Laminitis with no improvement

[PSD]

So they have been on about 5 weeks? that they are on at all is questionable and if they have any chance of helping they need to be redone every 4 weeks ideally but to me she sounds in too much pain to have 4 shoes done, I have dealt with a few laminitics over the years and all have become comfortable very quickly, apart from the one I mentioned earlier, on the right meds, a decent bed and a good farrier.
I think your vets have let you, and the horse, down from the very start, not uncommon they are not infallible, despite at times thinking they are, I think you need to call in the morning, if there is a senior partner you can speak to do so, get whoever is available to come out and be prepared to call it a day, they should accept your decision if there is nothing they can do to make her far more comfortable it is not fair to keep her going barely able to stand, looking at her long term future, and your commitment as the owner must also be a consideration, mine became a real challenge to keep weight off, keep in a restricted area, he took up so much time, caused a lot of stress, had a few more years but in the end I called it a day when he was teetering on the edge again after yet another day in the wrong field having jumped out to get to more grass, he had fun but I was spending most of my time worrying about what he was up to.

No so she had her first set on 5th feb and then I had a second farrier look at her who wanted to put the frog supports in but after looking at her x rays suggested aluminium shoes so she had these fitted after the second x rays on 26th. So she’s due another trim/x ray either next week or the week after but personally I would like it done sooner rather than later. The fact the vet dismissed that the x ray machine was broken and he would just do al 4 together really annoyed me and my farrier said it shouldn’t really have been left that way as he has only fitted the shoes in a way he could “guess” that was right.

having spoke to a close friend and the advice here from you guys I’m going to cal a different vet practice tomorrow and explain everything to them. I’ll also ring my insurance to just make sure i will still be covered for a second opinion, I just feel very let down and frustrated

 

[PSD]

Just like to add that the vet had to sedate her for the back shoes to go on.

 

[PSD]

I feel like a terrible owner now for allowing things that quite obviously shouldn’t have been done

 

[Equi]

I think you need to make some demands not ask advice any more. Most here agree the shoes should not be on - get a new farrier out and get them off and try filler. Have you had a look on fb or the like for laminitis specialists? get those xrays to a new vet (and yes you may have to pay extra for them to even look at them tomorrow if they will at all) but it really needs to be dealt with tomorrow. I don’t think you have any faith in your current vet so change them. It depends what outcome you really want here - is this going to drag on for many more months and what state will she be in “after” if any state? The biggest issue is you don’t know what triggered this. Try soaking the hay again but only for 10 mins and see how she does with it. Mix it with some dry stuffs so it may fool her a little until she can get used to it, it may seem futile but it could reduce the sugars a tiny bit.

set yourself a time limit too. Sending good vibes to you both x

 

[Equi]

I feel like a terrible owner now for allowing things that quite obviously shouldn’t have been done

You were following advice of a professional, it’s all many of us can do if we don’t have the experience of these things. Don’t be sorry about the past, focus on what you can do for the future.

 

[be positive]

I feel like a terrible owner now for allowing things that quite obviously shouldn’t have been done

Don't feel like a bad owner, you have been trying your best and can only follow advice given by the pros, it is only when we start to ask more questions that we find there may be different options, I have followed the advice of vets and sometimes regretted it, we want our horses to get better so put our trust in others when we need to, if it all goes well everybody feels good, when it goes wrong we feel guilty it is only natural but you should not blame yourself, see what tomorrow brings, take care of yourself.

 

[Fragglerock]

I know someone whose horse had a problem it turned out it was laminitis caused by toxins. She ended up with a second opinion before she got the diagnosis. The horse was in a very bad way and it took 18 months but she is now riding her again and the mare looks great. However the horse was in a lot of pain and it has cost a lot of money to get her to where she is, I'm not sure I would have done it. I say this with a horse that has been on/off with laminitis and abscesses for nearly 18 months now but he was never in a great deal of pain with the laminitis (abscess was different) only could be described as uncomfortable.

 

[holeymoley]

They’re not the worst x rays or rotation. However the problem you have is that clearly the cause is still there which is why there’s no improvement. I would be concerned that the painkillers don’t seem to be working. It’s good that she’s lying down and it’s good that she’s back to eating. I know you say she won’t eat soak hay but I would not be slow in stripping every form of food back so that she has a very very plain diet. Something like topchop zero to carry the meds/vitamins. You really need to look at the hay too and try and get it soaked even for half an hour. That shouldn’t reduce the palatability too much.

 

[PSD]

They’re not the worst x rays or rotation. However the problem you have is that clearly the cause is still there which is why there’s no improvement. I would be concerned that the painkillers don’t seem to be working. It’s good that she’s lying down and it’s good that she’s back to eating. I know you say she won’t eat soak hay but I would not be slow in stripping every form of food back so that she has a very very plain diet. Something like topchop zero to carry the meds/vitamins. You really need to look at the hay too and try and get it soaked even for half an hour. That shouldn’t reduce the palatability too much.

My vet seems to stick by the fact that it’s a DDFT injury that has brought it on and they can’t fix this until the laminitis has cleared up so they say. She’s on plain chop just so I can get her meds into her, I’ll give the soaking a go like you say even if it’s just 30 minutes it could be the breaking point. As you say for the amount of pain relief she is on, for her to not even be comfortable enough to manoeuvre is very alarming.

I was also told metacam isn’t good for long term use, how long is classed as long term?

 

[PSD]

I know someone whose horse had a problem it turned out it was laminitis caused by toxins. She ended up with a second opinion before she got the diagnosis. The horse was in a very bad way and it took 18 months but she is now riding her again and the mare looks great. However the horse was in a lot of pain and it has cost a lot of money to get her to where she is, I'm not sure I would have done it. I say this with a horse that has been on/off with laminitis and abscesses for nearly 18 months now but he was never in a great deal of pain with the laminitis (abscess was different) only could be described as uncomfortable.

that’s interesting. What were the toxins from? This is the thing I’m faced with, do I continue with the treatment and spending of money or do I let her go whilst she’s still somewhat bright - before it gets to the point where I HAVE to let her go. If this was me talking to someone else I know what I’d be advising but it’s so much harder when it’s your own and I really don’t want to give up on her

 

[holeymoley]

Unfortunately I don’t have any experience with laminitis being brought on by tendon injuries. I imagine it’s the case of the strain on the joints and trying to compensate for the pain. So it’s mechanical laminitis.

I can only compare to my gelding’s unfortunate experience with laminitis which was due to ems. Somewhat ‘easier’ to manage as the causes could be identified and eliminated very quickly by stripping the diet back to basics. He suffered extreme rotation and was on a very bumpy ride for the first 15 weeks. He was on 4 bute per day which seemed to take the worst off the pain off him. My concern with your case is that the pain relief doesn’t seem to be working.

 

[holeymoley]

I also put my guy on Zeolite which removes toxins.

 

[PSD]

I can’t seem to upload a video to show you how she is movement wise. That’s also my concern, I don’t expect her to be bouncing around but the fact she’s still in this amount of pain at this stage is worrying me quite a lot

 

[holeymoley]

Out of interest- you say she’s predisposed to ulcers. Are you giving anything along side for the stomach with the medication? Wondering if there’s something thats allowing them maybe not to work as well. Meds long term are not ideal for the liver or the tummy either.

 

[PSD]

Out of interest- you say she’s predisposed to ulcers. Are you giving anything along side for the stomach with the medication? Wondering if there’s something thats allowing them maybe not to work as well. Meds long term are not ideal for the liver or the tummy either.

no she isn’t on anything for the ulcers now as they’ve cleared up

 

[be positive]

no she isn’t on anything for the ulcers now as they’ve cleared up

I hate to say this but after 3 months of pain and meds they are likely to be back, they are at the moment less of a consideration than the feet but it is something to consider when you speak to the vets.

 

[Leo Walker]

Soak the hay in warm water. It will be soaked enough in 30mins and then rinse well. Even my fussy idiot eats it done that way.

 

[Fragglerock]

that’s interesting. What were the toxins from? This is the thing I’m faced with, do I continue with the treatment and spending of money or do I let her go whilst she’s still somewhat bright - before it gets to the point where I HAVE to let her go. If this was me talking to someone else I know what I’d be advising but it’s so much harder when it’s your own and I really don’t want to give up on her

Unfortunately I don't know any further detail as I was told by someone about her after she had gone past. If I see her again I will ask her.

 

[ester]

Mechanically I am confused about lifting the heel of a rotated laminitic. That's the opposite of what is usually done in order albeit it is usually suggested that the heel is lowered slowly. It is also totally inappropriate that the shoes have been on for 5 weeks, the trim will not be appropriate for now.

I have never heard of laminitis being brought on by a DDFT injury and am aware of plenty of those. Indeed cutting the DDFT is still sometimes used as a laminitis treatment (generally not recommended by those I would listen to).

Re. the toxins, that was sort of what I was getting at when I suggested something systemic and missed might be going on.

If you are unable to get your head around PTS then IMO you need to be doing some research now for second opinions, and be on the phone Monday morning arranging an appointment. I would also be messaging andrew poynton to see if anyone was imprint trained in my area or ordering some easyboot clouds asap.

Some useful links re.trimming etc by people who know much more than I do
https://forageplustalk.co.uk/the-realigning-horse-hoof-trim-dr-kellon/
https://www.imprintshoes.co.uk/treatment-of-laminitis/
https://www.daisyhavenfarm.com/blog/cloud-9-about-easyboot-clouds

 

[PSD]

Mechanically I am confused about lifting the heel of a rotated laminitic. That's the opposite of what is usually done in order albeit it is usually suggested that the heel is lowered slowly. It is also totally inappropriate that the shoes have been on for 5 weeks, the trim will not be appropriate for now.

I have never heard of laminitis being brought on by a DDFT injury and am aware of plenty of those. Indeed cutting the DDFT is still sometimes used as a laminitis treatment (generally not recommended by those I would listen to).

Re. the toxins, that was sort of what I was getting at when I suggested something systemic and missed might be going on.

If you are unable to get your head around PTS then IMO you need to be doing some research now for second opinions, and be on the phone Monday morning arranging an appointment. I would also be messaging andrew poynton to see if anyone was imprint trained in my area or ordering some easyboot clouds asap.

Some useful links re.trimming etc by people who know much more than I do
https://forageplustalk.co.uk/the-realigning-horse-hoof-trim-dr-kellon/
https://www.imprintshoes.co.uk/treatment-of-laminitis/
https://www.daisyhavenfarm.com/blog/cloud-9-about-easyboot-clouds

I could be wrong about the heel thing, I’ve been told that much info about her.
She’s had the shoes on for 2 weeks not 5, I’ve just spoken with another vet to have a second set of eyes look at her and they’ve asked for the information to be sent over to my current vet ASAP so that will be being done first thing on Monday morning. One of the liveries suggested getting my current vet back to x ray but I feel like that’s a complete waste of time given the way they’ve been so far.

would something to do with toxins show up on a regular cushings/ems test? Or would it need to be a different kind of blood test?

 

[ester]

A sorry, I should have gone back and checked I understood what I read last night!

Re. the toxins, no it wouldn't and I'm a) not sure where you start with that, b) am not sure it is always entirely doable. I think the general consensus is if you have a case that is not improving despite best management and treatment (the latter might not be the case here entirely) that there is something underlying perpetuating it but not always findable or resolavable.

I am glad to read you have been in contact today. I would stop with current vet and see what the new one says. I'd want someone to xray with markers and measurements, limited point in taking more without.

 

[PSD]

A sorry, I should have gone back and checked I understood what I read last night!

Re. the toxins, no it wouldn't and I'm a) not sure where you start with that, b) am not sure it is always entirely doable. I think the general consensus is if you have a case that is not improving despite best management and treatment (the latter might not be the case here entirely) that there is something underlying perpetuating it but not always findable or resolavable.

I am glad to read you have been in contact today. I would stop with current vet and see what the new one says. I'd want someone to xray with markers and measurements, limited point in taking more without.

that’s okay it’s confusing!

I think you could be right, from experience laminitics usually show some sign of improvement/comfort once pain relief is started and necessary measures put in place but this is just not the case for us. I’ve been to her this morning and still no chance for her, she hadn’t touched her morning net which I soaked for 30 minutes, nor had she eaten much of her tea net that wasn’t soaked. She’s had her feed which is plain chop just to her her medication into her but then she didn’t really touch her breakfast feed. But saying that she’s never been a pony to finish it in one go, she usually has it gradually over the day so I’m not massively concerned in that respect. That said, if she is off her hay then I’d imagine she’d be quite hungry and wolf it down.

I think that’s going to be my next route, I should have done this the first time I wasn’t happy with their input and I will absolutely kick myself now if it’s gone past the point of no return due to their lack of service

 

[Honey08]

I’d be upset at your vet’s general lack of concern or urgency regarding the fact that the horse has been in constant acute pain for such a long time. They seem to be of the “see what happens over the next few days” camp. I think a second opinion is needed urgently and if this horse cannot be made more comfortable ASAP I think it’s sadly time to let them go. Quality of life is so important to me.

 

[Honey08]

Sorry, I meant to say best of luck.

 

[Chianti]

My mare came down with laminitis just before the new year. My vet suggested it was a torn DDFT however she worsened gradually and the vet finally agreed to x ray her 2 weeks later. They found she had slight rotation in both fronts but enough toe to take off to correct this, the farrier was contacted with the x rays and the heartbar shoes went on. She seemed a lot worse after they were fitted so they were changed to aluminium heartbars and she was re x rays before these went on. Within 2 weeks she had rotated further and they vet and farrier diagnosed her with laminitis in her back feet. They have not yet managed to x ray her backs due to the machine being broke but she has heartbars fitted at the back just for some support. Farrier has suggested keeping her bed quite wet to help her feet expand and aid healing, which I’ve done. She is on 30 paracetamol a day, 500ml (I think - 500 on the syringe) metacam and now 1.5 sedalin a day to keep her heart rate down as it was double what it should be. She can barely move, she’s hardly eating and just really fed up.
Has anyone any experience with anything like this? The vets advised me to walk her if she will walk (which she won’t) but it’s bothering me how much she’s struggling with the amount of pain relief she’s on and with how long it’s been. She can’t even move over in the stable, her back legs are actually at a point where they look like they’re about to buckle any moment. I just feel like there’s something we’re missing, she doesn’t seem to be improving whatsoever, or is this just how lami goes? I do have her x ray photos and videos of her moving (or lack of) too.
Appreciate any comments.

I don't know if this has been commented on already but I would be concerned at the farrier's suggestion about bedding. If she's uncomfortable it would really help to have her on a very deep shavings bed. My last horse got laminitis and was obviously in some pain. Her shavings bed was already deep but I put another three bales in so you had to step up to get into her box from the door. I know the vet was pretty pessimistic but she didn't move from the stable for nearly a week and when I risked checking her out of it she was much better and did go on to recover. I wouldn't think about trying to move her out of the box as this risks more damage. I would always look at Robert Eustace's web page for advice. I really sympathise as it's a dreadful thing to have to deal with. I would get a second opinion asap and decide what to do from there.

 

[PSD]

I’d be upset at your vet’s general lack of concern or urgency regarding the fact that the horse has been in constant acute pain for such a long time. They seem to be of the “see what happens over the next few days” camp. I think a second opinion is needed urgently and if this horse cannot be made more comfortable ASAP I think it’s sadly time to let them go. Quality of life is so important to me.

I fully agree with you on this one. I’m getting a second opinion hopefully Monday and then will go from there. If she can’t be made comfortable then I can’t see her being able to recover, as well as that I’m not prepared to prolong her suffering anymore. I’ve owned her all her life and she is almost 11, I owe it to her to make the right decision

 

[PSD]

I don't know if this has been commented on already but I would be concerned at the farrier's suggestion about bedding. If she's uncomfortable it would really help to have her on a very deep shavings bed. My last horse got laminitis and was obviously in some pain. Her shavings bed was already deep but I put another three bales in so you had to step up to get into her box from the door. I know the vet was pretty pessimistic but she didn't move from the stable for nearly a week and when I risked checking her out of it she was much better and did go on to recover. I wouldn't think about trying to move her out of the box as this risks more damage. I would always look at Robert Eustace's web page for advice. I really sympathise as it's a dreadful thing to have to deal with. I would get a second opinion asap and decide what to do from there.

She was originally on a really deep shavings bed but the farrier said it was too dry and was making her feet too hard. He advised me to wet it through getting moisture to her feet which would help them expand and aid healing. Something I’ve never heard off but I was willing to try anything.

I won’t be moving her, I told the vet that which in his defence he did say only when she is willing to however she can’t even back up or move over in the stable, she just stands in the same spot shifting her feet

 

[Chianti]

She was originally on a really deep shavings bed but the farrier said it was too dry and was making her feet too hard. He advised me to wet it through getting moisture to her feet which would help them expand and aid healing. Something I’ve never heard off but I was willing to try anything.

I won’t be moving her, I told the vet that which in his defence he did say only when she is willing to however she can’t even back up or move over in the stable, she just stands in the same spot shifting her feet

I would make it deep again - if she's shifting her feet then the extra support might help. You can buy Hoof Moist to put on if her hooves are drying out. I don't know where you are but the farriers at Total Foot Protection in West Sussex are great - Mike Williams is a genius with problem feet. Might be worth giving Robert Eustace a call as well. He will know what's recoverable and what isn't.

 

[ester]

I presumed bed was still deep, just damp?

 

[PSD]

I presumed bed was still deep, just damp?

Yes however it probably isn’t as soft as a dryer bed. But the farrier said it would still support her feet