NQR horse - suspensory, lami, cushings, IR

[jsthain]

Hello!

I am writing this kind of at my wits end trying to figure out how to keep my horse sound. For background info he is a 2008 appendix gelding, used for eventing (training lvl) most his life, I’ve owned him almost 5 years. In that time he’s been a super easy horse to have. June '24 I noticed a general crankiness under saddle and unwilling to move forward so had vet out and ultrasound showed bilateral proximal suspensory desmitis, mild in left hind, moderate in right hind. Off any work but kept on normal 24/7 turnout for about 4 months until scanned clear and ready to return to work. Working with a PT for his rehab along with vet.

Then, around thanksgiving, he came up footsore in both front feet. Vet thinks lowgrade lami and xrays showed 5mm of sole. Yikes. Put pads and hind shoes on which helped for maybe a month or two but he’s just not quite right still. I’ve never been happy with his feet, he’s got quite small and narrow feet, always walking on his toes, and a very compacted heel.

And because he’s a horse and for some reason wants to check off all the boxes at the vets, was diagnosed with both cushings and IR this past month. Started him on pergolide a few weeks ago.

Anyways, I just feel like he’s not quite right even after everything we’ve done. I have a feeling that metal shoes are not helpful, but I don’t think my farrier will be supportive of trying the barefoot/glueon route. Where he lives is mud up to his ankles much of the year which is not helping his feet, but I can’t move him anywhere dry. I’m just at my wits end of almost a year of trying to get him ‘right’ but I don’t know where to go from now.

If anyone has experienced this before or has any advice it would be much appreciated!

[beowulf]

What do his feet look like?

You sound very diligent. With the B-PSD in the rear view I’d be suspecting hoof balance is playing a role in this. In my experience B-PSD has a farriery component, usually with NPA behind contributing to stress on the suspensories. A month won’t be enough to grow decent sole depth, but you’re on the right track. I have one that lives in rim pads (not full pads) for a very similar reason.

Now with the Cushings/IR, you may have multiple factors working against you since my experience has been once they’re clinical for this disease they tend to grow poorer quality hoof at a slower pace. In your position I would be going over all four feet with a fine comb. Some people supplement isoxsuprine or Farrier’s Formula to stimulate hoof growth, might be worth looking into but not mandatory.

May be the contracted heel is a symptom versus a cause, of long and/or upright toes and an unbalanced trim.

Since he is late teens, it may also be time that regular maintenance enters his life. Around that age, with that level of work, they can benefit from injections in the hock and/or stifle - or sometimes lower limb depending on their injury history.

Got photos of all four feet?

I would not fret about the mud too much unless your vet is concerned about it. My experience with horse keeping in the NE is much the same and people tend to worry about it more than it actually harms the horses. As long as they have some spots free of urine or manure, and can move around, it is better for their body overall to be in a muddy paddock 24/7 than in a stall. This time of the year high and dry ground is rare in my area.

[NaturallyHappy]

@jsthain

came up footsore in both front feet. Vet thinks lowgrade lami and xrays showed 5mm of sole. Yikes

Does this mean he’s laminitic?? He’s IR, so check his diet to be sure sugar/starch is in the correct range for these horses. Is your vet actively treating him for laminitis?

[ndirish07]

Agree with checking the feet balance. My guy separately did both hind suspensories. With the second one I feel like I got lucky in that the horse was in FL for training and was using a different farrier who opened my eyes to issues and imbalances that probably caused or significantly contributed to his injuries. I switched to that farrier and my horse is going better than before either injury (I also medicated hocks and SI last spring and keep him on a regime for hock injections going forward even if he’s not acting like he needs it with his history).

Also, I learned with my other PPID horse this year that when he did have a massive months long abscess the PPID didn’t help him-- he was slower to heal. I wouldn’t get too worked up just yet and give the pergolide time to work. And possibly consider a round of adequan or similar to target overall inflammation. I did that on his abscess because we thought he might need his coffin joint injected but with PPID he needed a non-steroid, but can have adequan.

[cayuse]

I’d look a little closer his diet especially if vet suspects Lami. He may need a diet overhaul to something low NSC. Also, Cushing’s can have an effect on tendons and ligaments IIRC. I had an older pony with Cushing’s years ago and he developed some tendon issues behind, vet said it was probably from, or exacerbated by, his Cushing’s.

[OverandOnward]

@jsthain

Off any work but kept on normal 24/7 turnout for about 4 months until scanned clear and ready to return to work. Working with a PT for his rehab along with vet.

What does his work schedule – if any – look like as of now? How is he responding to it? How are you responding to his response to it?

[OverandOnward]

OP, my question is if you are trying to assess how much work he can support with/without maintenance, vs retirement for soundness reasons.

Perhaps the real assessment is the big picture with this horse, because:

• Having one or two ongoing conditions to maintain and monitor is one thing.

• A horse starting to crumble in multiple areas of health, always another thing every few weeks, is something else. This is a horse with an increasingly lower overall health status.

There comes a point where it isn’t any one thing, it is all of the things.

There is a sort of rule of thumb in human caregiving for someone with a growing number of health conditions. The length of time between each new onset is significant to evaluating the overall status of the patient. Is it: Years? Months? Weeks? Days? from one new diagnosis to the next new diagnosis.

Large or small issues. A series of small issues can be a way-pointer just as much as large issues.

That’s how fast they are going downhill. That points the way to the general life status, prognosis, and approach for the patient. Not just condition by condition. I hope that makes sense.

[FjordBCRF]

@NaturallyHappy

Does this mean he’s laminitic?? He’s IR, so check his diet to be sure sugar/starch is in the correct range for these horses. Is your vet actively treating him for laminitis?

A lot of good hoof questions asked so far…what is his diet? How long does he get turnout and on grass or drylot?

@OverandOnward

There comes a point where it isn’t any one thing, it is all of the things.

Very good comments from O&O, particularly the one I quoted.

[jsthain]

His feet aren’t great, we actually just got xrays of his fronts today. His soles have grown back surprisingly quickly from November and his angles are OK, he is also at the end of his cycle. Maybe some slight rotation in the LF but hard to tell.

We think the last thing to the puzzle piece is that under the pads he’s got bad central sulcus thrush. So we’re pulling the pads and treating that and then seeing. But now I’m worried his soles are going to get thin again with no pads. He’s actually quite sound in the sand arena, but very ouchy over anything harder.

[jsthain]

No rotation, just suspected inflamation in his hoof capsule due to thin soles and frozen ground.

He’s getting a vitamin/mineral supplement (omneity) plus free choice grass hay (in a net) that’s usually lower quality. No grass and I’ve cut back on treats, so I’m not sure if there’s really anything else to do diet-wise. He’s not fat, just has some rib cover that he usually will lose by spring.

[jsthain]

Currently 3 days of 20 min walk, 3x3min trot each way, + cool down walking. He also gets lunged at the walk with 30 sec trot with the equiband system on. Plus some carrot stretches and core exercises.

He is much happier in work, and is sound in the sand arena, just everywhere else he’s footsore.

I’d say the suspensories are not bothering him anymore (fingers crossed) it’s maybe the feet? or being out of shape? But also hard for me to tell as I’m away at school and don’t get to see him often so I miss little things

[jsthain]

He lives out in about a half acre drylot with 5 other geldings, so it’s a huge mud pit always. He gets free choice grass hay in a net and then Madbarn’s omneity plus a cup of purina outlast. They go out on grass overnight every so often in the summer, but for that he will either stay behind or get a grazing muzzle.

[GraceLikeRain]

Is the hay tested? Sometimes people will think about hay in terms of rich/poor quality which is more based on appearance or protein level rather than the NSC.

If he’s in chronic mud with compromised frogs he’s not going to get why is needed to stimulate sole growth.

[jsthain]

I board and the hay changes enough so that hay testing is not feasible. I also don’t have any other options to move him to, we’re working on the mud, but it’s almost impossible here to have anywhere dry.

[dog_amp_horsemom]

regarding the hind end suspensory - did you turn out for treatment? My horse has a hind end suspensory and I have elected to just turnout as he does not run, I keep it wrapped, he comes in at night, in morning I give him a cc of Ace and turn out with hay and he seems quite content. He isn’t really lame with it. Did you do any treatment? cold hose, supplements etc? Did he come sound on that leg? I read that hind end suspensory is not good. He was diagnosed with ultrasound. thanks.

[jsthain]

We caught it very early on, he had mild thickening in both hind suspensories, no actual tears. I iced his legs about once a day for the first two or so months, but besides that no other therapies. He was also not lame on them, just starting to be not right and refusing jumps.

We elected to keep him living out as that is what he is used to and he doesn’t really get above a trot ever. Of course it depends on the horse, but keeping him out was great for maintaining his topline and basic fitness level. It took a good 4/5 months for them to come back to normal, but we’re 9 months out and starting to canter under saddle after a long rehab process and fingers crossed he’s better than ever.

I would recommend a cushing’s test, especially if your horse is older. Mine had no symptoms, but it makes them more susceptible to soft tissue injuries so talk to your vet about that as well.

[dog_amp_horsemom]

Thanks for the info. He is ten. so probably not cushings. Mine is also not lame, it was a coincidence that I was taking him in for something else and the vet saw a slight difference. I’m hosing it, keeping it wrapped - using a topical pain relief on that area, and red light therapy., he is turned out during the day and in at night as usual. He did have a ‘bubble’ like swelling in that area and that is gone. Good Luck with Yours and thanks again for the info

[dog_amp_horsemom]

just read your post about foot sore, not sure what you are dealing with but I did have a foot sore horse years ago and it was the sole. I bought Durasole per people on this very forum and it worked! I love that stuff.

[fivestrideline]

@dog_amp_horsemom

He is ten. so probably not cushings.

Cushings is not an “old horse” disease - it’s just that they tend to get severely symptomatic later in life. By the time the horse is showing classic Cushings symptoms, he’s had the disease for years. Catching it early and managing it from the start can make a HUGE difference in QOL and long term usability.

I’d run the test just to be safe. IIWM.

[NaturallyHappy]

To your point, I’ve had more than one vet tell me clinical signs often show up before blood levels catch up.