Laminitis

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dressage_diva

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My 21yr old cob was diagnosed with acute laminitis on Monday morning - he'd been out all night, very reluctant to move, typical laminitis stance, warm feet, strong digital pulse in front legs (not as strong in hind legs and happy to rest hind feed). Vet didn't think it was a bad case and didn't feel the need to xray for pedal rotation just yet. She also didn't think he had any symptoms of Cushing's/EMS so advised holding off the blood test just yet (our grass has shot up a lot the last week and we felt that was most likely to be the cause as he's such a good doer).

He was given IV painrelief, put on bute twice a day, deep shavings bed, small amounts of soaked hay. This morning he seemed brighter, though understandably still in a lot of pain, but he moved forwards to get his hay/breakfast, whereas yesterday he was very reluctant to move.

However, this evening his left lower leg has completely blown up and is incredibly swollen; small amount of heat in the right leg but no swelling. He is still definitely brighter and has an appetite, though is still reluctant to move too much.

Is swelling around the fetlock/tendon normal in laminitic horses and is it odd it is only one front leg that's swollen? Part of me thinks it might just be because he's been standing in all day on box rest (he's usually out at night and in light work during day) and perhaps he's just standing more on that leg, but I'm also worrying in case either the laminitis is more severe than we first thought or it's something else? I'm going to ring the vets first thing tomorrow AM but would appreciate any advice this evening.

Thanks
 
I have never heard of swelling to that degree with lami, and also its odd that its only in one leg. If it were one of mine I would ring the vet this evening, mine are always happy to advise over the phone with something like this.
 
dressage_diva said:
My 21yr old cob was diagnosed with acute laminitis on Monday morning - he'd been out all night, very reluctant to move, typical laminitis stance, warm feet, strong digital pulse in front legs (not as strong in hind legs and happy to rest hind feed). Vet didn't think it was a bad case and didn't feel the need to xray for pedal rotation just yet. She also didn't think he had any symptoms of Cushing's/EMS so advised holding off the blood test just yet (our grass has shot up a lot the last week and we felt that was most likely to be the cause as he's such a good doer).

He was given IV painrelief, put on bute twice a day, deep shavings bed, small amounts of soaked hay. This morning he seemed brighter, though understandably still in a lot of pain, but he moved forwards to get his hay/breakfast, whereas yesterday he was very reluctant to move.

However, this evening his left lower leg has completely blown up and is incredibly swollen; small amount of heat in the right leg but no swelling. He is still definitely brighter and has an appetite, though is still reluctant to move too much.

Is swelling around the fetlock/tendon normal in laminitic horses and is it odd it is only one front leg that's swollen? Part of me thinks it might just be because he's been standing in all day on box rest (he's usually out at night and in light work during day) and perhaps he's just standing more on that leg, but I'm also worrying in case either the laminitis is more severe than we first thought or it's something else? I'm going to ring the vets first thing tomorrow AM but would appreciate any advice this evening.

Thanks
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Laminator is very good for horses with laminitis as it helps the blood flow http://www.equimins.com/laminator-for-horses.htm
 
If it is cellulitis, it can look pretty dramatic but responds really well to antibiotics. My very elderly Tb went down with it about 6 weeks ago, I thought he had an abscess in his foot as he was very reluctant to move and I struggled to find anything wrong. i also wondered about Lami as he's got cushings. His hind leg suddenly blew up and my vet came out very quickly. He's Ok now but still has a bit of a fat leg although not lame on it. I hope your boy is OK, please keep us posted.
 
Thanks had good chat to vet last night that knows him very well and we decided it was unlikely to be cellulitis and she told me to cold hose it and bandage him overnight and she's popping in to see him this morning.
 
Hi everyone, unfortunately after 5 weeks of good progress my horse seems to have very suddenly deteriorated and I'm after some advice/experience.

Horse was tested for Cushings/EMS and came back negative (as we expected as he doesn't have any other symptoms of either). He was x-rayed 3 weeks ago which showed only a very slight pedal bone rotation so he was fitted with heart bar shoes 2.5weeks ago and has been on box rest with only soaked hay and steadily improving. He was dropped down to 1 bute every other day a few weeks ago and vet was happy for him to go for 10min walk in hand each day. He was pottery for first few steps out of stable, but improved after that and was almost walking normally. We've been really happy with his progress, but suddenly mid-morning yesterday he refused to bear any weight on his right fore. Both forelegs are swollen, but not as much as when I originally posted. There is a small amount of heat in the hoof, but not much. Called vet straight away, he was strongly reacting to hoof testers near his toe so we agreed to take his shoe off his right fore and investigate for an abscess. Couldn't find anything, but we gave him stronger painkillers and poulticed him. This morning there is nothing on the poultice (apart from a bit of gunk around his frog) , his legs are still slightly swollen and he is still unable to put any weight on that foot.

I have the vet coming later this morning to x-ray him to see if the pedal bone has rotated any more. Is there anything else we should be considering? I'm just slightly surprised he's very suddenly taken such a step back, particularly because he literally deteriorated within a few hours and has been comfortable on his current routine for 2.5weeks. I suppose I'm just wondering if there is a chance this is something other than laminitis?

Positive vibes much appreciated!
 
Recovering from laminitis can be such a rollercoaster ride. Our mare did have abcesses in both of her front feet. The pedal bone also dropped quite dramatically and caused a split in the sole. I am not saying this to alarm you. She did come sound and we had her for another 10 years but she did need a visit to the laminitis clinic and a fair bit of remedial farrier work.

You mention gunk around the frog, could it be thrush?. A friends gelding had that partly caused by the heartbars while recovering from lami. Sending positive vibes.
 
Thanks Nettle123. There wasn't any gunk around the frog before we poulticed, but it looked a bit grubby when we took the poultice off this morning. It didn't smell like thrush usually does, but will definitely mention it to the vet when she comes later (stuck another poultice on too). I can't believe thrush could make him this lame though - he's a very stoic horse and takes a lot to even have a slight lameness with him!

Did you find your mare's abscess easily? That was both our first thought and the vets when she saw him, but she had a good dig around and couldn't find anything. I keep hoping it is that rather than his pedal bone. When testing his feet he seemed to be in pain nearer the toe than the pedal bone and we also couldn't see any visible evidence of the pedal bone pushing on his sole. Obviously the xrays will reveal if there's any more rotation. But if there is no change in pedal bones I'm just wondering what our next steps should be and if there's anything else (more obscure) that I should consider? I've never seen him in so much pain (though he's still his chirpy self!) and he doesn't have the laminitic stance he had originally - he doesn't want to even put his foot down on the floor :(
 
Vet came and we found that his pedal bone hadn't rotated any more, but the whole bone had dropped down and he's practically got no sole left - explains why he suddenly got worse. He's having imprint shoes put on by a remedial farrier on Monday.
 
dressage_diva said:
Vet came and we found that his pedal bone hadn't rotated any more, but the whole bone had dropped down and he's practically got no sole left - explains why he suddenly got worse. He's having imprint shoes put on by a remedial farrier on Monday.
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Oh no, poor chap, hope the imprints work xx
 
LJR said:
Oh no, poor chap, hope the imprints work xx
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Thank you, me too! He's still so cheery (frantically trying to move around his stable) even though he can't put weight on his right fore. Hopefully the frog supports he has on until Monday will keep him comfortable over the weekend.
 
That's not good :(
I used andrew Poynton to consult on my old cushings/laminitic horse and he is not a million miles from you, would very much recommend.
It's a long road back once they start sinking so all Id say is be realistic about the outcome. Good luck x
 
Thanks IHW - I will look into him. I trust my vets (used them for years and they've always been brilliant for all my horses) and current plan is to use their remedial farrier but if no success will look up Andrew.

Had frank chat with vet yesterday as don't want to put horse through too much selfishly but so far she has told me that we are not there yet and she strongly believes we should continue (and horse's chirpy attitude seems to agree with that!)
 
Poor fellow. If you can control his pain level its always worth persevering. Our mare had a dorsal hoof resection on both front feet. She was at the lami clinic for a while and it was almost 12 months before she was ridden again and off box rest. Once she was right though we had no further problems for 10 years until she developed EMS and the laminitis came back with a vengeance and we let her go.. Keeping my fingers crossed for you.
 
One thing I would add is that I think you need to keep looking for the underlying cause of the laminitis. I think we're understanding more and more that it's a symptom, not a disease in itself. Cushing's and EMS can have false negatives, as well, and horses can present with really subtle symptoms/unusual symptoms. I really hope you manage to get to the bottom of this! :( Best wishes for his recovery, in the meantime.
 
I'm feeling your pain at the moment. Have a livery here who went down with acute laminitis in January for no apparent reason. She also tested negative for cushings - both on normal blood test, and TSH test, but had all the physical signs of insulin resistance, so she was put on Metformin and aspirin to manage the symptoms. We restricted her diet, and she has been living in a sanf pen since she came off box rest. She's had 3 cycles of Imprint shoes, then a short spell barefoot with boots, before she was shod in bar shoes and equipak as she wasn't comfortable (xrays taken at every change). She's recently had a blip, and is currently on Metacam to manage her pain over the weekend, before the vet and farrier come back early next week to xray and re-shoe her - probably back in Imprints. She's on an even more serious diet, on the basis that she has too many fat cells, which secrete cortisol, so we won't be able to get her laminitis under control, unless we can reduce her bodyfat significantly. She's on D&H Ultimate balancer at recommended levels, Topspec Zero (flavoured oat straw) and ad lib barley straw with 16hr soaked old hay mixed in. She's disgusted with this regime, but we really do have to be cruel to be kind.

Theorising here, but I make sense to myself - I still think that you need to look at grass setting him off as a symptom of metabolic issues. Horses don't generally get laminitis because the grass is rich. They get it because their bodies are unable to cope with rich grass - it's a symptom, not a cause.
 
spookypony said:
One thing I would add is that I think you need to keep looking for the underlying cause of the laminitis. I think we're understanding more and more that it's a symptom, not a disease in itself. Cushing's and EMS can have false negatives, as well, and horses can present with really subtle symptoms/unusual symptoms. I really hope you manage to get to the bottom of this! :( Best wishes for his recovery, in the meantime.
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Thanks I'll speak to my vet and see if there are any more other tests it would be worth running.
 
Auslander said:
Theorising here, but I make sense to myself - I still think that you need to look at grass setting him off as a symptom of metabolic issues. Horses don't generally get laminitis because the grass is rich. They get it because their bodies are unable to cope with rich grass - it's a symptom, not a cause.
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Thanks, do you know if there are any specific tests I should be requesting? He's had fasted blood tests done which were normal - are there any others worth doing? Since he's been on box rest he's lost weight and condition (I wouldn't say he's overweight at all now) - would that still occur in a horse with EMS or Cushings or is that less likely given they're usually insulin resistant?

My vet says she's seen a huge surge in laminitic cases this spring/summer and that they are making up a lot of her cases at the moment (way more than normal) and in all of them it's taking much longer to recover than usual.
 
Horse now has imprint shoes on both front feet (put on yesterday) but at present doesn't seem any more comfortable. Does anyone have any experience of using these shoes? How quickly did your horse improve once they were put on.

My vet was hoping he would show some improvement quite quickly and farrier came and checked on him today and was disappointed he hadn't yet really improved. He has said to give him another day or so to see if he improves.
 
dressage_diva said:
Horse now has imprint shoes on both front feet (put on yesterday) but at present doesn't seem any more comfortable. Does anyone have any experience of using these shoes? How quickly did your horse improve once they were put on.

My vet was hoping he would show some improvement quite quickly and farrier came and checked on him today and was disappointed he hadn't yet really improved. He has said to give him another day or so to see if he improves.
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sadly mine
did not improve but there was another factor as the pedal bone was dying. They are really good shoes though keep at it as might take him getting used to them and maybe laminator might help http://www.equimins.com/laminator-for-horses.htm also

https://trinity-consultants.com/product/setback-salts/
 
spookypony said:
Losing condition and/or muscle despite having good appetite is a classic Cushing's thing. How's his appetite?
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Oh his appetite is great! He's only lost condition and muscle since we popped him on box rest and put him on restricted diet of just soaked hay (he was previously living out at night, ad lib hay during day and exercises 5days a week plus walker). Vet is certain he does not have cushings as his blood test was so negative (it wasn't even close to borderline). We have agreed to up his soaked hay as he is not overweight.

Had another chat with her yesterday about Cushings/EMS and she is certain he has neither. She doesn't want to do the glucose EMS test as she doesn't think we will find anything and giving him a high dose of sugar might just aggregate his lamintis further. She has said if I'm still concerned we can trial him on Metaformin just as a precaution but she thinks it would make no difference.
 
TYSSANDI said:
sadly mine
did not improve but there was another factor as the pedal bone was dying. They are really good shoes though keep at it as might take him getting used to them and maybe laminator might help http://www.equimins.com/laminator-for-horses.htm also

https://trinity-consultants.com/product/setback-salts/
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So sorry to hear they didn't work for your horse. What caused the pedal bone to die, if you don't mind me asking? Was that evident from x-rays? Thanks.

Will also look into the links you suggested.
 
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