Steroid-induced laminitis

[Lindsay_Berreth]

Hi all. I’m dealing with an almost unbelieveable issue with my new OTTB gelding. He’s 7, and I just got him 8 weeks ago after losing my heart horse to EPM and subsequent supporting limb founder. It was months of heartbreak and pain, and I came across this sweet guy to start as my next project.

All has been well until last Friday when he came in with a swollen hock due to a tiny puncture. The next day, after cold hosing and buting, he got cellulitis, so I called the vet out, and she treated him with a shot of Exceed, banamine, naquasone and something with a little dex in it.

The swelling started going down over the weekend, but on Monday morning he was foundering severely on both front feet out of nowhere. He’s healthy, a bit on the thin side since we’re trying to put weight on him and only 7 years old, so he has no predisposing factors. I know that he’s a lightweight with Ace, but that’s the only thing I’ve ever given him to help with nerves with the farrier. We’re still new to each other, so when the vet who treated his hock asked me routinely if he was prone to founder, I said, “I have no idea, but he’s a lightweight with a sedative.”

We’re getting X-rays on Friday to see what we’re dealing with, but for now I’m icing as much as I can and he’s on banamine and Pentoxifylline. I’ve consulted with a couple of other vets over the phone, and they agreed the treatment for the puncture wound and the doses of meds were appropriate.

I’m not looking for medical advice, as I’ve been through founder with my heart horse and my mom’s trail horse who was overweight and susceptible to it due to his breed, but I guess I’m just wondering if there’s anyone out there who’s had this happen to a perfectly healthy horse? I guess he’s just sensitive to steroids. It’s the only thing I can think of that triggered it. He was on small paddock turnout over the weekend for the hock, and yeah, maybe it was stressful for him to disrupt his routine, but as an OTTB who raced until he was 6, I’m certain he’s been through more stress than that, so it doesn’t seem like that itself would trigger founder.

I’ve heard that steroid-induced founder does have a more favorable outcome in general, so I have hope, but this is so disappointing and emotional for me and so unfair for him.

[ChocoMare]

As a trimmer, I’ve seen several of my clients’ horses that had mild to mid-range laminitis from steroids… from significant hoof-wall separation to just external rings or vertical surface cracks running the full height of the hoof.

Alas, as the trimmer, I don’t see it until the damage is done. If the client wasn’t aware of the connection, I point it out and let them know: unless it’s truly a MAJOR thing, no more steroids. And if truly needed, get those legs into tubs of ice water.

Hate it that it can only be discovered/found the hard way - sigh

Jingles for a full recovery for your boy!!!

[Lindsay_Berreth]

Thank you! I’ve been icing as much as possible over the last couple of days and will continue until the vet comes on Friday.

[NaturallyHappy]

I’m so sorry. We had that happen once from Dexamethazone. That horse recovered well.

[Calvincrowe]

I have heard of laminitis caused by joint injections, but not from steroids. Is your horse in Soft Ride, or similar, boots at this point, too? They were a game changer for my IR horse who just went through a moderate laminitis episode. I also put him in our sand rolling pit so he could self-adjust his footing, and lie down comfortably as needed. Good luck, keep us posted.

[Marla_100]

Yes, stress can be a precipitating factor in laminitis- look up cortisol levels during stress-
The stress then the meds probably put his system over the edge.
If your new boy is the sensitive, nervous type you may want to keep this in mind in the future.
Sadly, I learned the hard way which is why I spent too much time studying cortisol and it’s effect in horses.
So sorry you’re experiencing this. But your horse is young and he should come around OK.

[JB]

@Calvincrowe

I have heard of laminitis caused by joint injections, but not from steroids.

Many (most?) joint injections contain some type of steroid to help with the immediate inflammation. So maybe HA, a steroid, and then an antibiotic.

[equinelibrium]

I’m so sorry this is happening, founder is terrible as you know all too well I’ll second the Soft-Ride boot suggestion, they probably gave my old boy another year of quality life after he started having severe foot issues. They’re expensive but worth every penny!

I do know two horses that have foundered after steroid joint injections. It was later discovered both had underlying metabolic issues which made them more susceptible to it. The good news is both made a full recovery and are healthy and happy now!

[Lindsay_Berreth]

I’m definitely using the Soft Ride boots. I feel bad I can’t ice him 24/7 right now, but I’m doing the best I can with a full-time job. He’s getting about 8 hours while I sit here and work at the barn.

Curious about the metabolic issues you’ve experienced? I’m still learning about all of this, but I wouldn’t think a 7yo OTTB would have metabolic issues.

He doesn’t seem like a sensitive or nervous type at all, which is why I bought him. I had a bad experience with one of those while my heart horse was recovering from an injury a few years ago and got dumped and broke both my ankles, so quiet and kind was a key thing I needed. Perhaps this one internalizes stuff. He did come from a busy eventing barn with lots of horses to my super quiet fox hunting barn. He’s learning to be independent, so maybe he’s internally stressed about that.

[equinelibrium]

Sorry, I re-read my post and realized it wasn’t very clear. I wasn’t trying to suggest your boy has metabolic issues, just pointing out that the two times I’ve personally seen this there were underlying conditions that likely made those particular horses more susceptible to founder after injection, but it can definitely happen with “normal” horses too. My guess is that a horse without those issues would be less likely to have another episode than one that doesn’t. I would be really surprised if your boy had metabolic issues but stranger things have happened!

He sounds like a sweetie, hopefully his quiet and kind nature will make the rehab process easier for both of you!

[Lindsay_Berreth]

No worries! I’m just sort of wondering aloud if young, healthy OTTBs can have metabolic issues. Guess I need to do some Googling!

[sascha]

I’m so sorry. Founder is horrifying. All I can say is that I had great luck with a weight-bearing founder (I know you’re going through steroid founder this time) by throwing EVERY book I could find at my horse. I used all the western medicine stuff that was given, plus acupuncture, Chinese herbs, styrofoam insulation inside boots, ultra-deep bedding, and forced exercise (walk only on soft footing to start).

That last point (forced exercise) was against what “regular” vet advised, but both farrier and Chinese med vet were both for it. I’m glad I did it. To me it was frightening on the one hand, but made so much sense. If nothing else, it was a great way to judge progress of healing. When we could go 2 minutes without having to stop and rest, that was a milestone, a few weeks later when we were up to half an hour of hand walking on firm footing, that was another milestone.

We also went 12 weeks between resets. Knock on wood, my horse is sound (high level dressage sound) and working daily years later

To answer your actual question, I have seen horses founder out of the blue and I know at least one who has dealt with steroid-induced founder. The ones that came out of the blue and the steroid-induced one all recovered to 100% in time. IN TIME, they recovered. Patience and perseverance - as long as you can keep them comfortable, then you/they have time.

I wish you all the best of everything, great doctors and good luck!

[Lindsay_Berreth]

Thank you! Glad to hear you’ve had success and heard of success stories. It’s such a shame. I had my last horse for 13 years, and it’s taken me some time to grieve and open my heart to another horse. We’re both ready to go and have fun with the training. He’s so willing. I’m hoping this doesn’t take ages to sort itself out. I can only afford one horse at a time, so this is it. Hopefully with aggressive treatment he’ll have a chance at a full recovery.

[McGurk]

I have had friends just go through this in a otherwise healthy, young, non-founder prone horse who was prescribed Dex appropriately for a skin condition.

The horse had no previous history of reacting to steriods; it was a very weird, random thing.

The horse has recovered well - still requires some specialized shoeing, but is sound and competing again.

Sorry you’re having to deal with this.

[EmilyM]

I don’t have any sage advice as I’ve only heard of steroid induced founder in IR horses. But I’m here to just say how sorry I am and I hope your horse is better soon. One of mine did this last year at the onset of a fever. Turns out he is IR. he’s now sound and I’m riding him

[Roni4444]

I know a trainer who lost a GP horse to laminitis after maintenance steroid injections.

[ChocoMare]

While such a young horse may not be “metabolic” as we understand the term, as in Equine Metabolic Syndrome or Insulin Resistance, we do see EPSM/PSSM in many TBs.

It may be worth your while to have him tested via hair sample to see if that is a factor. EPSM + Steroids = laminitis in my experience.

[Lindsay_Berreth]

Thanks for the reply. I’m familiar with many equine injuries and diseases over years of owning horses, but not that one. I’ll ask my vet to do that.

[frisky]

A horse at my barn foundered after a joint injection last year. The horse did not make it, however there were other complications- freaking out over fireworks, escaped stall one night, owner maybe didn’t totally follow the feeding program. I think the horse was also a tad IR, although she seemed young and looked fairly healthy. This horse was on the other side of the barn and I did not (want to) know the whole story.

My horse also experienced laminitis last year. She has a history of it and is fine now. She had a weird incident a few weeks ago that seems to have resolved now. Another boarder, who used to be a trainer at the track, kept telling me that I should be giving my horse some dexamethasone. This person happened to have some available to give me. I’m pretty sure that would have been the worst thing that I could have given to my horse.

[EmilyM]

i’ve honestly abandoned using dex completely once i learned that it can induce laminitis. didn’t stop mine from having it but i have learned to cope with various allergic type reactions, etc without