Laminitis with no improvement

[ester]

They are terrible xrays which if left much looks make it look like the decision will be taken away from you, your vet and your farrier.
There is a reason this is ongoing and not improving for her but we can't always resolve those reasons.

 

[splashgirl45]

so sorry,its a bit late for the vet to say insulin levels need to be bought under control, someone should have looked at this issue before.... in your shoes i would PTS as soon as possible as there is significant sinking in both x rays...please stay strong and remember you are the one to make a decision not the vet....hugs xx

 

[holeymoley]

There seems to be quite literally mm’s between the bone coming through the sole.
I’m so sorry this is the outcome xx

 

[PSD]

I’m absolutely baffled at my vet. It’s not
The reaction from him that I expected, the thing is she’s already on metformin and it isn’t bringing her levels down but how does he know this without tests? How can he be certain that’s what’s causing it? I’m just in a bit of state of shock right now if I’m honest. I knew they would be worse results but more to the fact of my vet is happy to continue even when they look like this

 

[ycbm]

I have to ask PSD.

Why are you letting him?

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[holeymoley]

I’m so sorry this is the case. If it was insulin resistance then I’d expect to see it at least to have corrected itself even slightly with the diet she’s been on.

I’d bute up to the max so that she’s as pain free as possible, and give her the biggest bucket of carrots/apples/grass/her favourite food and let her go with that last bit of spark xx

 

[Rosemary28]

Sending big hugs PSD. Stay strong, your little mare is so lucky to have you xx

 

[DabDab]

I’m absolutely baffled at my vet. It’s not
The reaction from him that I expected, the thing is she’s already on metformin and it isn’t bringing her levels down but how does he know this without tests? How can he be certain that’s what’s causing it? I’m just in a bit of state of shock right now if I’m honest. I knew they would be worse results but more to the fact of my vet is happy to continue even when they look like this

I know it's difficult and the vet really isn't helping, but you have to get on the phone again and tell them in no uncertain terms that you want her pts asap.

The vet isn't the one who may have to go down tomorrow morning and find their beloved horse with bone broken through the sole of her hoof, you are.

 

[Pearlsasinger]

I have to agree with the others.
As I think I said before I have had 2 equines pts because of laminitis. the Section Apony had a resection but was pts eventually, she was a managed laminitic leading a good life with her field companions but got some sheep feed when the wind blew a bag into her field. The other was a young Shire, which I now think had PPID but it's years ago. Her pedal bone dropped until it was almost through her sole, farrier was horrified that vet had allowed that to happen. She was pts then. It is a horrible decision to have to make but it has to be made in the best interests of the horse.
You can't let this go on any longer.

 

[ycbm]

PSD I'm sorry if I'm wrong but I'm picking up signs that you are waiting for the vet to tell you its OK to give up. He isn't going to, he has his own agenda and his ego is too invested in "winning".

I'm so sorry, but you need to summon every ounce of your inner strength and make the right decision for her, very soon.

The x rays are truly horrific.

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[meleeka]

So the cause hasn’t been found because she’s still getting worse. Everything has been tried to try and treat the cause and it hasn’t worked. If the vet thinks the insulin is too high still what does he propose to do about that? Wave a magic wand?
I think you need to get your brave pants on and ask the vet to come and pts. I was one of the people who thought it was worth a shot, but these latest xrays would make me make the call. I’ve seen worse but the cause was found and treated (Cushings) There is literally nothing else to try

 

[PSD]

So the cause hasn’t been found because she’s still getting worse. Everything has been tried to try and treat the cause and it hasn’t worked. If the vet thinks the insulin is too high still what does he propose to do about that? Wave a magic wand?
I think you need to get your brave pants on and ask the vet to come and pts. I was one of the people who thought it was worth a shot, but these latest xrays would make me make the call. I’ve seen worse but the cause was found and treated (Cushings) There is literally nothing else to try

well she came back positive for EMS but he now thinks the dose isn’t high enough. I’m not really sure how he can decide that’s the case when he hasn’t checked her insulin levels

 

[PSD]

PSD I'm sorry if I'm wrong but I'm picking up signs that you are waiting for the vet to tell you its OK to give up. He isn't going to, he has his own agenda and his ego is too invested in "winning".

I'm so sorry, but you need to summon every ounce of your inner strength and make the right decision for her, very soon.

The x rays are truly horrific.

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no you’re right that’s what I was hoping would happen. But now I have a totally different view about the vet completely

 

[ITPersonnage]

PSD I'm sorry if I'm wrong but I'm picking up signs that you are waiting for the vet to tell you its OK to give up. He isn't going to, he has his own agenda and his ego is too invested in "winning".

I'm so sorry, but you need to summon every ounce of your inner strength and make the right decision for her, very soon.

The x rays are truly horrific.

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What she said. I'm literally looking at this story unfolding and thinking WTF?

 

[Roxylola]

Not only that, the vet cant recommend pts. If they do and then insurance wont pay out you could sue them. If there are other options they are a bit stuck really they have to keep suggesting how you can treat

 

[meleeka]

well she came back positive for EMS but he now thinks the dose isn’t high enough. I’m not really sure how he can decide that’s the case when he hasn’t checked her insulin levels

That could be correct since there’s only so many things it could be, but time isn’t on your side here. He should have put her on the highest dose he dared given how precarious the situation was when you called him. Somebody said earlier that metformin tends to lose its efficiency over time (I’ve no idea if that’s correct) and if you can’t lower the insulin enough with diet when she’s on box rest, what hope does she have?

 

[PSD]

Not only that, the vet cant recommend pts. If they do and then insurance wont pay out you could sue them. If there are other options they are a bit stuck really they have to keep suggesting how you can treat

Is that true? I thought you had to keep going with the vet until they have no options left?

 

[Roxylola]

Is that true? I thought you had to keep going with the vet until they have no options left?

The vet is really obligated to keep going as long as you want to keep going. You can tell the vet at any point you want to pts and they will but if you want to keep treating they wont say otherwise

 

[Equi]

I’m sorry it’s come to this. I wouldn’t be waiting for the vet to pts at this point. Insurance be dammed. Get a gun out.

 

[southerncomfort]

Those xrays are absolutely horrific. She must be in absolute agony.

No half decent vet could look at those xrays and not at least suggest PTS as an option. I'm absolutely horrified and disgusted at your vet.

If you struggle to get your view across on the phone, try writing it down before you make the call (I'm sure someone on here could help you with what to say).

I'm so upset on your behalf. Losing a horse in any circumstances is incredibly painful, but to have to fight to end her suffering must be making it a hundred times worse.

 

[be positive]

Is that true? I thought you had to keep going with the vet until they have no options left?

You may not get an insurance payout, I hope that will have no bearing on your actions, but there is nothing to stop an owner having any horse pts, they may be perfectly healthy and the vet can refuse but having lost a few over the years, some which had treatment options but I was not happy to treat for my own reasons, usually quality of life after treatment, I have never had a vet question my decision.

1 did look at the perky bright pony stood in lush grass and thought it may be too soon but she only told me that after he dropped very quickly and her words were ' he was ready to go, I thought he would fight it he looked so bright' he was a chronic laminitic that had fought through a bad time, come sound but got it again a few years later and I was not prepared to make him go through another fight so he had an hour on lush grass, hence looking bright and cheeky and went quietly.

If the vet will not pts I would get the local hunt out as I know them and they are extremely caring, good with the horses and not too bad at dealing with the owner but ideally have your OH there so you can have a proper hug, it is not a good time for social distancing.

 

[ycbm]

The vet is really obligated to keep going as long as you want to keep going. You can tell the vet at any point you want to pts and they will but if you want to keep treating they wont say otherwise

This isn't true Roxylola, sorry. A good vet will tell an owner that the time has come.

The insurance will pay as long as the vet says it's a welfare issue.

This vet isn't going to. PSD is going to have to forgo the insured value of her pony. Treatment will be covered.

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[Roxylola]

Ycbm, perhaps some will. I think it depends on the owner and how well they know each other. I'm actually pretty confident my own vet would but we have very similar points of view. And I think maybe on how you ask - so what now? Or what do we do next is a very different question from an owner you dont know who has been keen to treat an animal up to now vs do you think it's time? From an owner who you've known for years and emphasises quality of life

 

[AmyMay]

Sorry op, but I really hope you’ve made arrangements for her to be put down tomorrow ??

 

[ester]

Given that the most accurate insulin tests require dextrose/karo syrup feeding do you really want to be doing that with a horse this much on the edge?

If my vet wouldn't do it I'd call someone else.

 

[TheMule]

Thank goodness you listened to your horse and had the x-rays done today not next week. Now you can put her out of her misery in secure knowledge that it was the only option for her rather than always wondering 'what if'

 

[PSD]

Given that the most accurate insulin tests require dextrose/karo syrup feeding do you really want to be doing that with a horse this much on the edge?

If my vet wouldn't do it I'd call someone else.

she’s had that test done a while back when I switched to the new vets.

I had the hunt come take care of my old cob last year and they were fantastic, they will be the option if the vets dont comply. I can’t arrange anything now as they are closed but I have them calling me first call tomorrow morning.

 

[PSD]

I feel very let down by the vets, both that I have used have failed my horse. I’m shocked at how much has changed within her feet in such a short space of time, absolutely nothing has changed with her management I just don’t understand it at all.

 

[ycbm]

You have been very let down.

At some point, PSD, so many laminae have died that the foot just can't cope mechanically with the load. She may have got no worse (or even better) EMS wise, but laminae have probably still been snapping because they are taking too much load.

Its very common in horses with a broken front leg for the foot on the other leg to founder purely because of the strain, no diet issues at all.

Be strong tomorrow, our thoughts will be with you.

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[View]

Oh goodness, stay strong and ensure your girl goes peacefully. Hugs.