Sore front feet

[southerncomfort]

A few days ago our 21 Yr old pony started looking sore coming out of the stable in the morning but became sound after a few strides.

Vet called and thinks she looks generally stiff and creaky. Had a positive reaction to flexions on near fore and off hind.

She reacted to hoof testers on both front feet. The reaction was over the whole sole and not just at the toe. Insulin and ACTH well within normal levels. No heat and no pulses. Access to grass severely restricted all winter due to mild temperatures. Vet wondered about concussion as she has a tendency to march along and we have a couple of stony tracks here.

Pain has become worse. She doesn't want to lift either front leg and reacts to me tapping the soles with a hoof pick. Soles are hard and thick.

I've whacked a poultice on both feet just in case and vet coming back tomorrow amd ive texted my trimmer, but I'm really worried and have never seen anything like this.

What else, other than laminitis could cause sore soles? Could onset of arthritis cause a secondary issue with the feet?

Eta: bute being given twice a day.

 

[Nari]

I'd get a farrier out, but to me it sounds very like laminitis regardless of what the vet says. I've had just the same symptoms and in the end it was laminitis and despite his tests coming back ok I swear it was metabolic linked and indeed a subsequent acth test came up borderline and he responded well to prascend though ultimately I lost him.

 

[Lady Jane]

My friends horse ended up with laminitis even though there were no typical symptoms. I would treat for laminitis but your farrier is really the expert in that field

 

[ester]

Yeah this is lami until proven otherwise. If she’s worse on 2 bute a day I’d want X-rays asap to plan next steps.

 

[sbloom]

Yeah this is lami until proven otherwise. If she’s worse on 2 bute a day I’d want X-rays asap to plan next steps.

I've heard of several people now taking this approach, treat as lammi unless/until you find out it's not.

 

[PinkvSantaboots]

Agree with the above it sounds like laminitis I am guessing you just did the basic cushings test, my mare had 3 of those until it came back positive they are not that reliable, ask your vet for the more advanced test it involves giving the horse glucose before the test and its much more accurate.

If it is laminitis and its caused by a metabolic condition you need to get the medication into them to get the laminitis under control otherwise it just doesn't improve and the chance of recovery is far less.

 

[southerncomfort]

I'd get a farrier out, but to me it sounds very like laminitis regardless of what the vet says. I've had just the same symptoms and in the end it was laminitis and despite his tests coming back ok I swear it was metabolic linked and indeed a subsequent acth test came up borderline and he responded well to prascend though ultimately I lost him.

Oh I am sorry.

She's been on Prascend and Metformin since around November.

Results from last week were
Insulin 2.0 (low)
Acth 25.4 (normal)

To be honest I've lost faith a bit and have just re-registered with my old vets. I've booked them for tomorrow and said that I might need xrays.

 

[Pearlsacarolsinger]

To be honest I've lost faith a bit and have just re-registered with my old vets. I've booked them for tomorrow and said that I might need xrays.

That sounds like the best course of action

 

[southerncomfort]

Thanks for the replies. Food for thought.

Just to clarify, she's been on Metformin and prascend since around November.

Results from last week were

Insulin 2.0 (low)
Acth 25.4 (normal)

Grass intake has been severely restricted over winter due to mild temperatures. Since vet visit last week she's been either stabled or in the school due to horrendous weather and since her pain worsened I've had her in on a deep bed.

I honestly can't think of anything other than laminitis but I'm baffled by the lack of heat pulses etc when she's so sore.

To be honest if it is laminitis I've got a big problem because if she can come down with it in winter on little to no grass and with normal Insulin and acth then how the heck am I going to keep her lami free the rest of the year? Very worrying.

Have re-registered with my old vets who are coming in the morning and ive said that I might want xrays taking.

 

[meleeka]

I’d redo the blood tests. If she has laminitis now, those figures are likely to be wrong. If it were mine I’d insist on the TRH blood test for cushings which is a lot more reliable.

 

[southerncomfort]

I’d redo the blood tests. If she has laminitis now, those figures are likely to be wrong. If it were mine I’d insist on the TRH blood test for cushings which is a lot more reliable.

They were only done on Thursday though...?

She was diagnosed with cushings last Autumn and has been on Prascend ever since.

If she'd been out on a hard or stony surface I might have wondered about concussion laminitis, but she hasn't. ?‍

If she's come down with laminitis off-grass and with normal Insulin and acth then I've got a serious problem. Don't think I'll sleep very much tonight. ?

 

[sbloom]

Unless you find it's something else it may be worth having the Equi Biome test done, there are other options for helping with lammi prone horses and fixing the hind gut balance is definitely a good one to try.

 

[ester]

I agree atypical re pulses etc but worsening = I’d want to see what was going on in them based on the symptoms you do have (and age and history)
It may not be but it needs eliminating I think before you can move forwards with what else it might be.

 

[ester]

Also sympathy for them being such a bloody worry x

 

[southerncomfort]

Unless you find it's something else it may be worth having the Equi Biome test done, there are other options for helping with lammi prone horses and fixing the hind gut balance is definitely a good one to try.

Thank you I'll definitely look in to that.

 

[southerncomfort]

I agree atypical re pulses etc but worsening = I’d want to see what was going on in them based on the symptoms you do have (and age and history)
It may not be but it needs eliminating I think before you can move forwards with what else it might be.

Thanks Ester.

I agree. I think xrays are essential at this stage.

 

[racebuddy]

just caught up def agree and xrays needed . how is your pony today xx

 

[southerncomfort]

Had a chat with farrier last night who was very helpful.

Padded her feet overnight and she was more comfortable this morning.

New vet out this morning. Very, very thorough.

No obvious symptoms of laminitis. No heat, no pulses. Nothing visual, no stretched white line etc.

Didn't react to hoof testers applying pressure to the sole, but did react to tapping the foot with them which may suggest pain in a joint further up the leg.
However she was remarkably flexible on lower limbs and had a good range of movement. Neck also very flexible, no stiffness. Lameness to right fore on trot up, but looked much better than yesterday.

Upshot is, vet not 100% convinced the problem is in the feet but absolutely not ruling it out. Potentially sore feet due a problem elsewhere further up but no big indicators of where that might be.

Farrier said that he has seen a couple of cases of asymptomatic laminitis though its not very common.

We agreed that xrays of feet are needed so we can at least rule out pedal bone rotation as a cause. Although this is less likely as you'd expect to see a pain reaction to sole pressure.

Unfortunately by this point storm Dudley hit us full force. Pony is very good but unlikely to stand still for xrays during a storm, so xrays will be done tomorrow morning.

So still a bit of a mystery but feel we're getting closer to some answers!

Bang goes my first month's wages in my new job!

 

[sbloom]

Liked but not for the loss of wages! Good luck and fingers crossed.

 

[tda]

Hope the weather calms down for you tomorrow xx

 

[southerncomfort]

Liked but not for the loss of wages! Good luck and fingers crossed.

I'm trying to look at it as 'thank goodness I have a job to pay the bills'! ?

 

[southerncomfort]

Hope the weather calms down for you tomorrow xx

Thanks, it's absolutely horrible up here.

Apparently Eunice is bringing snow with her on Friday so I'll be glad to get xrays done before then!

 

[Birker2020]

A few days ago our 21 Yr old pony started looking sore coming out of the stable in the morning but became sound after a few strides.

Vet called and thinks she looks generally stiff and creaky. Had a positive reaction to flexions on near fore and off hind.

She reacted to hoof testers on both front feet. The reaction was over the whole sole and not just at the toe. Insulin and ACTH well within normal levels. No heat and no pulses. Access to grass severely restricted all winter due to mild temperatures. Vet wondered about concussion as she has a tendency to march along and we have a couple of stony tracks here.

Pain has become worse. She doesn't want to lift either front leg and reacts to me tapping the soles with a hoof pick. Soles are hard and thick.

I've whacked a poultice on both feet just in case and vet coming back tomorrow amd ive texted my trimmer, but I'm really worried and have never seen anything like this.

What else, other than laminitis could cause sore soles? Could onset of arthritis cause a secondary issue with the feet?

Eta: bute being given twice a day.

https://forums.horseandhound.co.uk/threads/abscess-help-wanted.815579/#post-14845013

Sorry for long reply, bear with me.

I'm going through the same now, but no lameness even on a tight turn on both 'reins' in hand. Sole very sensitive to hoof testers, so much so the farrier I knabbed yesterday to try his testers on my horse said "no way can you put shoes on with this reaction".

I am cold poulticing with iodine and sugar following three days of hot poulticing starting last Friday afternoon and nothing coming out on 2nd or 3rd days. Horse is happy to bang stable door/side of stable with bad foot, happy to pick up, not too happy to keep opposite front leg in air when you pick out foot, but when you exert the slightest pressure on the sole he goes through the roof, or at least he does with the hoof testers, with me pressing down he was ouchy but ten mins later no reaction when he was distracted by mints in my pocket.

I rang the vet yesterday evening to discuss as I didn't know whether to continue to cold poultice, hot poultice or get her to come out and dig around and she's said to xray next week if still sensitive on sole. She suspects a bruise and thinks it might be that, and if no better to xray which is what I think.

This all came about after he half sprung a shoe, the clench got driven through the foot creating a hole in the hoof wall. I asked him to come and remove the shoe, he took the shoe off and in doing so found the horse was extremely sensitive on the inside of the foot, so much so he had to take each nail out individually so to lessen the pain.

So basically I'm suggesting maybe your horse has a bruised foot.

Previous horse with a different farrier had two bruises in two separate shoeings, never in the five years previously or the 12 years after but one after the other shoeings. Foot was bleeding, dripping blood on stable floor. Never forgotten it, wasn't even aware at the time horses could drip blood from their feet like that.

Both were haematomas, although I do remember horse was quite lame at the time.

 

[tda]

Thanks, it's absolutely horrible up here.

Apparently Eunice is bringing snow with her on Friday so I'll be glad to get xrays done before then!

Strangely it's not too windy here yet.......but I know you are much higher up than me.
Yes snow expected ? take care x

 

[ester]

Thanks for the update and at least more comfortable for now too.

 

[southerncomfort]

So xrays show slight rotation in both front feet. Some medial imbalance but this is probably due to how she's been standing while she's been sore. Slight thinning of the soles. Doesn't look major but they are going to do proper measurements back at the clinic. Toes are a little long.

So it's possible that this is a laminitis attack without any other obvious symptoms. I'm worried because her attacks have no early warning signs or symptoms so it's impossible to know she has it until she's in pain and even then their are no heat or raised pulses.

I'm also worried about what the future holds. If she can have an attack in winter, off grass and with normal bloods then I don't see her ever being out in a field again. I just don't know if I can keep her happy living in a school/stable for the rest of her life.

All the vets who have seen her have said she is not overweight in the slightest.

More immediately the vet is talking about putting shoes on (she's never been shod), potentially heart bars.

 

[ester]

Definitely a tricky situ re management I really feel for you as you are doing all you can (I said the same about my boy a few years ago when poss sub clinical lami re. If he can’t cope with what we can provide - own land so very tailored there would have to be questions).

I don’t know if it’s worth doing one of the other ppid tests to double check prascend level is right (I don’t even know if they use them for that but I’d ask!)

not sure if cloud boots/similar would work in your set up? Imprints seem to work well for comfort in lami cases too.
Sorry it wasn’t better news

 

[southerncomfort]

Thanks Ester.

I'm not completely against the idea of shoes but my concern would be that she might appear sound but not be. So for now at least I'd feel happier padding/using boots I think. The Clouds look very comfy!

I'm trying not to get too ahead of myself and just concentrate on getting her comfortable for now.

 

[Apizz2019]

Our ems pony had no heat, pulses etc but was footy over stony ground.

Then came the weather last year, the perfect lami storm, fertilised fields and on unsuitable hay for a week, then bam, we had laminitis - thankfully mild as I caught it early.

Since micro managing his diet, and although he'll always be ems and predisposed to laminitis, he's got rock crunching hooves, moved much better, has more energy etc.

I think we can often miss something rumbling away under the surface until it becomes a problem. Looking back at ours, he had high heels and quite upright hooves, was stiff in front and had the puffy eyes and fat pad on his bum.

I'd suggest stripping the diet right back but also testing for ems and Cushings, as it's highly likely to be one, or both, that have caused this, if not cocussion, stress laminitis etc.

I hope yours gets better soon!

 

[meleeka]

They were only done on Thursday though...?

She was diagnosed with cushings last Autumn and has been on Prascend ever since.

If she'd been out on a hard or stony surface I might have wondered about concussion laminitis, but she hasn't. ?‍

If she's come down with laminitis off-grass and with normal Insulin and acth then I've got a serious problem. Don't think I'll sleep very much tonight. ?

If she was tested with the normal test the result may well be inaccurate. It’s fairly common. A TRH Stimulation test can give a more reliable result.