the pedal bones will be unstable within laminae after only a short time, even an apparently mild case, which may never have been caused by grass sugars in the first place.
unfortunately it is also true that some cases will never ‘come right’, no matter how much support, box rest, medications and love.
Generally, the longer the horse is kept supported and quiet on box rest, the better, and usually a calendar month minimum, often more like 6-8 weeks inside, with sedative as necessary because many will be feeling much better and stir crazy. It’s lock them in and throw away the key. And, if horse starts to re exhibit symptoms, back to square one until stabilised again. It is a very difficult process for both carer and animal.
About grass, no reason why you can’t pick him the odd bucketful, but don’t want him walking about to graze, and very short, growing grass will be more stressed and sugary anyway.
If you do not want to put him through extended recovery and rehab because of his mental state, age, and uncertainty about future quality of life, then don’t.
You obviously love him dearly, he has had a good life, and no responsible owner wants to watch sad decline.
If you want to proceed, then keeping him contained at this delicate stage (and tbh, since he has now been out, probably for another month to be more confident) is definitely safer.
Good luck.

 

[Exasperated]

Thank you, I’ve been completely honest in my post and said I have taken his management into my own hands, she has said she is happy with him moving around in a penned area, but not grass turnout no, but if you could see where aive moved the fence too, for today (just behind where I’m standing to take the photo) it is pretty much brown all over as it’s the gateway and there’s a patch where I was feeding my mare hay over the winter which has killed the grass. He will be in there for a reduced amount of time too with soaked hay. It’s the best kind of pen I can do with the options I have. Unfortunately I’m back at work today but my friend will be bringing him back in at lunch for me. Farrier didn’t have any issues with him being ‘out’ just not really on grass.

Also to add - he will never be painkiller free as he’s on one Danilon per day anyway for arthritis.

I’m surprised the farrier thinks he is ok to walk about on tarmac /concrete / whatever, because keeping still is usually more stabilising. Are his hooves all bound and padded up? Might be better speaking with the vet, altho some of them have contradictory views, too.

 

[Pearlsasinger]

I must admit that i hadnt looked poperly at the photo before my first reply. That is a lot of grass!
I wouldn't worry about the fact that he has been back out at grass for a few days, presumably he had been out before this started.
I would bring him back into box rest for a while longer, supporting his hooves and I would ask the vet to do the TRH-Stim test for Cushings, it is much more accurate and Prascend could make a huge difference to him, as it seems rather odd that he should start grass induced laminitis at this time of the year.

 

[meleeka]

This morning I feel even more terrible. My friend has rang me (who owns the land and stables) and said it is coming from a good place and she isn’t criticizing me but she really doesn’t think I should put him out I should just hand walk him in the arena. I feel terrible. She said she obviously can’t stop me from turning him out but she doesn’t think it’s a good idea. I hate keeping him locked up in the stable. Luckily he isn’t a stressy sort but what kind of life is that?! She isn’t that experienced either so I guess I usually take what she is saying with a pinch of salt. She has offered to hand walk him at lunch while I’m at work which is kind. I’ve managed tonnes of laminate cases before now but this one is so much harder with him being my boy. There’s too many emotions involved I guess. It’s even worse now because he’s been out the last few days so he will want to go out. I don’t know what to do for the best.

I like the phrase "You shouldn't take criticism from someone you wouldn't take advice from". It's your horse, and it's up to you to decide what's best, with the guidance of your vet and farrier.

 

[Red-1]

I must have been a fool as I bought one of mine as he was finishing 3 months of box rest for lami, which had been in a thickly bedded box and no exercise whatsoever. I was told by my vet that he mustn't have grass for another 6 months to a year. His hooves still looked weak, with an ominous bulge in front of the frogs on the fronts.

The vet advised he was ready to leave confinement; I kept him in a thickly bedded stable or turned out on the arena, and to bring back to work he was either walked in-hand with padded boots (starting at a mere 100 yds!) or ridden on the deep carpet fibre arena. It was a balance as his hocks had stiffened up due to the box rest. Riding was 10 minutes at walk only, and not every day.

He has improved immensely over the years. He is now rock crunching and barefoot.

He is now able to go on grass but muzzled. The first year, he only had a few hours at grass, starting at 15 minutes and building up from there. Over the years (since 2020) he has got so he can have much more time at grass, but muzzled.

Even now, I know it is a risk. He has just started acclimatising to summer regime (winter is an all weather track), and today did a full hour on grass, muzzled. I know that this is faster and more than I have ever done, plus I didn't scalp the grass first, but he is now 20 and I am prepared to take some risk for quality of life. He hasn't had a trace of lami since 2020 and bloods have been normal.

That pen yours is in does have some significant grass cover. I would perhaps do another month or so with you walking yours 2 x a day in the arena, if it is soft, and the farrier/vet agree. Maybe it would be a good idea to take your friend up on their kind advice and he can have 3 x. I am surprised he is no longer padded at 3 weeks, especially if moving on firm surfaces. Essentially, the part that holds the inner and outer foot had broken down somewhat, so if the soles are not supported, the attachment can come away, causing rotation of the pedal bone. This takes as long as the foot takes to grow to repair properly, as new laminae grow down, so supporting the foot is usually done for much longer than just 3 weeks. After the acute stage, the support can be soft bedding/carpet fibre, or padded boots.

At 27, I guess it is a calculated risk that you are taking, with the view to PTS if the pain increases any. That would not be 'wrong' IMO, but even so, I would have a muzzle. They are freely available in tack shops or on line. Mine lines up for his to be put on in the morning, as he knows that means grass time! However, I am another who thinks he is not standing in that photo in a comfortable manner and would look to have another vet visit for further advice.

 

[spotty_pony2]

I have decided, to box rest for at least a few more weeks and hand walk in the arena. If this means he can then go on to living a normal horse life in time then this few weeks will be worth it. He is well in himself apart from this and even the Vet was surprised at the huge improvement in such a short space of time. He seemed perfectly happy to stay in this morning if I’m honest, I do think it’s more me. My friend put it in a good way - he doesn’t know what’s best for him he’s relying on me to keep him safe which is true as he won’t realise it’s grass that made his feet sore. I have sought professional advice (it’s all in my original post) and I have been told since if they relapse it is sometimes worse the second time round and he might not come back from that. So I think I’m going to have to wait it out for a few weeks and then go from there….

 

[spotty_pony2]

I like the phrase "You shouldn't take criticism from someone you wouldn't take advice from". It's your horse, and it's up to you to decide what's best, with the guidance of your vet and farrier.

Exactly. I do agree I think I’ve moved a little fast though to get back to grass turnout and so I think going back a few steps is probably best. Both Farrier and Vet agree with that. Farrier said there was nothing to see in his feet yet but it will probably not show until next time he comes as it’s such early days.

 

[spotty_pony2]

I’m surprised the farrier thinks he is ok to walk about on tarmac /concrete / whatever, because keeping still is usually more stabilising. Are his hooves all bound and padded up? Might be better speaking with the vet, altho some of them have contradictory views, too.

No the area is bark and the arena is a soft sand surface. No feet aren’t bound up, he wasn’t that bad thank goodness, he is very well shod support wise and had pads with infill material. Vet thinks this is why it showed up all of a sudden because he is already on Danilon for arthritis and has the pads, the earlier symptoms had been masked. Vet has said same as farrier and to hand graze him for 5 mins in a few weeks to introduce grass gradually. Farrier said he’s in the clear and he was perfectly normal being shod, no signs of pain or anything, no heat, no pulses. Both vet and farrier have said it’s testament to my care that he’s improved so quickly so I don’t want to get the next bit wrong.

 

[Exasperated]

Exactly. I do agree I think I’ve moved a little fast though to get back to grass turnout and so I think going back a few steps is probably best. Both Farrier and Vet agree with that. Farrier said there was nothing to see in his feet yet but it will probably not show until next time he comes as it’s such early days.

Did the vet specifically advise walking sessions? Obviously helpful with his arthritis, but we had a Sec C mare first episode of lami aged 33 (starting Cushings, subsequently onto meds), and it was inside only, bound and bedded, doing daily massage and leg stretches instead for her stiffness, for five weeks. Lived to be 40, able to graze without any muzzles, no more episodes once the Pergolide began.
At least you are tackling it at this time of year - but all through summer: thick bed, bored horse, hot stable, flies, lovely-looking fields....!

 

[mustardsmum]

Glad to read you are keeping him in. Get a thinline muzzle or one of the ones @Red-1 partner makes - both nice airy muzzles that are comfortable for the horse, for when you eventually turn out. Might be an idea to turn him out at night and in during day when you reintroduce him to grass. Bare in mind as he’s on Bute all the time - he may not be as recovered as you think. The Bute will keep him comfortable to be shod - so farrier may not notice any sensitivity.

 

[Lucky Snowball]

I’m glad you’ve decided to keep him in. ( I do think that pen has a lot of grass, maybe make it much smaller and graze it off with a different pony before he’s out again. )
You’re doing well and he looks happy. A few weeks or even months of box rest will soon pass and I think it will be worth it in the long run.
Good luck and please keep us posted.

 

[spotty_pony2]

Did the vet specifically advise walking sessions? Obviously helpful with his arthritis, but we had a Sec C mare first episode of lami aged 33 (starting Cushings, subsequently onto meds), and it was inside only, bound and bedded, doing daily massage and leg stretches instead for her stiffness, for five weeks. Lived to be 40, able to graze without any muzzles, no more episodes once the Pergolide began.
At least you are tackling it at this time of year - but all through summer: thick bed, bored horse, hot stable, flies, lovely-looking fields....!

Yes the Vet has said walking is fine, if he is happy to do so (which he is). She asked me to send her videos and said she was happy with his progress.

 

[spotty_pony2]

I’m glad you’ve decided to keep him in. ( I do think that pen has a lot of grass, maybe make it much smaller and graze it off with a different pony before he’s out again. )
You’re doing well and he looks happy. A few weeks or even months of box rest will soon pass and I think it will be worth it in the long run.
Good luck and please keep us posted.

Yes he does seem fine, I think it’s probably me that feels worse about it, I really hate keeping horses in for long. He’s in on his own too (except for when the others come in in bad weather or when I’m exercising them. There is only three horses here altogether so it’s nice and quiet and not stressful as there’s not horses going out and coming in all of the time so that’s a bonus. He’s doing really well on his own and doesn’t seem too bothered. I can see him from my window in my house (and also from in bed when he is looking out!) so I am very lucky and couldn’t have him much closer really to be able to look after him.

 

[ihatework]

My position on this, rightly or wrongly, is quality of life.

If you want to significantly prolong life, then it might be that you need to reconsider the management you are currently defaulting towards.

But, he is 27, on long term pain management for arthritis and I agree, what sort of life is it to be cooped up in stable getting stiff and bored?

I would probably do what you are doing.
But I would be monitoring super closely and be prepared to pts the minute it was going tits up. Which realistically it will do at some point.

(ETA missed the update! Still the jist of what I say stands, even if doing more active management for a few weeks)

 

[spotty_pony2]

My position on this, rightly or wrongly, is quality of life.

If you want to significantly prolong life, then it might be that you need to reconsider the management you are currently defaulting towards.

But, he is 27, on long term pain management for arthritis and I agree, what sort of life is it to be cooped up in stable getting stiff and bored?

I would probably do what you are doing.
But I would be monitoring super closely and be prepared to pts the minute it was going tits up. Which realistically it will do at some point.

(ETA missed the update! Still the jist of what I say stands, even if doing more active management for a few weeks)

Oh yes I am very aware of this and I won’t let him suffer. Quality of life is very important to me hence why I was trying to get him out of the box orally a bit too early because I was thinking if his mental wellbeing too. I wouldn’t want him in for months and months on box rest whatever because it wouldn’t be fair. I think this is why I was so desperate to start getting him out and I do it a bit early but at the same time I understand that he needs plenty of time to heal first to give him the best chane or recovery. He actually (luckily) does quite like his stable and I’ve often found in the past that he is less stiff when in than out due to the fact that he likes to have a good lie down at night in the stable so he’s plenty of rest.

I’ve come home tonight and he was happy to have his dinner and haynet and seems settled. It’s me who has been fretting all day. I wish I could fast forward these next few weeks. I think he is probably better when I’m work in some ways so he gets some peace!

 

[tristars]

I have arthritic bits, if my my legs feel a bit stiff I give them a massage with little massage head machine I bought 20 years ago

And the difference is amazing, it moves the circulation In the big muscles too which would be ideal for a pony standing in, to soften and relax , moves the blood, also deep heat roll on for joints, and stretching, rotating legs, carrot stretches for the back and neck

And a good hard grooming for lymphatic drainage