Steroid induced laminitis-thoughts?

[wanderersmelody]

my 20 year old TB cross has steroids in his hocks yearly. Never had any issues.. 2 weeks ago he had his annual top up. Gave him 5 days off, kept him in for 3 days, reduced hard feed, and only turned him out on very poor grazing on the 4th day. On day 6 he was pottery when riding. Day 7 he seemed better but day 8 he was chronic lame and in pain, so much that he was shaking and I called the emergency vet who gave him pain relief. Carried on box rest and bute twice a day and treated as is possible lami because of the steroid injection. Regular vet came out 2 days later and x rayed. Showed no rotation of pedal bone but did show quite bad arthritis on all 4 pasterns/legs. Took bloods and am currently awaiting results for Cushing and Ems levels. Vet said he believes the lameness to be arthritic rather than lami but to me, he would not be lame in all 4 feet? Yesterday (day 13 after injection) he was very reluctant to weight bare on his ‘good’ back leg. So I suppose my question is has anyone had steroid induced lami? If so, what were the symptoms and what was the outcome? I’ve read so many articles and the prognosis doesn’t read well. He’s currently n Bute twice a day and 24 paracetamol twice a day and I’m not seeing any signs of improvement which I would have expected if arthritis related? Still soaking hay and reduced sugar in feeds. Any advice greatly appreciated

 

[Goldenstar]

It’s awful bad luck and I all I can say is I have never seen sudden onset reluctant to move arthritis in a old horse .
My instincts would say it has to be lami with no rotation which is good perhaps his arthritis is making it hard for him to adjust himself to get relief from his feet .
Does he have pain on hoof testers ?
I would be expecting the vet to be very pro active with pain relief on an oldie like him I would not go on long if you can’t get his discomfort managed .
I know you know that the prognosis is not great so I would be pushing to make sure he’s made comfortable .
I think some vets are not mindful enough of managing pain because they don’t know the horse and they are not caring for him they don’t have the same feel for the horse as those caring for him that him will have .
I would get the vet back today if you can and have serious talk .
Can you hose his feet , if that gives him relief then I think you can safely assume lami is the primary acute issue .

 

[ester]

Fwiw I have seen sudden onset reluctant to move arthritis in a friends horse, he totally looked like he had lami to me but it was advanced kissing spines despite the fact he'd been eventing all season fine. I thought it was totally bizarre but did teach me that it can happen.
Like GS I think the pain relief situ has to be most important atm.

 

[Lurfy]

I have a tb that got cortisone induced laminitis. He was prescribed cortisone shots for 5 days due to severe hives. On the 6th day he was showing clear laminitis signs. Pain and heat in front feet. We spoke to the treating vet and immediately removed him from pasture and only fed soaked hay and treated hooves with buckets of ice filled water. He stayed off pasture for about a month in a dirt yard with shavings to provide soft footing. He thankfully had no rotation and completely recovered.

 

[wanderersmelody]

Thanks for your replies. Just an update (I am so confused now). This morning, he's sound on his fronts? No pulse, no heat - nothing. But PIG lame on his good hind. If I didn't know better I'd say it was an abscess! I am waiting fo the farrier to come and see. I've been to see the vet too and he says highly unlikley for the fronts to clear up so suddently (day 14 now after the jabs), but still be chronic lame in back foot - which has got so much worse. He is slightly relieved after the paracetamol. Just waiting on the farrier now - but I will update with the blood results as its always so interesting to read other peoples stores, when you are struggling with your own. Praying for this to all have been the onset of an abscess. Think I'm clutching at straws - but hey ho! Be a bloody expensive vet bill for an abscess if thats what it is - !

 

[SEL]

Any chance the injection site could be infected ? Frozen to the spot and dead lame = high temperature and a tonne of antibiotics for a horse on our yard. Couldn't see anything at the injection site but vet thought it must have been the entry point.

 

[oldie48]

Any chance the injection site could be infected ? Frozen to the spot and dead lame = high temperature and a tonne of antibiotics for a horse on our yard. Couldn't see anything at the injection site but vet thought it must have been the entry point.

I think it would be unusual for it to take this long for an infection following hock injections to develop. Normally in the first 24-48 hours, I believe.

 

[wanderersmelody]

Any chance the injection site could be infected ? Frozen to the spot and dead lame = high temperature and a tonne of antibiotics for a horse on our yard. Couldn't see anything at the injection site but vet thought it must have been the entry point.

Its been just over 2 weeks now, so unlikley an infection. I'm thinking more and more lami flare up, but also possible abscess. Ihave farrier coming this afternoon to check for abscess. If not, back to the xrays to see if pedal bone started to rotate. Poor thing is on 3 legs although comfier when poulticed (which again makes me think lami).

 

[wanderersmelody]

I just wanted to give an update on this post. It turned out my horse did have steroid induced laminitis. He had it in all 4 feet but we managed to stabilise all but his RH. I didn’t get the best advice from my vet on my treatment plan (which I discovered too late into the onset of the lami), and sadly the pedal bone rotated so badly that it started to penetrate his sole. He had very thin soles anyway and deteriorated pretty quickly. I had to change vets mid way and got a 2 nd opinion from another vet and 2 farriers who all concluded the same outcome. I had him PTS on 15th June. He didn’t have Cushing, but blood tests showed that his EMS was slightly raised at 26 (normal is 20 so it was only just over). Other than that he was a typical non lami gee and actually hadn’t been out on proper grass since the previous October due to winter turn out. The more I’ve read up on it, the more common I realise it is, so when your vet tells you there is a low risk of lami reaction, please please think very carefully about having the injections. Have a Cushing and an EMS test done first but also consider alternatives to steroid injections, which now exist. I’ve lost my horse of a lifetime……..had him 17 years from an unbroken 3 year old. Devastated. ?

I did keep a very very detailed excel spreadsheet with each days symptoms and treatments if anyone would ever want this. Please do contact me and I hope this doesn’t happen to anyone else.

 

[Hepsibah]

I just wanted to give an update on this post. It turned out my horse did have steroid induced laminitis. He had it in all 4 feet but we managed to stabilise all but his RH. I didn’t get the best advice from my vet on my treatment plan (which I discovered too late into the onset of the lami), and sadly the pedal bone rotated so badly that it started to penetrate his sole. He had very thin soles anyway and deteriorated pretty quickly. I had to change vets mid way and got a 2 nd opinion from another vet and 2 farriers who all concluded the same outcome. I had him PTS on 15th June. He didn’t have Cushing, but blood tests showed that his EMS was slightly raised at 26 (normal is 20 so it was only just over). Other than that he was a typical non lami gee and actually hadn’t been out on proper grass since the previous October due to winter turn out. The more I’ve read up on it, the more common I realise it is, so when your vet tells you there is a low risk of lami reaction, please please think very carefully about having the injections. Have a Cushing and an EMS test done first but also consider alternatives to steroid injections, which now exist. I’ve lost my horse of a lifetime……..had him 17 years from an unbroken 3 year old. Devastated. ?

I did keep a very very detailed excel spreadsheet with each days symptoms and treatments if anyone would ever want this. Please do contact me and I hope this doesn’t happen to anyone else.

I'm so, so sorry for your loss.

 

[foxy1]

Thank you for the update, it was very kind of you to take the time to post and it could well help someone in a similar situation one day.
So sorry for your loss ?

 

[ycbm]

I just wanted to give an update on this post. It turned out my horse did have steroid induced laminitis. He had it in all 4 feet but we managed to stabilise all but his RH. I didn’t get the best advice from my vet on my treatment plan (which I discovered too late into the onset of the lami), and sadly the pedal bone rotated so badly that it started to penetrate his sole. He had very thin soles anyway and deteriorated pretty quickly. I had to change vets mid way and got a 2 nd opinion from another vet and 2 farriers who all concluded the same outcome. I had him PTS on 15th June. He didn’t have Cushing, but blood tests showed that his EMS was slightly raised at 26 (normal is 20 so it was only just over). Other than that he was a typical non lami gee and actually hadn’t been out on proper grass since the previous October due to winter turn out. The more I’ve read up on it, the more common I realise it is, so when your vet tells you there is a low risk of lami reaction, please please think very carefully about having the injections. Have a Cushing and an EMS test done first but also consider alternatives to steroid injections, which now exist. I’ve lost my horse of a lifetime……..had him 17 years from an unbroken 3 year old. Devastated. ?

I did keep a very very detailed excel spreadsheet with each days symptoms and treatments if anyone would ever want this. Please do contact me and I hope this doesn’t happen to anyone else.

I am so sorry for your loss.

I agree with you that the risk is currently being brushed aside by some vets. I recently saw a horse which gimped on stones, suggested a Cushings test before any steroid injections were given. Vet brushed that off, refused to test, failed to warn the owner about lami risks, and bang it went down with lami immediately after joint injections. The vet then suggested a Cushings test, horse was negative, possibly a false negative or possibly the foot sensitivity was low grade lami waiting to happen and the injections tipped it over.
.

 

[wanderersmelody]

I am so sorry for your loss.

I agree with you that the risk is currently being brushed aside by some vets. I recently saw a horse which gimped on stones, suggested a Cushings test before any steroid injections were given. Vet brushed that off, refused to test, failed to warn the owner about lami risks, and bang it went down with lami immediately after joint injections. The vet then suggested a Cushings test, horse was negative, possibly a false negative or possibly the foot sensitivity was low grade lami waiting to happen and the injections tipped it over.
.

its shocking. Don’t get me wrong, I knew the risk of lami as had the injections before without issue BUT I didn’t “really” know the risk as hadn’t investigated it myself. I think there needs to be better awareness. My vet was more focussed on the arthritis after , than the lami and that where my problems really began as he wasn’t treated for lami….. shoes were wrong, he said - turn out, no hay soaking, stay on straw bed. Was told was all the right thing to do, and it wasn’t until I complained and challenged that they started taking it seriously but by this time the wrong shoes had been on for almost 5 weeks and aided the pedal bone into nosedive. ?

 

[brighteyes]

Oh that's so sad - really sorry and thank you for the full and thorough update.

I have no idea why, in the light of so many instances of steroids triggering a laminitis attack, vets are quite blithe in their use or recommending them.

I was offered a steroid jab for my TB's mega-hives breakout, which I politely declined. They subsided as spontaneously as they appeared but had he got into distress, I might have been tempted to risk it. Might.

 

[wanderersmelody]

Oh that's so sad - really sorry and thank you for the full and thorough update.

I have no idea why, in the light of so many instances of steroids triggering a laminitis attack, vets are quite blithe in their use or recommending them.

I was offered a steroid jab for my TB's mega-hives breakout, which I politely declined. They subsided as spontaneously as they appeared but had he got into distress, I might have been tempted to risk it. Might.

So pleased you had a better outcome and pushed back.

 

[FFAQ]

I am so sorry OP ?. My own horse is (hopefully) recovering from a laminitis attack following steroid injections in his hocks and i'm kicking myself because I really wanted to do arthramid and the vet insisted on steroids first. I should have just changed to a different vet.

 

[Aperchristmas]

I am so, so sorry for your loss. It's awful to lose them, let alone when they're in so much pain. I'm sorry you didn't have the best advice initially but if it helps, the steroid-induced lami cases I've seen rarely turn out well even when they're predicted and managed perfectly from onset. It's often a tough choice to make whether to give them steroids or not - I nearly had to make that call with one of mine who hadn't had laminitis before but I knew was potentially prone. Luckily his symptoms improved enough for us to avoid steroids because at one point, it was a choice between PTS now or PTS if the steroids go wrong.

You clearly did your utmost for your horse and I wish you all the best. Hugs.

 

[wanderersmelody]

I am so sorry OP ?. My own horse is (hopefully) recovering from a laminitis attack following steroid injections in his hocks and i'm kicking myself because I really wanted to do arthramid and the vet insisted on steroids first. I should have just changed to a different vet.

I’m pleased yours is recovering. It’s scary just how common it is though isn’t. Fingers crossed for you x

 

[HappyHollyDays]

I’m sorry you have lost your boy.

I think with Vets it is a bit hit and miss. My Connie had mild laminitis three years ago and now has hock arthritis (totally unconnected), my regular vet refused to inject with steroids because of his history and he has Cartrophen instead. Yet at the same practice when my little warmblood pony who has EMS with paper thin soles suddenly went lame for no reason another newly qualified vet wanted to dig his foot out just on the off chance there was a possible abscess. My response was over my dead body was anyone going to touch the bottom of his feet and she backed down but it shows the difference in approaches and experience.

 

[PinkvSantaboots]

So sorry for your loss laminitis is so awful I lost my mare to it in 2015 it has made me very aware of it I constantly feel for pulses with my other horses.

 

[Orangehorse]

I know someone who lost a horse in similar circumstances. The horse was a cobby sort and had hock issues. Vet was devastated and very apologetic (and knocked a big sum off the bill).

When the dust had settled, the vet said he had been giving this treatment for 20 years without problems, but had had cases in the past 12 months, it might have been as many as 4, so was going to get the drug company to investigate.

 

[Jeni the dragon]

I'm so sorry for your loss.