It is my understanding the wiser thing to do is wrap legs to keep them warm. It is also my understanding soaking is not always a good thing as it allows/encourages the sole to soften which make make the possibility of rotation worse. IR horses w laminitis seem very individual in nature and what works for one, doesn’t for others. OP, my heart goes out to you. We recovered a pretty severe case and my fingers are crossed for you.
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I now use Back on Track quick wraps during cold snaps. Not sure if it helps but I don’t think it can hurt. I’ve heard “winter laminitis” can be compared to Raynaud’s disease in humans, which is where blood flow is decreased to fingers, toes, etc. This happens due to spasms of blood vessels in those areas. The spasms happen in response to cold, stress, or emotional upset. My mom has this in her toes, and I know that she gets the best relief from keeping her entire foot and leg warm which I why I turned to the leg wraps. With this in mind, I would not be icing the feet in cold weather (especially where you’re dealing with metabolic-induced laminitis as it doesn’t help in that case).
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My pony got a bit sore when the cold temps hit. I upped his blanket a level and booted his legs, still iced his feet with packs of peas as they were warm but no pulse. Since blanket and boots, no issues. He is Cushings and IR and had a bout this fall with his levels. Was fine in July, showing signs in August but blood test came back fine as per vet, in Sept blood test levels were off the chart high. Put him on meds and took about 6 weeks to be super comfortable without boots. He’s back in super light work, ride him for 15 min to check the mail.
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What medications did you put your guy on?
He’s on Prascend and the diet suggested by the ECIR group. He was on ace/bute combo plus ulcer meds until he pulse/heat went away.
Thank god he was at home so I could monitor closely.
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General comment.
Laminitis is the acute inflammation. Founder is the structural changes resulting from laminitis. The acute inflammatory phase will recede when the causes are addressed. But a horse with founder will stay tender footed long term after the laminitis has receded, unless you can get the feet to structurally change through appropriate trimming.
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I’ve been doing more research and joined the ECIR PPID/ IR group. The info on there is definitely different than what is easily found on the internet. For future people who stumble across this thread with a similar issue, this is the gist of the information:
Endocrine/ metabolic laminitis is not an inflammatory disorder, which is why NSAIDs seem to have minimal effect for helping with pain (and is probably why I haven’t seen a difference in my pony’s pain level). It seems like vets still readily encourage the use of NSAIDs with any form of laminitis though.
Icing is also not advised in these types of laminitic episodes because it isn’t caused by inflammation.
It mostly seems to be connected to vascular and nerve problems (think nerve/ feet neuropathy in diabetic people). Because of this, icing just slows blood perfusion and doesn’t actually help. The better option is to warm the legs (as was already mentioned here) by wrapping or using lined shipping boots. The use of the herb “Jiaogulan” has also been shown to be helpful in improving circulation and thus decreasing pain (but this herb can’t be used with NSAIDs as the drug blocks the effectiveness of the herb).
Metformin is preferred over the use of thyroid medications because it is faster acting in lowering insulin levels and getting the cause of the laminitis under control. Unfortunately my vet’s office was closed yesterday, so I’m going to call them this morning to ask about getting a prescription for Metformin for my horse.
Acetaminophen hasn’t been shown to be overly effective for use in laminitis episodes either. My pony actually developed a bit of diarrhea yesterday (which I suspect was caused by the acetaminophen), and since I haven’t noticed any positive difference since starting it, I didn’t give her the evening dose or this morning’s dose. The diarrhea is now gone and, if anything, pony actually seems a bit more comfortable this morning.
I’m going to see about getting her starting on Jiaogulan and Metformin today (this combination apparently provides quite a bit of relief in ~3 days for metabolic laminitis), so we’ll see how that goes.
I’m a bit miffed at my vet for not offering the correct info in the first place, but it seems like in most of the information I’ve found from other people on the internet, their vets also started their horses on a thyroid medication and encouraged icing. I guess just because they’re a vet it doesn’t mean they’re knowledgable about every area of care…
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Or it could be that until the source/cause of the laminitis is pinpointed, those tried and true methods are not going to harm the IR horse, can help the non-IR laminitis cases, until the vet/owner can change the treatment to non-inflammatory treatments. Vets are not omniscient.
Good for you for doing research- - but be careful of information on the internet, even if it is from a solid group like the ECIR one. I did research there as well and found some quite contradictory advice.
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Yes, and I can’t feel too annoyed at the vet as I do also work in healthcare and there is just so much information to know that it’s impossible to be knowledgeable about every area.
I’m mostly upset that the vet didn’t prescribe Metformin or another similar drug right away. I thought it was odd to prescribe a thyroid med for an issue with insulin, and when I asked the vet about it they basically agreed and said that it would take a few weeks to make a difference. Which made me worry because then the cause of the laminitis wouldn’t be fixed for a very long time which would just give an opportunity for the rotation to get worse and make the prognosis less favourable…
I’m actually still a university student, so I have access to scientific journals and the research in those does support the info given by the ECIR group.
Metformin can cause horrible, painful blistering and peeling of the lips… it’s been prescribed for a couple of horses I’ve cared for. There does seem to be one source that Metformin came from that did not cause blistering but I don’t remember the manufacturer. You might ask about that…then you have a whole’ other set of problems.
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Ditto!!!
Pony seems about the same today as she did in the beginning. She did perk up that one day where she seemed a bit better and was able to follow me about the stall, but now she just stands in a corner shifting her weight. The boots still haven’t arrived yet either.
I called the vet yesterday to ask to discuss other pain management options and about the possibility of adding in Metformin, but I never got a call back despite asking the receptionist a couple of times for one. Hopefully I hear from them today, otherwise I’m just going to get a different vet.
It’s been exactly a week since this started and, as of this morning, pony seems the same as she did a week ago. Shouldn’t there have been some difference at this point if the current treatment was doing something?
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It took my horse 14 days before he quit rocking and grinding his teeth.
I had an appointment to put him to sleep on the 15th day. He was in so much pain, not responding to pain meds (which I now know why) and drenched in sweat in his winter coat- it was awful!
The night before the appointment, he finally quit rocking and perked his ears up.
Vet came and took xrays instead.
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I know this is hard, but it really does take time-- it is incredibly painful and pain medications really don’t help much. I am so sorry your pony is suffering but you are doing all the right things. Eating, drinking, pooping is good. Rocking, sweating, not eating and drinking, lying down all the time is bad. Are you using ‘homemade’ boots? Foam and duct tape? I bit the bullet and paid to overnight my SoftRide boots and did not regret that cost one bit, but the foam/tape ones did help immensely in the interim. Hugs, Gywneth! We get it.
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I have been using the foam and duct tape. The Easyboots just arrived and are on her now, so hopefully those provide some comfort. I did order them overnight shipping, but they were ordered on the 23rd and I guess with Christmas they just got delayed.
I finally got ahold of the vet and they thought Metformin would be a good idea at this point. She did confirm that the rotation/ pain would just continue to get worse until the insulin levels are under control. She didn’t want to prescribe a different pain medication, but said I could try switching to bute instead of the Previcox…
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I’m not sure if it applies to laminitis, but my vet feels Bute is a superior choice for immediate pain relief
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New bolton sold me some comfort mats too that have some give but I don’t know where they are sourced.
It doesn’t apply to metabolic laminitis. There is no pain relief for it. I mean, I hate to keep pointing it out, but there is no NSAID that helps the pain. There is no metabolic pathway for it to help. Please, quit suggesting changing pain meds.
ETA: My horse got what felt like gallons of Bute. It did absolutely nothing for him. It actually made me feel better about PTS because he wasn’t responding to pain meds. My vet never explained that he wouldn’t actually experience relief from all the drugs, even though he charged me for them all. Then I found the ECIR group and, after He saved himself, by eventually responding to the emergency diet, I learned. A LOT.
Dr. Kellon has devoted her life to studying this disease, and has created a tremendous data base and learning forum for all our horses.
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I didn’t suggest it. OP says her vet said she could try Bute instead of Equioxx and I replied that my vet in general believes that Bute offers a bit more immediate relief
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Hopefully the boots will help her feel better. I think 1 week would be the shortest amount of time you should expect to see improvement. It might take more like 2 or 3 weeks. As long as she’s eating and drinking and willing to be on her feet, those are good signs.
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