Pedal bone rotation - what is the prognosis?

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Hi, I have a 16hh mare who has been suffering with laminitis for about 12 weeks now, she was getting better until about two weeks ago when she deteriated very quickly and we could see the pedal bone buldging through the bottom of her sole (although not penetrated). The vet came straight out and xray'd which confirmed severe rotation (only in back two feet) front feet have not been affected at all. She has been fitted with imprints which have eased her discomfort. I am just wondering what the chances of a recovery are? Is she likely to become sound in the future? Will she be able to go out and graze? The vet said at the time it was touch and go, she literally has 1mm of sole holding the pedal bone in. If anyone has experienced this i would be grateful for some advice.
Thanks
 

Sandstone1

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I dont want to upset you but I lost a mare with this last year, she was a old girl and It was not fair to put her through anymore.

She also got worse very quickly and pedel bone started to come throgh sole.
I really hope your outcome is better all I can say is take advice rom your vet and do what you feel is right, best of luck.
 

JVB

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Poor mare and poor you

To be honest if it were me I would have pts two weeks ago once rotation became severe. I lost my old mare 5 years ago to this, she came down with lami all of a sudden in front feet we had xrays done straightaway and she was then on box rest, it took about 3 months and at that point she was on small patch of bare grazing for few hours a day but we had xrays done again and she was showing a lot more rotation. Personally I think when it gets to that stage they are in a lot of pain and I couldn't risk my poor girl going through the agony of the pedal bone breaking through the sole as it is meant to be horrendous for them.

My deepest sympathies as it is an awful condition but I am surprised your vet has not already said pts.

If you do decide to pts load her up with a ton of bute and give her a nice afternoon as pain free as possible with plenty of her fav feeds - it's what I did, she had about 8 bute in total on her last day and had been having 6 a day before then.

Best wishes
 

soloequestrian

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Have a read of Jaime Jacksons 'Founder, it's prevention and cure'. A very comforting book, although may not be on your vets reading list yet.
 

Sandstone1

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Poor mare and poor you

To be honest if it were me I would have pts two weeks ago once rotation became severe. I lost my old mare 5 years ago to this, she came down with lami all of a sudden in front feet we had xrays done straightaway and she was then on box rest, it took about 3 months and at that point she was on small patch of bare grazing for few hours a day but we had xrays done again and she was showing a lot more rotation. Personally I think when it gets to that stage they are in a lot of pain and I couldn't risk my poor girl going through the agony of the pedal bone breaking through the sole as it is meant to be horrendous for them.

My deepest sympathies as it is an awful condition but I am surprised your vet has not already said pts.

If you do decide to pts load her up with a ton of bute and give her a nice afternoon as pain free as possible with plenty of her fav feeds - it's what I did, she had about 8 bute in total on her last day and had been having 6 a day before then.

Best wishes
Thats almost exactly what happened with my mare, thought she was getting better and then suddenly got worse. I do think its worse the bigger they are.Its a horrible situation to be in you have my sympathy, but speak to your vet.
 
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Thanks all for your replies. Although she is obviously still in pain you can not tell until she walks out of the stable, she is always nudging for scratches and shouts to me when i walk down the yard to her, this makes it so hard. At her worst she was shaking with pain but that was way before we noticed the pedal bone had rotated. I've had her since she was a baby, she is now 14 which makes it so hard. I have said to my vet that i am not prepared for her to stand in a stable and suffer for 6 months, she said that i'd know in the next couple of weeks if there was any hope for her becoming sound. I have read so many horror stories i really dont know what to do, I just dont feel like she is ready to give in?
 

Sandstone1

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I know how you feel my girl was ok in herself eating and looking for fuss right up to the end, but she was on so much pain relief that it was masking how bad she really was Id had her for over twenty years and it wa so very very hard to let her go but I could not le her suffer anymore.
I can only say I hope the outcome is better for you, your mare is much younger than mine I really do feel for you as its horrible.
 

Lotty

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My heart goes out to you and your mare ((hugs))

My 16.1hh mare was diagnosed with laminitis at the end of March and has been stable bound. She has had 4sets of Imprint shoes on and on Monday the farrier put on some metal heartbar shoes as she was rushed to the vets. These were put on to stop the sole pressure which was causing serum inside her hoof. At the moment she is at the vets being tubbed and packed with epson salts but there has been no more movement or rotation.

My mare had a slight rotation in her left fore, that has improved and 5weeks ago she rotated in the right fore. It's awful I know, I have read just about everything and I'm in tears most of the time. x x
 

Dizzydancer

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Hi my friends horse (roughly 17.2 clydesdale x shire) had lami and pedal bones were basically through her feet- she couldnt get up one morning she had her feet padded and bandaged by them managed to stand using walls to lean on etc. Vet came out said kindest thing to pts as she is so tall and would never be able to go out etc, they got 2nd opinion and she had surgery to resect the pedal bones and false soles put on while hers repaired. that was 2 years ago...cost alot but she now does go out in field and is full of energy she has to have hoof boots on to get to field as the yard is concrete but then she gallops off. The vet is amazed and now he knows how calm and chilled out she is he agrees it was the right decision, but probably not for a horse that you want to be able to ride etc.
on the other hand a 13hh pony got it this year on my yard and he was getting better went down hill farrier came to chnage his shoes etc over and immediately saw the changes in his pedal bones and vet came out he was pts immediately as he was a hunting pony who lived out 24/7 so unfair to put him through it, like yours he was bright till the end. unfortuntely a hard decision to make. good luck i hope you do whats best for your horse x
 
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She was on 4 bute a day at her worst (about 10 weeks ago) we had reduced down to 1 a day until last week when she went down hill we put it back up to 4 per day. Two days ago she was looking more comfortable in her stable so we reduced to 2 per day, I am not sure how much pain shes in to be honest, she hides it very well. I will have to see what the vet says tomorrow (next check in appt) I dont want to see/think of her in pain but on the same hand i dont want to give up on her when she could make a full recovery? I am not bothered if i can never ride her again, providing she can go out for more than an hour a day in the future. Being a stabled horse for the majority of her life is no life for her is it?
 

Sandstone1

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I think the vets like them to be sound off any pain killers for awhile before they can think of them going out.

Its a really horrible disease and I can only say speak to your vet, have you tried the laminitis trust, they are supossed to be good, also speak to your farrier. Ifyou are not happy with your vet you can ask for a second opinion,
you may have to make the final desision,but if you try all avenues first at least you will know you have tied every thing.

Good luck I really do feel for you.
 

Lotty

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Mine was almost sound until 5weeks ago until she had a setback.

My mare is happy and alert, also shouts & nickers for me. I think she's a fighter so I'm hanging on like you x
 
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I swapped vets when she got worse 2 weeks ago or so because i wasn't satisfied, farrier is also very good and calls in on her weekly to check how things are going. He saw her Monday and is calling either today or tomorrow as well, Monday he seem'd pleased with her progression but she was still on 4 bute then (and lame) waiting to see what he says now we've cut her down to 2 per day. I am happy she has the best people looking after her. I am worried i wont know when I have to say enough is enough because she just seems fine in herself.
 

Kellys Heroes

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Does the fact she has never once come sound in the last 12 weeks mean she never will? She was almost sound at one point.
Our mare has been diagnosed with very slight rotation in both front feet (she is 16 y/o and 14.2hh) and at one point she was also suffering seizures :(
she was dog lame, like not even able to hobble around her stable. She has been lame and unwell since April (but was only on bute for a couple of weeks). However now, she is coming slowly sound and has just lately been a bit iffy in trot but nothing else - we now have a date to get back on her next week if she keeps on improving.
If your mare is not in any visible pain I think its a personal decision to be made between you and your vet but I think my decision would be pts if it came that she could not even go out in the field :( My heart goes out to you and your mare, I can only imagine how difficult it is.
 

Sandstone1

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I swapped vets when she got worse 2 weeks ago or so because i wasn't satisfied, farrier is also very good and calls in on her weekly to check how things are going. He saw her Monday and is calling either today or tomorrow as well, Monday he seem'd pleased with her progression but she was still on 4 bute then (and lame) waiting to see what he says now we've cut her down to 2 per day. I am happy she has the best people looking after her. I am worried i wont know when I have to say enough is enough because she just seems fine in herself.
I really do understand how you feel. I could not bring myself to make the desision to pts without the senior vet coming out and showing mejust how bad her feet were.
She was happy and bright right to the end, but she was a old lady and was used to being out at grass and it was not going to be any life fo her shut in a stable. She was also on a lot of medication.

I hope your mare overcomes this and Im sure what ever happens you will make the right choice for her. If you are happy with your vet and farrier, you can only go with their advice. Shes much younger than my mare and it sounds like she a fighter.
has she been tested for cushings? I know shes young for it but it can sometimes be a factor in laminitis, just a thought.
 

Kokopelli

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Although it is not very common at all my old mare managed to survive it, she got pts later in the year due to a chest infection but was completly sound, we rescued her off a dodgy dealer who just left her and didn't feed her. She had rain scald etc and we were so glad she had a happy retirement!

Dow hats best for your horse I hope she pulls through.
 
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No not tested for cushings, previous vets suggested it if no improvement, but she was improving then. Vet said she looked too healthy to have it as well as very soft shiny coat etc.
I have just spoken to my vet, told her my farrier said improved slightly on feet and this morning her pulses were not bounding as they had previously although they are still quite strong. She wants to xray in a weeks time unless more improvement seen. If continues to look more comfortable/pulses come down more then she will leave it until the farrier is due to come and trim/put new imprints on and xray then to check whats happening - thats only about 2/3 weeks away anyway.
She did say could take a few trims to see any great improvement due to the severity of whats happening in her feet. She has also said that if any more movement however slight should happen then it will be too much as it is already borderline! Its going to be an awfully long 3 weeks of dread to see those next xrays!

Thanks all for your support. Talking to people that have not suffered/dealt with this is no help, they have no idea what it feels like and how hard it is!
 

soloequestrian

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Following on from my earlier post, have a look at http://www.hoofrehab.com/LaminitisUpdate.htm too. The barefoot rehabilitation ideas are pretty much at the other end of the spectrum from traditional laminitis treatment. My mare had mild laminitis after an operation earlier in the year and I rehabbed her with bare feet. The way it's done meant that she could be off medication and out in the field months before the traditional route would have allowed. She is now back to full soundness and had the benefit of not going crazy on box rest in the meantime. I really would urge you to have a look at all the literature that's out there on this, even if only to be able to make a fully informed decision if you have to. The UKNHCP forum is a great place to speak to people who have experience of this kind of rehab too.
 
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Thanks for that, i will have a read. I dont really know much about it. To be honest i'd ruled it out because my mare has always had sensitive/thin soles and had to have silicone in her shoes to protect her soles, her soles bruise so easily if walking on stoney ground. I will read though and perhaps discuss with my farrier.
 

Sandstone1

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Best of luck for the next three weeks, regarding the cushings the vet thought it was a factor with my old girl altough she didnt look like she had it really, she had a nice coat looked great for her age etc. we didnt test for it but she was put on pergolide for a while. Sadly it didnt make any differance in the end.
I also tried a supplement called permanax which might be worth looking in to.
I have my fingers crossed for you both.
 
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Thanks, I will let you know how things go.....I have been told to give no supplements as it might cause her to have another "attack" but will look in to it for when she has got better. Im going to mention testing for causes next time the vet is out, i have read a lot on insulin resistance as well which i need to discuss with them further.
Thanks again......I have everything crossed!
 

mrdarcy

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Thanks for that, i will have a read. I dont really know much about it. To be honest i'd ruled it out because my mare has always had sensitive/thin soles and had to have silicone in her shoes to protect her soles, her soles bruise so easily if walking on stoney ground. I will read though and perhaps discuss with my farrier.
Sorry to hear your mare is in a bad way but do not despair.Plenty of horses come back from pedal bone rotation. In fact rotation is a bit of a misnomer. It is the hoof that is growing away from the bone not the bone pushing itself downwards. If you can regrow a healthy foot then the pedal bone will be back in the position it needs to be within the hoof capsule. It's growing the healthy hoof that will be the issue. From the way you describe your mare's history I would say she is almost certainly either Cushings or Insulin resistent and has been for a while - the fact she has always had sensitive soles and needed silicon infill screams that her feet have been hurting for a long time. Sensitive soles are caused by the exact same processes as laminitis. In shod horses the symptoms can be masked by shoes holding the sole off the ground and in extra sensitive cases the use of pads. She most likely has been suffering from bouts of low grade laminitis for as long as you've had her. Do not blame yourself though, in any way. Low grade laminitis is extremely common and unfortunately very easily missed in shod horses.

In the abscene of a doing a test for Cushings/IR I would treat as if she were IR. She is probably a horse that cannot eat grass ever. Instead she will have to live off soaked hay and be kept on a 'dry lot', either a sand paddock, hardstanding, concrete yard - whatever you have access to. Despite what some people think depriving horses of grazing on UK fields is not sad for the horse - if I had the choice my horses would never be turned out on a traditional paddock again! Horses simply aren't designed to eat the grasses we have in our fields and horses like yours unfortunately react extremely badly.

I would also get a hair analysis done - she is very likely short of some crucial vit or mineral and supplementing whatever she is deficient in will get her system back into balance, which is crucial for regrowing healthy feet.

It's already been mentioned in this thread but I urge you to read Founder Prevention and Cure the natural way by Jaime Jackson. It's a brilliant book and has saved the lives of many horses. Jaime has helped thousands of horses recover from laminitis, rotation and even horses where the pedal bone has penetrated the sole and a few cases where the hooves have sloughed off altogether. The hoof has an incredible ability to heal itself and regrow, all we have to do is remove the cause of the damage in the first place.

Good luck and please please read that book.
 

amandap

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I urge you to read Jaime Jackson's Founder book too. I also suggest you have a look at Pete Ramey's web site and recommend his book, 'Making natural Hoofcare Work for You' and DVD series 'Under the horse'. The DVD series is expensive but it is worth every penny imo for helping understand hooves and how diet, management etc. affect them. It gives you info to put you in a postion to make more informed choices rather than just relying on the 'Professionals'.
http://www.hoofrehab.com/

Have a look at his articles section too. I wish you the best and do find out as much as you can, this will be his biggest help.
 

Lgd

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The Fell Pony I competed until the end of last year rotated his pedal bone to similar levels as your mare. Sinking and foundering on the x-rays. His was deemed to be a traumatic rather than laminitic cause so the vet did an immediate dorsal wall resection followed by surgical shoeing to gradually realign the pedal bone. Vet's best prognosis at the time was pasture ornament or light hacking. He only did the resection because the pony was still bright in himself and felt it was worth giving him a chance.

That happened in the February and by the April he was sound again. By August his pedal bone alignment was almost back to normal.
My mare was injured and my friend was unwell so I started riding him and he did his first affiliated competition in the August and qualified for winter music regionals at elementary and medium level. He was in the top half of a huge class at Myerscough regionals and the following year was placed in both classes. He qualified again last year but unfortunately has now developed arthritis in the foot and missed the regionals this year as a result. He is sound in the summer but needs bute 3 times a week in the winter so has retired from competition. He was rising 17yo when he had the rotation and turned 20yo this May.
 
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Thank you all for your kind word. Unfortunately my beautiful darling did not make it, the choice was taken out of my hands. She was getting better until yesterday she was unable to put any weight on the worst affected foot, farrier and vet came out, thinking possible abcess but that was not the case, the bone had moved more and sunk they tried to help her but said it had gone to far so said no alternative but to pts. Devasted! Words can not explain how i am feeling at the moment, half the time i dont know myself. At least she is not in anymore pain!
 

finkle

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Im sorry your little darling didnt make it. Just started reading your thread and then got to your last post. Im so sorry, it was obvious how you adored her.

She is free from pain now and was blessed to have had you as her owner, caring for her until the end.
 

Sandstone1

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I am so very sorry. I do know how you feel as I went through it last year, but I know that does not make it any easier for you.

Im sure you made the right choice and at least shes not in pain anymore. You tried your best for her and gave her the chance you couldnt do any more.

So sorry.
 
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