Laminitis vs COPD

SizzlerB

SizzlerB

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Hi all,

Will try and explain this as quickly as possible, just want some opinions, "what would you do" etc.

My 19 year mare suffers from COPD, it is managed by her being on a vet supplement called Respimin. I also ensure when she's stabled in the winter that hay is well soaked, and I have a supply of Ventipulmin incase she gets snotty etc. This is all working well - vet happy etc etc.

Last Thursday evening I went down to feed, Monday to Weds last week I came down to her pacing and carerring around. Thursday eve she was clearly lame on off fore, some swelling in the leg around the tendon, but no heat or pain. By Friday swelling also in near fore, but again no heat/pain but obviously lame on off fore.

I brought her in again to cold hose. Within half an hour, both front legs had increased in swelling size and were very hot. Mare had difficulty walking. Vet called.

Vet diagnosed laminitis in all 4 feet - we believed caused by concussion. 10 days of bute and a mild sedative. Box rest on deep bedding. He advised that he would like to come back in a few weeks to blood test for Cushings and EMS.

Farrier believes concussion caused to off fore from hairing round the field triggered the lammi.

Yesterday - day 6 - she escaped from the stable as I opened the door - no obvious sign of lameness (yes I know she is on bute). Put her back in once caught. Walking - or rather marching - round the stable alot!

She is becoming very unhappy/depressed and snotty with the odd cough, my worry is now the COPD.

What would you suggest? We had another mare a few months back also diagnosed with concussion lammi - she would not stay indoors and so an outdoor pen was made and she is now in a very small bare paddock but back in work.
 
That's what I'm thinking amymay - I forgot to say in my first post, she has never had laminitis before. Nor does she have access to alot of grazing anyway - all my paddocks are small and always short grass - I just rotate them regularly.

Would you pad the feet or see how she goes ? I haven't had a huge deal of experience with lammi but I have this feeling of dread of causing long term damage if I do the wrong thing!!!!
 
The problem with small 'bare' paddocks is this. Though there looks to be little or no grass present, what there is is grass under stress. Stressed grasses produce more sugars, and this is found in the 1st couple of mm in the grass leaf.

Any grass which grows on a bare paddock is quickly found and consumed by the horse. Many people find that overweight horses do not lose weight on a bare paddock, and the growth of sugar rich stressed grasses is the problem.
Hence the old saying, that 'You always see a fat horse on a bare field.'

When drought conditions occur, it is easy to see why concussion laminitis is diagnosed, given the hard ground and apparent lack of grass. However, the grass though short is very rich and can easily trigger laminitis, therefore the trigger is not the hard ground but the grass, dietary being the cause of the attack rather than concussion from the hard ground.

Supplimentary feeding of cereals to horses on a bare paddock can easily tip them into the excess sugar caused dietary laminitis.

My own solution for horses in your particular circumstances, is to take them off grass paddocks all together, keeping them in a menage if possible with ad lib soaked hay or haylage, and no supplimentary cereal feed. Mag Ox should be given in a neutral (sugar free) balancer.

If the diagnosis for laminitis is correct, then the use of bute as a pain killer and anti inflamitory, can seriously harm the recovery of the lamina, making recovery long, protracted and sometimes impossible.

It is interesting that your other horse, now back in work, appears to be recovering. It should be noted that lamanitic horses should be given as much gentle exercise as possible as anything which causes the sugars in the system to be used up or perged, and anything which can increase the blood flow to the feet encouraged, taking the shoes off is a great help, and the use of hoof boots, to protect poor thin soles a must.
 
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She doesn't and never has had cereal feed - she has a small single handful of hifi lite to enable me to add her CPOD supplment. She is not obese. The paddocks she has always grazed have been short but adequate grass, not bare.

I don't have a manege to use and with how depressed she is becoming stuck in the stable I would have to seriously consider her future I think....... :-( Not only that, but she wont stay in alone so my pony is in too to provide with some company - luckily the poor love isnt too fussed but it's another one stuck indoors day and night!

How life changing this is turning out to be :-(
 
I'd be checking her fat score to see if that is putting her at increased risk of laminitis:
http://www.worldhorsewelfare.org/information/right_weight_advice

I'd also be checking out whether she has any signs of early Cushing's (actually just starting this process with one of my gang):
http://www.prascend.co.uk/
http://ecirhorse.com/

I'd also be ensuring that her feet are being trimmed appropriately in order to keep the breakover well back and flares to a minimum, so that the leverage effects of concussion are kept as low as possible. There are quite a few photos of feet in good shape on this site for comparison:
http://www.hoofrehab.com/

One of the current schools of thought on laminitis is that it can occur as a result of a cumulative effect of different things compromising the hoof structure. So it may have been just one extra thing that tipped her over the edge. So I'd be considering all aspects of her management so that you can ensure that all risk factors are kept as low as possible.

Beyond that, I guess it's down to the individual to decide what risks to take in the hope of benefits in other areas. So although a small grass pen might increase the risk of her getting too many sugars, it might also keep her less stressed and therefore help her recovery in that way. My own biggest fear with small pens with intensive grazing is the bare ground that results, and bare/disturbed ground is associated with an increased risk of grass sickness....... so there's that to weigh into the equation too, depending on the risk of grass sickness in your area.

To be honest, though, if you all suspect concussion laminitis from a few minutes haring round, then if it was me I'd be either looking to reducing my trimming interval but if that's already only 4-6 weeks, then I'd probably be looking to change my farrier to one who would keep the feet in better shape.

Hope she does ok.

Sarah
 
Thanks Sarah - will have a good read of the links when Im at home over the weekend.

It's such a minefield which is what I find worrying - what's right/wrong, best/worst to do! My instructor said whilst there are no obvious signs of cushings, at her age is definately best to get her checked. This has already been pre-arranged with the vet anyway.

The only thing in her routine which has changed is that she has been out of work for 6 weeks.

Guess it's a case of taking each day!

Thanks for you advice guys
x
 
SizzlerB said:
Thanks Sarah - will have a good read of the links when Im at home over the weekend.

It's such a minefield which is what I find worrying - what's right/wrong, best/worst to do! My instructor said whilst there are no obvious signs of cushings, at her age is definately best to get her checked. This has already been pre-arranged with the vet anyway.

The only thing in her routine which has changed is that she has been out of work for 6 weeks.

Guess it's a case of taking each day!

Thanks for you advice guys
x
Click to expand...

Because the balance between sugar intake and a laminitis attack in some horses is very fine, something as innocuous as a break in the work routine can tip them over. In our own case the attack happened as we were snowed in for 3 weeks and exercise was much reduced and a lamanitic attack was the result for an already carefully monitored horse.
 
The only advice I will give, and I seriously hope you take it for the sake of your horse, is to not take any advice from here and contact the laminitis trust.
 
I feel your pain! It is a heartbreaking situation to be in,and I have had to try and manage my mare through it (although her lami was the result of good grass not concussion). She will also constantly box walk if kept in for more than two days,and try to escape whenever she can. The vet that treated her for laminitis was happy for her to go in a section of field with her herd on the other side of the tape,as this actually allowed her to rest her feet. She was given soaked hay to eat,a little chaff with her danilon(bute allergy too) and he put putty "insoles" in her hooves,secured with vetwrap,rubble sacks and duct tape. My farrier is very impressed by how well her feet recovered,they are 1 size larger now,but with no long term damage.I hope your mare comes through as well as mine did.
 
Before you even consider putting your horse out on a bare paddock I would check the vet is ok with this. A pony at our yard is recovering from laminitis in his back feet and he was kept in for 7 weeks as the vet instructed too much movement would cause even more damage. He was blood tested and found to have diabetes as the concern was cushings because of him being lami clear in his fronts. Despite his owner being desperate for him to go out even for a short time, x rays showed his bone had moved 5% and 7% in the back. 12% is an end of road diagnosis so get some professional advice before doing anything!
 
Sophstar said:
Before you even consider putting your horse out on a bare paddock I would check the vet is ok with this. A pony at our yard is recovering from laminitis in his back feet and he was kept in for 7 weeks as the vet instructed too much movement would cause even more damage. He was blood tested and found to have diabetes as the concern was cushings because of him being lami clear in his fronts. Despite his owner being desperate for him to go out even for a short time, x rays showed his bone had moved 5% and 7% in the back. 12% is an end of road diagnosis so get some professional advice before doing anything!
Click to expand...

Thats an interesting post, is the pony actually recovering or is it just not getting any worse or better. I would be looking for quite an improvement after 7 weeks. I have seen horses recover from quite a lot worse than 12% rotation. There are quite a number of reasons why some horses fail to achieve a pedal bone reversal, and some people seem quite happy if they can just stop the rotation getting worse and maintaining the foot as it is.
 
He is on the road to recovery:) He is now allowed out for just an hour a day and then gets 2 small haynets of overnight soaked hay, and a handful of happy hoof. He looks like a completely different pony and he wasn't even fat to start with but is now streamline! The vet and the farrier worked with the x rays together and he has had his feet trimmed back and I think they are having another set of x rays done next week to determine if shoeing might help. They had to re run the blood tests as nothing came up the first time but second time round his glucose % (i think that's what it was) was 8% or so over the normal range. The vet says this isn't in range with him having to be medicated for it but just strict management should maintain it, so no more sugary treats!
 
cm2581 said:
The only advice I will give, and I seriously hope you take it for the sake of your horse, is to not take any advice from here and contact the laminitis trust.
Click to expand...

Absolutely. I would be contacting them and following an equine vet's advice. Laminitis can be deadly and following advice (however well intentioned) from possibly unqualified people who do not know your horse is not a good idea.

Hope everything turns out OK.
 
Thanks everyone. I plan to ring my vet again this week as he wants to see her again anyway. Im lucky as he knows her pretty well as does my farrier. Sometimes the internet scares you half to death! Will take everything on board and give the LT a go too.
New habit this morning...kicking the door and pawing the ground :-/
 
Pale Rider said:
If the diagnosis for laminitis is correct, then the use of bute as a pain killer and anti inflamitory, can seriously harm the recovery of the lamina, making recovery long, protracted and sometimes impossible.
Click to expand...

Can you provide any reference for this fairly counterintuitive claim?
 
alsiola said:
Can you provide any reference for this fairly counterintuitive claim?
Click to expand...

I have for some time been looking at the treatments for laminitis and the widely varying outcomes. The recovery time and repair to the lamina, which in turn leads to the reversal of the rotation of the pedal bone appears to be inhibited in many cases and the use of Non-Steroidal Anti-Inflammatory Drugs and the degree of their application appears to suggest that NSAID's may well be the prime cause of this. I have therefore tried to summarize published on going and current research, mostly from the US, into the treatment of laminitis using these drugs.

NSAID is the abbreviation for Non-Steroidal Anti-Inflammatory Drugs of which Phenylbutazones or bute is the most common drug used in the treatment pf laminitis. The name is given to a group of medicines that have an anti-inflammatory effect which differs from steroids. Their principal action is the inhibition of prostaglandins. Since prostaglandins play a central role in developing inflammatory reactions, their inhibition results in a diminution of this response to injury. It is customary in medicine to treat inflammation as unwelcome, although recently more and more papers question whether we should not treat inflammation as an important healing mechanism which should be respected.
While NSAID’s have an anti-inflammatory effect, they are also thought to have a pain relieving effect, though this is less substantiated. The aggressive use of NSAID’s has recently been questioned in the treatment of laminitis because of complications of NSAID therapy in the horse and lack of histological evidence of inflammation in affected laminae. High doses of Phenylbutazone were not associated with greater analgesic effects on lameness scores than was the low dosage. Considering that toxicity of Phenylbutazone is related to dosage, the higher dosage may not be beneficial in chronically lame horses
Non-steroidal anti-inflammatory drugs are the cornerstone of treatment for many painful conditions in horses, including arthritis, laminitis, and colic. Although these drugs are an important component of therapy for these disease syndromes, overuse and misuse of NSAID’s can result in gastrointestinal injury, kidney damage and even death in horses. Researchers at North Carolina State University’s College of Veterinary Medicine have investigated these drugs in horses with colic-related intestinal injury. This research has uncovered previously unknown adverse effects: NSAID’s actually retard healing of damaged gastrointestinal tissue.
However, because these drugs are absorbed systemically and are transported throughout the body via the bloodstream, they reach unintended targets where they can have adverse effects. Specifically, there is increasing evidence that two organ systems are particularly susceptible to these drugs: the gastrointestinal tract and the kidneys.
A preliminary study investigated the attitudes, and evaluated the current practice of a sample of the veterinary profession in the UK in relation to the management of pain in horses. In June 2001, a questionnaire was posted to 260 veterinarians in specialised equine practice, and 140 veterinarians in general practice with a significant equine caseload. There was a 25 per cent response rate to the questionnaire, which recorded information about the availability and prescription of analgesic drugs, the factors influencing the selection of analgesics and their administration, and estimates of the severity of pain associated with selected clinical conditions. There were considerable variations in the practices applied to manage pain in horses, implying that there are similar attitudinal barriers to the optimal management of pain in horses.
Pain relief for laminitis is usually given for long periods. The apparent need for such a strategy itself raises questions about the efficacy of the analgesic effect. The perceived need for long-term medication should also ring an alarm bell with regard to the risk of toxic side-effects. In the absence of good scientific support for the use of NSAID’s, the presence of continuous warnings about their use from researchers, and the generally unsatisfactory results from the currently orthodox management of laminitis, it seems sensible to reconsider our whole approach to this devastating disease.
When conventionally, NSAID’s are used, we know they do not offer complete pain relief for horses with chronic laminitis. They reduce the pain, ‘awaiting’ the moment the pain disappears. They also interfere with the inflammation process necessary for good healing and therefore usually prolong suffering because healing is slower or only partial.
 
alsiola said:
Can you provide any reference for this fairly counterintuitive claim?
Click to expand...

I have for some time been concerned about the treatment for laminitis and the fact that the healing process to the lamina appears in some way inhibited, leading to situations where pedal bone rotation reversal is only partial or non existant. The study of Non-Steroidal Anti-Inflammatory Drugs in the treatment of laminitis and other acute painful conditions in the horse, carried out primarily in the US suggest that the use of these drugs is the cause of this. I have attempted to summarize some of the current research, in support of my 'counterintuitive claim'. NSAID is the abbreviation for Non-Steroidal Anti-Inflammatory Drugs, of which Phenylbutazone, or 'Bute' is the most common used in the UK. The name is given to a heterogeneous group of medicines that have an anti-inflammatory effect which differs from steroids. Their principal action is the inhibition of prostaglandins. Since prostaglandins play a central role in developing inflammatory reactions, their inhibition results in a diminution of this response to injury. It is customary in medicine to treat inflammation as unwelcome, although recently more and more papers question whether we should not treat inflammation as an important healing mechanism which should be respected.
While NSAID’s have an anti-inflammatory effect, they are also thought to have a pain relieving effect, though this is less substantiated. The aggressive use of NSAID’s has recently been questioned in the treatment of laminitis because of complications of NSAID therapy in the horse and lack of histological evidence of inflammation in affected laminae. High doses of Phenylbutazone were not associated with greater analgesic effects on lameness scores than was the low dosage. Considering that toxicity of Phenylbutazone is related to dosage, the higher dosage may not be beneficial in chronically lame horses.
 
Part 2.

Non-steroidal anti-inflammatory drugs are the cornerstone of treatment for many painful conditions in horses, including arthritis, laminitis, and colic. Although these drugs are an important component of therapy for these disease syndromes, overuse and misuse of NSAID’s can result in gastrointestinal injury, kidney damage and even death in horses. Researchers at North Carolina State University’s College of Veterinary Medicine have investigated these drugs in horses with colic-related intestinal injury. This research has uncovered previously unknown adverse effects: NSAID’s actually retard healing of damaged gastrointestinal tissue.
However, because these drugs are absorbed systemically and are transported throughout the body via the bloodstream, they reach unintended targets where they can have adverse effects. Specifically, there is increasing evidence that two organ systems are particularly susceptible to these drugs: the gastrointestinal tract and the kidneys.
A preliminary study investigated the attitudes, and evaluated the current practice of a sample of the veterinary profession in the UK in relation to the management of pain in horses. In June 2001, a questionnaire was posted to 260 veterinarians in specialised equine practice, and 140 veterinarians in general practice with a significant equine caseload. There was a 25 per cent response rate to the questionnaire, which recorded information about the availability and prescription of analgesic drugs, the factors influencing the selection of analgesics and their administration, and estimates of the severity of pain associated with selected clinical conditions. There were considerable variations in the practices applied to manage pain in horses, implying that there are similar attitudinal barriers to the optimal management of pain in horses.
Pain relief for laminitis is usually given for long periods. The apparent need for such a strategy itself raises questions about the efficacy of the analgesic effect. The perceived need for long-term medication should also ring an alarm bell with regard to the risk of toxic side-effects. In the absence of good scientific support for the use of NSAID’s, the presence of continuous warnings about their use from researchers, and the generally unsatisfactory results from the currently orthodox management of laminitis, it seems sensible to reconsider our whole approach to this devastating disease.
When conventionally, NSAID’s are used, we know they do not offer complete pain relief for horses with chronic laminitis. They reduce the pain, ‘awaiting’ the moment the pain disappears. They also interfere with the inflammation process necessary for good healing and therefore usually prolong suffering because healing is slower or only partial.
 
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My mare has never had lami in the 21 years i own her , she was treated for tendon problems at first which delayed treatment.

Now xray confirms she has it in one foot mainly , but no IR and no Cusshings.My mare escaped and made her lami worse. My mare has asthma too.

I soak her hay up to 1 hr , I was told not to feed haylage. She is also on formula for feet and laminator , she isnt aloud out yet . She has styrofoam pads on and 1 bute am and pm.

I am however going to change her to danylon as soon as that is finished .

You could get some Heras fencing . We have loads of this here made our round pen out of it too.
You could try sedaline while she is in calm her down .


Speek too the Laminitis Society and speek to your vet.

Your mare:

She might be not showing lameness but being out could tip her over the edge like it did with my mare when she escaped.
COPD is manageable with proper care. I think you need to find out exactly what the state of her problem is , as leaving it or doing turnout walking round to soon could make her worse. Specially if it is concussion , her hooning around could be detrimental to her.
 
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Leviathan thanks for your reply. Bute finishes today as does the sedalin. Shes coped really well COPD wise its just horrible seeing her so fed up bless her. Hope everyones make a good recovery x
 
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