Quality of life for a laminitic...

clydeviewequestrian

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Hi everyone,

My Welsh Sec A suffered laminitis around four years ago and recovered well, he was then diagnosed with cushings and we tried to treat him with prascend but he went very depressed and wouldn't eat so we had no option but to stop it and the vet agreed as he wasn't showing any other symptoms and he was doing well with the usual restricted diet.

Three months ago he suffered laminitis again, we did the blood tests and tried him again on the prascend and he had no issues with it this time and his levels came down considerably. My horses are in at night in winter and turned out on a hardstanding during the day, he was sound but looked uncomfortable being on the hard standing so I turned him out for an hour in his small paddock that has very little grass in it.

The next day he had laminitis so he is now back in 24/7 on a deep bed and danilon again. I have contacted my vet and she has suggested brining him in for x rays which I completely understand is a sensible thing to do but my worry is if we take him for x rays and work with the farrier until his feet have improved, won't he most likely just continually suffer laminitis anytime he gets a bit of grass if he can't even go out for an hour anymore? To me i don't mind restricting his diet and turnout but I don't think spending his life inside on pain killers is fair...

Sorry for rambling on but what would you do?

Paige
 

be positive

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It is a difficult condition to manage and a juggling act at the best of times, I suspect that as he was feeling uncomfortable on the hardstanding he was already in the danger zone and turning out on grass was just enough to tip him over into an acute attack rather than the hour at grass being the only issue.

I have managed a few and would not consider keeping one in for the rest of it's life, I would be happy with a well restricted turnout and hardstanding provided they were comfy on the hard.

I had one pts because I could not keep him comfortable, I struggled to keep him in any paddock because if he felt well he jumped out, if he was sore he stayed in but that defeated the object if getting out ended up with him sore, after 3 years of swings and roundabouts I called it a day because he was spending more time in than out and I could not see a future for him living such a restricted life, it was a hard call to make but my life was revolving around his requirements and it was actually a relief to let him go, he spent his last morning up to his knees in grass and I knew I had done right by him.

It does not answer your question but whatever you do will not be wrong if you do it for the right reasons.
 

Pearlsasinger

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I am sorry to say that as soon as you have a Cushings diagnosis you know that is the beginning of the end. Some respond well to Prascend, others don't. Some can be managed on it for years, others can't. We lost 2 last year, 22 and 23 years old. One had been on Prascend for just over a year and the other had only been on it for a few months. Neither was laminitic but they both went downhill rapidly and became ataxic at the end.
I have always said that I prefer quality of life over quantity for my animals, so I would not keep a laminitic permanently off grass.
 

ihatework

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A couple of years ago I PTS a 20yo TB type who had advancing cushings and who I felt had a significantly impacted quality of life.

He had been maintained, retired and out 24/7, on prascend for 4 years before suffering his first laminitis attack. I had told myself when that day came he would be PTS. The vet guilt tripped me into not doing the deed and instead we xrayed (no rotation), was shod (had been bare) by specialist, was box rested for a month (has dust allergy and mild arthritis so got stiff and snotty) and then spent rest of summer in a tiny bare paddock. He had a reasonable winter turned out but continued to loose weight and looked a bit ropey come spring. The inevitable happened and he became laminitic. The hunt came out the next day.

I wish I’d told the original vet where to go, once they go into that spiral then unless managed to the Nth degree and with all their natural freedoms taken away, then what is the point?
 

splashgirl45

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my mare was diagnosed with cushings at 20 and had never had laminitis, she was on prascend for 5 years and i kept her almost as normal and just made sure i managed her feed properly. she was out 24/7 in the summer and all day in the winter and was kept in work by hacking daily. i stopped riding her in march 2016 (she had just turned 25) as the ground was very hard but treated her the same as previously. she became a bit footy in sept 2016 and although not diagnosed with laminitis my vet and i think she was borderline so i made the decision to not put her through box rest and PTS..i decided that quality of life was more important for her but still miss her every day....
 

meleeka

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I am sorry to say that as soon as you have a Cushings diagnosis you know that is the beginning of the end.

My mare has been on Prascend for 5 years and has never looked better so this hasn’t been my experience at all.

OP- the key to managing a cushings/laminitic is firstly getting their levels back to normal. Have you had a recent blood test? When mine had laminitis that didn’t respond fairly quickly I took a gamble and upped her tablet. The improvement could be seen in a couple of days. A friend had a supposedly normal blood test but her pony was still getting laminitis. She upped the dose anyway and pony has been fine ever since. Mine has gone from 1 tablet to 1 1/2 then 2 and now back to 1 1/2 and her levels are normal on that.
 

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I am sorry to say that as soon as you have a Cushings diagnosis you know that is the beginning of the end.
PAS, I'm sorry that you lost your two horses so soon after diagnosis but please don't weigh in on every Cushing's thread with such doom and gloom. It's not helpful and can be demoralising for those of us with Cushing's horses.
A Cushing's diagnosis isn't great news, for sure, but many horses can be successfully managed with it for years. It does sound, though, that the OP's pony's Cushing's is no longer manageable.
 

MiJodsR2BlinkinTite

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Years ago I had a horse with lammi and Cushings...... in those days diagnosis and treatment wasn't where it is now.

Laminitis is always going to be a difficult condition to treat and a nightmare to manage effectively.

I cannot say what I would or wouldn't do in the circumstances the OP describes, and my heart goes out to anyone trying to do their best for a pony in these circumstances and just not knowing how long the situation can be sustained.

There is no mention of the age of the pony OP refers to: but I think, in the circumstances, that PTS would certainly be one option I would consider, particularly if the animal has reached "veteran" age. Also, the cost involved in keeping a laminitic such as this properly and effectively managed, must be borne in mind; and frankly I don't think anyone who has to make a "decision" for purely economic reasons in a case like this, could be blamed.

Then of course there is the concern re. welfare of the pony. It cannot - it would appear - live what might be termed a "normal" existence, i.e. being able to go out with the herd and eat grass, albeit on rare occasions.

Sooooh sorry for anyone in this situation, just so very heartbreaking.
 

SpringArising

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I think I would probably be calling it a day with this pony if he can't be made comfy under any circumstance. One thing I really do miss about keeping horses in [the dry south] of France is that you never had this constant worry of what the grass is doing, having to muzzle/strip graze etc. because there WAS no grass and all horses just got ad-lib hay instead. It was lovely.
 

clydeviewequestrian

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Thanks everyone for your replies, they are kept on my own yard so I don't have anyone to really get a second opinion from so I'm finding this helpful!

He also does try and jump out of bare paddocks even though he has hay on occasion when hes feeling well which doesn't help him! He is only 13 years old but the last few years he looks much older to me although he did have a tough start to life.

I had a blood test done a few weeks ago and they came back well within the normal range, both me and the vet are reluctant to increase the tablet due to his reaction the first time.

In my opinion he is having a poor quality of life and I wouldn't like to see him go through laminits anymore but I am unsure about how to say this to the vet and if she will think I am giving in too soon
 

SpringArising

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In my opinion he is having a poor quality of life and I wouldn't like to see him go through laminits anymore but I am unsure about how to say this to the vet and if she will think I am giving in too soon

"I'm thinking of having X put to sleep. I can tell he's not comfortable, this is his second time with laminitis and he makes it very difficult to manage as he can't be stabled 24/7, he's not happy on the hardstanding and he jumps out of bare paddocks. It's really taking a toll on the both of us".

That's really all you need to say and any vet who's decent would not try to convince you to keep alive an unhappy pony.
 

Pearlsasinger

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PAS, I'm sorry that you lost your two horses so soon after diagnosis but please don't weigh in on every Cushing's thread with such doom and gloom. It's not helpful and can be demoralising for those of us with Cushing's horses.
A Cushing's diagnosis isn't great news, for sure, but many horses can be successfully managed with it for years. It does sound, though, that the OP's pony's Cushing's is no longer manageable.


Thank you for your concern. You will have noted, I am sure, that I said that some can be managed for years - as well as that some can't. I hope that yours falls into the first category. I was very lucky because I had hacked on her only 10 days before she was pts, at the time she seemed just a little lacking in sparkle but otherwise her normal self. Others have to be retired for years. There is no telling which yours will be at diagnosis, you have to be ready for any scenario and to do the right thing by your horse at the right time.

I am afraid that I am of the school of thought that horse-owners should be in possession of all the facts, as far as possible, about conditions that their animals may/have so that they can make informed decisions. You won't find me in fluffy bunny land. If you don't like my posts, feel free to put me on ignore.


OP, if you feel that he has a poor quality of life, that would be the decision made for me and your vet certainly shouldn't try to talk you out of it.
 

ester

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Ok so options as I see it (was waiting to see how old), which you may or may not consider doable and obviously that is personal choice. He is obviously still very grass sensitive despite his levels being ok.

change the turnout from hard standing to sand or pea gravel (obviously this is a serious financial undertaking).
Is he shod? if not can you boot for keeping on the hard standing, if he is shod pads might be helpful?

Also I did wonder if he is fed anything else and if so what? and how good your hay is?

PTS is certainly an option too, my own is much older and metabolic by symptoms, I have said that if he were to get lami with our current set up (tracked grazing) then he will be PTS as for me I wouldn't want him to live out his retirement on hay on an artifical surface (and his teeth kind of preclude that as a solution anyway)
 

splashgirl45

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it is a very difficult whatever age they are, i was looking at my horse all of the time to check if she was happy, in the last week before she was PTS i selfishly kept hoping that she would go to sleep and not wake up ..... she didnt seem so perky even going to the field and i got the vet to check her in case i was missing something that could be sorted out., the vet confirmed my fears , but if she had been 13 i would have still made the decision as her cushings levels were continually going up even on 4 prascend a day.........quality of life is the priority IMO......
 

YorksG

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My mare had blood tests which showed levels below treatable levels, but was symptomatic, although without laminitis. We then ha the "stim test" when she was eight times what was acceptable! She was prescend and the levels were dropping, however she became ataxic an was not her usual jovial self, partly because she had lost her field mate, but also because she was ill. As with any illness in any animal, different beings have different reactions and different time scales. For me the quality of life for any animal is what is important and the owner is the one who makes that decision.
 

Peregrine Falcon

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My old chap is 25 and now basically retired. He was blood tested as part of a MOT a few years ago. Borderline cushings but as asymptomatic no treatment advised. Should he ever go down with laminitis then he'll be pts. He gets very stressed being in as he lives out 24/7. Quality of his life is vitally important for me and he's spent many hours working out electric fencing so restricted grazing wouldn't be an option. All the best for whatever you decide.
 

Casey76

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If you haven’t already, I’d highly recommend you join the ECIR group (https://ecir.groups.io/g/main), if nothing else they can offer support and advice.

It is possible to keep a horse on a completely grassless lifestyle (and for them to be happy!) without having them shut in a box, though this arrangement is much more common outside of the UK, where the image of horses in vast green fields is more the normal thinking.
 

millikins

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Hi everyone,

My Welsh Sec A suffered laminitis around four years ago and recovered well, he was then diagnosed with cushings and we tried to treat him with prascend but he went very depressed and wouldn't eat so we had no option but to stop it and the vet agreed as he wasn't showing any other symptoms and he was doing well with the usual restricted diet.

Three months ago he suffered laminitis again, we did the blood tests and tried him again on the prascend and he had no issues with it this time and his levels came down considerably. My horses are in at night in winter and turned out on a hardstanding during the day, he was sound but looked uncomfortable being on the hard standing so I turned him out for an hour in his small paddock that has very little grass in it.

The next day he had laminitis so he is now back in 24/7 on a deep bed and danilon again. I have contacted my vet and she has suggested brining him in for x rays which I completely understand is a sensible thing to do but my worry is if we take him for x rays and work with the farrier until his feet have improved, won't he most likely just continually suffer laminitis anytime he gets a bit of grass if he can't even go out for an hour anymore? To me i don't mind restricting his diet and turnout but I don't think spending his life inside on pain killers is fair...

Sorry for rambling on but what would you do?

Paige

I would not travel a pony with acute laminitis, I would expect the vet to bring portable equipment.
 

Clodagh

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If you haven’t already, I’d highly recommend you join the ECIR group (https://ecir.groups.io/g/main), if nothing else they can offer support and advice.

It is possible to keep a horse on a completely grassless lifestyle (and for them to be happy!) without having them shut in a box, though this arrangement is much more common outside of the UK, where the image of horses in vast green fields is more the normal thinking.

Even without resorting to just a box, it is difficult to keep a happy horse with no grass, unless you can afford to feed all your horses forage and have them living with the poorly one on woodchip or similar. Not so much normal thinking, as that in the UK grass grows wherever it can and vigorously so.
 

clydeviewequestrian

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"I'm thinking of having X put to sleep. I can tell he's not comfortable, this is his second time with laminitis and he makes it very difficult to manage as he can't be stabled 24/7, he's not happy on the hardstanding and he jumps out of bare paddocks. It's really taking a toll on the both of us".

That's really all you need to say and any vet who's decent would not try to convince you to keep alive an unhappy pony.


Thank you for this, I'm terrible at stringing a sentence together at the best of times! I have decided to put him to sleep, I called the vets yesterday and was told they would get a vet to call me back...im still waiting!! Will need to force myself to phone back again tomorrow as if having to do it once wasn't bad enough! Also had to wait almost a week for danilon so not very impressed, luckily a friend had some to keep me going
 

millikins

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Thank you for this, I'm terrible at stringing a sentence together at the best of times! I have decided to put him to sleep, I called the vets yesterday and was told they would get a vet to call me back...im still waiting!! Will need to force myself to phone back again tomorrow as if having to do it once wasn't bad enough! Also had to wait almost a week for danilon so not very impressed, luckily a friend had some to keep me going
You are really not being offered a very good service, especially at such a distressing time. Is there another practice you could use or your local hunt?
 

clydeviewequestrian

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You are really not being offered a very good service, especially at such a distressing time. Is there another practice you could use or your local hunt?

Ive no idea about a local hunt to be honest, the only other practice I could use has quite a poor reputation unfortunately..not ideal at all!
 

millikins

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Ive no idea about a local hunt to be honest, the only other practice I could use has quite a poor reputation unfortunately..not ideal at all!

Your username indicates you are in Scotland so I'm no use as in Surrey. But my local hunt offers a "fallen stock" service with a qualified person using a captive bolt (think that's right). I've had two put down this way, Hunt were on time, quick and sympathetic. Google search would give you your local Hunt and secretary's contact. Best wishes.
 

clydeviewequestrian

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Your username indicates you are in Scotland so I'm no use as in Surrey. But my local hunt offers a "fallen stock" service with a qualified person using a captive bolt (think that's right). I've had two put down this way, Hunt were on time, quick and sympathetic. Google search would give you your local Hunt and secretary's contact. Best wishes.

Thank you I will have a look!
 

Roasted Chestnuts

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Where are you OP?

If you are in my area then I use avondale and find them great. They came gave me my options and left me to decide. Kia’s favourite vet came out and it was all done in 20mins then grayshill picked him up and took him away. The whole process was 30mins from vet arriving to grayshill leaving. I was numb but thankful it was quick and easy. He just went down.

I lost my boy after fighting cushings for 2years. It was an abcess and subsequent infection that took him. He also wasn’t gaining weight and his teeth were done as well. I battled the abcess for a while as it kept coming and going before we had to call it a day as we couldn’t manage his pain and to get out the infection we would have had to respect most of his frog and hook wall on one side. I wasn’t willing to put him through it or me either.
 
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