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  Discussion on Low-grade laminitis?
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Member:
Keating

Posted on Saturday, Dec 13, 2003 - 2:41 am:

Dr. O,
My 7-year-old quarterhorse came down with acute laminitis on Nov. 25, after having been lame in one front foot since Oct. 5. What I am wondering now is whether the two conditions are related - that is, could the earlier lameness have been a sort of low-grade laminitis that suddenly flared up in both feet?

This is the history (some or none of which may be relevant): he is a reining horse; when I bought him 14 months ago his feet were tender and he stumbled occasionally at the lope. He was barefoot on the front at the time - I put front shoes on him and the stumbling stopped.

He was sound through the showing season and we also did lots of trail riding, often on quite hard ground, with no problem.

He has always been somewhat short-strided but this fall I often noticed that he seemed to be taking very short steps at the beginning of a ride, but then would loosen up.

Then on Oct. 5 I was riding on a soft surface and a half hour into our ride he came up lame quite suddenly, on the left front. I gave him 10 days' rest and when he showed no improvement, had the vet in. Hoof testers revealed extreme sensitivity in an area near the toe of the left foot. No noticeable heat or elevated pulse. He suspected a fracture and xrayed the foot. The xrays revealed nothing so we treated it as a bruise, confining him to his stall and small adjoining paddock. (I soaked it daily in the vain hope that an abcess might blow out.) We put him on bute for a while and then stopped it.

Three weeks later, when there had been little change, the vet did a nerve block, to make sure the problem was actually confined to the hoof, which it was. The vet tells me that the horse has very thin soles.

On Nov. 24 he xrayed again. The xrays still revealed nothing. On Nov. 25 the horse suddenly displayed the classic laminitis signs - by the time the vet arrived, he was lying down and very reluctant to rise. We soaked both feet in ice water, put him on bute and Atravet; the vet applied lily pads and we put him in a stall with soft bedding. We also applied nitro-glycerin to the coronet band 3 times a day for 2 weeks.

He is still in the stall, with the pads, on bute and Isoxuprene (in place of the Atravet).

The vet tells me that the pulse in the left front is still very slightly elevated, though the right front has been normal now for about a week.

The horse seems to have no discomfort at all - I know he's still on the bute, but before the laminitis flare-up, even on bute, he was being very careful turning around, etc.

Do you think that the initial lameness could have been a precursor to this bout of laminitis - sort of a low-grade condition that then erupted in both feet?

We haven't figured out the cause yet, except for this: when he was initially confined to his stall and paddock, to keep him entertained I hung a "boredom ball" in his stall - it's made of cut-up hay and grain, bound together with corn syrup and molasses, about the size of a softball. He played with it and ate the thing in the course of about 8 days. Three weeks later I replaced it with a new one, which he ate in a period of 3 days, finishing it on Nov. 24 - the day before the flare-up. That is the only change in his diet - he was getting mainly grass hay, no grain, a little beet pulp and mineral supplement.

Sorry to take so long, but I am desperate to get this wonderful horse well again. I've read the excellent article on this forum and all the posts.

Thanks,
Kathleen
Moderator:
DrO

Posted on Saturday, Dec 13, 2003 - 8:16 am:

I can't tell Kathleen what the relation was between the first lameness and the second, there may be none, and the best I can do is conjecture a fairly complicated situation: Horses that are severely lame in one front leg can founder the opposite front leg from the excessive weight bearing. But it sounds like you had a bilateral founder, unless the horse was still lame in the first leg from the bruise: caused the other side to founder, and now is recovering from both?
DrO
Member:
Canyon28

Posted on Saturday, Dec 13, 2003 - 9:02 am:

just be careful with the pads, I hope they are taped on or a hospital plate. If he has abcesses under the pads , you wont know it, and under a pad is a perfect place for bacteria to breed. I lost my favorite mare to laminitis and abcesses, due to letting a vet and my farrier talk me into putting pads on her. By the time she was reshod again , four weeks later, the abcesses had gotten into her coffin bone, because of the pads we could not see this. sounds like your horse may also be navicular. Is he stalled someplace away from your home, or fed by others? I dont see how he could have foundered unless he had gotten into some other grain or very hot hay. Hope you can determine the cause. good luck to you.
chris www.canyonrimranch.net
Member:
Keating

Posted on Saturday, Dec 13, 2003 - 10:56 am:

Thanks for the responses. Dr. O, the reason I say it was a bi-lateral founder is that suddenly there was heat and strong pulse in both beet, which there had not been before.
And Christine, yes, these are pads that are taped on. His shoes were removed at first onset of lameness.
Member:
Keating

Posted on Saturday, Dec 13, 2003 - 11:15 am:

Christine, I also meant to add, in response to your question: he is stalled at my friend's place nearby - there is no grain on the premises, and no other hay. This is why the cause is still a mystery to us.
He is a powerfully built quarterhorse, probably slightly overweight during the summer but by September was looking fit and in good weight.
Kathleen
Member:
Keating

Posted on Wednesday, Dec 17, 2003 - 5:02 pm:

An update on my gelding. Today the vet trimmed his front feet (2nd trim since onset of left front lameness Oct. 5) and revealed significant bruising to the left front sole in the toe area (just inside the white line). The right front showed similar bruising to a much lesser degree. This confirms my vet's theory that the initial lameness was caused by bruising - probably going back to August.
Then, I suppose the immediate cause of the laminitis that came on Nov. 25 was probably the molasses in the "stall ball": given his sensitivity - with the interruption to normal circulation in the area of the laminae caused by the bruising - this could have been enough? Does this make sense?
He is still confined to his stall, with lily pads, and Bute and Isoxuprene. The pulse in his left front is still slightly elevated. We will x-ray next week to see whether there's any change in the coffin bone. (We had xrays from the day before the laminitis episode.) We are considering putting him on pergolide (sp?) if the pulse is not back to normal by then.
I'd be interested in any comments.
Thanks,
Kathleen
Moderator:
DrO

Posted on Wednesday, Dec 17, 2003 - 5:48 pm:

How much molasses did the horse consume over how long a period?
DrO
Member:
Keating

Posted on Wednesday, Dec 17, 2003 - 6:05 pm:

On Nov. 21 we hung a "boredom ball" in his stall - this is a softball-sized hard (baked) ball made of mostly cut up hay, with some grain, held together with molasses and corn syrup. I can't say the volume of any single ingredient, but when you look at it, it's pale green and all you see is hay with small bits of grain. He has had one in the past, consuming it in about 8 days. This time he had finished the ball on Monday and I hung another one. On Tuesday when he was found lying down the ball had broken and the dogs had been found with a part of it, so we don't know how much the horse had. At most he had one to two of these balls between Friday and Tuesday.
Member:
Canyon28

Posted on Wednesday, Dec 17, 2003 - 6:46 pm:

I dont see how it would be possible that this little ball caused your horse's problem. No way. I would look for another cause. Do you have any weeds in your hay? sometimes poisonous plants will cause laminitis and other effects.
chris www.canyonrimranch.net
Member:
Keating

Posted on Wednesday, Dec 17, 2003 - 7:04 pm:

Christine, I can't guarantee the hay is free of poisonous plants, but the other horses in the barn (including a small pony) and many other horses in the neighbourhood are eating the same hay every day, with no ill effects. I agree that it doesn't sound logical - obviously if I had thought that these balls were a risk I'd never have provided them. But there was absolutely no other change/addition to his diet.
Moderator:
DrO

Posted on Thursday, Dec 18, 2003 - 6:36 am:

I too think it unlikely as a cause and sometimes founders are unexplained, see the article on overview to review the known causes. There are not any weeds that I am aware of that cause a primary laminitis though black walnut shavings can.
DrO
Member:
Keating

Posted on Thursday, Dec 18, 2003 - 11:12 am:

Thanks for your response, Dr. O. On one hand, I'll feel better if I don't have to blame myself for causing the laminitis by giving him the ball; on the other hand, it's disturbing not to be able to point to a cause because then I'm powerless to do anything to prevent its recurrence.
I'm sorry to belabor the point, but do you see any link at all between the bruising that clearly existed in that part of his feet, and the laminitis? They both involve the blood circulation in the very same area, don't they?
Thanks,
Kathleen
Member:
Suzeb

Posted on Thursday, Dec 18, 2003 - 11:52 am:

Hello Kathleen,
I have been reading your posts with interest and have gone through a similar situation myself. I think the bruising that you are seeing at the toes may be because your horse has been landing toe first on the ground (hence the stumbling) for some time. I suppose if the concussion is great enough it might result in a mechanical founder as opposed to a systemic founder induced by too much rich food. I would still not feed the "Sugar" ball mind you. Did your vet do any hoof testing or nerve blocks in the heel area and reevaluate. One thing I do find alarming is that your vet has considered Pergolide to keep the pulse down? Is he cushinoid? I would think a round of anti-inflammatories (Bute) would do the trick. I think you need to get a second opinion on your horses condition to figure out what is going on. My horse who used to be a stumbler had long toes and underrun heels. He landed toe first because his heels were sore. Good supportive shoeing, bute, time off from working and weight watching diet changes have helped my horse tremendously. The really bad pain could be from strained ligaments and tendons running down the back of the leg and attaching to the coffin bone. Impar ligament, deep flexor tendon? What does your farrier say about your horses hoof confirmation? Sorry for all the questions, but I think I know what you are going through. Hope this helps.
Susan B.
Member:
Keating

Posted on Thursday, Dec 18, 2003 - 12:30 pm:

Hi Susan. Thanks for your interest. Actually, the stumbling stopped when I put front shoes on last year. (He had been left barefoot in the front by his previous owner for the show season for reasons relating to his sliding stops.) He was fully vet checked at that time and had no heel problem.
After the onset of the initial lameness my vet did careful hoof testing on a weekly basis and there was no question that the sensitivity was in the toe area and none in the heel.
My horse is on Bute and has been from the onset, as well as the Isoxuprene.
The pergolide is being considered not as a way of bringing the pulse down, but as a response to the continued elevated pulse. Note that I said we are "considering" it.
The horse is 8 years old and has no Cushings symptoms, but something is happening that's not explainable by diet or any of the other usual causes of laminitis. So we have to wonder whether it could be hormonal.
As far as his hoof conformation goes, he has good feet "for a quarterhorse" (that is, I wish they were bigger!)and has had excellent farrier care. He definitely does not have long toes or underslung or contracted heels.
What I do regret is the riding I did this summer on him when I turned him out for a few weeks at our ranch in the interior. It was nothing more than I've done for years on my Arab mare, but the ground is hard and uneven and he seemed to enjoy the flat out gallops so much, that I think I really overdid it with him. We live and learn!
Thanks,
Kathleen
Member:
Canyon28

Posted on Thursday, Dec 18, 2003 - 12:35 pm:

I know that standing around in a stall does nothing for a horse's hoof and foot circulation. If possible I would get him out in a pasture until he recovers.
Member:
Keating

Posted on Thursday, Dec 18, 2003 - 1:03 pm:

Thanks, Christine, for your concern. I hate seeing him cooped up as well, but to be honest, I think he's quite happy. And his buddies who have the run of their paddocks all seem to spend most of their day just standing as well - mostly at his stall door, where they "talk" to each other all afternoon.
As far as turning him out goes, I'll stick with my vet's advice - he's concerned that while those sensitive laminae are compromised, we not take any chances. Also, keeping him in deep bedding allows him to stand with his toes slightly down, relieving the tension from the ligament that pulls on the coffin bone.
Kathleen
Moderator:
DrO

Posted on Friday, Dec 19, 2003 - 6:30 am:

Kathleen's vet is right Christine: while foundering, exercise is contraindicated as it mechanically worsens the damage. Best to wait until some of the pathology subsides.

You see red areas in the sole of healthy horses all the time so I do not know if you can draw a relation or not. Maybe if I saw the amount or degree of the bruising in your horses feet I would feel different. Certainly there is a condition called road founder where excessive concussion induces founder or at least founder like symptoms: are we experiencing a true founder (disease of the wall lamina) or does the bilateral solar bruising (disease of the solar corium) just look like founder is always a question in my mind.
DrO
Member:
Keating

Posted on Friday, Dec 19, 2003 - 11:38 am:

Thanks for your reply, Dr. O. Yes, I've certainly seen red in a hoof that didn't seem to signify anything, and my vet said the same as you did: but this - particularly in the left foot - was to a degree that he felt was significant, especially given the history. I'll update you after the xrays next week.
Kathleen
Member:
Keating

Posted on Monday, Dec 29, 2003 - 2:11 am:

Good news today! The new x-rays show absolutely no change from the x-rays we had taken the day before the laminitis episode. He's still confined to his stall and on Bute, but I'm seeing light at the end of the tunnel! And when I walked him across the yard to have the x-rays, for the first time since Oct. 5 he was walking freely and without any discomfort at all. It brought tears to my eyes to see him looking so good. And my vet complimented me on keeping his weight down so well. I'm so looking forward to rehabilitating this horse.
Thanks,
Kathleen
Member:
Keating

Posted on Tuesday, Jan 6, 2004 - 11:48 am:

It's me again, getting more and more concerned. It's 6 weeks today since the onset of my horse's laminitis episode and he still has heat in his left front hoof (which is the one that was lame and bruised before the laminitis). He's still on stall rest, with lily pads, and on 1.5 (gr?) Bute 2xday and the same of Isoxuprene.
Is it common for the inflammation to last this long? I know that inflammation serves a purpose, but is it harmful for it to continue like this?
He will be seen by my vet again tomorrow, but I'd be really interested in your opinion, Dr. O, and in others' experiences.
Thanks so much,

Kathleen
Member:
Savanah

Posted on Tuesday, Jan 6, 2004 - 12:51 pm:

Kathleen, I totally feel for you. I have been going through a very similar mystery lameness with my quarterhorse for over a year. I could write pages and pages about the onset, inability to diagnose, treatment, etc. but only if you are interested. Bottom line, be patient - don't give up. These things can take a very long time to figure out.
My mare is finally turning around with the following strategy:
-natural balance shoeing with frog support pads and dental impression material (re-set every 4 weeks) this has been the most helpful thing we have done for this horse;
-30 isoxuprene (used to be 60) per day - I know there is controversy over whether it works or not, but my mare relapses without it (gets sore and a stronger pulse);
-1 gram of bute anytime I feel a pulse (and I check her twice a day);
-hoof supplement with minimal mixture of ingredients (I use "super-hoof" - my horse broke out in hives from farriers formula);
-mooreman's minerals for grass hay;
-no cantering under saddle, no small circles at the trot;
-24 hour turnout;
-avoiding stress triggers such as shivering (she gets cold easily even though she has a normal winter coat - maybe she has a thyroid problem?), spread out vaccinations, don't worm and vaccinate at same time, no unusual supplements with "cure-all" ingredients;
-my vet also is considering permax, but we have held off to use it as a last resort because my horse (like yours) has no symptoms of Cushings other than the mystery laminitis. We did a dex stress test and it showed nothing abnormal, but then again, are those tests any help?

Anyway, I just wanted to reach out and give you some hope - hang in there and don't get desperate - there is a solution out there, you just have to be methodical in figuring out what is helping and what isn't.
Moderator:
DrO

Posted on Wednesday, Jan 7, 2004 - 5:55 am:

I think monitoring the foot for heat is not a useful inicator as is the degree of lameness, though neither is perfect. If the horse is sound or at least improving, just be patient, some horses stay very lame much longer than yours has.
DrO
Member:
Keating

Posted on Wednesday, Jan 7, 2004 - 11:56 am:

Thanks, Dr. O. I don't mind being patient, as long as I feel I'm on the right track.
May I ask one more question? In your post on Dec. 19 you said that excercise is contra-indicated until some of the pathology subsides. Can you explain? I've been checking for heat because I find the pulse hard to guage, but it's the pulse my vet is monitoring - I interpreted this as watching for the pathology to subside. At this point he walks soundly - haven't tried him at any other gait; he has no sign of discomfort; and xrays 3 weeks post episode showed no change in the coffin bone. At this point (6 weeks post) would you be starting hand walking? Thanks for your patience.
And thank you, Michelle for taking the time to share your experience - you certainly are a model of patience and meticulous caregiving.

Kathleen
Moderator:
DrO

Posted on Thursday, Jan 8, 2004 - 7:27 am:

Pathology is study of how disease functions and it's effect on the tissues. In the above reference it means "ongoing disease" and specifically with founder ongoing pain is the most important assesment if active disease is continuing.
DrO
Member:
Keating

Posted on Thursday, Jan 8, 2004 - 2:25 pm:

Thank you, Dr. O. That's helpful. My vet checked the horse last night and instructed me to begin weaning him off the Bute, while keeping an eye out for any return of pain or discomfort. He'll remain in his stall til he's off the Bute completely - which is just as well, with the weather we're having. I'll let you know how he does. And thanks again.

Kathleen
Member:
Keating

Posted on Tuesday, Mar 9, 2004 - 10:38 pm:

Just writing to report what I hope is the end of this story. On Feb. 11 I had permission to ride my horse again. I was a little apprehensive, not knowing what effect the 4 months of confinement would have had. I needn't have worried - it was as if he'd been ridden all winter. He doesn't even seem to have lost a lot of conditioning. We were in a pretty intensive reining clinic this weekend, and he was tired by the end, but doing great. I think the time off was good for him, mentally as well as physically. Even his fetlocks, which had always been puffy, are looking better than ever.
So, thanks, Dr. O, and everyone else who wrote. I was pretty scared for a while, and it was good to have a place to come to for support and advice.
Kathleen
Moderator:
DrO

Posted on Wednesday, Mar 10, 2004 - 5:35 am:

Great to here it Kathleen, good luck!
DrO
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