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  Discussion on Heart murmur+poor circulation=lethargy and lameness?
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Member:
Santucci

Posted on Monday, Feb 17, 2003 - 9:41 pm:

Our 29 year old mare hasn't been doing too well lately. I'll give you a little background and then tell you what's going on now.

The mare was shown extensively until she was 21, including show jumping, then we retired her because of intermittent, but mild, lameness problems. Her overall health and vitality at that point were exellent. She was bred at age 22 and again at age 24 and had two beautiful foals. She suffered a hairline fracture in her left hock, then a pulled suspensory ligament in her left front, also two bad episodes of lameness in the left front that got better with rest and cortisone, although that leg is still weak. Oh, she also had colic surgery about 4 years ago. She eats well and has maintained her weight well, in fact in terms of how she looks you'd never guess her age. She gets alfalfa twice a day, a coffee can of equine senior once a day, a scoop of Grand Flex, and 1 gram of bute in the morning.

About 6 weeks ago I went out to see the mare and she could barely walk. Apparently there were some new horses in the turnout next to hers, and she was trying to play with them and must have pulled something. Finally got the vet to come out a couple of days later, by then she was walking pretty well, but he did an exam on her anyway. He did flexion tests on all four legs and said he couldn't really find anything wrong except lack of muscle tone. Then he used hoof testers on all four feet and got no reaction at all. He says that most horses will have some reaction to hoof testing if you squeeze hard enough, he thinks because she didn't react at all that she has some nerve damage due to poor circulation. She does have a slight heart murmur. He wants us to have her shoes pulled in hopes that going barefoot may improve the circulation in her feet as the hooves will be able to flex more. Also he said her biggest problem was that she wasn't moving around enough and getting enough exercise, and he wanted us to put her in a different turnout or turn her out with other horses so that she'd be encouraged to move around more. Unfortunately those changes haven't been possible, so we've been going out and hand walking her for at least 20 minutes every day. I was hoping to seem some improvement, at least a little more muscle strength, but so far she doesn't seem any better. In fact I wanted her to turn yesterday, she shoved me with her nose and I accidently jerked on the lead rope, and she stumbled and almost fell. Basically she's just lethargic and seems depressed. If there's something interesting going on, she perks up. For example last week I was walking her around and there was a horse trailer in our path, she got really excited because she thought she was going for a ride, but once we were past the trailer she got DrOopy again.

I know I'm rambling here, and at her age I know I can't expect much, but I just wonder if you might have some suggestions. It's so sad to see her looking so down all the time.
Member:
Mwebster

Posted on Monday, Feb 17, 2003 - 9:58 pm:

I'm hesitant to write, because I know it's DrO's opinion you are really seeking, but gosh, why not pop her in the trailer, take her for a short ride to a new place for a good walk and see how she does? Our horses are younger -- 25, 22, and 9 -- and they're all in work, so a different situation, but I know our older guys would be pretty unhappy if they never left the property. Is there some reason you retired her from hacking out? Exercise is what keeps them young, so it could be a strength issue.

On the hoof test, neither my farrier nor my vet has ever managed to make our 2 older horses flinch (the younger one hasn't had the test), so I'm not sure I agree with your vet. I'm interested to hear what DrO says!

Melissa
Member:
Santucci

Posted on Monday, Feb 17, 2003 - 10:13 pm:

Thanks for your response, Melissa. The mare is really pretty lame much of the time lately, plus now that my daughter is out of school and has to work to support her horse habit, she doesn't have much time to ride the old mare, as she also has a 3 year old. We had wanted to lease her to some kids last year, but when she wasn't lame she was too much for them to handle!

Last summer I was riding the old lady and she stumbled badly, then was lame for several weeks. My daughter does ride her bareback once or twice a week, and she's more active then, but still pretty lame.

I've thought about taking her to an equine clinic in Phoenix, but it's a four hour trailer ride each way, and as unsteady as she's been lately I don't know if I want to put her through that.

I really hoped that by walking her more there would be some improvement, maybe we just haven't been doing it enough.
Member:
Mwebster

Posted on Monday, Feb 17, 2003 - 10:34 pm:

Hi Carolyn, I feel as though I'm reading about the future of my 22 yr old gelding, who has arthritis. He stumbles sometimes too, especially downhill, and last year was lame for a bit after a particularly bad stumble. Did you get a diagnosis for your mare's lameness?
Melissa
Member:
Santucci

Posted on Monday, Feb 17, 2003 - 11:02 pm:

Hi again! No real definitive diagnosis on the lameness. Every vet in the county has looked at her at one time or another, and the reaction is pretty much, she's old, what do you expect? The vet who saw her last time said he didn't find anything wrong with her, not even much arthritis. I'm going to call him again and see if he can explain why, if there's nothing wrong, she's still so lame!

It's frustrating, because I don't know if she's lethargic because she's in pain, but if that were the case it seems like she wouldn't be eating well. Maybe I need to contact that psychic on the Animal Planet!
Moderator:
DrO

Posted on Tuesday, Feb 18, 2003 - 3:56 am:

I agree with Melissa that just because a horse does not react to the hoof testors does not mean there is something wrong. It is a pretty tenuous basis for such an unusual diagnosis: nerve damage secondary to circulatory disease. I have not seen nor heard of such a disease process in horses.

At 29 the most common treatable reason for such lethargy is probably Cushinoid disease. A good physical exam and complete blood panel might be the starting point and if no other reason is found, a trial of pergolide indicated. See » Equine Diseases » Endocrine Disorders » Cushing's SynDrOme and Pituitary Tumors for more.
DrO
Member:
Santucci

Posted on Tuesday, Feb 18, 2003 - 7:40 pm:

Hi, Dr. O, thanks for your response. I've read the article on Cushings and will talk to the vet about doing blood work to check for that. We usually do blood work once a year to check overall health and everything so far has been normal. She doesn't have any of the other clinical signs of Cushings, weight is OK, seems to be drinking and urinating normally, and she's REALLY starting to shed - when I got home Sunday I think I was wearing as much of her hair as she was!

I forgot to mention earlier that one reason the vet thought she might have some kind of nerve thing going on in her feet is that she seems to walk like she's on eggshells - puts her feet down very carefully like her feet are asleep or something. And if the ground is rocky she's especially timid about where she steps - maybe because she's stumbled several times.

If some of her problems relate to lack of exercise, will hand walking her every day for 20 minutes help? Or should we increase that? I try to walk her in an area where there is some ground variation, but she seems to get "stuck" at the top of the berm around the race track and has a little trouble getting down the other side. Her legs just seem weak. I also try to have her walk over ground rails on the theory that getting her to pick up her feet should be good exercise.

Some of our friends can't understand why we are paying board and vet bills on a horse we can't ever ride again, but she's part of the family and I want to do whatever I can to keep her going. Thanks so much for the Advisor - it's always helpful and interesting.
Moderator:
DrO

Posted on Wednesday, Feb 19, 2003 - 6:04 am:

The walking on egg shells could be mild founder one of the common symptoms of Cushings. Even though she does not react to hoof testors it is more diagnostic that she is sensitive to hard ground. Horses who have been intentionally denerved in their feet do not walk gingerly and do not worsen on rough ground.

Yes if her problems relate to lack of exercise hand walking would help but I see no evidence of that in these posts.
DrO
Member:
Santucci

Posted on Wednesday, Feb 19, 2003 - 8:34 am:

Hi, thanks again. I'll get the vet out ASAP to do blood work for Cushings. As you may have guessed the vet care here is pretty basic, they're all good guys, but this is a rural area and they all do everything from household pets to cattle, so I hope we'll be able to get the Cushings blood work done. Plus they sometimes get offended if the owner does research and makes a suggestion they haven't thought of. And sometimes getting a vet when you need one in an emergency is impossible. I'll keep you posted.
Member:
Santucci

Posted on Friday, Feb 28, 2003 - 11:17 am:

Update...the vet came out yesterday. Again examined the mare and couldn't find anything wrong with her legs that would explain the lameness/weakness. Then he checked her feet and said that the heel on her left front, which is the leg she has injured a couple of times, was too long and the heels were contracted. He said that's what is causing the lameness, that her heel is painful so she stabs the ground with her toe to avoid pain in the heel. The vet had just attended at 10 day workshop by Martha Olivo and is now gung-ho about every horse going barefoot. He didn't want to do the dexamethazone stress test because he said that could trigger laminitis and he wants to wait until the foot situation is corrected.

That all sounded pretty reasonable to me. The vet left, I put the mare up, then the barn owner came up and asked what the vet had said. When I told her, she said he didn't know what he was talking about, whenever he can't find a reason for lameness he blames it on the feet, "one up, one down" I guess is the old horseman's expression and means that the bad leg isn't bearing as much weight and that's why the heel is so long.

As I think back, last spring when the mare was badly lame on the left front for weeks, the heel on that foot grew so long that she was standing on the heel, not on the shoe.....bad owners for not noticing this right away. Also even if she appears to be bearing weight on both front feet equally, I can push against the back of the left leg and it gives, the right leg doesn't. So I don't know if I agree that there is no problem with her legs. She is also very reluctant to pick that leg up.

We have always relied on the farrier to keep track of when the mare needs to be shod or trimmed, but in December due to bad weather and illness, she went nearly 4 weeks beyond her normal shoeing time. I was checking our records just now and realized that it's been 7 weeks since she was shod, I thought she was done every 6 weeks, and her name isn't on the list for next week either. The farrier is very good, has been doing this for decades, but now I'm wondering how good his record keeping is! Obviously I've been relying too much on the barn owner and the farrier. If the heel on the bad leg is growing too fast, would more frequent trimming be advisable?

I'm going to ask the farrier to pull the shoes and I'll leave the notes that the vet left, unfortunately the farrier doesn't go for these new fangled ideas that the vet keeps coming up with, so this should be interesting.

So, Dr. O, any thoughts? Is the long heel causing the lameness like the vet says, or is the lameness causing the long heel like the barn owner says?

Do you think it would be OK for me to ask the vet for a script for Pergolide even if the blood work hasn't been done? I'd like to start her on that if possible, at least.
Moderator:
DrO

Posted on Saturday, Mar 1, 2003 - 12:42 pm:

Without seeing the horse I really do not know but what evidence did he have the heels were causing the lameness? To assess whether the heels are too long and the horse has poor ap balance see the article » References » Equine Illustrations » Leg Anatomy and Conformation » Foot and Pastern: proper a-p (anterior to posterior) balance and trimming.

I don't think I would approach it with, "can I have the medicine?". Better is to discuss with him the pros and cons of a trial treatment since he does not wish to do the diagnostic work. The article on Cushinoid Horses addresses the test vs inducing laminitis question the vet rasised and you might want to talk to him about this also.
DrO
Member:
Santucci

Posted on Wednesday, Mar 5, 2003 - 7:12 pm:

OK, I'm between a rock and a hard place here. I left a note for the farrier to pull the mare's shoes and also left a copy of the vet's notes on how he wanted the feet trimmed. In the meantime I e-mailed the vet with a couple of questions and told him the mare was having her shoes pulled today. He fired back that just pulling the shoes wasn't enough, the feet had to be trimmed in a certain way for "barefoot soundness", and the only people in the area who know how to do that are the two farriers who attended this Martha Olivo workshop with him (one of whom a friend of mine said she wouldn't have shoe a dead dog, by the way.)

I don't want to tick off the vet, because he has a tendency to DrOp people as client's if they don't follow his recommendations - he won't even come for emergencies.

On the other hand, I don't want to tick off the farrier, who's been shoeing this horse for more than 10 years and has an excellent reputation, by calling another farrier.

Is it essential for a farrier to attend one of these workshops in order to keep a horse sound while barefoot? The mare was barefoot when we got her and perfectly sound, she was barefoot for a couple of years when she was leased for breeding....am I doing the wrong thing by having the regular farrier trim her?

Member:
Santucci

Posted on Wednesday, Mar 5, 2003 - 7:25 pm:

Forgot to mention that the vet also suggested something called Chaste Berry, which I see is mentioned in the Cushings article. Any experience/thoughts with this product?
Member:
Suzeb

Posted on Wednesday, Mar 5, 2003 - 9:32 pm:

Hello Carlyn,
I can certainly sympathize with your situation. Have you gone to www.marthaolivo.com to get a feel for this type of barefoot trim? The Chaste Berry product is called Hormonise. It sound like your vet is wanting to try the "Natural" approach and your good farrier is trained in traditional methods which is not a bad thing. You need to have a good vet/farrier team working together and not contradicting one another on what is best for your horse. Just an aside on the going barefoot, your horse may have some discomfort and if she is in a laminitic state from the supposed Cushings disease you may have to have some foam shoes ready. This would be scary for me if I were in your situation, but you are ultimately the horses Mommy and you have to decide what's best for your horse. I hope this helps and your horse gets better. Susan and Laser Bilsky
Moderator:
DrO

Posted on Thursday, Mar 6, 2003 - 6:51 am:

There are members of this board that have and have not had a positive effect with the Horminase. I still highly recommend Pergolide which has a very dependable record. Susan is right, they need to work together and it strikes me your vet is being a bit of a ass: To say only these 2 buddy's are the only ones that can trim your horse is too much. Have you thought about asking the farrier, who he might recommend?
DrO
Member:
Santucci

Posted on Thursday, Mar 13, 2003 - 7:11 pm:

Hi, Dr. O, I did ask the vet if a trial of Pergolide would be possible, but he didn't respond to that part of the e-mail. As far as the vet and farrier working together, well, they despise each other. And the farrier essentially works for the barn owner - he never communicates to us. I'm rather fed up with the lot of them and trying to find a place to relocate both the horses. We are also having behavior problems with my daughter's 3 year old - neither the barn owner nor the farrier can handle her, but she's an angel for us. I think it's a personality issue.

In the meantime, I'll try again diplomatically with the vet to see about the Pergolide, but I bet he won't do it unless I agree to contact one of the farriers who does this special barefoot trim thing.

I still don't understand the big deal about this "new" technique - farriers have been trimming barefoot horses for years and doing fine. Is this just a fad?
Moderator:
DrO

Posted on Friday, Mar 14, 2003 - 5:43 am:

I went to the site above and could not find a actual description of the trim but I am suspicious of any "only one way" here.

We have an article on one man's view of the natural trim at » Care for Horses » Hoof Care » The 4 Point or Natural Trim. We also have suggestions for horses chronically foot sore at » Equine Diseases » Lameness » Foot and Sole Problems » Navicular Disease / SynDrOme.
DrO
Member:
Jimhug

Posted on Friday, Mar 14, 2003 - 8:03 am:

When I saw the site, it seemed to me that her trim method is based on the work of Dr Strasser and Jaime Jackson which many farriers practice so I don't see it as a "new" method of trimming.
Member:
Suzeb

Posted on Friday, Mar 14, 2003 - 1:47 pm:

Hello Carolyn,
My apologies for not spelling your name correctly in my first post. Since you are having such a difficult time between farrier and vet, is it possible that you could contact someone at the equine facility in Phoenix and ask for a name of a vet in your area that could come out and see your girl? It's just a thought but this may be a good compromise between the anxiety and stress of trailering and not knowing what condition your horse may or may not have. I hope this helps. :-)Susan and Laser B.
Member:
Santucci

Posted on Sunday, May 4, 2003 - 2:22 pm:

Hi, everyone. Time for another update. We had Shasta's shoes pulled about 2 months ago. The vet looked at her feet and conceded that the farrier had actually done a pretty good job (first time that's ever happened!) She was very tenderfooted for a couple of weeks and I was worried, but that's getting better. She's still very cautious on rocky ground but OK in the arena or even on hard ground as lon as there are no rocks.

We started Hormonise about the same time, she gets one dose daily. The vet seems reluctant to try Pergolide. I have a two month supply of Hormonise so I'll check with him again after that's gone.

The vet checked her again about a month ago and feels that most of her lameness/weakness comes from her lower back and hips. He did some heavy massage along her spine, and son of a gun if she didn't walk better afterwards. So now before I walk her I spend about 10-15 minutes massaging, with the heel of my hand, a battery operated massager, and a magnetic massager. I also try to move and stretch all four legs. There are certain spots on her back where she licks her lips or chews, so I think it does feel good.

And for the first time today I really feel like we are making progress! I've been urging her to walk faster all the time, and today she actually trotted! She is still very lame, but her head was up and her ears perked, and the expression on her face was like, "Cool! I'm trotting.!" So I'm very pleased. I don't think she'll ever be sound again at her age and with all the wrecks she's had with her legs, but she's had more energy and enthusiasm than she's had for weeks! Thanks for all the suggestions and support.
Member:
Santucci

Posted on Wednesday, Jul 2, 2003 - 3:05 pm:

I'm so pleased with how well Shasta is doing that I had to post another update. She's been on Hormonise for about 3 months, in addition she gets GrandFlex and Conquer (Legend in gel form) and one gram of bute in the mornings.

About a month ago we also talked the barn owner into turning two more mares out with Shasta and our 4 year old. I was worried about that at first, thinking that at her age she might be prone to getting picked on and hurt, but after a few days of squealing and being obnoxious, everyone has settled down. Having more horses to interact with makes life more interesting, so she's getting around more. She's not the boss mare, but she's #2!

We've also had three sessions with an equine massage therapist/chiropractor which have been very helpful.

And, most fun of all, for 3 weeks she was a lesson horse for horse camp. 24 little kids walked, groomed, and bathed her within an inch of her life! When I saw her each afternoon, she was bone tired! Teaching kids is hard work! But the exercise was certainly good for her.

She is so much more alert, I don't have to drag her around the race track - sometimes she actually drags me! Yesterday I hand-walked her with a friend who was riding, and we kept up with them! And she seems much stronger as well. If she continues to do this well in the fall I think we'll take her to Phoenix to the big equine center there and see if anything can be done about the lameness. Earlier this year I wasn't sure she could handle the trailer ride, and now it's too darned hot!

So for those dealing with problems with senior citizen equine friends, don't give up! There are things that can be done to improve their quality of life - you just have to be willing to be persistent and keep trying different things.

Everyone have a great 4th of July holiday!
Moderator:
DrO

Posted on Thursday, Jul 3, 2003 - 6:39 am:

That is wonderful to hear Carolyn.
DrO
Member:
Santucci

Posted on Thursday, Jul 3, 2003 - 8:26 am:

Thanks, Dr. O. And I should have added, keep reading The Horseman's Advisor and asking for help from Dr. O and all his loyal readers!
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