Blood Work and XRays on foundered pony

[DiamondJubilee]

First of all I do want to say I’m working with my vet and farrier, but would love some others input and opinions if they have encountered anything similar to my situation with my 3 year old (will be 4 years old this April). I’m waiting to hear back from my vet about the bloodwork, as it just came in, so I know she will have some great ideas/input and will help me and my pony out for sure. I trust her 100%.

Back when this guy was a 2 year old, he had his Rhino/Flu only at the end of October (was not overweight and not on pasture) and he foundered the day after (now at the time I thought he pulled something in his shoulder in turnout, I did not think of founder until this spring when he had his shots again). He was sound 3 weeks later as I did show him at the Royal (a large indoor show in Toronto), but it was touch and go as I wasn’t sure what was wrong, thinking he just pulled a muscle as he was sore, but not THAT sore.

When he has all of his shots in May 2023, he then foundered the next day (he was also not overweight, not on grass and is not a huge eater - gets very little low NSC grain -all of my ponies do, just in case). I called the vet right away and asked if it could be possible he foundered from his shots, explained my thoughts (as then I recalled his soreness back in October and put 2 and 2 together). She said its for sure possible, to treat with flunixin, and once he’s sound, to work him (hard to do when he’s 3 as I just like to lightly ride for 20 mins maybe 2-3 times a week, but of course would do the best I can do). I did not have extra $ at the time to do xrays and bloodwork, but treated him like a foundered pony (soaked hay, no pasture, even less grain with less than 10% NSC- about 1 cup a day, added natural vitamin E, Madbarn W3 oil, and chromium) and spoke with my farrier who trimmed him the best he could without xrays.

He was fairly sound 6 weeks after and we put shoes and then pads on him, and have not had any issues since (*knock on wood). I finally had some extra $ and had some xrays (mid Dec) and bloodwork sent out. Xrays were instant and showed rotation. The xrays were also sent to my farrier and vet called him as well to make a plan for shoeing. He has decreased some of his heel (as per the vet) and added snow pads as well as some liquid padding (not sure what its called but its white and blue and he pours it in the foot, puts the pad on and has the pony put the foot down so it squishes out.
It then hardens up, but is still softish).

The pony is now boarded at a indoor for the winter where I ride him 4 x week for about 30-40 mins. He continues to be sound and is moving really well. Same grains and supplements daily.

Now when the vet pulled his blood (mid Dec 2023), she suspected IR but he didn’t really have any of the symptoms to me so I’m stumped. The vet sort of agreed with me but wanted to do the blood work anyway to rule things out. I did not fast him at all when she pulled blood - he was actually eating hay when I brought him in, so I’m not sure if that would skew any of the numbers (I will mention this to the vet when she calls me as well to discuss the bloodwork). He was then lightly sedated (with flunixin as she was a bit worried he may founder) and had his teeth done since I was about to take him to an indoor to continue his training (moved him Jan 2024).

When she pulled blood she asked me if he drank a lot of water/urinated a lot (he does not - inside he drinks about 5-10L water - hard to tell what he drinks outside but I have a 80L bucket and 4 ponies drink a total of about 40L/day, normal amount of pee in his stall for a 14h pony, which is very little- for sure less than my 14.2h guys), asked if he was tired or lethargic when I rode him (he’s quite peppy, not crazy forward, but not lazy or tired at all), she noticed he was not overweight or had any fat pockets on him. The only odd thing I did mention is that he has a bad case of scratches that I have been dealing with for the past year. She mentioned IR horses tend to have skin issues and with treatment, they clear up. But other than that, no other symptoms that I can think of.

If you have read my long saga, I appreciate it! I will attach his blookwork, xrays and current pics of him so you can see his weight (pics from mid Nov and then under saddle last week).

Going forward his shots will be intranasal, with flunixin started 2 days before his vaccines and up until 1 day afterwards (as per the vet).

[Untitled]_2024011613104793.pdf (201.6 KB)

[JB]

@DiamondJubilee

he foundered the day after

@DiamondJubilee

foundered the next day

Unless there’s a catstrophic, acute bout of laminitis that simultaneously causes founder, he became acutely laminitic, which may then lead to founder. Becoming sound 3 weeks later makes things confusing

Founder would have shown externally in the feet from Oct '22 to May '23

@DiamondJubilee

The vet sort of agreed with me but wanted to do the blood work anyway to rule things out. I did not fast him at all when she pulled blood - he was actually eating hay when I brought him in, so I’m not sure if that would skew any of the numbers

“fasting” for EMS testing should mean he’s eating normal forage, just no concentrate meal

@DiamondJubilee

Going forward his shots will be intranasal,

I’m not aware of IN vaccines other than strangles - ?

When was the confo shot taken?

The xrays certainly show a chronically foundered feet, and I’m really curious how your farrier didn’t see this long before Dec 15? Where there any xrays done before then? I think the answer is no, just checking. Your farrier REALLY should have seen this founder long before December, they are so classic in presentation

It IS really strange that such a young horse, in great outward physical appearance, is soooo sensitive to vaccines.

I would definitely NOT give all vaccines at once from here out. I’d do rabies first (when it’s that time of year), then EEE (because it’s SO deadly), and then space the rest out as much as possible, 2-3 weeks between. Most vets would be willing to leave you with the vaccine, telling you how to store it until needed, so you don’t have to pay for 3-4 farm calls.

[DiamondJubilee]

So he would have had his small grain meal in the morning, and the vet pulled blood around 1pm, so it should have been fairly accurate then (he had his grain 8 hrs beforehand) and I didn’t have to worry about “fasting”. Thank you for letting me know!

He was completely sound 3 weeks after his Rhino/Flu shot, as I showed him in hand with 0 painkillers, so perhaps a bout of laminitis then? Could he recover that quickly?

There were some hoof rings for sure from late October 2022, but my farrier didn’t say anything to me, nor did I mention it to him really. I didn’t think much of it, as it was subtle, but it was there.

From May 2023, my farrier was trimming him like he had laminitis, as in he told me he was not trimming off too much toe, but I’m sure he was also doing other things, I just never asked. He was sore, the farrier did notice he had a digital pulse in May and did ask me then to get xrays, but with the surgery of my yearling and dog at that time, I had no extra $ to do his xrays. So I did save up some $ and did his bloodwork, teeth and Xrays mid Dec 2023 and sent the xrays right on to my farrier since he was coming out to retrim/shoe him a week later. My vet also called him on the phone to discuss a plan. My farrier is also able to continue to trim him at the new farm which is just 10 mins down the road from my farm.

My vet told me they have a rhino/flu intranasal that they could use for him. As for the other shots, I will do them one at a time, spread out (I did a 4 way in May, will not do that again).

The confo shot was taken Mid November 2023, so just a few months ago.

He has been sound since the end of July 2023. His right front foot now really shows a dish in it. Even back in November 2023, it was not that noticeable - he just had some rings/lines. But it has really dished out the past 2 months or so.

I’m expecting my vet to call me in the next day or so to go over the bloodwork and see if he needs any meds to help prevent any flare ups. So far he is doing well at the new farm, though he is on different hay. Same grain and supplements.

[JB]

@DiamondJubilee

He was completely sound 3 weeks after his Rhino/Flu shot, as I showed him in hand with 0 painkillers, so perhaps a bout of laminitis then? Could he recover that quickly?

Yes, laminitis can go as quickly as it came, depending on the cause. Much more likely to be short-lived when it’s from a vaccine, than if it’s because he’s been on and still on grass

@DiamondJubilee

There were some hoof rings for sure from late October 2022, but my farrier didn’t say anything to me, nor did I mention it to him really. I didn’t think much of it, as it was subtle, but it was there.

The rings at that point, shortly after the first vaccine incident, were from the incident, and at that point wouldn’t necessarily point to founder, it was too soon

@DiamondJubilee

From May 2023, my farrier was trimming him like he had laminitis, as in he told me he was not trimming off too much toe, but I’m sure he was also doing other things, I just never asked. He was sore, the farrier did notice he had a digital pulse in May and did ask me then to get xrays, but with the surgery of my yearling and dog at that time, I had no extra $ to do his xrays. So I did save up some $ and did his bloodwork, teeth and Xrays mid Dec 2023 and sent the xrays right on to my farrier since he was coming out to retrim/shoe him a week later. My vet also called him on the phone to discuss a plan. My farrier is also able to continue to trim him at the new farm which is just 10 mins down the road from my farm.

I guess my issue is that it didn’t take just a few months for the feet to look this obviously foundered, so I’m really not sure how the farrier didn’t see this and trim more appropriately

Not trimming “too much toe” is the opposite of what to do in feet like this, where the toe lamina are continuing to stretch. The heels got progressively taller, as that’s what happens with founder - heels grow faster than toes. It all leads to the classis tall heeled, ski-tipped toes look.

The LF is less foundered-looking, largely because the degree of founder is much less than the RF, but holy cow there’s a LOT of excess vertical foot there. There’s also a ton of excess vertical foot in the RF.

@DiamondJubilee

My vet told me they have a rhino/flu intranasal that they could use for him.

oh, right, I forgot that was available. Definitely worth trying if you really need that protection given a show schedule

You may need a new farrier, if this one can’t start trimming properly off the xrays. If he can, great. But it sounds like you might also need to be more vocal about changes you see if things like this happen again.

It’s still really weird that such a young horse would react so aggressively from a vaccine, but not all that surprising it’s the f/r vaccine. That, and rabies, seem to be the 2 that trigger the most aggressive reactions.

I don’t know the deal with adjuvants and IN vaccines, so talk to your vet. If they’re used similarly, then I would use a different manufacturer of that vaccine.

[candyappy]

I have no experience / insight in your issue but just wanted to say how beautiful he is and hopefully you can find a way to manage the vaccines.

[DiamondJubilee]

Thank you @JB, lots to think on. Still waiting for the vet and I’m sure she will call me today to make up a plan. The vet clinic said the vet has the bloodwork now (yesterday) and that she will go over it and call me shortly. Do you see anything alarming with the bloodwork?

Not that it matters too much, but he was due for a trim when the xrays were taken (he was 6 weeks at the time). The vet said she may have to pull shoes to get good xrays so I was timing it with when my farrier was coming (he was coming the next day) so he wouldn’t be sore for long in case shoes had to be removed (they didn’t of course though). The vet did mention that she thought the farrier was doing a good job without ever seeing xrays (she mentioned that she was happy he had some toe I believe, but he had far too much heel) and that she would call him to make a plan. My farrier did take pictures of his feet before he trimmed him (right after he spoke to the vet), took some measurements and then retrimmed him according to what the vet wanted. He has only be trimmed once since these were taken and he gets done again this Saturday.

And thank you @candyappy

[JB]

@DiamondJubilee

Do you see anything alarming with the bloodwork?

Did I miss the bloodwork? I went back to your OP where you said it would be attached, but I don’t see it

@DiamondJubilee

The vet did mention that she thought the farrier was doing a good job without ever seeing xrays

Depending on when in the cycle, and when relative to these xrays, she saw his feet, I can’t imagine being happy, the RF especially. Both feet are just TALL. At least she did recognize too much heel

If you can get a good ground-level lateral view of each foot after the trim, that would be the most helpful
Good Hoof Photos - How to take Good Hoof Photos

[DiamondJubilee]

I was able to click on the link that says “untitled…:” just below the last xray photo and the bloodwork file opened for me. Let me know if it works!

The vet did get back to me in an email and says he has Non Obese Equine Metabolic Syndrome and she wants him on Metformin to help get his insulin levels down. I asked a few questions as I thought if his insulin is high, so would his glucose levels, but those were normal. It looks to me like his thyroxine levels are low as well.

She just mentioned his insulin and leptin levels are high, even with his no grass, low NSC grain (as well as I give him under the recommended amount of grain), so suggests to start with metformin and then retest his blood in a month and go from there.

My farrier comes out on saturday to retrim and I’ll take some photos on Sunday.

[JB]

ohhhh, I missed that, thanks!

So, yeah, 92 for insulin is quite EMS/IR

Glucose being normal with insulin being high, means the IR is being “compensated”, which is far better than also high glucose and uncompensated IR

Review: Equine metabolic syndrome

T4 is indeed low, which isn’t uncommon in IR horses and contributes to making them overweight, but he’s got age working for him for now. Do you know his breeding? TBs tend to be hard(er) keepers while IR, opposite of what usually happens.

Leptin is a bit high at 12 (I think you want < 10). High leptin contributes to that insatiable appetite

[DiamondJubilee]

He is family bred so has a Welsh Sec B dam and his sire is a British Riding Pony (so BRP is TB/Welsh/Arab in the background). So risk for EMS is there for sure (those darn welsh ponies!!).

The funny thing is he does not care about food. He actually doesn’t even eat one full flake of hay through the night, where my other hoover ponies that are not EMS can easily eat 2 or more flakes (if I let them). Outside with free choice hay he picks at it and then walks away to snooze after a few hours. And then just goes back and forth all day.

I do work him on the flat/poles 4 x week for about 30-40 mins and he is moving well and is comfortable for sure, so thats good news at least. He has lots of energy throughout the ride and does not peter out or tire. I know once sound, exercise is good for insulin levels and keeps the blood flowing to the hooves.