Laminitis! First time treating ....

[SCM1959]

Yesterday morning, my wonderful Rocky Road, 26 year old TWH, could hardly walk. The day before, he was fine.

The vet came out and diagnosed laminitis so I am doing the front feet icing as many times a day as I can.

A 3-gallon bucket worked well, but I could only do 1 foot at a time.

My instructor loaned me her Davis foot soaking books and wow oh wow, how much easier this is and I can do both feet at the same time.

My question though … it takes every bit of strength I have and a LOT of shoving at him and very firm speaking to get him to lift his left front. I suspect the right front is more painful as he lifts that one more readily.

I am already so sore and can “feel” my lower back, so I know I am overdoing it.

This is a horse who anticipates and lifts his feet in succession when I have a hoof pick in my hand or when the farrier comes, so I know it is because he is uncomfortable. But I do have to ice his feet.

I have a vague recollection of some place to pinch or push at or something on the lower leg to get a horse to lift his foot. Sort of like when a doctor uses his little hammer to test our reflexes.

Is there a place? Leaning on him and shoving at him to shift his feet and then trying to bend down fast to grab the boot to put it on is really hard. I do not have a helper.

If I could get him to lift his foot when I am already bent over, I would be able to get the hoof boot placed. I am speedy with the hoof boot and can get it under his foot lickety split.

Thank you!

SCM1959

[4LeafCloverFarm]

The cue to lift their foot is to squeeze right above the fetlock/ankle joint - even pressure of both sides (the tendons at the back of the cannon bone - not the front, just for clarity). Some people slide their fingers down from below the knee joint, down to the fetlock and then give a little squeeze.

As for that left front, maybe instead of trying to get him to flex that much to get a boot on, try one of those really low flexible rubber pans… walk him into it, stop, then dump in ice and cold water - then walk him out of it. Easier on you and the horse.

Sorry you are dealing with this. Know it can be scary your first time. Did the vet indicate if the laminitis was brought on by feed, weight and/or grass? Did you vet prescribe bute or another NSAID? The acute phase may be brief or linger, but the icing/cold hosing, bute, a deeply bedded stall, and some love, it will pass before you know it. Make sure to take care of yourself as well!

[SCM1959]

Thank you so much @4LeafCloverFarm

Duh on me that it did not occur to me to walk him into the rubber feed pan. I tried to use that last night and had the same trouble lifting his foot. Walking him into it sounds so smart.

So I think my plan for the next soaking will be hoof boot filled with ice and water on the really sore foot and walk him into the pan and then fill with ice and water for the other foot.

My vet gave Rocky 4 grams bute yesterday and I gave 3 grams this morning. Tomorrow 3 more and then Monday and Tuesday 2 and Wednesday 1.

He is coming back to x-ray Rocky’s feet on Tuesday. I am keeping my fingers crossed that I caught this early enough.

We have no idea how or why this happened. Rocky is in good weight … I can see a faint outline of his ribs. He is out 24/7 so he did not have a sudden change from stall/dry lot to lush grass. We have not had rain here for a while, so the grass is somewhat poor. It has been hot, but he has lived in SC his entire life, so he should be used to heat. There are no obvious signs of Cushings, he is in his summer coat now and he is not shedding at all.

SCM1959

[4LeafCloverFarm]

Laminitis sometimes is hard to pinpoint a cause when its not overtly apparent. but one thing is certain, once they’ve had one bought of it, they are much more likely to have another. So its prudent to evaluate everything - hay, grass, feed/grain, how long turn out is (and what time of day), etc.

My two that are prone to Laminitis must be managed differently now (after years of doing well on the same regiment). One is kept 24/7 in a mostly dirt paddock, while the other can be out on pasture for about 6 hours a day during daylight hours. Both are kept slightly underweight and fed low NSC feed and alfalfa pellets.

Also speak to your farrier once you have the x-rays done to discuss possible need to change his normal trim. May or may not be necessary, depending on whether there is rotation or not.

Wish you and Rocky well.

[walkinthewalk]

Fold up an old bath towel to stick under the worst hoof when someone has to work in the other one, then switch it to under the other hoof when working in the worst one:)

Cheap frozen peas duct taped to the hoof are a good way to ice the hooves without softening the souls from soaking them several times a day

1. TWH’s are thrifty horses, generally speaking; that puts them on the infamous “Predisposed List” for metabolic issues.

2. Good advice above - read and re-read:)

3. No more 24/7 pasture. He’s going to have be in limited turnout.

4. If at all possible, get his hay tested for NSC% (non-structural carbohydrate), and to see if it has mineral imbalances. High iron depletes copper:zinc whic these metabolic horses need.

5. No grains of any sort in the feed pan. I would also look for either a soy-free ration balancer or buy a condensed soy-free vit/min supplement and use Timothy pellets as the carrier.

6. Your farrier needs to confer with your vet — your horse’s hooves have now become special needs hooves – you are about to find out just how qualified your farrier is. Those without any training in rehabbing foundered hooves often do more harm than good regardless of how great they are with healthy hooves:)

6.1. Hopefully your vet does not have his head in the 80’s by recommending heart bar shoes. There are several brands of corrective shoes for foundered horses and also various models to address break over, heel height for tendon relief, etc.

6.2. VetTec also makes a pour-in packing that is some of the best stuff to come down the pike for sore hloves.

---

I speak from experience I’m afraid.

Of my three Walking Horses, two ended up with metabolic issues. One never foundered and was controlled easily by diet and a shorter pasture time.

The other one foundered so bad I thought I would lose him. His insulin numbers were more than three times higher than what is considered a high-normal number. Cornell University marveled that he was even alive. That was in 2012. He is doing pretty good today. His insulin is in remission he goes out to pasture without a muzzle but his hours are limited.

His hooves are a constant issue. My farrier is AFA certified and has specialized training to deal with foundered hooves. My horsewould not be doing as well as he is without her expertise. He wears the Avanti PLR Natural Balance shoes and VetTec’ EquiPak CS hoof packing. He was in wedges in the beginning but eventually moved out of them.

It is to your horse’s advantage for you to educate yourself as much as possible about the management his hooves will now need. Don’t let someone snowball you with misinformation. . If your vet is good with lameness issues then you’ve got a pretty good chance for great help. If your Ferrier has been trained in rehabbing foundered hooves then you should be able to breath easier.

Otherwise you need to be really well educated so you can recognize if your professional caregivers are shooting from the hip and end up doing more harm than good to your horse

[kiwihill3000]

I’m located in CT and there has been a huge scare about a weed in hay causing laminitis. A number of people I know in my area have had totally healthy horses come down with severe laminitis because of it. The hay was sourced locally and from Canada. Here’s the link: https://m.facebook.com/permalink.php?story_fbid=2692527397441749&id=295164377178075. I hope it works. It’s called Hoary Alyssum. Not sure if this would be a concern for your horse but worth mentioning I think!

[4LeafCloverFarm]

Good advice above from @walkinthewalk. Which reminds me - you might want your vet to test for IR if they haven’t already. While not all IR ponies/horses get laminitis, it can predispose them to it. Its a simple blood test.

Use this time while he is recuperating in a stall to research/plan. If you need to make adjustments to pasture or paddock to restrict grass, get that done. Order a grazing muzzle if redoing your paddock/pasture isn’t feasible right now. Typically, a recuperating horse just past the acute phase will need some turn-out (or vet may OK regular turnout), in a smaller paddock with no access or very little access to grass, until they are totally out of the woods.

What are you currently feeding him (besides hay)? Many senior feeds are low NSC - but not all of them. And “low NSC” on a label (or a claim to be low NSC) in one brand feed many actually be super high compared to another. Typically, anything lower than 11-12% is good (though many prefer under 10%). Alfalfa pellets/cubes/chopped are good choices, as alfalfa is typically low in NSC (though not all horses tolerate Alfalfa).

As you taper the bute per your vets recommendation, make note of any downward turn in Rocky’s lameness. He may need bute for more than just a few days to keep him comfortable. He may need 1gm in the AM and 1gm PM for a few days (I’ve had better luck splitting the dose than giving once a day - but others may feel differently) before getting none at all. But each horse is different in how quickly they rebound.

[SCM1959]

@4LeafCloverFarm I was just coming in to give a report and to ask more questions.

I do not have a barn, unfortunately. I have Rocky in a small pen made from round pen panels under some trees for shade. I bedded the pen with the pellets that expand when wet. I have two grazing muzzles and one is brand new.

I just came in from the morning soak. Rocky was lying down and it took him a while to get up and then he stood and rocked. I thought he might fall down. This really scared me as I had a bit too much from Dr. Google last night. Ugh.

What a great idea about the bath towel. Thank you, @walkinthewalk !

I tried the walking into the pan last night … it worked sort of well. This morning I used walking into the pan and the immediate lifting of the foot because “yikes! my foot is in a pan!” to grab his foot and put it into the boot.

I am very fortunate as our vet, if you could say he has a specialty, it is lameness issues. My farrier is also very good and I know he keeps up with certifications.

Rocky has been on Triple Crown Senior for years. I looked up the NSC last night and it is fairly low. We are lucky that we have an independent feed store here that stocks many kinds of feed. We also have Tractor Supply, but I find that they are always out of things.

I buy Standlee compressed bales of timothy. I have been giving him a small amount of alfalfa while soaking to entice him to be still.

I gave him his bute dose this morning but like your idea of splitting the dose. I will text my vet to see if that is okay to do.

I am going to get some chopped hay today that I can moisten for him. I don’t think he is drinking enough. I think I will hang a water bucket so he has another option besides the water trough.

Rocky had a stifle issue last year and had to be kept in this pen. Straight alfalfa seemed to make him jumpy. Standlee has a timothy/alfalfa bale plus an alfalfa/orchardgrass bale that may work better.

Thank you for your help!

SCM1959

[4LeafCloverFarm]

Sometimes we have to work with what we have, and make do. Since you don’t have a run-in shelter or barn, I would suggest doing one of the following to make him more comfortable.

• [B]Carport[/B] - do you have a carport? If you do, move your panels into the carport and make his pen there. Get several rubber mats to lay over your concrete/gravel, then deeply bed with regular shavings. You can use some 1X6 boards around the bottom to keep the shavings inside the pen.
• [B]Garage [/B]- or it you have a garage - ditto above (just make sure nothing is within reach of his nose)
• If neither of the above - Use Tarps to make a shelter. It will take several - a few to wrap around 2 or 3 sides of panels and a very large one to make a roof (bungee cords are perfect for securing them - but baling twine would also work). Use 2 steel pipes vertically on opposite sides of the pen, then a pipe overhead connected to those two. Then put the tarp over the overhead pipe - and voila! You have a tent. then mat the ground and bed deeply.

Another option would be to stall board him somewhere for a month. Either way, you need to get him on something nice and cushy to help relieve his hoof pain and encourage him to get off his feet.

Long term though, I’d be researching small shelters (like 10X12 or 12X12) - need not be a true horse run-in. Lots of different buildings can be modified for this purpose (especially if he’s of smaller stature). He’s of “that age” where having a shelter of some sort would really be beneficial to both of you.

[SCM1959]

@4LeafCloverFarm – his pen is bedded very deeply with the expanded pellet bedding. It is really, really soft. He is under a large stand of trees that give shade all day.

We do have a garage, however the idiot builder used the wrong type of finish on the cement and it is so slippery when it gets wet that we have to walk very carefully so we don’t slip. I am not sure how deeply I could bed an area in this garage that I would not be terrified that he would punch through the bedding and slip.

The other good thing about this pen is that it is inside our pony’s pasture, so that gives Rocky company. Dusty hangs out near the pen (mostly because he is majorly jealous of the timothy hay) and I know Rocky enjoys hanging out with his friend.

I am headed out for soak #3. Soak #2 was much better than the first one today. Obviously the bute had kicked in because he was walking much better. No rocking at all. I sent a text to my vet about splitting the bute dose so it isn’t completely worn off by morning. The other idea I have had is going out really early, say about 5:30 and giving him his bute but waiting to ask him to move around for foot soaking till about 6:30.

I have it on the “Honey Do List” to build a shelter in Rocky’s paddock. I had just told my husband that I really need one since Rocky is getting older. He is 15 hands 3.

SCM1959

[Scribbler]

I would also suggest going to Pete Ramey’s hoof rehab sites. He is the top barefoot trimmer, specializes in rehabbing founder now, and even if you choose to continue with shoes, he has some of the best general information on hoof balance. Also the ECIR group for discussing diet.

Laminits (the acute inflammation) and founder (long term changes in hoof structure resulting from laminitis) and metabolic issues are definitely areas of new and expanding information. Horses live longer, we want them to be active longer, people have higher investments emotionally and financially in horses, but also many pet horses are effectively obese (like many pet dogs and cats) which brings on metabolic issues and then laminitis . The solution is going to be individual to your horse, and involve medical treatment and diagnostics (rads of the hoof when the inflammation subsides), first aid (like icing), perhaps long term medication (if he has PPID/Cushings), changes to feed, exercise, turnout, grazing, as well as hoof trimming and shoeing and general care.

Knowledge about all this has really developed in the last 20 years, and not all vets and farriers will be uptodate on all of it.

The owner really has to be the one self-educated on all of this and be the advocate for the horse, and get the various specialists working together. It’s not something you can just hand over to your farrier or vet and hope for a good outcome.

[4LeafCloverFarm]

@SCM1959

@4LeafCloverFarm
We do have a garage, however the idiot builder used the wrong type of finish on the cement and it is so slippery when it gets wet that we have to walk very carefully so we don’t slip. I am not sure how deeply I could bed an area in this garage that I would not be terrified that he would punch through the bedding and slip.
SCM1959

Well, that is what the rubber mats are for - so they don’t slip on concrete or get bruises from gravel (and it also adds a layer of cushion too).

But its good he has a buddy that checks on him and keeps him company.

[tpup]

Get him some Soft Ride boots. They are life savers! We had to get our pony’s heels raised to stop the pulling/rotation on the coffin bone and they provided almost immediate relief. (we got the laminitis pads - blue/purple ones) They are expensive and worth every penny. My horse was turned out in a dry lot in them.

I would also do metabolic testing. My 7 yr old Shetland pony had NO signs of Cushing’s. Kept having bouts of laminitis, flares - we ran bloodwork and he has Cushing’s!! Put him on Prascend and he has not had any flares since.

Sorry you are going through this. It sucks :(!

[SCM1959]

We had a really wonderful day today. I was able to do 6 soaks. First thing this AM, he was quite sore, but he had been lying down. He got up very easily but then seemed shocked that his feet hurt so much. I gave him his 3 grams of bute and cleaned his pen and freshened his water and then led him to a flattish area to do the soak. At Soak #2 he was very bright and walked much better (this was about 2 hours after #1). All day, he walked better and better. Still obviously sore, but he moved around his pen a lot today, which I thought was good. Yesterday, he laid down twice and today he stayed standing and moved around a good bit.

I hung water buckets at different places and levels from the rails of the pen and made note of how full his trough was. He drank well today.

I am hoping for another good day tomorrow. The vet comes on Tuesday to do x-rays … fingers crossed. I will ask him about the soft ride boots. I already had the farrier scheduled to come on the 12th (one week from tomorrow). I did call and leave him a message to let him know we won’t be doing the usual shoeing for Rocky this time.

Thank you to everyone for all of the suggestions. COTH is just the best.

SCM1959

[Pico_Banana]

I unfortunately just went through this. My horse was treated at Tufts and they put her in SoftRides and used Jack’s Ice Boots on all four legs for the 72 hour ice protocol.

https://www.doversaddlery.com/jacks-ice-boots/p/X1-04584/?gclid=EAIaIQobChMI0eHQqPfu4wIVBJ-fCh0Llg-SEAQYASABEgL82vD_BwE

I had bought a pair of the ice boots before she even went to Tufts and they are actually really easy to use. You have to get your horse used to the sensation of pouring the ice in, but if you take it slow, it should go okay.

My only modification to the boots – which Tufts is now doing – was to put a breakaway piece in the straps that go over the back. I used landscaping “tape” (that stretchy stuff that you use to get shrubs to grow in a certain direction. Tufts used gauze bandages strips. Just tie a loop in the boot part and then clip the strap to the loop.

To keep the straps of the hind boots up, criss-cross them in the middle.

Best of luck to you.

[SCM1959]

So the vet came this afternoon and took x-rays of both front feet. Rocky was perfectly behaved. I am always so proud of how hard he tries to cooperate.

He’s going to develop the x-rays at home in the A/C. It is 90+ here today and so hot.

I am to trace Rocky’s feet to figure out the size for Soft Ride Boots. The farrier will pull shoes on Monday because Rocky wears nail-on shoes and nailing on new shoes would be too painful. The vet confirmed to me that our farrier is probably the best in our area to care for foundered feet. I am so lucky to have such good men to take care of my Rocky.

He says I don’t have to keep up the icing, but that it won’t hurt and probably helps his feet feel better. I will cut back to 4 times per day from 6. We now have a system going with the Davis boots. It’s not hard to lift the left front anymore, well, not as hard as it was. Quite obviously the right front is the worst. He agrees that I should split the Bute dose. One gram AM and the other PM.

The vet thinks Cushing’s. He said even though Rocky is not fat, he is slightly overweight due to being out of shape. We had such a wet spring and then high heat, so we haven’t been out riding much over the past few months. And, his sheath is swollen which he says sometime indicates Cushings. I didn’t know this! He is overdue for a cleaning (I usually do it while he is sedated for his dental work – not that he needs sedation for sheat cleaning, but the sedation seems to relax everything!). We missed the January dental work because of the Cub Scout Pinewood Derby that goes on all day. And now we missed the summer dental visit because it was just this past Saturday and Rocky was obviously too sick to go. So now I am way overdue with both teeth and sheath.

Everyone has been so nice and helpful. Thank you so much.

SCM1959

[SCM1959]

Checking back in to give an update.

The xrays showed very slight rotation. This is good … I was so afraid of the results! The farrier comes on tomorrow to do a special trim and then I will trace his feet to determine sizing for Soft Ride Boots.

Where is the best place to order the Soft Ride boots? I have been to the website, but am primarily interested in getting the boots here as quickly as possible. Wish they were on Amazon Prime, ha, ha.

My vet told me to be sure to get the orthotics for the boots. The website shows 8 different kinds of orthotics with 6 different thicknesses. The standard ones that come with the boots are a turquoise color. The other kinds are different colors. How do I know which orthotics to get? I have asked my vet and I have sent him the link to the orthotics choice page, but he has not given me any feedback.

I spoke with my farrier yesterday and he says the ones that come with the boots are usually fine. Does COTH agree?

And … just to add to all of this crazy, I went out Friday morning to clean Rocky’s pen, scrub water buckets, etc. to find his eye all swollen and half shut. So yes, he managed to scratch his eye and $200+ later for vet visit, exam and meds, I am treating his eye 4 times a day. Luckily his eye looked completely normal by the end of the day Friday, so I don’t think the scratch was too bad, but we will do the entire 10 days of treatment nonetheless.

The good news is that as of Friday afternoon, Rocky is easily and readily following me around his pen. He is walking very nicely now. I can still tell that his feet are not 100% but someone who does not know his way of moving may not even be able to tell anything. Hooray! I am feeling very optimistic for a good recovery now.

SCM1959

[4LeafCloverFarm]

Glad he’s more comfortable. Is the vet going to wait for fall to test for Cushings/PPID? Or did he already start him on the medication (Prascend)? Has the vet already tested for IR? Finding the cause (or at least narrowing it down) for the bought of laminitis is important so you can make whatever changes are needed in his daily routine. Because he is much more at risk of another bought of laminitis now.

[SCM1959]

@4LeafCloverFarm - the vet did say we would wait to test. When I asked how in the world this happened/came on so suddenly, he immediately said Cushings. I said “with no symptoms?” and that is when he said Rocky was slightly overweight/out of shape but the most obvious sign was a swollen sheath. The sheath swelling has lessened considerably over the last few days.

I believe we will start the Prascend very soon. Interestingly, I have a friend who lives about 2 hours from here who has her TWH gelding on Prascend already. He was showing subtle signs of Cushings, so it is more pro-active for him. She has kept him with the herd on grass, muzzling him for most of the time vs. keeping him in a dry lot all alone. Tornado is about the same age as Rocky, 20 years +.

I am particularly interested in what my farrier will have to say tomorrow. He is so knowledgeable and he is very good at explaining things.

I still don’t know if I should get the Soft Ride Boots only with the pads that come standard or should I get one of the 8 other kinds. And I don’t know how thick the pads should be. The farrier says in his opinion, the standard pads usually are fine, but until he examines Rocky’s feet, he won’t know for sure.

I guess the Soft Ride website is the best place to buy the pads?

SCM1959

[4LeafCloverFarm]

Can’t help with the boot questions. I’ve never used those boots.