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  Discussion on Lame Clydesdale - almost 2 wks, still no answers
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Member:
jent

Posted on Monday, Jul 13, 2009 - 4:38 pm:

Hi Everyone,

I posted a question about restraining my 10yo Clyde gelding due to scratches in the 'behavior' forum, but decided to post here to talk specifically about his lameness. We board our horses about 20 mins away and during the week of 6/30, we hadn't been out in a couple of days. The barn owner called the eve of 7/1 to let me know that she had trouble getting him into the barn that day and that she had been seeing him walk 'tenderly' on his feet the few days before. We'd had his feet trimmed about 3 wks before, so she thought he was tender from his trim and didn't 'think' to tell me sooner... sigh.

When I arrived on 7/2, I found a horse in a seemingly great deal of pain. Hung his head, barely made eye contact, refused to move. He had been eating, drinking, pooping and peeing. He stood as if his fronts were tender but alternated weight shifting on his hind legs. The movement was deliberate, as if he was weight bearing as long as he could stand on one side, and then shifting to the other side. Feet were equally warm. slight reaction to hoof testers on front left, and sole looked a bit bruised.

X-rays showed no sign of laminitis... started 2g bute 2x/day for a week and he seemed to be more comfortable and more responsive. Vet shaved a few spots on his legs to uncover some scratches, but they did not seem severe enough to cause his symptoms. But I proceeded to treat for scratches.

He prefers to lay down when he's in his stall and doesn't rise when I enter... I take the opportunity to treat the visible scratches and pick his feet...

Last Thursday, I DrOpped his bute dosage to 2g/1x/day per the vet. His symptoms have gradually improved to the point where he'll leave his stall to go out to graze for a few minutes. Yesterday I turned him out in a dry lot with the other geldings for most of the day. He didn't lay down at all. He walks 'almost' normally on soft ground but is VERY tenderfooted and hesitant on concrete and gravel.

Vet came this morning and we shaved all of the feathers off his 4 legs to really see what we were dealing with scratches-wise. My other Clyde has worse scratches than he does and is perfectly sound. So the vet nerve-blocked his hind feet and there was no improvement in his movement. There was also no significant reaction to the hoof testers although it was difficult to tell because he was trying to shift his weight off of his sore legs. After the nerve block, he continued to shift his weight from his leg hind to his right hind, alternatively lifting his legs slowly and deliberately. When we walks on concrete/gravel, his hind legs have a bit of a tremor when he lifts them, as if he's stretching out a muscle cramp.

So I am going to switch his diet to an EPSM diet to see if that helps. Vet suggested a broad-spectrim antibiotic (4x/day for 3 wks!) but I declined as we don't have a definitive reason to give him that. Since he has been getting marginally better, we're going to continue to see how he does with turn out, remaining days on bute, and different feed... Next thing to do is take him to MI State Univer vet teaching hospital for evaluation, assuming I can get him in the trailer.

I know that a muscle biopsy will definitively diagnose EPSM... from what I understand, it's not a small punch biopsy but rather a 2inx2in pc of muscle removed... can anyone tell me more about this procedure, recovery, etc?

Does anyone have experience with drafts or any of the combined symptoms I've described? I feel so badly for the poor guy.
Member:
leslie1

Posted on Monday, Jul 13, 2009 - 5:44 pm:

Jen
I think there is a vet on rural heritage that specializes in draft/epsm. maybe peruse that sight, if you havent already. there is a virtual vet forum
heres a little link someone who had an acute case with a Shire.
https://www.ruralheritage.com/messageboard/virtualvet/5371.htm

Dr Valentine has a book called Draft Horse Owner's Manual.
Member:
scooter

Posted on Monday, Jul 13, 2009 - 5:49 pm:

Hi JenT, Normally epsm doesn't make them look sore footed or isn't different whether the ground is hard or soft. When my horse had laminitis he would continuously shift his weight in the rear also. FME they usually get laminitis in the rears too.

It is possible for them to have sore/bruised hooves, abscess, laminitis ect. with nothing showing up on the x-rays at first, or ever if it is mild.

I am not saying he has laminitis, but from your description I would be looking at his hooves 1st.

Can you pad his hooves or put boots on him to see if there is a noticeable difference?
Member:
jent

Posted on Monday, Jul 13, 2009 - 6:48 pm:

Thanks Leslie... I've read the article Dr Valentine wrote about EPSM but wasn't aware of the book...I read the info in the link and will look into it even more.

Diane... my farrier, who has experience with drafts and does barefoot farrier work only, said that laminitis cannot be diagnosed by x-ray... when I inquired about that to my vet, he was very offended (I guess there's some history between the two of them anyway....). The nerve blocking of his hind feet should have made the symptoms go away but there was no change in his gait at all... I can check with the farrier about boots. Do they even make them 'dinner plate size'??
Member:
jent

Posted on Monday, Jul 13, 2009 - 6:52 pm:

So if laminitis could feasibly still be on the table, then perhaps I shouldn't be turning him out at all? Have been leading him to graze for a few mins every other night or so and turned him out yesterday for a few hours. He's in a 12x12 stall that has a concrete base but she has a mat over the top and I've asked for 'extra' sawdust to be put in there... I'm worried that the footing in his stall is contributing to the problem. And how depressing is it to be in a stall, in pain, all day long? Oh how I WISH I had my own property... I'm actually working with a realtor now.
Member:
leslie1

Posted on Monday, Jul 13, 2009 - 7:11 pm:

Maybe he has some Laminitis/ouchiness going on because he is having an acute episode of epsm and putting his weight on his fronts. they getting sore especially, if the stall flooring is not ideal.
Did the vet only block the hind feet or?
Is it possible he got cast in his 12X12 stall and hurt his back or hips?
Just throwing things out there.
Member:
scooter

Posted on Monday, Jul 13, 2009 - 7:56 pm:

Did they block her front hooves? I don't want you to go by me. Your vet needs to figure it out. I am just saying I wouldn't rule out his front hooves(any problems) not just laminitis because she looks "lame" behind. Is she short strided on the fronts on the cement too?

JenT if you buy some construction grade styrofoam(not the white stuff)usually pink 2ins thick minimum. from the home improvement store, cut it to the shape of her feet and duct tape it on it would pad her hooves until the vet could look at her again.. It may not be her hooves, but improvement on soft ground and sore on hard ground usually proves to be in the hooves MOST of the time. IF IF they have laminitis in all 4 hooves FME they weight shift quite a bit behind.

Laminitis(infalmmation of the laminaie) can't really be diagnosed by x-ray, until it turns into a founder with rotation. It usually takes a little while for that to show up on x-rays.
Member:
jent

Posted on Monday, Jul 13, 2009 - 11:12 pm:

The vet only blocked the hind feet because he said that there was no evidence of laminitis thru the x-ray of the fronts.

I don't think there's a way he got cast in his stall... there's enough activity around the barn that it would have been noticed, unless it happened overnight.... he's big, but he's not that big.

He's short-strided in the front and the back, almost like he wants to walk like Frankstein if that makes any sense. He makes a concerted effort to have his heels hit first, on all 4s.

I spoke with my farrier again tonight and she advised me to used CleanTrax on him, which is some sort of 'potion' that's mixed in a gallon of water, sprayed on, and then he's wrapped in Saran wrap for 45 mins. The fumes help kill the fungus and it's supposed to kill all 3 stages of the fungus. She has also seen scratches make a horse this lame....

But she said that for laminitis, I need to encourage movement to encourage his the blood flow to his hooves and thus encourage hoof growth... having him stand in his stall all day is not good, but then his legs get dirty and he doesn't tolerate having them washed...

He was a little swollen tonight from the injections but I hosed him off with cold water, let his legs dry, and then sprayed him with some spray the vety gave me that he doesn't tolerate well either.... sigh. Keep the ideas coming tho.. something's sure to work.
Member:
scooter

Posted on Monday, Jul 13, 2009 - 11:48 pm:

JenT all I can say is IF he is foundering don't make him move. I really hate to say this stuff because you don't have a diagnosis, so just take it FWIW. Horses that are foundering don't want to weight their toes. That's why they will stand stretched out in front, if it is in all 4 you get the weight shifting. I had one mare that acted like her back hooves were touching hot coals every time she put her back hooves down.

The best thing you can do for your horse at this point until you have a diagnosis is put VERY thick bedding in his stall and don't move him...just in case. Call your vet and get a diagnosis. A vet should be able to tell if a horse is foundering...usually just by watching them walk! If not the walk, heat in the hoof and a bounding digital pulse is USUALLY a sure give away. I have had horses lame from scratches and it is different then laminitis/founder.

Good place to start to see if symptoms match, tho some produce their own weird symptoms too,

https://www.horseadvice.com/horse/messages/4/5322.html
Member:
juliem

Posted on Tuesday, Jul 14, 2009 - 12:11 am:

Second to what Diane says--NO NOT have him moving any more than you can. Your farrier's advice is outdated. Movement if he's foundering, and it sure sounds as if he may well be, will cause further damage, especially with a heavy horse like him. Laminitis (founder) could certainly be occuring without changes showing up on xray at this point. By the time you can see evidence on xrays, the damage is well underway. A concrete floor will need much more than rubber mats and extra sawdust to keep your big guy comfortable. As Diane says, DEEP bedding! Read the article and find out if your vet knows how to apply styrofoam to his feet--if he's suffering from laminitis it'll make him more comfortable.
I have to say, if your horse is foundering, getting a vet and farrier that can work together and that are both up to date on laminitis research is imperative. The current standard treatment is quite different that what is used to be--and as a result, many more horses are saved. So, until you know what's going on, you're going to have to do your homework, become a big thorn in the side of your vet and farrier or find a new team. Two things that will help and won't cause further damage regardless of what's going on: Stall confinement with DEEP bedding and a couple of layers of styrofoam taped on his feet as per instructions--which I bet are in Dr. O's article. That's what I'd do if he were my horse. And I just might be looking for another vetfarrier team!
Member:
scooter

Posted on Tuesday, Jul 14, 2009 - 7:03 am:

Take into consideration also, bute sometimes makes them feel well enough that hoof testers doesn't effect them.
Member:
canter

Posted on Tuesday, Jul 14, 2009 - 7:22 am:

Jen, you're not that far from MSU, which has a very good vet school, as you know. It may be time to take your Clyde there for some definitive answers.
Moderator:
DrO

Posted on Tuesday, Jul 14, 2009 - 9:25 am:

Hello Jen,
There is not enough information here to make a stab at a diagnosis and a lot about your post that is confusing. So let's straighten out the confusion and help you learn what needs to be done to diagnose the problem.

So let me start with the most likely explanation for an all around stiff moving horse is bilateral front limb lameness and founder is not the only cause. Also important is that lack of rotation on radiography does not rule founder out. But there are other causes of both bilateral front limb lameness and other causes of a stiff moving horse, for more on this and other aspects of the proper diagnosis of lameness see the article associated with this discussion: Diagnosis of Lameness. There is a section specifically on the Stiff Moving Horse that helps with rule outs, but if the disease process not readily evident on physical exam then back up to the beginning of the article on how to localize lameness in the leg.
DrO
Member:
jent

Posted on Tuesday, Jul 14, 2009 - 12:16 pm:

Thanks everyone... my posts are confusing because the entire situation is confusing. I suspect multiple issues here, with the scratches, possible EPSM, possible laminitis... I've done so much reading, I'm dizzy and even more confused then before. He has some symptoms for each disease but not all. He does have some heat in his feet near the coronet band and there is no significant digital pulse. Also, he is on less bute now that he was when he was originally hoof-tested, so I don't think the bute is masking anything... but it was a good thing to consider.

My vet had to go out of town for a family funeral and will be back Thurs... I think I'm going to ask him to come and nerve-block his front feet, even though he may argue the need because the x-rays were negative. Either that, or just stop dinking around and take him to MSU where they will likely repeat the tests anyway... this is SO frustrating.
Member:
shanson

Posted on Tuesday, Jul 14, 2009 - 1:17 pm:

After reading the article(s) that Dr. O cites, can you post photos of his feet? If I were you, I'd want to rule out any issues with the farrier work. Her recommendation to get him moving when he's in this much pain makes me wonder about her.
Member:
jent

Posted on Thursday, Jul 16, 2009 - 10:03 pm:

We just returned from MSU Vet Hospital with a diagnosis of laminitis which has progressed to founder in his hind legs. There are still no radiographic changes in his front feet. We decided to travel to MSU because my local vet came out and nerve-blocked his hinds on Tues morning, but he was still as lame as ever, so he was stumped.

Vet at MSU said that it's impossible to dose enough block to allow them to be completely pain free once they have foundered.

So... the MSU vet said that he needs 1.5gms bute 2x/day, only grass hay (no grain), and must be encouraged to remain off of his feet by deeply bedding his stall. They were obligated to paint a grim picture and told us we 'may' have to make a hard decision at some point but we are committed to doing what we need to do to save Prince and allow him quality of life. He has already shown improvement in the 2 wks since he came up lame, so we will remain optimistic.

In the meantime, I am still getting conflicting info from my barefoot farrier... she said that new research has shown that allowing them to move at will in a dry lot would stimulate blood flow to speed up new hoof growth. She's manages about 5 founders a year successfully with this method. I have to ask her, though, how many of these are drafts. Prince is 18hh and 1,666lbs.

So, I have more research to do... the vet wants him to lose about 200lbs. I will post pics of his hooves when things settle down a bit.
Member:
scooter

Posted on Thursday, Jul 16, 2009 - 10:35 pm:

Jen I am glad you were able to get a diagnosis. I can tell you from experience, while your horse is in the acute stage of founder AND on bute DON'T move him.

#1 bute makes them feel better so they may move around more then they should...leading to more tearing of the lamanaie, and quite possibly more rotation and or sinking...It is only common sense if you think about it

#2 bute is very important at this stage to keep the inflammation down, they may LOOK like they feel better, but the bute can make it APPEAR that way.

The best luck I have had with my horse is padding his feet with styrofoam, that is something that does take practice and is time consuming.

I actually went to taping on pads you put in boots on my horse and he was immediately more comfortable and it was EASY
https://www.easycareinc.com/Other_Products/Comfort_Pads.aspx

Founder is not fun and you have the fall out for years sometimes...sometimes not!

Read the articles in here they are the best information you can get. They helped get my horse back to sound after a bad founder and he is doing great now! (other than his injured fetlock)

Good Luck with your boy.
Member:
vickiann

Posted on Thursday, Jul 16, 2009 - 11:12 pm:

Good advice from Diane, Jen, but want to add that I have had excellent outcomes following laminitis and know of many horses who recovered very well and perform as good as ever.

My farrier has helped some severely foundered horses that resumed completely normal lives -- functioning, showing, working, having babies.

I hope that you will have a good outcome as a result of your devotion and care.

Hang in there.
Member:
juliem

Posted on Friday, Jul 17, 2009 - 12:09 am:

As Vicki says, many horses can recover from founder that would have been beyond help years ago. But please, as Diane says, don't move him. Your vets advice for a deeply bedded stall is spot on. Movement tears those inflamed laminae loose and that attachment is what that holds the coffin bone in place. Then you will have rotation. This is grossly over simplified, but as Diane says the bute may make him want to move and that's not going to be in his best interests. Ask your farrier--if you're committed to staying with her-- to discuss this with the vets who saw him at MSU. As 1600 pound horse moving on feet with a compromised coffin bone attachment is disaster. It's called a coffin bone for a reason!
Member:
scooter

Posted on Friday, Jul 17, 2009 - 7:13 am:

Dr.O. as I was reading this I was wondering about blocking the hooves to dx founder, I have never heard of this....can that be done?
Moderator:
DrO

Posted on Friday, Jul 17, 2009 - 8:09 am:

There are characteristic findings when a foundered horse is blocked in the front feet Diane. If the horse has these characteristic findings, founder and other causes of bilateral front limb lameness are ruled in, if not you look elsewhere for the cause of the lameness.
DrO
Moderator:
DrO

Posted on Friday, Jul 17, 2009 - 8:18 am:

Opps I forgot to reply to Jen.

Jen I do not know of any research that says foundered horses should be allowed to move around. The idea that they should be moved around is actually an old concept and in the case of very mild founders may have some validity, you should follow MSU's advice in my opinion. Not only would I feed a grass hay I would consider soaking the hay you are feeding to reduce the founder inducing nonstructural carbohydrates. For more see, Diseases of Horses » Lameness » Diseases of the Hoof » Founder & Laminitis » Forage (Spring and Fall Pasture) Associated Founder.
DrO
Member:
vickiann

Posted on Friday, Jul 17, 2009 - 9:27 am:

What I have understood is that the "moving around" period should only be when the feet first lose circulation and are colder than is normal, prior to the heat and pain setting in.

If there is validity to this thinking, most people would miss this stage entirely because there are no symptoms unless you monitor the feet continuously for the temperature.

I think that some holistic veterinarians and perhaps others will still recommend this limited exercise idea from time to time after the laminitis and pain has set in, but those people who I know who have followed this advice seem to have had some degree of rotation, while using the deep bedding and not moving around until the pain is gone and medications have been stopped, has resulted in no rotation for me and others.
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