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New Member:
Martyr

Posted on Thursday, Aug 3, 2006 - 7:53 am:

This may not be the appropriate forum for this question, so I apologize.

My 8 year old mare has chronic laminitis (metabolic problem) that has been manageable for the last year. A little over a week ago, she became very lame on her left hind due to an abscess that was drained from the sole and also popped in the coronary band. She also had a high fever. Next she developed a significant cellulitis all the way up past the hock. Next there was some evidence that she was developing an abscess on the right hind. Various tests and blood work was done. Of course, vets and farriers are involved in this case but can't watch her 24/7 like I can. Unless you find it necessary for me to provide more details about her illness, I'll jump right to the question which is puzzling me and I think might help with her diagnosis.

She has become more and more recumbent and anorexic, even though the fever is now under control with Naxcel. She has been down now for more than 24 hours. She goes from the sternum position to the lateral position constantly;i.e. only a couple minutes between changing positions. When in the sternum position, she looks almost normal and will drink and nibble on hay. Then, she falls back into the lateral position as though someone hit her with a tranquilizing gun. While in the lateral position, her respiration increases and she makes some groaning type noise. Then she will suddenly pop back up to the sternum position like nothing has happened. It's very weird to me, and I am wondering if anyone has seen anything like this. During her bouts with acute laminitis, she was never in the stance or lying down, so I don't know what to make of this. My gut feeling says there is more than a hoof problem causing this.

My vet is coming again tomorrow (he lives a distance away).
Member:
Scooter

Posted on Thursday, Aug 3, 2006 - 8:40 am:

Hi, Marion did she start laying down more after you started the naxcel? We had a horse at the barn that reacted to it like that. Abscesses can be very painful, does she ever stand? What does she walk like if you can get her to move? Just a few thing to consider. Good Luck
Moderator:
DrO

Posted on Thursday, Aug 3, 2006 - 9:15 am:

What you describe sounds like a reaction to acute and severe pain Marion though a complete exam will be needed to rule out other causes.
DrO
Member:
Erika

Posted on Thursday, Aug 3, 2006 - 10:00 am:

Poor mare, Marion! Please have her re-examined as per Dr. O. My heart breaks for both of you. Laminitis is terrible!
Erika
New Member:
Martyr

Posted on Thursday, Aug 3, 2006 - 11:38 am:

Your replies are appreciated.

I have good news since my initial post. My mare is now standing. I can see that an abscess has started to break out of the heel on her right hind. Dr. O was right about the severe pain. Just imagine--absesses in both hinds plus extreme cellulitis!

In my many years of owing multiple horses, this is the first time I have had a horse abscess. I know they are common with foundered horses, but this is the first for this mare.

In answer to someone's question, Naxcel was not responsible for her lying down. As far as I'm concerned, Naxcel is a wonder drug, although I don't doubt some horses have had complications with it.

This poor mare goes in and out of acute episodes. There have been times where she looked sound enough to ride, and then times where she was walking stilted. She gets digital radiographs every two months to assist the farrier with de-rotation.

It's a mystery sometimes what brings on an episode. I monitor her diet with low NSC hay and she eats no grass. I am fortunate to have her at my farm where she can be a pasture pet that isn't allowed pasture
Member:
Sonoita

Posted on Thursday, Aug 3, 2006 - 3:36 pm:

My heart aches for you and your horse.Prayers and good wishes your way.
Happy Trails
Wanda
Moderator:
DrO

Posted on Friday, Aug 4, 2006 - 6:49 am:

A few comments Marion. If you are having bilateral abcessation, I would look for predisposing causes: are the little black spots that form in the white line and fornix of the heel being attended to?

Next concerning, Naxcel, despite owning 8 to 15 horses at a time I have not had to administer systemic antibiotics to one of my horses in...so many years that I cannot remember when. And my horses frequently travel and come into contact with other horses. If you are using a lot of antibiotics I wonder if perhaps you are over using them? It is true if I had a horse laying on the ground from pain associated with infection I would treat but just the single use of an antibiotic on a farm, greatly raises the number of resistant organisms on that farm. If I am telling you stuff you already know bare with me as lots of folks read these posts for guidance.
DrO
New Member:
Martyr

Posted on Friday, Aug 4, 2006 - 8:24 am:

Yes, I am dealing with bilateral abscessation and don't know the cause. Those vets and farriers involved so far are assuming it is a result of bacteria getting into the fissures in the foot. I do not know what you mean by the "little black spots", but you can bet I will know by the end of today. One of her hind feet is wrapped because the vet had to dig very deep to get the abscess. Therefore, I don't know what it looks like.

My primary vet will be here this afternoon, and I will report back with his findings. Since the mare became ill, I have had several vets and two farriers look at her. Because we are not anonymous on this forum, there some details that are not appropriate to provide.

Regarding Naxcel and antibiotics.....I do not overuse them, and since I was a member here in the past (2000), I do know that you are not in favor of using them unless absolutely necessary. We waited 9 days before starting Naxcel and did so because the mare was getting worse with the cellulitis and fever. Frankly, it was a bit of a desperation move. I have only 3 horses and the only other time one has been on antibiotics was for a laceration, and she was at the clinic at the time.

I appreciate your comment "if I am telling you stuff you already know.....". On any forum, there are very well informed posters, and those will little to no information. Sometimes the well informed can get insulted when they are assumed ignorant.

The wonderful thing about forums like this is that others can learn for our real life experiences. This is my second horse to get laminitis. I am responsible; I allow them to get too obese.

FWIW, my primary reference manual is Adams' Lameness in Horses and my 'consulting' podiatrist is Dr. Stephen O'Grady. He reviews my bi-monthly digital radiographs on my mare.
Moderator:
DrO

Posted on Friday, Aug 4, 2006 - 10:49 am:

One way to let us know your experience level Marion is to fill out your profile, I often take this information into account when I reply. Hope things continue to improve. The little black spots usually form in the white lines (when severe as seen in founders with remarkable rotation referred to as seedy toe) but also can occur in fissures. Anywhere dirt and moisture accumulate. These are focal areas of thrush. They act like a cavity in a tooth. They start as a infection of the dead horn which causes no pain but then digest horn eventually reaching the sensitive tissues where infection blossoms and creates an abscess. I should have referenced the article Diseases of Horses » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels.
DrO
New Member:
Martyr

Posted on Sunday, Aug 13, 2006 - 9:29 pm:

So much has happened since I last posted that my records and my brain are disorganized. This poor mare is still fighting to stay alive. Vet bills are over 5k now.....I've lost track.

I believe my mare has a neurological condition in addition to badly abscessed feet which are secondary to her laminitis. I suspect either West Nile or EPM. I think should would be dead now if she had EEE and she has tested negative for EHV-1, Potomac, and Erchilia.

From the first week of this illness, I told my vet I thought she was acting like a neurological case, but he didn't buy into that theory then, and he still doesn't. I think mostly this is because he feels the chances of having two big problems simultaneously would be one in a million.

When I watch this mare, I just can't imagine how it isn't obvious that her behavior and symptoms go outside the realm of painful feet. She is semi-paralyzed behind in my opinion, and also in some semi-coma from time to time. It is clear to me that she cannot hold her head up for long, apparently from weakness or nerve damage.

The temperature now seems to be under control, even without Banamine. However, I am instructed to keep her on Banamine.

Today makes 3 weeks since this all started, and the mare has been recumbent for the majority of the time. She has stood up each day, most times with help from me. She doesn't stand for long, and that is when I can see the muscle facilations. If she tries to rise without help, she ends up in the dog sitting position. That is why I tested for EHV-1. I have a closed herd of 4 and no horse has left the farm in a long time.

She eats and drinks enough to stay alive, but that is only due to my nursing her from the ground. She eats better while lying down.

Each week, we decide to proceed with euthanasia, but my vet or some other glimmer of hope puts the decision on hold.

I've read so very many articles on West Nile and EPM and most information is coming from the same sources. I can't find any West Nile case that has lasted as long as mine. That is probably because most people would have opted for euthanasia by now.

Probably I will allow her to cross rainbow bridge this week. I only wish I had a definite diagnosis.
Member:
Frances

Posted on Monday, Aug 14, 2006 - 7:43 am:

Marion, you poor thing - I have no advice to give, but just want to say how much I feel for you in this desperate situation. The lack of a diagnosis to work from must be driving you mad.

Hoping for the best for you,

Lynn
Moderator:
DrO

Posted on Monday, Aug 14, 2006 - 10:37 am:

Oh Marion, I was so hoping once the abscesses blew open that the pain would improve. Before giving up, the feet should have all horn undermined by infection pared away and carefully debrided and treated with mild antiseptics like povidone (Betadine) ointment. If this leaves the solar corium largely exposed the feet should be bandaged. Give this a few days before giving up, just in case it is pain from infection causing the horse to be unable to stand.
DrO
Member:
Vickiann

Posted on Monday, Aug 14, 2006 - 12:04 pm:

So sorry to hear of the struggles you are having, Marion. A friend of mine whose horse tested positive for West Nile had laminitis as a secondary factor (and later abscesses, I think). She was VERY sick, but over time she recovered completely and is doing very well now as a performance horse. I hope you may still have a good outcome. This sounds like a one-day-at-a-time scenario. It is too bad if no test was done for West Nile -- especially if you believed there were signs of neurological problems. You and this horse have certainly been through a great deal together and I hope you will have improvement and better answers soon.
Member:
Kamla

Posted on Monday, Aug 14, 2006 - 7:12 pm:

Marion, I have been watching this conversation but haven't entered it because it is too painful. My heart breaks for you. I have the orphan foal eating sand. I lost his mama to laminitis on July 18.

She foundered for unknown reasons on May 27, 10 days prior to foaling. The night of the 26th she was fine and on the morning of the 27 she was very slightly ouchy in her front feet. I immediately took her to the vet. Because of her advanced pregnancy we were not able to do much but take xrays, give bute and put her in the Reddin 18 degree shoes. Because I brought her so soon, she didn't have much of a pulse in her feet and the xray showed nothing. The vet felt we had caught it in time and she would be fine.

After foaling she appeared better for a few days. Then she began to progressively go downhill. We xrayed every 2 weeks and each time she was a few degrees worse with no signs of abcesses. She was very painful but stayed up and took excellent care of her foal. She was alert, hungry and interested in her surroundings, never failing to talk to me each time I came out to check on her.

Each day I would walk her the few painful feet to the walker and tie her so that her foal could play outside in the sun for a short time. When her foal was about a month old she began to spend more time down. But even then she still took excellent care of her baby. Getting up and down feeding him when he was hungry. Of course each time she got up and down was a struggle and the signs of her fight were beginning to show, bleeding elbows and hocks, misc. scratches and a huge hemotoma on her side.

Then the morning I was dreading finally arrived. I walked to the barn and was greeted by an almost hysterical foal. Evidently mama hadn't been getting up as often as he wanted. When I opened the door to the stall and walked in there was no welcoming nicker. She stayed down. When I went to her and she looked at me I knew what she was asking me to do. All the light was gone from her eyes. For the rest of the weekend I asked to get up and nurse her foal which with great effort and tremendous pain she did.

I took her to the vet and upon removal of the bandages and the special shoes we found that her poor abcessed feet had finally broken thru at the coronary band. It appeared as though she was loosing both her hooves.

At this point the vet gave her only a 20% chance of even being alive in a year much less having any quality of life. After much soul searching and agonizing I made the decision to have her put down.

So on July 18 my beautiful Feena went across the Rainbow Bridge. I had the vet block both of her front feet and took her home. I let her and her colt out to graze in the green grass in my backyard, something she had not been able to do in 7 weeks. The colt ran and played, nursed and napped as his mama looked on, just like mares and foals are supposed to do. When the vet arrived I put the foal in their stall and loaded the mare in the trailer to take her to her final destination. While loading she turned and called to her colt once and walked into the trailer. She never made another sound. It was almost like she was saying "I've got him to where you can handle it. You will have to take it from here".

Trust your heart and pray, you will make the right decision.
Member:
Paul303

Posted on Tuesday, Aug 15, 2006 - 1:17 am:

Aaahhhhhh.......the pain. I have no words.
New Member:
Martyr

Posted on Tuesday, Aug 15, 2006 - 8:05 am:

Dr. O, both hind hooves have been debrided several times and wrapped. The digital radiographs taken when she was lying down showed (according to my vet) some necrosis and infection at the tip of the coffin bone that would probably require surgical debridement. My vet's protocol was to hope we could fight this infection without surgery.

I sent the radiographs off to a noted equine podiatrist who in turn consulted with a highly respected and well known US vet. His opinion was that the 'halo' that was seen on the radiographs was caused by the abscess track, etc. etc. At this point the conversation was over my head. The podiatrist vet said that there cannot be an infection in the coffin bone, since it is hollow and has no marrow. I don't know if this is a semantics thing or not.

My position is that I would go ahead and opt for the surgical debridement if I thought that was her primary problem, but I still say she has some neurological disorder. By process of elimination, it has to be West Niles, EEE, or EPM and I highly doubt the later.

After reading articles on this site about Novartis' anti-serum for West Niles, I suggested to my vet that we try it. He is totally convinced this is all a foot problem, just as I am convinced it isn't. He chooses not to pursue testing, etc. for West Niles. If I keep pushing the issue, I fear I will lose my vet.

I would love to consult with a vet that has seen several horses with West Niles or other similar diseases. I highly doubt that there are many vets that have sat by a horse's side and watched the symptoms for hours like I have (I don't mean that in a nasty way).

Here are some neurological signs I have seen:

- Her tail does not swat flies. In fact, she
shows no annoyance when flies are all over her.

- Loud noises do not phase her.

- She eats hay when in the lateral position. She
prefers that to the sternum position. This
tells me it is difficult for her to sit up.

- She does some odd movements with her neck when
she is in the lateral position. She bites with
her teeth (not grinding) and rapidly moves her
tongue. She goes into what looks like sleep.
Other times she gets sort of stiff looking,
her respiration increases, and the hind end
muscle fascillations start. Often after this,
she will jerk herself her to the sternum
position, like waking from a bad dream.


- When her little 'seizures' (or whatever they
are) end and she sits up, she looks relatively
normal and the soft look in her eye is back.

- She shows evidence of wanting to rise, but
is too weak to do it. Clearly it is not her
feet preventing this. If I help her by
pulling a bit on the halter, she can get up,
but it sure isn't a pretty sight.

- Last Friday I had the vet block both hind
feet to the hilt in order to prove my theory.
She was already standing when he got here. I
would have preferred her to be down. The
blocks made her more comfortable, but I did
not see any miraculous improvement. Again,
my vet and I did not see the same thing.

Crazy as this all may seem, it is important for me to have a definite diagnosis before I put her down. I have put down 4 other horses in the last 15 years, so I am able to make the decision when warranted. In other words, I am not one to keep a horse in pain for selfish reasons nor do I live in denial about illness. If this mare didn't give me those moments where she looks hopeful, it would make things easier.

I tried to upload some photos here, but the size was too large. I don't have time to fiddle with that right now.

I hope all this detail is not boring anybody. If nothing else, it is serving as a record for me.
Member:
Vickiann

Posted on Tuesday, Aug 15, 2006 - 11:30 am:

Marion -- If you were to call the University of Florida Veterinary School (in Gainesville) and ask to speak to whoever has the most experience with West Nile, I am sure they would talk to you and give you some help with your questions. Some of what you are describing sounds like what I have heard of some West Nile cases, though I have not heard anything about seizures accompanying the illness. That can come with EEE or WEE, though, I believe, -- so maybe it could with West Nile too. Why a Vet. would refuse to do a simple test that you ask for is beyond me. If for no other reason,he should do it for your "peace of mind." Your horse is fortunate to have you as her owner.
Member:
Paul303

Posted on Tuesday, Aug 15, 2006 - 11:50 pm:

Please, Marion, don't think we're bored! Detailed information like your's is so important. Thank you for taking the time to put it all down for us.
Member:
mrose

Posted on Saturday, Mar 3, 2007 - 6:18 pm:

Marion, I was just reading through this and wondering what was the outcome; were you able to save your mare? Did you find she did have neurological problems as well as the problems with her feet?
Member:
martyr

Posted on Sunday, Mar 4, 2007 - 9:29 pm:

My mare Annie is alive and well, thanks to my vet, my wonderful farrier, and of course God. I will never know if what I thought were 'neurological' symptoms were caused by intense pain from severe founder or some other reason. Her high fever could have brought on the founder OR the infection of the coffin bone could have caused the high fever. The later is what my vet thought, but some other experts disagree.

Every 4 weeks for the last 6 months I have had my vet here to take digital radiographs and a specialist farrier (Dr. Esco Buff) setting heartbar shoes to precision. Both hind feet on my mare were sinkers. Radiographs were misleading because there was a false sole. What is interesting is that the sequestrum around the coffin bone reabsorbed after a couple of months. That hind (the left) will never be 100% normal because of that, but the other 3 hooves are on their way back to normal.

Annie will always be prone to attacks of laminitis. She is one of those 'insulin resistant' mares with the fatty crest and abnormal fat deposits. I am doing as much as I can with her diet, but it's a challenge.

I don't know how I made it through the tough times with this mare. It was heart wrenching for sure.
Member:
mrose

Posted on Monday, Mar 5, 2007 - 12:34 am:

Wow! for some reason when I was reading this post this morning the entire thing didn't come up. I've just re-read it all. I am so glad your mare (and you!) survived this! I am battling a severe laminitis episode with a cushiniod gelding right now. It has been on and off since end of November, so I have an inkling of what you went through. I just hope my boy's outcome is as good as your mare's. It is very frustrating, as you well know.
New Member:
elsa722

Posted on Monday, Mar 5, 2007 - 12:48 am:

Hi Marion- I've owned an Insulin Resistant/Cushing Pony and have had to put down a horse with founder so I know what you have gone through. Just wanted to make sure you know about a website that deals with this issue. It can be a bit boggling as it has tons of info but it was a life safer for me. It is a Yahoo group moderated by Dr. Kellon. https://pets.groups.yahoo.com/group/EquineCushings/
Moderator:
DrO

Posted on Monday, Mar 5, 2007 - 8:28 am:

Marion thank you for updating us and delighted to hear Annie is doing so well. What are the chances of getting the radiographic record of this case published here for all to see, it may help someone in the future when faced with a similar problem.
DrO
Member:
sonoita

Posted on Monday, Mar 5, 2007 - 1:38 pm:

Marion,
I too would love this info.So happy your mare is doing better.
Happy Trails
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