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  Discussion on Thickening of white line-Foundering?
Author Message
Moderator:
DrO

Posted on Saturday, May 14, 2005 - 12:41 pm:

Welcome Jennifer,
This has nothing to do with too much protein and you should base what and how you feed on your horses overall condition. Rather than spot treat your feeding program, I recommend you review Care for Horses » Nutrition » Equine Nutrition an Overview of Feeding Horses and follow the overall principles. One change I would make is to not intermittentently supplement and feed differently morn and night. Take what is working and divide it up so that she gets the same amount of each compnent of her diet daily and at each feeding.

The most common reason for a stressed white line at the toe without history of founder would be overloading the toe by leaving it a bit long when trimming. It seems unlikely to be related to the lameness since it occurred in both white lines but a long toe may put extra stress on the coffin joint. If the toe has been unloaded it may very well look better in the next two shoeing periods. If the horse remains lame perhaps reassesment by your vet is in order.
DrO
New Member:
Jennifer

Posted on Wednesday, May 18, 2005 - 2:02 am:

Dear Dr. O:

Thank you for your guidance and re-assurance on this. When the farrier trimmed up the toes really well so I am hoping to see improvement. Her toes had appeared a bit longer in the past couple shoeings than the way she was normally trimmed-don't know why the farrier would do that; he has been working on her for four years. I have re-read the above mentioned article and found some great guidelines. The facility where I boarded her was insistent on feeding only grass in the morning and only alfalfa in the evening. On several occasions they have mis-fed her in the past few months which left me very angry and concerned about colic and a host of other issues. I have just been able to move her to a much better facility.I was thinking to give her more consistency in her diet to switch her to grass at both feedings and handling the supplemental feeds personally each day to establish a consistent diet for her. If you think that these dietary changes would be beneficial to her I would really appreciate any feedback you may have.
Thank you again!
Jennifer
P.S. This website is the best!
I lost one horse to EPM five years ago and it was virtually unknown in California. This site offered me more information and support than any other source or local vet could provide me. I fought with the vets so save him for six months. Though it had a tragic ending Horseman's Advisor helped me understand this disease and for that I am truly grateful.
Moderator:
DrO

Posted on Wednesday, May 18, 2005 - 7:50 am:

When you switch to just grass you may be lowering the energy and protein so if the horses condition is where you want it you may need to supplement. I like feeding alfalfa to those who don't grow fat easily, perhaps approximately the same weight of cubes to make up for the hay, with the concentrate would be convenient. What supplements are you feeding?

Opps, I just went and read. Yes you could give these as a treat twice daily or premix and place them in bags to make it convenient for the barn.
DrO
New Member:
Jennifer

Posted on Wednesday, May 18, 2005 - 5:07 pm:

Hi Dr. O:
The supplements I am feeding her per day are
1 lb Moor-Glo (rice bran), Nutrena Senior 1 lb, Missing Link (4oz), Next Level joint fluid, and a Biotin supplement. She has always been a high strung Thoroughbred with a slightly more solid warmblood type build (easy to maintain a healthy weight @ 16.3h, approx. 1300 lbs) so I thought perhaps switching her to all grass hay with these daily supplements may be of benefit and calm her a bit. Of course I'll adjust the amounts of supplements in accordance with how her weight is maintained on the grass.

If you could let me know if you think of this program and could offer any suggestions or adjustments to amounts I would really appreciate it.
Thank you
Jennifer
Moderator:
DrO

Posted on Thursday, May 19, 2005 - 7:04 am:

Can you give me the nutritional break down and concentration of the above? Also what is the type and quality of the grass hay?
DrO
New Member:
Jennifer

Posted on Friday, May 20, 2005 - 3:13 pm:

Sure Dr. O
She receives high quality bermuda grass hay (heavy feedings). As for the supplements this was the information I could locate from the labels:

Nutrena Senior:
protein 14%
fat 5%
fiber 16%max
Could not locate ingredients on Nutrena website

Moorglo
protein 14%
fat 18%
fiber 14%
Main Ingredients: stabilized rice bran, soybean hulls, dehydrated alfalfa meal, ground flaxseed, beet pulp

Missing Link
protein 18%
fat 28%
fiber 10%
Linoleic Acid (omega 6 per 40 gram)5%=2000mg
Linoleic Acid (omega 3 per 40 gram)12.5%=5000mg
Main Ingredients: ground whole flaxseed, molasses, rice bran, dried yeast, dehydrated alfalfa

Any suggestions or feedback would be appreciated
Jennifer
Moderator:
DrO

Posted on Saturday, May 21, 2005 - 7:19 am:

There is enough protein here to insure a 10% protein level in the total diet even if you replace the alfalfa with coastal. If you wanted to simplify things you could replace one of the high fat supplenets with the other they look very similar with the missing link a little more concentrated and both could be replaced with a higher protein Nutrena ration and a little vegtable oil added. Might save a lot of money too.
DrO
New Member:
Jennifer

Posted on Saturday, May 21, 2005 - 7:37 pm:

Dear Dr. O

Thank you for taking the time to review all this and advise me. I really appreciate it!

Jennifer
Member:
Unicorn

Posted on Tuesday, May 24, 2005 - 7:36 pm:

Thickening of the white line can be a symptom of stress related founder.

The usual causes are the toe left too long causing excess force in the breakover and strainig the laminae.

Another common cause of stress founder is high heels this means when the coffin bone is loaded it has a downward angle. The high heels are unnaturally loading the toe putting excess force on the laminae.

The third trigger for thickening of the white line may be heel pain/navicular. The means the horse is unwilling to load its heels and lands on its toes first. If you watch from a distance and see if the horses toe hits the ground first or if you have a sand arena you will see a little wave of sand as the horse lands on it toes.

All the above are fixable with a correct trim. If it is high heels you will notice the coronet band is too parallel to the ground. If it is low heels and long toe the coronet band will be too steep an angle. Some where around 30 degrees from the ground is the correct angle for the coronet band.

Regards
Darren
Moderator:
DrO

Posted on Wednesday, May 25, 2005 - 7:37 am:

Darren concerning the effects of elevating the heels you have your stresses wrong. Elevating the heels decreasing the stress on the laminae by unloading the abducting force of the deep digital flexor tendon. A well established treatment for severe rotating founder is to elevate the heels.
However I do agree with the comments on the long toes, particularly when accompanied by low heels, for the same reason stated above.
DrO
Member:
Unicorn

Posted on Wednesday, May 25, 2005 - 9:03 am:

Actually it is old treatment regimes that think the DDFT is responsible for pedal bone rotation and damage.

Having disected feet it is easy to understand why the heels must be lowered, if they are not the coffin bone can descend in the hoof capsule causing the hoof wall to rotate upward and sometimes angle away.

Having worked on foundered horses myself and seen the work done by a farrier now doing barefoot trimming on really bad cases. The methods of lowering the heels to allow the new hoof capsule to align correctly are so positive that horses that would normally been destroyed are up and galloping around once they heal. There should be no such thing as pedal bone rotation or permanent damage from founder. I took one pony that had not happily walked for 3 years to cantering down a concrete driveway in 8 weeks by lowering the heels correctly.

All horses can be cured of founder no matter at what point the damage occured. The only risk is if the heels are left too high the coffin bone can be eroded at the tip.

I have not checked out the current horsemans advisor info on founder recovery so I don't know what level of recovery is expected.

I have seen pics of horses foundered 3 years previous returned to full competition.

I know of cases of sole penetration in all four feet that are sound as ever after having the heels lowered correctly.

Founder is no longer a death sentence to a horse, the forces involved in stabilising the hoof are now so well understood that a horse with laminitis leading to founder can be treated and wallking sound within 6-8 weeks. The hoof itself is at risk of recurring founder from work loads if the hoof is let to grow too long in the heel. This risk is mitaged once the hoof capsule grows through. The horse with a new hoof capsule is at the same level of performance before the founder episode.


Regards
Darren
Moderator:
DrO

Posted on Wednesday, May 25, 2005 - 10:30 am:

The process you describe above is detailed in the article on rehabbing founders but you misunderstand the physical forces on the laminae and are incorrect about lowering heels to prevent rotation. The heels should be lowered until the coffin bone and laminae are stable.

Lumping all founders together as though a chronic grass founder is the same as a founder resulting from septic metritis is a terrible mistake.
DrO
Member:
Unicorn

Posted on Wednesday, May 25, 2005 - 12:29 pm:

I would be interested to know the reasons for different treatments as both retained placenta and severe digestive interuption both release toxins and particulant matter into the blood stream. each of these is due to the death of cells and the necropsy that follows. A queenslander by the name of Chris Politt spent a large amount of time creating founder in horses to study the effect the particles have on damaging the lamanitic cells.

You state that the DDFT and resultant forces react differently depending on the trigger to lamanitis. I would like to know why you would treat them with raised heels other than DDFT tension?

It can be more complicated than just lowering the heels depending on the damage done. The key to recovery though is to keep the forces in a natural state. This means keeping the heels at the lowest height possible, if there are other complications like a DrOpped coffin bone trimming the wall and padding the foot may be necesary. The main thing is not to allow the heels to become too high. The most effective treatments are done with minor trims every couple of days.

The only time founder becomes disasterous is when the coffin bone is allow to rotate out of position and is maintained in that position too long. The incorrect forces will erode the tip of the bone. This is easy to detect on Xrays. In bad cases more than 30% of the bone can be eroded by high heels. This bone erosion is not unigue to founder I have seen some frightening Xrays on IVIS of TWH incorrectly shod to the point the bone was no longer useful.


I do apologise if I seem to be pushy, I like to question the world as other people see it so as to learn beyond the "we say so" structure. If I did not have the inclination to push boundaries I would have lost most of my horses to that parasite attack, as every one else said I could not be right.


Regards
Darren
Member:
Jennifer

Posted on Wednesday, May 25, 2005 - 5:00 pm:

Luv is shod with natural balance shoes and wedge pads on both front heels because she has low heels to begin with. The wedge pads also helped by offering support with the mild coffin joint degeneration in the left front she was diagnosed with four years ago.

She seems to be moving well this week. The only hitch is that she develops the head bob when going counter-clockwise in a tight circle with the left front as the lead leg. If she make a larger circle or goes straight she appears fine.
Thought perhaps this information may be useful.
Moderator:
DrO

Posted on Wednesday, May 25, 2005 - 6:42 pm:

I am sorry Jennifer, your discussion has been side-tracked a bit. If the lameness is improving as you post suggests, a wait and see attitude is reasonable. If it quits improving it might be good to have it localized. Have you used any bute since the injection?
DrO
Moderator:
DrO

Posted on Wednesday, May 25, 2005 - 7:16 pm:

The questions are not troubling Darren. The difference between a grass founder and a septic metritis, is a bit like the difference between a cold and having a severe pleuropneumonia. Yes while they are both infections of the respiratory tract the first is fairly easily treated and has a good prognosis of being returned to perfect health while the second is going to require every possible skill to manage and you still might lose the horse.

I attended Chris Pollets lecture on founder at the 2003 AAEP meeting and I agree with your implication that he is a very fine researcher on founder and the Faculties of Natural Resources, Agriculture and Veterinary Science at the University of Queensland is a premier institution on Founder Research. I think his MMP pathway induction by bacterial toxins looks very promising as a initiating cause for some founders and his prolonged very cold therapy a promise for the catastrophic causes of founder, see the article Overview of Founder for more on this.
DrO
Member:
Jennifer

Posted on Wednesday, May 25, 2005 - 7:28 pm:

Hi Dr. O
She appears to be making some progress. It varies from day to day, but generally it seems positive. Right after her injection she was given bute for the three days following the procedure to assist in recovery. She despises the taste of it and most of the time will not even eat it no matter how many tricks I use to get it down her. She does not appear to be uncomfortable in any respect other than the tight circle head bob. My vet agrees with you that we should wait and see for the next 4-6 weeks and continue to let her work lightly (lots of walking, trotting, little cantering) to keep her muscles loose. She does most of the work going clockwise to put the least amount of strain on her left leg. It also keeps her happy emotionally and psycologically to be out regularly as she becomes miserable and stir crazy when confined to her stall.

I feel so foolish for not adding this information sooner as it did not seem relavent to the original issue but I want to run it by you anyway. This past January during a very rainy season I came out one day to find Luv's left front leg and chest swollen and she was very lame. I immediately had the vet out and we determined that it appeared she had hyperextended her left front slipping in the mud and pulled the tendon in the inner front left leg and her chest muscle.Radiographs confirmed no fracture was sustained. The vet stated that it was tendinitis and we stall rested her for six weeks with only light hand walked after week to prevent her from going berserk from confinement. The swelling and lameness subsided fairly quickly with two small lumps along the tendon shealth gradually shrinking in size. With the awful conditions from a long, muddy rainy season it was difficult to let her get back to a somewhat regular exercise routine safely so handwalking was the exercise of choice when weather permitted.

One issue from this injury still remains. Even now one small bump on the tendon shealth remains. I palpate her legs before exercise and again afterwards. I find the bump swells in size after she exercises, however by the next day it is a small lump again. She is not tender when I touch or apply pressure to it. I always wrap her legs before work to provide protection and cool her out thoroughly so all the muscles can stretch out and keep her limber.

Do you think that this could be causing part of the problem in regards to the lameness?

After tendinitis, do small bumps on the tendon sheath such as the one I described every disappear or is could this be scar tissue or a small tear in the shealth that has yet to heal?

Is there anything more I can do to help in her recovery in regards to the tendon injury?

Having the coffin joint issue, tendinitis, and thickening of the white line all as complications with her soundness in the left front makes trying to pinpoint the source of the problem difficult. Any further testing or recommendations for treatment would be greatly appreciated.

Jennifer
Moderator:
DrO

Posted on Thursday, May 26, 2005 - 8:14 am:

If the behavior of this swelling has not changed any from when she was sound and here is no heat or pain this seems less likely than residual discomfort from the joint. The injections can sometimes be mildly irritating (and rarely we get severe reactions) and is the reason for the bute, if she did not get the bute this may simply be this.

If you are very worried about these other possiblilities you should go ahead and have him come out, these questions should be pretty easy to answer on a good physical exam followed up by imaging to determine severity and proper treatment.
DrO
Member:
Jennifer

Posted on Sunday, Jun 12, 2005 - 5:57 pm:

Hello Dr. O:
Just wanted to give you an update. My vet re-examined Luv twice and reviewed the images again. She believes that the source of her lameness is coming from the torn tendon sheath in the left front. We injected the area on Thursday and she has been placed on bute 1 gram bid for three days. I am cleaning and changing the bandage each day and will remove it on Monday.

I have one concern though. I noticed that the injected leg is warmer that the untreated leg from the injection site down to the hoof. There is no accompanying swelling, lameness, discomfort, or depression.
Is this normal?
Should I be doing anything additionally and when should this warmth subside?
Is there a good prognosis for a torn tendon sheath?

Jennifer

Thank you for your advice.
Moderator:
DrO

Posted on Sunday, Jun 12, 2005 - 11:16 pm:

I often find one leg warmer than another and without any other symptoms not significant. That is not the same as saying you don't keep an eye on it for change. Concerning the prognosis that will depend on location and extent and best determined by the one who can examine the horse.
DrO
Member:
Jennifer

Posted on Monday, Jun 13, 2005 - 3:49 pm:

thank you for addressing this.
jennifer
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