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  Discussion on Unilateral Laminitis / use of Vasodialator (Viagra)
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Member:
brandi

Posted on Monday, Feb 7, 2011 - 2:25 am:

I have a 15yo paint gelding, severe navicular horse, been posting on this site about him for years. He is pasture sound (barely), barefoot (many, many booting & shoeing options with negligible results) and on 114mg/day previcoxx (dog version of equioxx). He is more sore on the left and does not usually allow his left heel to fully contact the ground when standing.

10 days ago he had a too-short trim by my regular (5 years) farrier, and he was remarkably more lame (never happened before). Upped his Previcoxx to 227mg and he was about normal 4-5 days later so backed the previcoxx back to 114mg. 3 days after this he was vaccinated and had dental work with sedation. He has reacted badly to vaccines once before, but it was assumed due to rabies - which he did not receive this time - he got WNV & Flu/Rhino. However, that evening, he came in 4/5 lame in the right front only (his better foot). Very slight swelling on his neck at the left side injection site.
Upped his Previcoxx that night again to 227mg, vet came out next morning, guessing possible abscess or laminitis. Next 2 days he was on 114mg previcoxx and 10cc banamine, no change in pain, only induced ulcer symptoms. Banamine was stopped, previcoxx back to 227. Other treatments: softride boots, deep bedding, stall rest and alternating ice/heat (ice in case of laminitis, heat for abscess).
On Monday night we started 200mg Viagra, 2x day thereafter. By Tues night, 5% better, by Weds night 25%, at this point we backed down to 50mg 2x/day and he continues to improve, though the progress has slowed dramatically. Because of all of this, I'm pretty convinced that I am dealing with Laminitis. Would you agree?
I've spent thousands upon thousands of dollars on this horse over the past few years, just to give him a quality life at pasture. Every type of boot/pad solution, all sorts of shoes, and tons of therapies, even a couple of experimental surgeries. I can no longer do that, I have to be extremely practical now. And in the back of my mind I feel like I need to reserve a few hundred bucks for the inevitable.
I'm not 100% sure if I'm here looking for treatment answers, or just support. I would like to know more about the Viagra treatment, is there a standard protocol for dosage, etc.? Why isn't there more info on its use in this type of treatment? I only found it mentioned in 2 posts by members and no real response to the questions surrounding it. But I know it's been used experimentally for years - isn't there any data?
I also feel like there is a gap in knowing what to do besides pain meds, foot pads & stall rest. If I weren't doing the viagra, is this all I would be doing? Is any walking detrimental? Should I not even walk him out of his stall 25 feet to graze?
I would appreciate feedback, in 25 years of horse ownership I've never had to deal with laminitis. I'm somewhat lost. Thanks.
Member:
briggai

Posted on Monday, Feb 7, 2011 - 9:03 am:

Brandi, I'm so sorry for what you and your horse
are going through!
I hope DrO. will be able to answer all your questions,as I can see you need this.
Keep posting about your horse and HANG IN THERE!
GAILB
Moderator:
DrO

Posted on Monday, Feb 7, 2011 - 5:35 pm:

Hello Brandi,
I don't think it is clear that this is a founder. Anytime I see a unilateral founder, other than from excessive weight bearing because the other leg is nonweight bearing, I am suspicious of other possibilities.

Concerning the use of Viagra for founder, there are no published studies at this time and I have only read about anecdotal use. I would personally not recommend it at this time. Concerning treatment remember those pain relief meds are antiinflammatory also. Exercise recommendations are handled in the article but I would add to your list correction of any underlying cause which includes nutritional management, and possible trimming it indicated. See the article for more on all this.
DrO
Member:
kpaint

Posted on Monday, Feb 7, 2011 - 7:36 pm:

Hi Brandi, so sorry to hear your troubles with your gelding. Sounds as if you have given him a great pasture life. Have you had recent X-rays? I am not very familiar with a 'severe navicular' condition; I'll have to read what happens and what to expect as the condition progresses. Has your vet, in the past, told you what to possibly expect as the horses ages and/or the condition progresses?
Member:
gwenyth

Posted on Wednesday, Feb 9, 2011 - 4:43 pm:

Brandi, it is possible that a too short trim could be making him sorer than you can imagine. I dealt with lame horses for years when I had a farrier, shoes and barefoot both - were the horses sore, did they have laminitis, did they have abscesses??? I could not figure out why they were lame all the time. I know that this may sound crazy, but your farrier may be the source of some of your problems.

Dr. O suggested his article on trimming and perhaps you should read it over a couple of times, as Dr. O has many, many good suggestions. Is this how your farrier trims, or maybe it's not the same? Go to some barefoot trimming sites and look at the foot pictures - do your geldings feet look like those feet, or is your horse "pasture trimmed", which might possibly be causing the navicular issues to get worse.

Navicular horses are sometimes made worse by incorrect trim methods, and you might want to investigate into a barefoot professional trimmer and not a "farrier". Farriers often trim the same way - whether they put on shoes or not - I personally know "severely navicular horses" that have been lame for over 5 years, and they have been greatly improved by using a barefoot trimmer instead of a farrier.

If I had a farrier that did a "too short trim".... - well, in the past 3 years I have realized that there is usually NO reason for a horse to be lame after a trim - except that too much foot was removed. It is different when you are transitioning a horse from shoes to barefoot, but not when a horse has been barefoot for a long time. There really is no reason for a horse to be lame after a good trim. But horses are often lame after bad trims - I know!

Good luck with your horse - it is frustrating.

Member:
brandi

Posted on Wednesday, Feb 9, 2011 - 11:40 pm:

Thanks everyone for your feedback and support. Yesterday Apache blew out an abscess at his toe that extended all the way to the medial heel. He is so much happier now. I am so much happier now - lighter in the pocketbook, but happier.
Linda, I very much appreciate you bringing the point to bear about whether or not the farrier is doing the job right - because it is extremely important to consider. I considered it, and I feel confident in him. He has been working with all 6 of my horses for 6 years, and early on, we worked under a 40-year veteran who was my previous farrier. He is competent and caring, and I know this was a 1-time mistake. I do not accept horses being lame after a trim as a matter of course, but I won't abandon someone whom I trust and whom I know has my horse's best interests at heart, due to one mistake. Not that you said I should, just that those are my thoughts.
Abscesses are so dang tricky, this horse got remarkably better, then remarkably worse. A rollercoaster of pain and emotion. UGH!
Thanks again for the feedback.
Member:
kpaint

Posted on Thursday, Feb 10, 2011 - 6:41 am:

good news that the source was found
Moderator:
DrO

Posted on Thursday, Feb 10, 2011 - 7:34 am:

Brandi I disagree that abscesses are tricky. They are one of the easiest lameness to diagnose and treat. Yesterday I was called out to see a horse that had been lame for a week. The horse was very lame, it had started less lame and worsened over the week with a history of slight lameness that resolved the week before.

The foot was a little warmer than the other but noticeably warmer on the inside quarter compared with the rest of the foot. None of the nails where particularly sensitive to a light hammer tap. But the inside quarter was distinctly and repeatedly sensitive to light pressure with the hoof testers. Pull the shoe and lightly clean up the sole and there is a tiny little defect in the horn of the sole in the sensitive region just under the shoe. Unfortunately this horse has a long foot and a very thick (over 1 cm) sole so I sharpen my knife and begin at the defect. Sure enough the defect gets larger the deeper I get and follow it down till puss pours out the hole. That horse will be 50% better this morn and nearly 100% by tomorrow. This is how almost all abscesses present. Each step follows the results of the last step but the suspicion of an abscess is high from the history and appearance of the lameness alone. Where you have this diphasic lameness there is often the initiating insult that sets up the infection which follows in days of weeks later.

I would bet your horse was sensitive in the heel and careful looking would have discovered a horn defect, black spot or corn, at the angle of the heel.
DrO
Member:
gwenyth

Posted on Thursday, Feb 10, 2011 - 10:13 am:

Brandi, glad that it turned out to be an abscess and it is quite possible that the trim was not too short, it just seemed to be, but the abscess just turned up then and he became lame.

You sound as if you are confident that your farrier is doing his best, and that is what is important. Competent and caring are a good combination, and you are lucky!

Good luck with your horse.
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