Steroid Induced Laminitis

[jackiex]

My vet prescribed prednisone for my horse suspecting an allergy, did not make me aware of the risk of laminitis and had not tried any other treatment beforehand. (Turns out it was a virus as now the others are coughing) Subsequently after ten days on the course, to my surprise and horror she took laminitis which affected all four legs. Shaking, sweating etc. She has been on metacam, acp twice daily, 20 aspirin but 17 days later still has strong digital pulses coming and going on her back legs. She was xrayed last week and showed 2 degree rotation on the right fore which incidentally was the only foot that seemed cold to touch. Has anyone experienced this and had a recovery. Is it normal for the digital pulses to come and go like that over the weeks. When they get stronger I am standing her in an ice bath and dont know if this is really doing any good or not. Now she has filled legs from standing in and my vet has said to start walking 5 mins three times a day. Not sure if I should with pulses still being strong in those two back legs. She has had impression material from the beginning and heart bar shoes with impression material fitted last week. Although at the beginning she was shifting weight from leg to leg, at the moment she appears to be sound and eager to get out of her box. Can anyone advise me about the digital pulses please?

 

[rema]

My lad is recovering from concussive lami (9 weeks after first diagnosis)..His digital pulses come and go daily and are still never the same hour by hour.Cold water tubbing actually makes the blood vessels constrict where as warm water will open them up.

 

[Oberon]

My vet prescribed prednisone for my horse suspecting an allergy, did not make me aware of the risk of laminitis and had not tried any other treatment beforehand. (Turns out it was a virus as now the others are coughing) Subsequently after ten days on the course, to my surprise and horror she took laminitis which affected all four legs. Shaking, sweating etc. She has been on metacam, acp twice daily, 20 aspirin but 17 days later still has strong digital pulses coming and going on her back legs. She was xrayed last week and showed 2 degree rotation on the right fore which incidentally was the only foot that seemed cold to touch. Has anyone experienced this and had a recovery. Is it normal for the digital pulses to come and go like that over the weeks. When they get stronger I am standing her in an ice bath and dont know if this is really doing any good or not. Now she has filled legs from standing in and my vet has said to start walking 5 mins three times a day. Not sure if I should with pulses still being strong in those two back legs. She has had impression material from the beginning and heart bar shoes with impression material fitted last week. Although at the beginning she was shifting weight from leg to leg, at the moment she appears to be sound and eager to get out of her box. Can anyone advise me about the digital pulses please?

Your horse has suffered with laminitis as a symptom of systemic inflammatory disease.

Cryotherapy in this instance is a recognised treatment and I would continue this.
http://www.ker.com/library/health/2010/06/cryotherapy-remains-relevant-treatment-for-laminitis.html

If the vet is happy for her to move and she is padded up nicely - then let her walk around.

As well as improving the circulation by movement (and we need to keep the blood flowing to get through this) - the psychological effects of being allowed out and about cannot be discounted. Some horses just give up - we don't want this to happen to her.

Digital pulses are an indication of pressure within the hoof capsule - but we already know she has lami, so it's not as relevant now.

 

[sanchob]

My pony had a steroid injection in march for an inflamed stifle and went down with laminitis 7 days later. They are supposed to tell you the risks !!! which my vet did but Unfortunately i was between a rock and a hard place as my pony was lame behind. I was told that they should never be moved especially with rotation as everything needs to settle and walking them can do no end of damage..not to mention the pain they are in. my boy had his feet padded -was sedated with pain relief for a month . Then when it settled down we tested him for IR which came back borderline .We put him on the metformin and he really improved . He was x rayed monthly and had no rotation but was on box rest until a month ago.He is now back in work and improving all the time . He is doing half hour school work and has just started cantering again and is turned ou for 1 hour a day with muzzle.

 

[Oberon]

Opinions differ on whether to box rest or not.

It was the norm previously but current thinking tends to be that walking within the horse's comfort is fair (under the guidance of the attending vet who has seen the horse in the flesh) as the benefits are definite and the risks are theoretical.

They are just as likely to cause more damage within the stable as they are walking outside - if the laminae is going to fail - it's going to fail whether they are standing on it or walking on it - the pressure is the same either way.

Treating the primary cause of the lami is the biggest issue, as is prevention .

 

[jackiex]

Thanks everyone for your advice. Since this has happened, I have visited almost every website offering information on laminitis, whilst not looking after her I am trying to find out more. A lot of the information I have read is not very encouraging for steroid induced laminitis effecting all four legs. I have had many horses with problems but had escaped the nightmare of laminitis to now. I had read about Chris Pollitt and his study with cryotherapy but wonder is it only beneficial in the development stages and not in the sub acute stage which I think we are currently at but I will continue with this treatment. My vet is completely clueless regards laminitis and I can only feel sorry for the animals he treats from day to day, especially when arriving 3 days following the attack to give the horse a trot up. He also told me he didnt make me aware of the dangers of laminitis from steroids as only cobby types get it!! Hopefully he can learn from this incident. I have been speaking to my usual specialist equine vet who unfortunately lives a long distance from where I live and he has been advising me by telephone as I can't travel her as yet and he has advised walk her 10 mins 3 times a day to relieve the filling and help keep her settled. I also have spoken to Sue from the Laminitis Trust who has offered me so much advice and says total box rest for 1 month after painkillers are stopped. I am worried my horse has to be experiencing further inflammation and laminae damage if there are still strong digital pulses, this is happening on the right hind which has less filling than the left hind. The filling in the legs are a concern but also this horse is feeling very good now, was out showjumping and super fit, has a stressed personality and is starting to get very lively in the stable which also concerns me regarding further damage. I have her in a very deep shavings bed. Should the strong digital pulse be gone by now or is this considered normal during recovery?

 

[HVG]

Digital pulses most certainly are indicating inflammation. Do not disregard them. You want to walk your horse as little as is possible at this stage. Manage filled legs with bandages & magnetic wraps to help increase circulation. The filled legs will not kill her. Walking a laminitic can. 2 degrees is not bad if it does not get any worse.

It sounds positive though that the horse is bright and lively. If she is prancing around in her box then up the ACP dose to actually sedate her. This is important. Stress causes blood vessels to constrict potentiating

 

[HVG]

Digital pulses most certainly are indicating inflammation. Do not disregard them. You want to walk your horse as little as is possible at this stage. Manage filled legs with bandages & magnetic wraps to help increase circulation. The filled legs will not kill her. Walking a laminitic can. 2 degrees is not bad if it does not get any worse.

It sounds positive though that the horse is bright and lively. If she is prancing around in her box then up the ACP dose to actually sedate her. This is important. Stress causes blood vessels to constrict potentiating laminitis.

Cold therapy will not alter the core temperature of her feet, so much as it helps you feel you are doing something, it won't help.

You are bang on with your suggestion of deep deep shavings.

Have you got the horse on a good laminitis diet?

It does not sound like your vet is giving you a great service.....

Best of luck

 

[jackiex]

This is a question I had actually asked my vet, can filled legs kill cause I know laminitis can. He had brushed this off and said, "you are worrying too much, she is fine, let her off in your sand school, this mare is sound, thats all you need". I on the other hand have read so much and I do feel less walking is better despite the advice of my vet as well as my farrier. Yes, she may appear sound at this stage but thats only in walk and I am not going to trot her up, also she has a high dose of painkiller in her and as far as I am aware, the rotation can come later on without the right care. I am constantly quoting to them the advice given by the lamintis trust but there seems to be so many views. I had bandaged her earlier and it helped with the filled legs.

Digital pulses I too feel are not to be disregarded which is why I had written this post so I hopefully could have my worries confirmed as opposed to these people who are supposed to be the so called experts who are saying not to worry, they are normal Whilst she is pretty lively in the stable, she has a high dose of painkiller which I cant give up due to the anti inflammatory effect, she is also on quite a high dose of acp, she is getting this morning and evening but whilst it was very effective early on, with the weather cooling etc, it doesnt seem to be just as effective.

 

[jackiex]

He is a local vet who I would only generally use for minor problems but with an emergency like this I had not many options as I knew travelling was out of the question. I have changed her from haylage to happy hoof, today I managed to source good hay so she is having that introduced from this evening, then I will introduce speedibeet also. I also started her on the homeopathic remody nux vomica to cleanse her body of toxins. I think this really helped her as her eyes looked quite bloodshot and now are so much brighter and clearer. I also have started her on the herbal lami support from Natural Horse supplies which contains Hawthorn Berries, Nettle, Burdock, Dandelion, Comfrey, Clivers and milk thistle and I added rosehips and chalomile. Not an expert on homeopathic or herbal remedies but was advised these could help.

 

[brighteyes]

Thanks everyone for your advice. Since this has happened, I have visited almost every website offering information on laminitis, whilst not looking after her I am trying to find out more. A lot of the information I have read is not very encouraging for steroid induced laminitis effecting all four legs. I have had many horses with problems but had escaped the nightmare of laminitis to now. I had read about Chris Pollitt and his study with cryotherapy but wonder is it only beneficial in the development stages and not in the sub acute stage which I think we are currently at but I will continue with this treatment. My vet is completely clueless regards laminitis and I can only feel sorry for the animals he treats from day to day, especially when arriving 3 days following the attack to give the horse a trot up. He also told me he didnt make me aware of the dangers of laminitis from steroids as only cobby types get it!! Hopefully he can learn from this incident. I have been speaking to my usual specialist equine vet who unfortunately lives a long distance from where I live and he has been advising me by telephone as I can't travel her as yet and he has advised walk her 10 mins 3 times a day to relieve the filling and help keep her settled. I also have spoken to Sue from the Laminitis Trust who has offered me so much advice and says total box rest for 1 month after painkillers are stopped. I am worried my horse has to be experiencing further inflammation and laminae damage if there are still strong digital pulses, this is happening on the right hind which has less filling than the left hind. The filling in the legs are a concern but also this horse is feeling very good now, was out showjumping and super fit, has a stressed personality and is starting to get very lively in the stable which also concerns me regarding further damage. I have her in a very deep shavings bed. Should the strong digital pulse be gone by now or is this considered normal during recovery?

OMG

 

[pottamus]

The whole thing needs manageing on a day to day basis depending on your horse that day - there is no other way.
My lad got so stressed from the box rest that he started box walking a track round his stable with the stress. Coupled with this he also stopped eating and started shedding weight at an alarming rate.
Between myself and the vet we decided to pen off an area outside his field stable that was just dirt and mud to get him out and let him stand in the sun for a few hours to relieve the stress. This helped him no end, which in turn helped his feet heal because he was not stressed. It also helped with the filled sheath that he was getting from lack of movement - his sheath had swollen up a lot and was getting uncomfortable for him, but this went down within two days of being outside for a few hours.
Being allowed out in a small pen in the sunshine in the day was a risk because he would be walking about, but it was better than him doing stable walking for hours and he started to eat his hay again.
Stress has terrible affects so keep an eye on that and if walking out for 10mins a day prevents a build up of stress, then that is probably a better option to be honest.
Good luck, hope it all goes well.

 

[sanchob]

we made our pony lots of toys from milk cartons and coke bottles which kept him amused and as soon as he was off the pain relief and sedation he was allowed to stand out side his stable while we mucked out etc. Digital pulses mean inflamation and pain - i was advised no walking etc until off pain relief and it seems to have been good advice . Also we gave him a bath in the stable- massage etc. you have to be ingenious . xxx

 

[Andalucian]

I'm very sorry your horse has reacted to steroids like this, its very frightening for you all.

I've seen this happen, and its not good - have about 6 months in mind in terms of a recovery period and be VERY cautious when considering any movement. In these cases the laminae are under extreme stress and movement is the last thing they need until they regrow and reattach sufficiently to take the strain of carrying the weight of the horse.

I wish you luck in caring for him in the intervening period. But be in no rush to return him to any kind of turn out or in hand walking.

 

[fiestiemaestie]

Hi all,

I was wondering if any of you would be willing to fill in my laminitis survey about your experiences. This is the link to the thread about it!

Thanks

http://www.horseandhound.co.uk/forums/showthread.php?t=562159

 

[HVG]

I 100% agree with Andalucian. Even if he/she is stressed in the stable hand walking is a killer with inflamed separated laminae. Please please don't do it. You say he's on a high dose ACP, what is this? ACP can be used multiple times a day in reasonable doses to provide sedation.

Trickle feeding can help.

Is this all under insurance? That will help. There are other natural veterinary products for stress. Google Zylkene.

X

 

[acw295]

How scary, that is one of my nightmares!

I wouldn't be letting that vet anywhere near my horse again - do you live somewhere remote or something? I guess we are lucky as have several specialist equine vets practices locally so would never let someone like that near mine. I appreciate not everyone has this though

I would listen to the Laminitis Clinic advice and not anything the other vet says. Deep bed, don't move about. What does your farrier think?

My coblet had to have steroid injections recently, I knew the risks anyway but vet still explained them thoroughly and also said that the key was giving a very accurate minimum dose based on exact weight, luckily she could be weighed and this apparently reduces the risks a lot - overdosing by small amount can be the tipping point.

I didn't sleep for the 2 weeks after she had it though as was terrified.

I'd also be insisting on blood tests as all the research I've seen suggests that even in steroid cases there is an underlying metabolic cause.

I do wish you both luck with the recovery x

 

[Fetherston]

My pony was given steroid induced laminits by the vet who actually overdosed him with steroids when he had his wolf teeth out. It hs been a long road back but as I write he is out in the field all day and although on a restricted diet, is thankfully doing well. The turning point came when I sarted him on a product which is actually not something which claims it does anything for laminitics but someone told me it had worked for them,. Its called Relax Me by Horse First. They make no caims at all but I wouldn't be without it. Good luck.

 

[_HP_]

The whole thing needs manageing on a day to day basis depending on your horse that day - there is no other way.
My lad got so stressed from the box rest that he started box walking a track round his stable with the stress. Coupled with this he also stopped eating and started shedding weight at an alarming rate.
Between myself and the vet we decided to pen off an area outside his field stable that was just dirt and mud to get him out and let him stand in the sun for a few hours to relieve the stress. This helped him no end, which in turn helped his feet heal because he was not stressed. It also helped with the filled sheath that he was getting from lack of movement - his sheath had swollen up a lot and was getting uncomfortable for him, but this went down within two days of being outside for a few hours.
Being allowed out in a small pen in the sunshine in the day was a risk because he would be walking about, but it was better than him doing stable walking for hours and he started to eat his hay again.
Stress has terrible affects so keep an eye on that and if walking out for 10mins a day prevents a build up of stress, then that is probably a better option to be honest.
Good luck, hope it all goes well.

This...

A stabled horse that is stressed can do as much damage as a relaxed one in a paddock. If the horse is happy in the stable then that is the best thing IMO BUT if not, I would make a small bare paddock and have her in there if possible.
Also...I would not feed Happy Hoof..it contains mollasses. Fast Fibre is good for laminitics...low sugar and no mollasses
http://www.allenandpage.com/Products/Rest-and-Light-Work/Fast-Fibre.aspx

 

[jackiex]

Thanks everyone once again for taking time to reply. I did take the decision not to take my mare out walking due to considering the advice from the laminitis trust and weighing up everyones comments. At the end of the day, the laminitis trust are dealing with cases continuously so they are probably the best qualified to advise. The horse is quite lively at times in her box bucking and skipping but I also thought if I take her out to walk her she would more than likely do more damage as I know she would certainly be trying to have a sport to herself on the end of the lead rope. Her strong pulses seem now to come and go but I think we are making progress. She is on 3ml morning and evening of sedalin (6ml per day), thats using the syringe. She is still on full dose metacam and 20 aspirin per day. The sedalin though does quieten her a little but within an hour or two she is back to normal. The swelling in her legs has come down well, started to bandage her 4 hours a day in nice thick gamgee with stable bandages. I am also using the equissage machine gently where they are filled so I am now happy with that.
Someone asked about the farrier, he is good at remedial work, however he too is of the opinion a walk wont do any harm. In fact, last time he was challenging a little with regards to my lack of acceptance to what he was saying and he went to walk off with her, horrified I quickly took the horse of him and put her back in her stable.
She is on hay now and speedibeet, no happy hoof. I am also giving her herbs including clivers, dandelion, nettle, comfrey, burdock, hawthorn berries, milk thistle which are all targeted towards organ support, reducing inflammation and swelling etc. I also am giving her chalomile which I was advised would help towards keeping her calm.
My vet did take a blood test at the beginning to check for IR and said it was fine, however this is the same vet that misdiagnosed her condition as an allergy and provided the steroids without any prior use to treat with any other medication and did not warn me of the side effects (thats because he wasnt aware there was a link with steroids in this type of horse which shows his incompetence), so I am not trusting what he has told me about the blood tests. I do live in a remote area and these are the only vets which cater for all animals, they are not specialist.
Unfortunately my horse is not insured, I do keep a number of horses and the price of insurance to replace the horse in event of loss is very high, this particular horse was one of my more expensive horses so will be taking legal advice but at the moment I am concentrating on doing my best for the horse, its not the cost, its the principle. It wouldnt matter if she was a good horse, bad horse, whatever, there has been mistakes made and I just pray she will recover. Having said that, I realise anyone can make mistakes but I do feel any vet has a duty to inform an owner of a horse of the risks, at least provide packaging with medication explaining side effects if I had have decided to go down that route or would have treated the horse with some other form of treatment first before resorting to steroids.
Finally, I will definitely not be rushing her back into work and certainly not showjumping for at least a year (or longer if it is advised by the specialist equine vet), thats if we ever get to that point but I will certainly be doing everything possible.

 

[HVG]

Jackie, can you PM me. I have some info for you. I don't know how to do it privately though!

 

[HVG]

Did you get my email?

 

[jackiex]

Hi, hadnt checked my emails. Have just read and sent you a reply. Thank you very much, I really appreciate your help.

 

[JEZA]

Thanks everyone for your advice. Since this has happened, I have visited almost every website offering information on laminitis, whilst not looking after her I am trying to find out more. A lot of the information I have read is not very encouraging for steroid induced laminitis effecting all four legs. I have had many horses with problems but had escaped the nightmare of laminitis to now. I had read about Chris Pollitt and his study with cryotherapy but wonder is it only beneficial in the development stages and not in the sub acute stage which I think we are currently at but I will continue with this treatment. My vet is completely clueless regards laminitis and I can only feel sorry for the animals he treats from day to day, especially when arriving 3 days following the attack to give the horse a trot up. He also told me he didnt make me aware of the dangers of laminitis from steroids as only cobby types get it!! Hopefully he can learn from this incident. I have been speaking to my usual specialist equine vet who unfortunately lives a long distance from where I live and he has been advising me by telephone as I can't travel her as yet and he has advised walk her 10 mins 3 times a day to relieve the filling and help keep her settled. I also have spoken to Sue from the Laminitis Trust who has offered me so much advice and says total box rest for 1 month after painkillers are stopped. I am worried my horse has to be experiencing further inflammation and laminae damage if there are still strong digital pulses, this is happening on the right hind which has less filling than the left hind. The filling in the legs are a concern but also this horse is feeling very good now, was out showjumping and super fit, has a stressed personality and is starting to get very lively in the stable which also concerns me regarding further damage. I have her in a very deep shavings bed. Should the strong digital pulse be gone by now or is this considered normal during recovery?

May I ask how all this was resolved? My cob has steroid induced laminitis and recently diagnosed with EMS. He's very lame.

 

[Chianti]

Thanks everyone once again for taking time to reply. I did take the decision not to take my mare out walking due to considering the advice from the laminitis trust and weighing up everyones comments. At the end of the day, the laminitis trust are dealing with cases continuously so they are probably the best qualified to advise. The horse is quite lively at times in her box bucking and skipping but I also thought if I take her out to walk her she would more than likely do more damage as I know she would certainly be trying to have a sport to herself on the end of the lead rope. Her strong pulses seem now to come and go but I think we are making progress. She is on 3ml morning and evening of sedalin (6ml per day), thats using the syringe. She is still on full dose metacam and 20 aspirin per day. The sedalin though does quieten her a little but within an hour or two she is back to normal. The swelling in her legs has come down well, started to bandage her 4 hours a day in nice thick gamgee with stable bandages. I am also using the equissage machine gently where they are filled so I am now happy with that.
Someone asked about the farrier, he is good at remedial work, however he too is of the opinion a walk wont do any harm. In fact, last time he was challenging a little with regards to my lack of acceptance to what he was saying and he went to walk off with her, horrified I quickly took the horse of him and put her back in her stable.
She is on hay now and speedibeet, no happy hoof. I am also giving her herbs including clivers, dandelion, nettle, comfrey, burdock, hawthorn berries, milk thistle which are all targeted towards organ support, reducing inflammation and swelling etc. I also am giving her chalomile which I was advised would help towards keeping her calm.
My vet did take a blood test at the beginning to check for IR and said it was fine, however this is the same vet that misdiagnosed her condition as an allergy and provided the steroids without any prior use to treat with any other medication and did not warn me of the side effects (thats because he wasnt aware there was a link with steroids in this type of horse which shows his incompetence), so I am not trusting what he has told me about the blood tests. I do live in a remote area and these are the only vets which cater for all animals, they are not specialist.
Unfortunately my horse is not insured, I do keep a number of horses and the price of insurance to replace the horse in event of loss is very high, this particular horse was one of my more expensive horses so will be taking legal advice but at the moment I am concentrating on doing my best for the horse, its not the cost, its the principle. It wouldnt matter if she was a good horse, bad horse, whatever, there has been mistakes made and I just pray she will recover. Having said that, I realise anyone can make mistakes but I do feel any vet has a duty to inform an owner of a horse of the risks, at least provide packaging with medication explaining side effects if I had have decided to go down that route or would have treated the horse with some other form of treatment first before resorting to steroids.
Finally, I will definitely not be rushing her back into work and certainly not showjumping for at least a year (or longer if it is advised by the specialist equine vet), thats if we ever get to that point but I will certainly be doing everything possible.

Can I ask why you're feeding the speedibeet? When mine got laminitis- quite badly - I fed a handful of straw based chaff and a balancer. I used Topspecs Anti Lam as it's meant to have in it things that will help with laminitis. She lived on it after that. I also fed soaked hay so that she could have more and used small holed hay nets to make it last. I was told by my vet to feed ACP three times a day so that she was woozy for most of the day. I think you're quite right in abiding by what the Laminitis Trust advises. They are the experts, having dealt with thousands of cases. I hope she recovers soo. Once they start to improve they can do so quite quickly.

 

[brighteyes]

Speedibeet is very low sugar and starch and high fibre - providing succulence also.

 

[ycbm]

May I ask how all this was resolved? My cob has steroid induced laminitis and recently diagnosed with EMS. He's very lame.

Can I ask why you're feeding the speedibeet? When mine got laminitis- quite badly - I fed a handful of straw based chaff and a balancer. I used Topspecs Anti Lam as it's meant to have in it things that will help with laminitis. She lived on it after that. I also fed soaked hay so that she could have more and used small holed hay nets to make it last. I was told by my vet to feed ACP three times a day so that she was woozy for most of the day. I think you're quite right in abiding by what the Laminitis Trust advises. They are the experts, having dealt with thousands of cases. I hope she recovers soo. Once they start to improve they can do so quite quickly.

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