The lami episode I was dreading ...

TwyfordM

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So my little welsh has always had random bouts of laminitis. Usually acute with no warning signs, not over weight etc or on ton of grass or feed. She had already had one bout when I took her on at the age of 5 (now 17)
Since then we had one maybe 9 years back that was very acute but full recovery within two weeks. Another about 5 years back and when we had a sudden flush of grass after flooding (was in work and fit and I was hoping we would get away with it - we didn’t) unfortunately had to move her about two weeks into episode and we had minor rotations with offside fore being the worst but still pretty minor. No changes in hoof trimming etc needed. Took about 2 months for full recovery but came sound again.

At this point tested for Cushings. Test came back very slightly above the threshold. We tried prascend but the side effects were so bad and with her being only slightly too high we decided to not Medicate yet she just keep an eye on symptoms.

Since then, no signs the Cushings was getting any worse. Testing showed it was still very much on the borderline so could just be stress of blood tests etc as she’s an unholy cow the minute she spies a needle ??‍♀️ If anything she was looking really well.
We commented a couple of months back how she doesn’t look like she’s got it at all .. tempting fate apparently!

In between lami episodes she’s damaged a few vertebra in her neck through what we think was a rotational fall jumping a 5 bar gate (she’s 12.1hh ?) so that was another long period of box rest. We’ve also had a few colics and liver issues but all seems to be resolved there. Neck injury means she’s retired but she still goes out for walks and odd free school/lunge when she’s not too stiff.

Few weeks back I noticed when turning out that she was a bit footy on the stones. So we turned around and went back to stable. Cresty neck sprung out of nowhere and coat growing back in ??‍♀️ Few days later still a very minor lameness in all 4 feet so I called the vet out figuring if we hit it hard with full lami regime we might be able to stop it becoming a big issue. Vet agreed. Weeks box rest. Bit of bute. Let’s check her ACTH again and see if levels changed.

Levels are now double the high end of the normal range, so we decided to try pergolide (Bova) paste to see if she had less side effects. So far so good. She seems happy in herself.

But, the laminitis a few days after last bute and two weeks after the initial appointment, Seems to have got dramatically worse. The offside fore is pretty bad now, and other front is going the same way. She is full blown acute attack. Not rocking back as all 4 feet but very reluctant to move etc

She’s due another ACTH test next week and we are going to do X-rays some point over next few days and Insulin resistance test. But the way she is now, I’ll be shocked if there’s nothing going on internally ?

If it’s definitely got dramatically worse and I would rather know ASAP if we need to get supports on her feet/it’s too far gone now. Rather than her struggling on unnecessarily.
She’s got such weird symptoms, heat in the hooves is intermittent. No consistency. No pulses. I’m looking at her feet and I’m no expert but having owned her for a long time - I feel like the angle of growth has changed which worries me. So I’m wondering if it’s just the Cushings or if there’s something else going on ...

She’s been on box rest, huge shavings bed. Handful of hifi for meds. Soaked hay and I don’t think she’s dropped any weight ? which is unusual for her as she usually has the bloody metabolism of a TB, can’t keep weight ON her? Usually even after two weeks of laminitis regime she’s approaching hat rack body type.

This is her yesterday...

E2E0DFBA-85F5-4C0C-A922-42E36F144EDC.jpeg

Ive just been up to the vets to pick up more bute for her and dose has been upped.

I love this little mare more than I can say but I have an awful feeling we may have reached the end of the road, won’t know for sure til X-rays are taken, but I don’t know how I feel about extended periods of box rest/restricting more than she already iswhen she’s dealt with so much over the years already.

Frustrating thing is she’s a tough little cookie and a fighter. Still her normal cheeky self. She’s got the will to keep going for sure, but I’m also aware that she’s very very stoic and if she’s now looking very uncomfortable walking that’s not a good sign.

Any ideas/advice appreciated.
I won’t let her suffer on if outcome is unlikely to be good, but while she’s still got her stubborn fighter mentality on I feel like I need to at least give her a chance.
 

PinkvSantaboots

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Worth testing for ems my mare had cushings and ems you can then use metformin and there are other things now for insulin resistance, sedalin can also help with blood flow and for pain control a lot of vets use paracetamol alongside Bute now for laminitis.

Just wanted to add a friend's Welsh a came down with laminitis really bad couldn't walk thought it was the end, they tested for cushings and ems the cushings was clear but ems was positive and she was put on some medication for it and within a week she was completely sound, I don't know what it was but I will find out for you, I would seriously consider ems just because of how big her crest is.
 
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Casey76

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How much hay is in that net? She really needs to lose weight, and therefore her forage must be weighed. 24 hour allowance should be either 1.5% of current weight of 2% of ideal weight - whichever is greater.

Bute has no effect on endocrinogenic laminitis. You must get her insulin level down, which means low starch and sugar forage.
 

TwyfordM

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How much hay is in that net? She really needs to lose weight, and therefore her forage must be weighed. 24 hour allowance should be either 1.5% of current weight of 2% of ideal weight - whichever is greater.

Bute has no effect on endocrinogenic laminitis. You must get her insulin level down, which means low starch and sugar forage.

Im needing to buy some new scales so no exact weight, but that’s the “night” net. Morning one is about half the size and it’s all soaked. But they are pretty light no more than a couple of kgs together which would be about right
 

ILuvCowparsely

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So my little welsh has always had random bouts of laminitis. Usually acute with no warning signs, not over weight etc or on ton of grass or feed. She had already had one bout when I took her on at the age of 5 (now 17)
Since then we had one maybe 9 years back that was very acute but full recovery within two weeks. Another about 5 years back and when we had a sudden flush of grass after flooding (was in work and fit and I was hoping we would get away with it - we didn’t) unfortunately had to move her about two weeks into episode and we had minor rotations with offside fore being the worst but still pretty minor. No changes in hoof trimming etc needed. Took about 2 months for full recovery but came sound again.

At this point tested for Cushings. Test came back very slightly above the threshold. We tried prascend but the side effects were so bad and with her being only slightly too high we decided to not Medicate yet she just keep an eye on symptoms.

Since then, no signs the Cushings was getting any worse. Testing showed it was still very much on the borderline so could just be stress of blood tests etc as she’s an unholy cow the minute she spies a needle ??‍♀️ If anything she was looking really well.
We commented a couple of months back how she doesn’t look like she’s got it at all .. tempting fate apparently!

In between lami episodes she’s damaged a few vertebra in her neck through what we think was a rotational fall jumping a 5 bar gate (she’s 12.1hh ?) so that was another long period of box rest. We’ve also had a few colics and liver issues but all seems to be resolved there. Neck injury means she’s retired but she still goes out for walks and odd free school/lunge when she’s not too stiff.

Few weeks back I noticed when turning out that she was a bit footy on the stones. So we turned around and went back to stable. Cresty neck sprung out of nowhere and coat growing back in ??‍♀️ Few days later still a very minor lameness in all 4 feet so I called the vet out figuring if we hit it hard with full lami regime we might be able to stop it becoming a big issue. Vet agreed. Weeks box rest. Bit of bute. Let’s check her ACTH again and see if levels changed.

Levels are now double the high end of the normal range, so we decided to try pergolide (Bova) paste to see if she had less side effects. So far so good. She seems happy in herself.

But, the laminitis a few days after last bute and two weeks after the initial appointment, Seems to have got dramatically worse. The offside fore is pretty bad now, and other front is going the same way. She is full blown acute attack. Not rocking back as all 4 feet but very reluctant to move etc

She’s due another ACTH test next week and we are going to do X-rays some point over next few days and Insulin resistance test. But the way she is now, I’ll be shocked if there’s nothing going on internally ?

If it’s definitely got dramatically worse and I would rather know ASAP if we need to get supports on her feet/it’s too far gone now. Rather than her struggling on unnecessarily.
She’s got such weird symptoms, heat in the hooves is intermittent. No consistency. No pulses. I’m looking at her feet and I’m no expert but having owned her for a long time - I feel like the angle of growth has changed which worries me. So I’m wondering if it’s just the Cushings or if there’s something else going on ...

She’s been on box rest, huge shavings bed. Handful of hifi for meds. Soaked hay and I don’t think she’s dropped any weight ? which is unusual for her as she usually has the bloody metabolism of a TB, can’t keep weight ON her? Usually even after two weeks of laminitis regime she’s approaching hat rack body type.

This is her yesterday...

View attachment 75363

Ive just been up to the vets to pick up more bute for her and dose has been upped.

I love this little mare more than I can say but I have an awful feeling we may have reached the end of the road, won’t know for sure til X-rays are taken, but I don’t know how I feel about extended periods of box rest/restricting more than she already iswhen she’s dealt with so much over the years already.

Frustrating thing is she’s a tough little cookie and a fighter. Still her normal cheeky self. She’s got the will to keep going for sure, but I’m also aware that she’s very very stoic and if she’s now looking very uncomfortable walking that’s not a good sign.

Any ideas/advice appreciated.
I won’t let her suffer on if outcome is unlikely to be good, but while she’s still got her stubborn fighter mentality on I feel like I need to at least give her a chance.


I have my welsh A on Timothy Haylage. Also my my other 3 lami horses on EA Turmeric which she helps too, so far any flare up this year has been 2 days tops with pulses and they go out 9-4, but the welsh A is on strip grazing
 

ILuvCowparsely

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Quick question do you know or do check the feet for heat and pulses?? It is worth asking the vet to show you so you can catch it early. My late mare also had styrofoam pads on to stop her sinking, also use Equimins Laminator to help with the blood supply in her feet.

Can you put ice boots on or cold wraps to help bring heat out?
 

TwyfordM

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Quick question do you know or do check the feet for heat and pulses?? It is worth asking the vet to show you so you can catch it early. My late mare also had styrofoam pads on to stop her sinking, also use Equimins Laminator to help with the blood supply in her feet.

Can you put ice boots on or cold wraps to help bring heat out?

Yep check daily pretty much. At first no heat or pulses but was footy. Bit of heat a few days later then nothing until this flare up where they’ve gone very hot but no pulses any time I’ve checked.

Did ice boots daily for the first week too.

Dealing with laminitis is pretty old hat me now which is why I’m finding this all bizarre as it’s not following the usual pattern ... honestly doesn’t make sense.

Eta - she’s had swelling around coronet bands intermittently too.
 

meleeka

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if she’s getting worse then chances are whatever is causing it is still there. That can only be diet or cushings/EMS. Hopefully the next blood test will give you some answers. With mine i’ve always increased the dose without the blood test if it’s looking like it isn’t working, but mines been on Prascend for a long time so it’s easier to tell.

How long are you soaking hay for? is your haynet teeny holed? The other thing worth mention is foot balance. Once you’ve got x-rays you can work with those to lessen the forces on her pedal bone. I’d also make that bed all the way to the door, so that her hooves are supported all the time, wherever she stands.

I really hope you can get her sorted. It’s not really evident how bad she is until she has xrays as they are all different.
 

CanteringCarrot

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I don't have much advice outside of what you're already doing/considering. I just wanted to say I hope that you can get to the bottom of it and that she gets well soon.

I agree with others that it could be EMS and medicating that could ease it.
 

TwyfordM

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if she’s getting worse then chances are whatever is causing it is still there. That can only be diet or cushings/EMS. Hopefully the next blood test will give you some answers. With mine i’ve always increased the dose without the blood test if it’s looking like it isn’t working, but mines been on Prascend for a long time so it’s easier to tell.

How long are you soaking hay for? is your haynet teeny holed? The other thing worth mention is foot balance. Once you’ve got x-rays you can work with those to lessen the forces on her pedal bone. I’d also make that bed all the way to the door, so that her hooves are supported all the time, wherever she stands.

I really hope you can get her sorted. It’s not really evident how bad she is until she has xrays as they are all different.

Hays being soaked for about 6hrs. I find anything longer than that and she won’t eat it otherwise I’d probably do 12.
She’s getting handful of top chop zero for feed, with a token amount of pony nuts on top. Plus small handful of nuts to take the pergolide paste in so it doesn’t get spat over the floor.

Haynets I made myself so have nice small holes and stronger rope so she can’t bite the holes bigger, morning net is double netted to last her a bit longer too.

Honestly she’s on less feed/hay than she’s ever been on in her life and she’s gaining weight and pretty obvious fat pads type situations.

This is the pony I struggle to keep weight on normally so I really worry that it’s EMS or something. So being tested either tomorrow or Friday waiting to hear from the vet as they need to bring portable X-ray machines at the same time to do feet.
 

meleeka

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Hays being soaked for about 6hrs. I find anything longer than that and she won’t eat it otherwise I’d probably do 12.
She’s getting handful of top chop zero for feed, with a token amount of pony nuts on top. Plus small handful of nuts to take the pergolide paste in so it doesn’t get spat over the floor.

Haynets I made myself so have nice small holes and stronger rope so she can’t bite the holes bigger, morning net is double netted to last her a bit longer too.

Honestly she’s on less feed/hay than she’s ever been on in her life and she’s gaining weight and pretty obvious fat pads type situations.

This is the pony I struggle to keep weight on normally so I really worry that it’s EMS or something. So being tested either tomorrow or Friday waiting to hear from the vet as they need to bring portable X-ray machines at the same time to do feet.
Do check your nuts, they should be well under 10% sugar and starch.

Perhaps you could give two nets, one soaked for 6 hours and one for 12, that way she’ll only eat one if she’s actually hungry?
 

Not_so_brave_anymore

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This is a very very familiar story to me this year. I've also got a little mare, with mild cushings, not "lean" but certainly not above a 4/5 body score- and she's had pulses up and down in her legs seemingly randomly for the past 2 months. (Similarly to you I've been able to catch it early each time- I had her feet xrayed a couple of weeks ago because she'd had so many minor episodes, and luckily she has no rotation or sinking)

I've just ordered a hay testing kit, because I'm starting to think it must be the hay?
 

Sandstone1

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Try something like fast fibre instead of the nuts? She does have quite a crest. It could be ems. Hopefully you will get to the bottom of it. I know how worrying it is. Fingers crossed for her.
 

buddylove

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I have just got mine under control (fingers crossed), complete box rest, 1 week with bute, weeks 2 and 3 box rest during day and out on a bare paddock at night, no bute.
He has 2 nets a day with only 1 small slice in. Ad lib plain straw chaff, and one feed of a handful of soaked speedi beet with his vit/mins, brewers yeast and cinnamon. Crest has disappeared and ribs are back.
It will be a while before he has limited access to grass.
 

TwyfordM

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Did you start feeding her a new ‘batch/delivery’ of hay before this suddenly exploded?

Yes and no, bought in Heston that was the same as the ad-lib one in the field. So it was a new hay in terms of what she usually has in stable, but not newly cut or green. Pretty sure it was cut in the autumn. They’ve been on it in the field most of the winter too

However, I wasn’t feeding this bale for long before it started so possibly connected
 

TwyfordM

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Try something like fast fibre instead of the nuts? She does have quite a crest. It could be ems. Hopefully you will get to the bottom of it. I know how worrying it is. Fingers crossed for her.

Fast fibre she won’t touch ? I’m surprised she’s eating the chaff to be honest, usually she would just leave it, I could probably put it in feed but I worry with it just being 1ml at the mo it would be pretty easy her her not get the full dose, id rather make sure it’s definitely going in
 

ester

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She definitely looks metabolic
I'd do xrays ASAP
re padding hooves gym mat can squish down very quickly then not really give any more relief. I'd probably see if I could get some easyboot clouds quickly for now.
 

scats

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I’ve just had Polly on a course of L94 from Trinity Consultants. She had a reaction to a wormer a while back and within 12 hours she appeared to have laminitis in all 4 feet and could hardly move. 24 hours later and you wouldn’t think anything had happened- flying round her stable totally sound etc. However, since then she has remained weirdly exhausted looking and these huge swellings appeared above her eyes. I felt like she was having a major metabolic struggle, possibly triggered by the wormer incident. Someone suggested I chat to Simon at Trinity Consultants, and he suggested trying her on a 10 day course of L94. By day 6-7, the eye pads had gone flat rather than bulgy and the look of fatigue had gone. Out hacking now, she is back to jogging and leaping about. She is now going on to Rexflo for 20 days, then probably the P45 long term.
Maybe worth giving Simon a call?
 
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