steroid induced laminitis

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sanchob

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my lovely welsh x cob has had a steroid injection in his stifle for inflamation which has triggered laminitis. we are gutted. he does a lot of dressage and was displaying unlevelness behind. we had vet out approx 1 month ago who said he was slightly lame in front but not really noticable. had weeks box rest then started walking him - he was still unlevel behind-so got second opinion .his stifle was enlarged and once x rayed showed inflamation so he was injected with steroid . exactly 1 week to the day later he went down like a ton of bricks . hobbled out of his stable thurs morn-called vet who came shortly after lunch time by which time he could not walk on front feet. the dreaded laminitis.we are treating it aggresively and he seems comfy at moment.
i was wondering weather the slight lameness in front was laminitis waiting to happen and the steroids have tipped it over the edge. aprox 3 months ago he got stung in his stable and his throat swelled -he had to have a steroid injection then and was ok ...
he is 14.3 - 6yr old chunky welsh x cob . he weighs prob a bit too much as has put on bit of weight thru not working . ( should weigh about 480 weighs 518 )
is fed lo cal balancer with small ammount of energy mix. his hay is soaked for hours. he has 3-4 hr turn out per day. anybody else had this happen please
 
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It depends on what steroid was used in his joint. Triamcinolone ( adcortyl) holds a higher risk than depo medrone but is favoured as it is chondroprotective . Ie. protects cartilage. There is some questioning over whether any other steroid is actually linked to laminitis. There is every possibility that the initial front limb lameness was early laminitis.
 
Slightly chunky Welsh Cobs are very prone to insulin resistance, and if this is the case with yours then box rest alone (due to the positive effects of exercise on IR) could induce laminitis, regardless of whether a steroid injection was given. I would get him tested for IR.
 
My friend's Welsh cob developed laminitis following treatment with steroids. He was then found to be IR and went on to metformin. He is fine now, but has to have a restricted diet and as much exercise as possible. It took quite a long time to get him to this point though.
 
I know the vets will probably jump on me for saying this - but there seem to be far too many complications and unhappy stories around the steroid injections for joint/spavin issues.

Vets maybe need to be more conservative before recommending these "quick fixes".
 
There is nothing quick fix about them I'm afraid. Many horses have "more conservative" treatment - ie bute and turn away but it is not what the owners want to hear, especially nog in the case if young and otherwise healthy animals. There is no wOnder cure/ treatment but when oral NSAIDS aren't enough to reduce the inflammation causing discomfort, steroids can do that job quickly. Definitely not always the answer but most of the alternatives are very expensive with poor success rates
 
My use of the word quick was wrong there. What I'm trying to say is the steroids are used when conservative methods fail.
 
brucea said:
I know the vets will probably jump on me for saying this - but there seem to be far too many complications and unhappy stories around the steroid injections for joint/spavin issues.

Vets maybe need to be more conservative before recommending these "quick fixes".
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I obviously can't quote hard stats but these things are far more openly discussed in North America than here and I woudn't say that view is supported by what I've seen/heard there. It seems here people only discuss it if it's gone really wrong! Perhaps the greater approbation around the subject makes people less inclined to admit they've done it so if it all goes well they keep their mouths shut. ;)

I'm not saying I'm pro or con and I have certainly heard people make the link between steroid injections and laminitis, but not with the sort of inevitability I've heard discussed here.

That said, I'm a bit surprised it seems to be such an early treatment here vs Adequan or similar. I was always taught that once you start going down the steroid route you are likely to need to do it more and more often with less and less success, although this is not always the case with some of the other options.
 
Janesomerset said:
My friend's Welsh cob developed laminitis following treatment with steroids. He was then found to be IR and went on to metformin. He is fine now, but has to have a restricted diet and as much exercise as possible. It took quite a long time to get him to this point though.
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it's nice to hear this as gives me some hope . vet is coming this morning to look at him and poss x rays. he looks much more comfy and is mooching around his stable quite well. just looks a bit shifty when standing for long periods.
 
glenruby said:
There is nothing quick fix about them I'm afraid. Many horses have "more conservative" treatment - ie bute and turn away but it is not what the owners want to hear, especially nog in the case if young and otherwise healthy animals. There is no wOnder cure/ treatment but when oral NSAIDS aren't enough to reduce the inflammation causing discomfort, steroids can do that job quickly. Definitely not always the answer but most of the alternatives are very expensive with poor success rates
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Unfortunately that is how they are viewed by many owners - as a "quick" option to get their horse right. And they are never without side effects or risks.

I had the option with my spavined boy, and chose not to, got an excellent result but it just took longer.

Alternatives are actually cheap - do nothing, get the shoes off, stop over trimming the feet and the sole and the frog, change the workload, get diet and especially supplements right, and provide the correct surface is often all that is needed to rehab most horses.

Look at what Rockley does with a tremendous success rate! Ok it is relatively expensive to send a horse there, but frankly by the time many owners get to the point of being "between Rockley and a hard place" they have already spent far more than the conservative rehab would have cost.
 
glenruby said:
My use of the word quick was wrong there. What I'm trying to say is the steroids are used when conservative methods fail.
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The evidence is often the other way round I'm afraid - conservative methods are very often used when steroids fail.

Many of the horses who are lucky enough to have ended up at Rockley have been through that route first.
 
sanchob said:
it's nice to hear this as gives me some hope . vet is coming this morning to look at him and poss x rays. he looks much more comfy and is mooching around his stable quite well. just looks a bit shifty when standing for long periods.
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My friend's cob now looks and moves the best he has ever looked and moved, so don't give up hope! He looked very bad at first. Please let us know how your boy goes on. Thinking of you. xx
 
thank you .when i read things like this it gives me hope for him..vet has been today and really pleased with him . we are reducing his meds as of today and x rays monday and then pads fitted in feet .
 
My welsh mare had steriod injections in to her hocks about 6 years ago and was fine, this was after the other way failed as she has djd in them. She had 6 months of Adiqan after that to and back shoes put on (id taken them of two yeas previously as didnt need them) as the way her hocks had started to fuse meant that she had uneven wear and a thin sole which didnt help the lameness. She is now fine but we did make sure she was under weight when had then done and on no hard feed, soaked hay and limited turnout as vets advise.


My brothers boy got lami last year and was found to be IR since he has been on the metformin he is looking and moving better than he ever was.

Sending happy thoughts.

X
 
Bruce's- the vast majority if hock spavin cases will not come sound with "barefoot" trimming, diet etc. not without the aid of medical treatment. Many Of the horses I have treated for oa of the hock have been barefoot or unshod ponies. Hoof balance has only been to blame in some cases. I disagree that that is a suitable alternative to NSAID or intra articular therapy in the chronically lame horse. Pain relief shOuld be first and foremost.
 
Tarr steps- yes that is my experience of joint injections in the uk. People get their horses treated routinely without much trouble. Having said that, so do people in the uk but when all goes well as it usually does they don't make a song dnd a dance out of it as they often wish to sell that horse without declaring history in the future! ;)
 
glenruby said:
Bruce's- the vast majority if hock spavin cases will not come sound with "barefoot" trimming, diet etc. not without the aid of medical treatment. Many Of the horses I have treated for oa of the hock have been barefoot or unshod ponies. Hoof balance has only been to blame in some cases. I disagree that that is a suitable alternative to NSAID or intra articular therapy in the chronically lame horse. Pain relief shOuld be first and foremost.
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Well mine must be in the very small minority then :)

Pain relief absolutely should be given - Danilone is great.

However I feel removing the concussion of metal shoes, letting the horses set their own balance, providing a supportive diet, adjusting the workload and work type to be more suitable for a horse with oa of the hock, is overall a lower risk approach than intra-articular steroids.

A chronically lame horse is a chronically lame horse for a reason. Medically treating spavin, or "navicular syndrome" with out addressing the underlying aetiology will only prolong the chronic lameness, albeit with a spell of temporary relief.
 
Ah but the underlying condition in this case is not necessarily something you can "treat" as such. Nor necessarily something you can actually prevent. Oa is an inevitability of old age. Our horses are living longer and with that comes a prolonged geriatric phase. And let's be clear - this is a discussion about oa not navicular - two very different situations.
 
No, not really all that different at root.

Both are brought about by our horse handling, management and exercise practices.

OA is not an inevitability for horses or people. I know several horses working into their 40's and one native who is working at 46, she's walking out just a couple of times a week with small children, but still doing something very useful. They've never had shoes and they've never had fancy bagged feeds - in fact you might baulk at the conditions they are kept in, they don't have access to lush pasture either, they live on a moor and eat anything that grows above ground level.
 
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