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| HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Hoof » Founder & Laminitis » Founder & Laminitis an Overview » |
| Discussion on Founder/dex or was it the hay | |
| Author | Message |
| Member: Fpony |
Posted on Saturday, Sep 13, 2003 - 9:45 pm: Hi Dr.O,I found my pony sore on both front feet this afternoon. I call my vet and was told to give 1/2 tab of bute and decrease his dexamethozone (sp?)tomorrow morning from 3 cc to 1 1/2cc. He had just started on the dex, due to his increased itching,11 days ago. He has gained weight in the last month (due to being on pasture longer than usual-constuction around the barn during the day) We just put up some second cut hay and had a wet bale that we opened and i was feeding. I don't feed much hay in the summer and this bale has lasted 4 days and there is plenty left with 2 horses eating it. That said it still is very green and I feel very guilty for feeding this to him. I had been mixing it with the first cut. OK, finally my question. Do you think the dex caused the founder? He had been on 5 cc first day, then 4cc for 5 days and now had been on 3cc for 5 days, today. Would this not have been a problem if he hadn't been slightly overweight and hadn't been given the rich hay? How do we control the itching in the future? In past years adt had worked well with no side effects. The vet that was on call also wants me to hose his feet. After reading your article,I'm nervous about this. Also, he had me use bute and not banamine was this because of the dex? I will ask these questions tomorrow when he calls but wanted your opinion. Thanks, Kim |
| Moderator: DrO |
Posted on Sunday, Sep 14, 2003 - 8:32 am: I have always thought the case for steroid induced founder is poor. However if founder occurs while on steroids, we recommend them be discontinued until sound. Yes the increasing weight and rich feed probably contributed to the problem. So your first steps should also include addressing this. Bute is what we recommend but is this an appropritate dose, it seems small unless this is a tiny pony (see article on Bute for more) Hosing would be fine: I just don't find it very helpful.Once you get the founder under control you can go back to the steroids. Until then our article on Sweet Itch in the skin section gives all the other recommendations we have. DrO |
| Member: Fpony |
Posted on Sunday, Sep 14, 2003 - 10:26 am: Thanks for your response Dr.O. I think the low dose of bute was because we needed to get him off the Dex.? Would it cause more issues to increase the bute dose? Foxy isn't small and weighs between 600-700lbs. The vet mentioned using 1 1/2 cc of dex for three days and then to go off it.I was already addressing the weight issue and will continue to get the weight off. He had been looking good up until a month ago. I rarely leave them on pasture all day. As for the second cut grass hay, I didn't want to feed it until mid winter and then just to add with our first cut. |
| Moderator: DrO |
Posted on Monday, Sep 15, 2003 - 5:11 am: How long has the horse been on dex and at what dosage Kim?DrO |
| Member: Fpony |
Posted on Monday, Sep 15, 2003 - 9:42 pm: He had just started it 10 days before with a loading dose of 5 cc then, 4 cc for 5 days and then 3 cc.He is now at no dex for tomorrow as they had me wean him off and my usual vet told me to increase the bute to 1 tab 2x a day. He is much improved today and is out in a soft sand paddock with access to the stall. My Farrier was here today and pulled his shoes (he tolerated this pretty well) and we put pads over his frogs and taped them on. My vet didn't seem to think she need to come and see him. I believe this is a mild case but i wish we weren't just going on my say. I have never seen a horse founder before. I asked about vaso diolators and she said she could get me some but I wonder if she thinks it isn't neccessary. She thought perhaps we should leave the shoes on as taking them off could make him more uncomfortable. She seemed mostly concerned about him getting itchy without the dex. I think I can control that by keeping him up at the barn esp at this time of year. Worth it if the dex is going to cause him problems. Maybe I'm making a big deal out of a small deal but I don't want to be saying later if I had only... |
| Moderator: DrO |
Posted on Tuesday, Sep 16, 2003 - 6:50 am: If he had been on dex just 10 days or even 3 or 4 weeks there is no need to "wean" the horse off the dex, adrenal suppresion requires at least 6 weeks to develop and the lack of cases reported in the horse suggest he may be even more resistant than other species. He could just be removed safely, see the article on steroids for more about this.I am not much for frog pads I admit. I like bare feet on very soft ground as I think this maximizes coffin bone support and promotes normal circulation. Acepromazine IM is a safe, cheap, readily available peripheral vasodialator, see article on founder for more on this. I think founder should always be treated as a big deal, though the very common form in overweight ponies is usually chronic with little to small changes. The important thing here is to realize that there are a number of causes that contribute to founder and I most of the mild/chronic cases are a combination of them, particularly the combination of body weight and rich feed. In older horses, like your pony, Cushinoid disease should also be considered. We have had almost identical circumstances in a large pony in the practice last week. With a acute exacerbation of COPD he had gotten pretty bad when we decided to try a bit of dex on him to speed his recovery. Of course part of his treatment was no stall time so this pony too was overweight and gaining on pretty good grass. Coincidence? These are now the only 2 cases of horses put on steroids for allergic disease that developed founder that I can remember, either here on the board or in my practice. On the other hand I have seen several other acute exacerbations of chronic founders this summer due to the heavy rain / rich grass this summer. It has always been a stated in the equine, yet unsupported in the scientific literature, that there was a relation between corticosteroids and founder. Because of my experiences and stance, I have always watched this closely for facts to suggest this is true and still know of no research to suggest there is one. Also many very experienced clinicians I have talked to feel their experiences run counter to this idea. But these two cases will cause me to redouble my efforts looking for a relation. Until then I will continue to use dexamethasone/prednisolone when I think the immune conponent of a disease is causing significant discomfort to a horse. DrO |
| Member: Fpony |
Posted on Tuesday, Sep 16, 2003 - 1:45 pm: Thank you Dr. O for your support. My farrier looked at the paddock and she too said that it would be fine for him to be barefoot as the loose sand fills in the foot nicely. The lily pads were off completely this morning and I left them off. He looks really good today and walking well.Is the vasodialator a good idea to have on hand incase of another bout in the future or is it only needed for moderate to severe cases? Have you ever heard of fall grass being high is sugar content like the spring grass? The nights are very cool and the dew is heavy. I'm nervous about putting my guys back on it. My horse has EPSM and he has started having difficulties about 3 weeks ago. Could the grass be a big contributor to both my guys issues? Foxy has had difficulty in the past with shedding his coat, (being July before it was all shed out)but being on a multivit seemed to help that. I still don't think it hurts to watch his diet and keep his weight down. As for the sweet itch, we will have to deal with that next year as I would like him to be ridden and it was impossible due to the itching and the irritation the saddle caused. Kind of a vicious cycle as the riding would help with his weight and conditioning. He went from not tolerating the saddle and rider for 5 min to completely tolerating it once on the dex. ( beside the fact that he seemed to completely enjoy being my son's mount  ) Kim
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| Moderator: DrO |
Posted on Wednesday, Sep 17, 2003 - 3:41 am: There is no doubt about it, fall, cool season grasses, can be as rich as spring grass.DrO |
| Member: Brezniak |
Posted on Monday, Jun 6, 2005 - 12:06 pm: Dr. O, I have read your post on steroids and founder and being that it is several years old, I wonder if you have found anymore information on whether steroids can cause founder. My problem is this: I have 2 horses that have foundered in the past that also have COPD, seasonally related. One had severely foundered after having a dead foal several years ago and is quite compromised. I have been treating them in the summer with clenbuterol and it has been fairly effective at a low dose most of the time. However, if the weather gets very humid, they need something else. I have tried prednisolone in half the normal dose and it was effective. However, 2 weeks later one horse got very lame and it was thought that they were having a laminitic episode. My farrier didn't think so; she had a bad subsolar abscess. I don't know what to do with these girls, who, by the way are mother and daughter. I am trying to find out any more information on the possible connection between steroids and founder. |
| Member: Fpony |
Posted on Monday, Jun 6, 2005 - 4:10 pm: Diane,Check out this site it has lots of information on laminitis and founder as well as Cushings and insulin resistance. Dr. Kellon moderates the site. They also have many folks that will help with shoeing/trimming advise. Good luck, Kim (and Foxy ) |
| Member: Fpony |
Posted on Monday, Jun 6, 2005 - 4:20 pm: ooppshttps://groups.yahoo.com/group/EquineCushings/ Forgot to leave the site! By the way geting weight off Foxy has always been difficult un til this year when i followed Dr. Kellon's mineral balanced diet. He is now a 5 on the condition scale and he use to always be a solid 7. My horse use to be an 8 and now too is a 5. They are gettiong more hay then they use to but can utilize the energy better now. Kim |
| Moderator: DrO |
Posted on Monday, Jun 6, 2005 - 8:53 pm: Diane, I don't understand your worry as your horse has an abscess. There has been no change in the thought that steroids do not cause founder, and further support of the idea that is not a complication of steroid use.DrO |
| Member: Brezniak |
Posted on Monday, Jun 6, 2005 - 11:29 pm: I am just worried in general because almost anything might cause the worse of the two horses to founder again. One vet I used was very worried about using steroids on her. Another seemed less worried so I am just soliciting as much information as I can get. I am also wondering by what mechanism that steroids could cause founder if it does. |
| Moderator: DrO |
Posted on Tuesday, Jun 7, 2005 - 6:17 am: No matter what theory you hypothesize first you need to show a relation and that relation just does not exist at this time. In experiments that have tried to induce founder with steroids, in reviews of very large numbers of case studies where steroids are used, and in 20 years of practice with my fair share of steroid use there is no evidence of this problem.But Diane why are you still having to use steroids or clenbuterol regularly? Humidity does not exacerbate a well controlled COPD unless it is accompanied by mold spores: have you got these horses managed as well as they could be? Are you following our recommendations in the article on COPD? DrO |
| Member: Brezniak |
Posted on Tuesday, Jun 7, 2005 - 12:44 pm: Thanks for the more detailed information. Why does anyone then even consider it an issue? Since steroids are anti-inflammatories why should they cause laminitis, which has an inflammatory component? I am not questioning you, just trying to understand in more depth.We have had this discussion before and in this area of the country it is well known (to vets) that many horses suffer from a seasonally related onset of heaves. It generally occurs from May through August when we have hot and humid weather. If you recall, I quoted a Tufts University Veterinary article regarding this problem so it's not just my own or a few peoples conjecture. Once autumn and cooler weather arrive, my horses do not have problems with COPD. Although horses are different than people, my own mother suffered greatly from COPD and it was always very bad when it became hot and humid and especially before storms. In fact right now the mold count is low according to the local weather. I have done as much as I can to alleviate these horses condition short of selling them. I have no pasture, use haylage, and they are out 24/7. I live on top of mountain where it is always cooler. I'm not sure what else I can do. |
| Moderator: DrO |
Posted on Wednesday, Jun 8, 2005 - 12:19 pm: I presume the reason for the connection is occasionally horses being treated with steroids develop founder. The problem is one of cause and effect has not been shown despite repeated tries and large reviews of clinical studies. There is even a study of horses with founder secondary to Cushings that were given dex where no ill effects were seen.It is very important to realize that founder is probably not a primary inflammatory event, for more on the proposed causes of founder see the Overview article. It is interesting to note there is one possible pathogenesis considering some of the newer thoughts on founder and that is where the steroids cause a insulin resistance resulting in decrease intracellular glucose. I apologize if I have forgotten past discussions about your COPD but have a hard time medically explaining a worsening of the COPD with hot-humid weather. Generally warm humid air causes bronchodilation and loosens secretions to make expulsion easier. That is why air humidifiers are used with those who have such problems. There is one effect that may look like a worsening and that is when horses experience this type weather they have an increased respiratory rate and depth in an attempt to cool themselves, so they may look worse. There is a synDrOme of summer pasture associated COPD and this may be what you have. Most likely pollens or perhaps outdoor mold spores are the cause. It does appear you are addressing many of the issues we recommend in the article but you might review it to see if there are other things you might do. If the horses are becoming distressed when it becomes hot, I wonder if a powerful fan in a one sided run in shed placed in the shade might help. DrO |
| Member: Brezniak |
Posted on Wednesday, Jun 8, 2005 - 1:07 pm: Dr. O, thanks for taking so much time with this issue. Can't remember a previous discussion? Must be getting old; it's happening to me too. I am not sure why heat and humidity causes asthma/allergies to worsen in humans but there is no doubt that it does. Increased mold spores may be it and I know that before powerful storms there is a particular type of mold spore that is the culprit.I know the current thought on founder is that inflammation is not a primary event. Unfortunately, I have become fairly knowledgeable about founder and being a chemist, have even read about matrix metalloproteinases, etc. Hopefully one day someone will find a trigger that can be detected prior to damage occurring and arrest it. Even then, the awareness that something is wrong in the first place will be a determining factor. I try to compare my two COPD mares to the other horses I have in terms of respiration, etc. I know the larger draft breeds have a lot of trouble dissipating heat. These two appear to breathe very differently even than my gelding, who is the son of the worse of the two and the half sister of the other one. Thank God he didn't inherit the tendency. |
| Moderator: DrO |
Posted on Friday, Jun 10, 2005 - 2:39 pm: In humans it is thought that the increased pollen and pollution associated with the warmer seasons is in fact the mechanism for problems during the summer.There has been found an arresting mechanism at least in experimentally induced laminitis, see "Soaking the Feet" subtopic in the Overview article for an amazing report. The idea is that it prevents activation of the MMP's until the activators can clear from the system. DrO |
| Member: Skeller |
Posted on Friday, Jun 10, 2005 - 11:14 pm: How would you manage soaking the feet, up to the top of the cannon bone, in ice cold water for 48 hours continuously? A special boot (actually I was picturing a swimming pool with a reinforced bottom.I'm befuddled and had to ask --Sandi |
| Member: Brezniak |
Posted on Saturday, Jun 11, 2005 - 11:30 am: It seems to me that soaking the feet/leg in ice water probably does nothing directly to stop tissue remodeling cause by release of MMP but rather effects the circulation in the leg. If the circulation is slowed then all biochemical processes will be effected. Interestingly enough one of my friends took a horse that was on its way to foundering into a stream, which had fairly cold water and kept it there for a while. The story goes that the horse did not founder. I sort of dismissed the idea but maybe there really is something to it after all.Back to the original reason that I posted my question, now that I have decided to put my horses on prednisolone if they have a bad COPD attack, my vet won't recommend it, i.e., they won't give me any. I have another vet that I use and maybe he will. People are also allergic to molds and horses may very well be sensitive to pollutants. They seem to be sensitive to almost everything so why not. |
| Moderator: DrO |
Posted on Saturday, Jun 11, 2005 - 4:29 pm: Here is a description of the set up taken from the 2003 AAEP proceedings:Six mature, Standardbred horses (three geldings and three mares) with normal feet and no lameness received alimentary overload with OF (10 g/kg) to induce laminitis. Each horse was confined to a stock, and one front limb (left) was placed in a rubber booto containing a mixture of 50% cubed ice and 50% water for the duration of the 48-h experimental period. The boot was continually replenished with ice to maintain a level just below the carpus. Forelimb HT, ambient temperature, and internal ice boot temperature were logged continuously using data logging devices...Cryotherapy, when applied to one foot, was effective in preventing the development of acute laminitis in the face of a challenge that caused laminitis in the remaining three untreated feet. The MMP's have a normal role and that is to, in small amounts at a time, break down the lamellar attachments so that the hoof wall can grow distally, a little at a time. In the MMP model of laminitis, factors in the blood cause a massive increase in this MMP activity. MMP enzyme activity like all enzymes are temperature sensitive. This gives us two possible mechanisms by which continuous cold therapy might work.
DrO |
| Member: Brezniak |
Posted on Saturday, Jun 11, 2005 - 7:27 pm: Both of these practices have examined my horses and we have been through the alternatives. Maybe they just are afraid to be blamed if there is another bout of laminitis. The time I did try prednisolone it was an option that the prescribing vet and I fully discussed and the decision was left to me. I decided that under those particular circumstances, I had to do something fast and was willing to accept the risks. Unfortunately, that vet has since left the area.In the cryo study, was a temperature-dependent study done to determine at what temperature an effect might be seen? Just curious. |
| Moderator: DrO |
Posted on Sunday, Jun 12, 2005 - 8:31 am: No just water that was kept a little above freezing.DrO |
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