Laminitis

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HOWEN

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Had the vet out for one of my horses today and he has been diagnosed yet again with laminitis. He had his 1st attack last spring and has slowly recovered, had a couple of mild attacks since. I am so careful with his diet, he is muzzled when turnout, has his hay soaked 24hrs ect everything the vet has recommended. I noticed yesterday he was very slightly lame when he came out his box, and to be honest I thought he had done a tendon. Being a complete worry wart, I am straight on the phone to the vet. The receptionist now knows me quite well it seems I am always on the phone to her. Anyway my vet, who has now been out and examined him, has informed me sadly he has laminitis again. So he is on box rest, with an even bigger shavings bed. Vet is coming back out next week to take bloods he thinks he may have something similar to human diabetes causing reoccurring attacks. So is anyone else in the same boat? What is your daily routine to keep them happy as possible?
 
well similar boat

my mare has been box rested since 11th july laminitis .

since the initial attack we had founder rotation infection of pedal bone abscess. etc still lame now just had xray again..

has your vet mentioned founderguard ??? My mare is on it. Its not cheap

£ 350 for 7 months course you give very little and it helps prevent founder and laminitis ; have a read of their site http://www.founderguard.uk.com/laminitisquestions.html

sorry to hear this i been pulling my hair out with worry but happier that she is on founderguard. Pm me if you want .



my routine is feed turn out others muck out half yard then feed her with her supplements founderguard 1 measure am laminator 1 bute and anti biotics of infection soya oil an muck out while she eating
1 section soaked hay over night then rinsed and fed.


lunch 1 section been soaked all night rinse and fed 30 mins equilibrium massage while i change her styrofoam pad

pm do the rest of horses then

give her eve feed with supplements anti biotics, flexi joint soya oil formula4feet laminator
1 section soaked hay as before , then late pm around 9 1 section mauve haylage for laminitics

she is on over a foot bedamax and add one in every day or 2
 
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Ask for blood and liver function test. If you are doing everything else right, then it def could be diabetes related and taking a look to see if mineral deficiencies are present will help balance things out and give you a better idea on management e.g. What to add or take out.

If vet confirms imbalance on lft, then don't give broad spectrum supp. You won't know what you will be overtopping with as some can cause more harm than good in large doses.

There is evidence to show magnesium is beneficial in humans with type 2. I should think if your vet is up to speed, he will suggest metformin trial with or without mg depending on results.

Also, contrary to popular belief, if deep bedding, it is better to remove shoes to allow sole support and increase circulation. What has happened is the weak laminar will be tearing each time he puts foot down so you want foot to be supported. Booting and padding is best way to keep comfortable.
 
Possibly IR or Cushings get him tested for both but dont use the dex test for the cushings diagnoses , What do you feed him?

Might be that he cant quiet deal with the grass, my IR girl cant have grass at all is out in a bark turnout with her hay and is now doing really well she has had 3 lami attacks quiet serious with rotation (good farrier is a must also) laminitis is the worst thing ever i hate it so sorry your little man has to deal with it if only there was a cure!
 
tallyho! said:
Ask for blood and liver function test. If you are doing everything else right, then it def could be diabetes related and taking a look to see if mineral deficiencies are present will help balance things out and give you a better idea on management e.g. What to add or take out.

If vet confirms imbalance on lft, then don't give broad spectrum supp. You won't know what you will be overtopping with as some can cause more harm than good in large doses.

There is evidence to show magnesium is beneficial in humans with type 2. I should think if your vet is up to speed, he will suggest metformin trial with or without mg depending on results.

Also, contrary to popular belief, if deep bedding, it is better to remove shoes to allow sole support and increase circulation. What has happened is the weak laminar will be tearing each time he puts foot down so you want foot to be supported. Booting and padding is best way to keep comfortable.
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Completely agree with this,

Is there any reason why your vet hasnt taken blood yet? The sooner the better because then they can start treatment sooner.

Also agree with taking the shoes off and putting lilypads on, ensures they are comfortable.

As you have had laminitis problems in the past then i would think it would be IR, which is what my horse was diagnosed with in June. He was put on metformin whilst on boxrest to stablise blood sugar, I would push the blood tests asap.
 
Thank you for all your comments. He is actually barefoot, always has been. The vet seemed quite please with this at the moment. He did mention bar shoes, but not 100% certain of these will have to google it. My farrier is due on Friday so I am looking forward to having a good chat with him. He is on bute for a week and I need to call the vet to let him know how he is doing and arrange bloods. The vet didn’t want to take samples as he said when he is having a bout of lami it could affect the results. He assured me this is a very mild bout and not to worry too much, but yes he does think he may have Insulin Resistance. He told me to soak my hay for 24hrs rather than the 12hr I have been doing, he was also pleased he was on Protexin. My horse is quite happy in himself hence the reason I thought it was a tendon. Last time he had an attack he became very depressed.
 
One of my mares went down with acute laminitis mid August last year. She could barely move, and in the few strides that she did take when forced, she looked as though she was going to keel over any second.

She was, and is, unshod. I would be very very wary of shoeing a laminitic. My belief is that unshod is best for a laminitic for several reasons, primarily:

- it is the only way that you can ensure that the compromised hoof wall doesn't take too much weight (with any kind of shoe, the hoof wall only has to grow 1mm and then it is still only the wall which is bearing the load). Therefore without a shoe there is less distance to sink, and fewer forces to cause sinking. Worth asking your trimmer/farrier to show you how to just rasp the wall every few days to ensure that you avoid the wall taking too much weight as it grows.

- It is the only way to be able to regularly adjust the heels backwards and to keep the breakover at the toe well back, thus reducing further leverage forces (and discomfort) on the already compromised foot. Some types of shoes DO have a cut back toe, but the moment the foot starts to grow at all, you are stuck with a breakover coming ever further forward until the shoes are removed and retrimmed. Much better IMHO to be able to rasp the toes back every few days to avoid leverage forces and further damage. In this way, you can also help ensure that the new hoof growth comes in at a good angle and is not compromised by leverage forces.

- You will tend to notice an unshod horse becoming footy before you would with a shod one. So you get an "early warning" of impending laminitis, and can react that much more quickly to it.

Be prepared to have to stick to your guns and ignore peer pressure and/or vet pressure to put on shoes.

Find a trimmer/farrier who has EXCELLENT success with rehabilitation of laminitic horses/ponies and learn all you can from them.

I'd also recommend the ECIR group that has already been suggested.

I also found these sites useful for weight control and management generally:

http://www.dodsonandhorrell.com/nutrition-feeding-advice/laminitis.html (with a link on that page to their other leaflet on laminitis)

And this one from World Horse Welfare's website:

http://www.worldhorsewelfare.org/information/right_weight_advice

This website from the manufacturers of Prascend (the tradename for pergolide for horses) explains equine Cushing's /PPID very well. Cushing's is one of the things the vet may blood test for, and is definitely worth having done if your horse has had more than one attack of laminitis and/or is around 12 years of age or over. With Cushing's, a lot of people find that pergolide is the only way they can really minimise the risk of another laminitis attack:

http://www.prascend.co.uk/

Your vet will probably also test for glucose and insulin resistance (IR). If your horse is insulinresistant, it probably points to either Cushing's or EMS. Some horses with EMS are prescribed metformin to help bring their weight down whilst they are unable to lose weight through exercise (whilst uncomfortable with laminitis). I think I'm right in saying that metformin tends to be used fairly short term. The idea being that longer term, you use regular exercise to help keep insulin resistance low (and therefore reduce the risk of laminitis that way).

Liphook vet hospital's info sheets on Cushing's (PPID) and equine metabolic syndrome (EMS) are also really informative:

http://www.liphookequinehosp.co.uk/interpretation.php

Oh, the other thing I've found really useful have been hoof boots so that once we were past the acute phase, I could actively encourage my pony to move around, at a slow walk, to encourage circulation and healing. I found old mac G2 boots easiest to put on and take off while she was still fairly uncomfortable. Then I've moved on to boas (which I had anyway), but the boas become more awkward to put on as the hoof changes shape (what I found was that as the old hoof wall flares out more, it gets difficult to fit the boa up over the heel of the foot).

But the boots have made an amazing difference to her comfort levels whilst she recovers. We've now just got a couple of mm to grow out of old hoof wall, and she gallops round the arena loose with the other ponies , but is still a little slow walking round the arena under rider. On hacks, she strides out about 80% of normal as long as she's wearing her boots on her front feet.

I love this Pete Ramey book (care and rehabilitation of the equine foot), and it has a mixture of pretty scientific stuff and more easily readable info. Not cheap but well worth investing in as part of your rehab programme:

http://www.hoofrehab.com/

Hope your horse does well. Once you have been able to identify the cause of the laminitis, it'll be easier to plan to minimise it recurring.

Sarah
 
flintfootfilly said:
I love this Pete Ramey book (care and rehabilitation of the equine foot), and it has a mixture of pretty scientific stuff and more easily readable info. Not cheap but well worth investing in as part of your rehab programme:

http://www.hoofrehab.com/
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Or, get your vet and or farrier to invest in a copy. ;) Pete Ramey gives good description and explanation of how to trim a laminitic hoof. Also on his 10 DVD series 'Under the horse.' http://www.hoofrehab.com/underthehorse.htm

Fingers crossed for your horse.
 
Leviathan said:
well similar boat

my mare has been box rested since 11th july laminitis .

since the initial attack we had founder rotation infection of pedal bone abscess. etc still lame now just had xray again..

has your vet mentioned founderguard ??? My mare is on it. Its not cheap

£ 350 for 7 months course you give very little and it helps prevent founder and laminitis ; have a read of their site http://www.founderguard.uk.com/laminitisquestions.html

sorry to hear this i been pulling my hair out with worry but happier that she is on founderguard. Pm me if you want .



my routine is feed turn out others muck out half yard then feed her with her supplements founderguard 1 measure am laminator 1 bute and anti biotics of infection soya oil an muck out while she eating
1 section soaked hay over night then rinsed and fed.


lunch 1 section been soaked all night rinse and fed 30 mins equilibrium massage while i change her styrofoam pad

pm do the rest of horses then

give her eve feed with supplements anti biotics, flexi joint soya oil formula4feet laminator
1 section soaked hay as before , then late pm around 9 1 section mauve haylage for laminitics

she is on over a foot bedamax and add one in every day or 2
Click to expand...


Just out of curiosity, What height is your mare?
Just wondered as my mare is on box rest with lami and never know the exact amount of hay im meant to be feeding.
 
Kaylea, I know you didn't ask about my pony's weight/heigh/ration, but thought I'd give it anyway for what it's worth!

Mine is a 14.1 Dales pony, who weighbands at 460kg at the moment (and that is just about her ideal weight). I feed her at 1.8% body weight dry matter, which translates as 10.2kg hay in a 24 hour period.

If I up the ration even slightly from this, she starts to gain weight. If I reduce, it she loses weight, so this really does seem to be her maintenance ration (and workwise she's just walking out for an hour probably about 5 times a week now).

With the rest of the gang, I've found similar in terms of %ages.

Gets more tricky when they start to have access to grass again and I can't control the ration quite so accurately.

Sarah
 
flintfootfilly said:
Kaylea, I know you didn't ask about my pony's weight/heigh/ration, but thought I'd give it anyway for what it's worth!

Mine is a 14.1 Dales pony, who weighbands at 460kg at the moment (and that is just about her ideal weight). I feed her at 1.8% body weight dry matter, which translates as 10.2kg hay in a 24 hour period.

If I up the ration even slightly from this, she starts to gain weight. If I reduce, it she loses weight, so this really does seem to be her maintenance ration (and workwise she's just walking out for an hour probably about 5 times a week now).

With the rest of the gang, I've found similar in terms of %ages.

Gets more tricky when they start to have access to grass again and I can't control the ration quite so accurately.

Sarah
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Thank you Sarah. All info on Lami is good I think.
 
kaylea said:
Just out of curiosity, What height is your mare?
Just wondered as my mare is on box rest with lami and never know the exact amount of hay im meant to be feeding.
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well from the lami trust they told me either 3lbs in am

3.lbs lunch and 9lbs evening

or 4lbs am 4lbs punch and 10lbs eve
I have been told do to 50/50 with hay and haylage but what i do is
1 section am 1 lunch 1 section around 5 ish then (1section small) mauve haylage for laminitics
so i am doing less than 50/50 .

and my mare is 16hhs IDXTB :)




laminitis link http://equinecare-and-control.weebly.com/l.html




.
 
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tango'smum said:
read some off jamie jacksons stuff, no box rest.. horses are aloud to move around in small area's
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I find this bizarre, surely if a horse is in pain and has damage to their feet, walking around will only cause more damage?

I am interested in reading some of the stuff though, seems to be so many ways and opinions of treating lami,
 
I was told that under no circumstance was he too leave his stable until he had second xrays and was off painkillers, personally i wouldnt have wanted him to leave whilst he was in pain,
 
Trim, surface, support and diet are also factors in Jaime Jackson et al's work. The problems come when the other aspects aren't in place and horses are forced to walk by humans or bullying other horses. Professionals like Pete Ramey have a good plan for these horses with clear trim guide lines and emphasis on pads boots and diet to support the horse and reduce strain and pain. I recommend (again lol) his DVD series Under the Horse, there are discs devoted purely to laminitis and include theory explained very clearly. Expensive but worth every penny. His new book is very dense (and expensive) but a great investment for vets and farriers/trimmers. It contains lots of current science as well as practical information and links the horses' whole body.
Generally horses in severe pain wont walk of their own volition...

I believe for weight loss 1.5 to 2% of body weight should be fed as forage and for acute laminitis this means hay (or equivalent) with non structural carbohydrate below 10%. If your hay hasn't been tested it must be soaked and rinsed. It's just not worth the risk guessing.
For weight loss in general don't forget to factor in any grazing to this equation...

I'm sorry to hear your horse is still struggling Leviathan.
 
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Still waiting on the blood results for IR with my mare. She has improved greatly and is now not lame but vet said box rest for a further 3 days. I can still feel her digital pulse, though it is not as strong or fast. Rotation of the pedal bone is so much more serious for a large horse. Mine is 50 kg overweight but has already lost 12 in the 3 days since I started measuring her. She loves her food and has always had adlib haylage. Unfortunately, those days are over and she can't understand what's wrong with me!
 
tango'smum said:
no there not forced to walk, they are give the option, ie' stable door left open or field shelter , with limited movement, small fenced area, no grass....
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I know. I have heard of some doing this though and putting in with a bully. They should be allowed to walk of their own volition when they feel ready is the point I was trying to make, not very well it seems.

Thinking about this, a big horse in a smallish stable will have to make lots of turns, possibly tight when they start moving. A larger area will allow straight lines and wider turns. I think the turning is more painful.
 
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amandap said:
I know. I have heard of some doing this though and putting in with a bully. They should be allowed to walk of their own volition when they feel ready is the point I was trying to make, not very well it seems.

Thinking about this, a big horse in a smallish stable will have to make lots of turns, possibly tight when they start moving. A larger area will allow straight lines and wider turns. I think the turning is more painful.
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ah you've worded it better than me, i would'nt put in with a bully though..
 
Leviathan said:
I would not have my mare outside walking around when her lamina is inflamed and breaking down ,
recipe for disaster:rolleyes:
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Ah yes, that would entirely depend on how the hoof is trimmed and managed. A wall-bearing hoof would damage the laminae more on any surface as the weight of the horse bearing down on the walls will push it away from the pedal bone.

A hoof that is bearing weight in the sole and frog, will actively support the structures that are inflamed allowing the horse movement without such degrees of pain as it would above.

Please look at video below which demonstrates what I am trying to say much better.

http://www.youtube.com/watch?v=ayEJacuoJ7I

Shod horses are testament to how strong the laminae really are!
 
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