What looks like Laminitis, but isn't?

[QUOTE=lady![](cts;8919638]
So … we have an update. For those who asked why I wasn’t getting Xrays as soon as possible, there were several reasons but if I bothered to go into them it would probably have just fostered some unnecessary drama. I was planning to wait until he had been thru another set of shoes, putting us somewhere into late December or early January. But thanks to the comments in this thread I did go ahead and get a set sooner rather than later (and will still do another set once his shoes are off).

The vet was on a very tight schedule and was squeezing me in strictly for a check of laminitis\coffin bone rotation. He did not do a thorough lameness workup, nor did we talk at length about treatments mainly because for now I’m sticking to my plan of giving the horse the winter off and continuing with shoeing.

He said the angles are good and there are no signs of laminitis or rotation. He was very concerned with pedal osteits, side bone, and a bone spur. He said these are the cause of intermittent lameness. He held firm to his assessment that the horse needs shoes. He recommended treatments such as Osphos, Tildren, and/or Equi-bone.

[IMG]http://i107.photobucket.com/albums/m292/lady_mcse/ReggieXrays/LF2.jpg)

[IMG]http://i107.photobucket.com/albums/m292/lady_mcse/ReggieXrays/RF1.jpg)

[IMG]http://i107.photobucket.com/albums/m292/lady_mcse/ReggieXrays/LF1.jpg)

Regarding the horse’s nutrition, I’ve moved him to a different barn where his herd is smaller, the barn less public (minimizing the possibilty that strangers are giving him treats unknown to me), and his feed schedule will be more rigid. He’s on a comparatively small pasture where the grass is mostly nibbled down to nothing.

(Note: the photobucket library contains 3 current xrays along with some older ones.)[/QUOTE]

I’m on my phone, so it’s hard for me to tell for the things your vet is worried about. I can say that In the old x-rays, I really dislike the way the foot is trimmed. It’s better now, but it looks like you have pretty bad flaring at the bottom, which tells me there was something serious that happened about 6 months or so back.
Is that the same vet who did both? Looks like someone got some new equipment. Looks like it was about time :lol:

[QUOTE=StormyDay;8919664]
I’m on my phone, so it’s hard for me to tell for the things your vet is worried about. I can say that In the old x-rays, I really dislike the way the foot is trimmed. It’s better now, but it looks like you have pretty bad flaring at the bottom, which tells me there was something serious that happened about 6 months or so back.
Is that the same vet who did both? Looks like someone got some new equipment. Looks like it was about time :lol:[/QUOTE]

sigh and you hit upon some of my issues with X-rays … um the latest 3 Xrays were by the guy I trust pretty well but his practice is 1.5 hrs away. Scheduling with him to come here is a nightmare (hence the super quick visit the other day). Other X-rays are from other vets, and the really awful ones from 2014 are by the geographically closest vet who I’m never going to again if I can avoid it. The ones from 2012 were the prepurchase exam, so at least I knew I was getting myself into trouble with what I was buying.

Pedal osteitis. Presented like laminitis in my TB, he couldn’t even walk. It can be easily aggravated in a day by stepping on something hard as it causes high sensitivity in the soles. It can be difficult to find on a x-ray too, took 4 vets about 30 x-rays of his feet to be able to see the decalcification. He now wears natural balance shoes with frog pads and is competing in upper level eventing completely sound.

What “cushion” do you have on the feet? I have had the unfortunate reason to learn recently that for PO you want a firm pad, preferably a firm pour in material, especially if the horse has thin soles. Leather pads and other soft pads don’t do much of anything to help with PO. My farrier thinks even a hard plastic pad isn’t enough especially for the bigger horses.

I have dental impression material under the frog pads. I have found that using a pour-in like Equi-Pak, even the Soft one, causes soreness as it fills the whole area and pushes on the sole. The light blue color of the impression material (the purple is a little harder I believe) works great but it MUST be in the back half of the foot only, alleviating stress on the end of the coffin bone, which is a huge reason for the lameness. The natural balance shoes are also set back on the foot, his toe actually hangs over - this way, the breakover of the shoe is just about even with the coffin bone, eliminating any torque on the bone. It looks a little unconventional, but this horse is now 22 and still running Intermediate happily.

[QUOTE=ladymcts;8919684]
sigh and you hit upon some of my issues with X-rays … um the latest 3 Xrays were by the guy I trust pretty well but his practice is 1.5 hrs away. Scheduling with him to come here is a nightmare (hence the super quick visit the other day). Other X-rays are from other vets, and the really awful ones from 2014 are by the geographically closest vet who I’m never going to again if I can avoid it. The ones from 2012 were the prepurchase exam, so at least I knew I was getting myself into trouble with what I was buying.[/QUOTE]

I think I could take a better x-Ray with my phone than some of those x-rays :lol: the last ones are clear though. I wish I could zoom in, but I am on my phone and when I try to a big ad pops over the screen.

Thank you cdeventing and others!

What you’re saying about Pedal Osteitis and the pads and the aggravation by stepping on something hard pretty much confirms what I’ve been seeing, and that I might be on the right track with the solutions I’ve been trying to work at for this horse.

Right now he’s got the metal shoes on and we’re using Euqi-Pak, the version that has copper sulfate in it because thrush was also an issue. For the two times we’ve shod him, we’ve used the Equi-pak across the whole sole. The vet had said (in July), to leave the foot “Open-toed,” but the farrier wasn’t super familiar with equi-pak. He had used it before some, but basically I bought all the equipment and we were working as a team to get it applied. Having 8.5" hooves was a challenge because Equi-Pak only sells smaller sized foamboard squares. Contacted Equipak and got info about the style of board used, but trying to find the foamboard from other suppliers was not working out, so in the end we duct-taped four squares together. Anyway, I digress! Because of all that stuff, we did end up doing Equi-pak over the whole hoof, but I was already leaning toward trying to get it installed to only the back half of the foot on the next round of shoes which should be early December.

The vet had also suggested Clear Castle Frog supports as an option (in July). I typically use “Well-shod” for my farrier supplies, and they sell the castle products, but didn’t offer the draft size. I emailed them and they said they’d have them for me in 3 weeks. Ten weeks went by with nothing, so now I’ve been on the phone with them once and have to call back again. Seem like nice people, but I think I need to go elsewhere to get them. In October, the vet said he liked the Equi-Pak approach and don’t bother with the castle supports. But I’m still interested in acquiring some to have on hand and may try them later down the road a bit.

The horse’s old barn had paddock areas that were hard packed lime, probably almost as hard as concrete. He was spending more time in paddock than I liked, and the times that he went out to pasture he was running around like a fool. I am guessing that both things were very hard on his feet, and with having “thin soles” (I was first told this in 2014), I decided to go ahead and move him to a different barn where he’s got a smaller area to move in, and on soft stall bedding at night, with no hard-packed lime areas, and no gravel areas (old barn had gravel between pasture and arena).

Because of 8.5" hooves, my non-metal options are limited. Right now I’m planning to leave him with this set of shoes and Equi-Pak until the end November which would be 6 weeks. Then we’ll do one more set of metal shoes, and see if we can’t get the Equi-Pak on the back half of the hoof only. When that six weeks is up we should be mid-January, and I’d like to try leaving the shoes off for a few weeks. Unfortunately that will be middle of winter and we may have frozen ground without snow, so I may also change my mind depending on the weather.

I would prefer to transition way from metal shoes. Barefoot would be ideal, but I’m starting to think that may not be an option for this horse. I do have some barefoot practicioners I can work with, and will at least get their opinions. Non-barefoot wise, my second-best ideal situation would be Hoofwings, a custom boot that’s going to run me over $400/pair. (Don’t tell me Old Macs or Boa’s or Easyboots, because they don’t exist for 8.5" feet, and I used them before with 7" feet without much success.) I say this would be an ideal, if we could manage to do hoof boots for trail riding and still have him being comfortable enough to not need artificial support while in barn and pasture.

But because the hoofwings are over $400/pair and because I suspect he may need that hoof support 100% of the time, I will talk to my farrier about trying out Easy’s Slippers. I already have the equipment to apply the glue-on non-metal shoes, but he has not done them before. The nearest place I know for sure we could get an experienced farrier to put them on is a 3 hour trailer ride, which doesn’t sound like a great option for a horse with sore feet.

So right now I’m in wait-and see mode … trying to evaluate how the horse does at the new barn, what the weather’s going to be like, how willing my farrier is to experiment, etc. Thanks again everyone for your input, I’m feeling like I bought a “lemon” with this horse, but his amazing personality makes it all worth it. He’s one awesome dude with sore tootsies.

I’m not advertising anything, just providing links so you can check out the products I mentioned if you care.
Equi-Pak: http://www.vettec.com/equi-pak-180cc
Castle Frog Pads: http://www.castleplastics.com/specialty.php
Easy’s Slippers: http://advancedequinecomfort.com/
Hoofwings: http://www.hoofwings.com/index.html

[QUOTE=ladymcts;8919952]
Because of all that stuff, we did end up doing Equi-pak over the whole hoof, but I was already leaning toward trying to get it installed to only the back half of the foot on the next round of shoes which should be early December.

The vet had also suggested Clear Castle Frog supports as an option (in July). I typically use “Well-shod” for my farrier supplies, and they sell the castle products, but didn’t offer the draft size.[/QUOTE]

Use Play-Doh to ‘dam’ off the area where you don’t want Equi-Pak. The Play-Doh easily comes out after the EquiPak sets up.

Large frog support pads: http://www.centaurforge.com/Castle-Large-Cushioned-Frog-Pad-Clear/productinfo/46500/

Hope this helps.

[QUOTE=ladymcts;8904179]
OK, before I go on to any other answers … I should admit that I just had one hoof Xrayed last week. It was one of his hind feet which I suspected had an injury from a long time ago. The vet was unable to find anything really serious, but did see mild pedal osteitis. Now that I’m having more time to read up on that, it sure seems to fit this horse’s story.

He’s had chronically thin soles, flat footed, and his environment has been one which allows him to run wherever the he wants with acres to roam, a fairly big herd, and him being herd boss. If laminitis and\or chronic bruising of the coffin bone from too little sole cushion (pedal osteitis) are both part of his story, then my decision to move him last week to a much smaller barn with smaller herd and smaller pastures, and give him the winter off while continuing shoing with cushion supports, may all help him.

I will definitely be getting Xrays of the front feet soon. I was planning to get thru 3 cycles of shoes, per vet recommendation, before doing another set. That should get us to about January or so. If he continues to have laminitic-like episodes while at this new smaller facility and with shoes & equipak cushinging in place, then I will have those X-rays done sooner rather than later.

Now, back to some answers …

Laminae - Stressed and stretched, some separation. Not bloody.

Injury of withers, shoulders - This was one of the most recent suggestions by his current vet. After this last bout, she suggested our next step might be to test him again for insulin resistence, and then possibly pursue the full body imaging necessary to diagnose something like kissing spine. This horse did have significantly atrophied shoulder when purchased in 2012. That was missed during pre-purchase exam, and attempts to contact the seller and breeder went unanswered. Four years later, I can still see some difference between the two shoulders, but you have to really look for it. So I’ve always suspected maybe he had a shoulder injury as a colt.

Tying up, Part I - Is it possible to have a tying up episode with no physical exertion involved? This last laminitic episode occurred more than six weeks after the last time he was ridden, and 8 days after being trailered for a 1 hour round trip and shod. At the time it happened, he was in a paddock with other horses where there isn’t enough room to get up a good canter. He’s also herd boss and no changes to herd lately, so it’s not likely that he was chased around or doing chasing around to the point of real exertion.

Tying up, Part II - He was tested very thoroughly in early 2015. The university vet school kept him for four days and some of the testing involved ptuting him on a hot walker and monitoring muscle enzymes before, during, and after exercise. However, that was now more than 18 months ago, his first laminitic-like episode was in June of 2016.

PSSM\EPSM - While drafts in general are predisposed, it’s very rare in Clydesdales. I was advised that based on this horse’s symptoms, genetics, and history, that it was not worth pursuing the muscle biopsy. See two paragraphs above where they did some testing that should have identified muscle-related problems.

Weather change - These episodes have not coincided with weather change, but I would say they have generally coincided with some form of stress. Until the very last one which is why I’m writing … I don’t know what the heck brought this one on. No stress, no riding, no walking on hard surfaces. Not even out to pasture where he might have been thundering around and bruising his soles.

Diet - Two quarts of safe choice with a concoction of supplements that include Vitamin E, Hoof Supplement, Red Cell, and in summer months an electrolyte. Access to round-bale hay 24/7.

Journal - I’ve been keeping one of the big stuff, not thought to include weatehr factors yet. Thanks for the suggestion.

ACTH - January 2015, baseline was 13.3pg/ML

Bloodwork - I’ve had oodles of bloodwork taken in the past. The two things I have usually heard were “markers for inflammation” and “anemic.” Red Cell has helped address the anemia, but I’m aware that it’s just kind of putting a bandaid on something without knowing the root cause. His lifestyle does not suggest ulcers, but battling worms has been an issue, with frequent positive egg counts in spite of frequent dewormings with a good rotation plan. The most recent bloodwork was done a month ago (along with the Dex suppression test for Cushings), and it was good. No concern about inflammation or anemia. So I thought we were doing well … but this is the first laminitic-like episode since that bloodwork was done and getting shoes.

sigh thanks everyone!

In summary -
-Have changed his environment drastically
-He will be getting lots of time off this winter
-Will get Xrays at the very LEAST after his third set of shoes, but sooner if he has another incident
-If another incident, will do bloodwork again and will consider testing for insulin resistence again[/QUOTE]

pedal osteitis, side bone and ring bone are very common in drafts.

I think you’ll find he has bony changes in all the little bones going down to coffin.

I’d think you want to treat it like any arthritis-- keep inflammation down. Cold hosing. Some joint supplements w HA, whether IM, IV or oral or both.

I’ve had good luck with Cosequin ASU Plus for 20+ yo draft mare with jewelry everywhere and dodgy fetlocks. Once stuff remodels fuses—it doesn’t bother them much. But hot weather, hard ground, more active can irritate and set up the inflammatory cycle. For my mare-- I tried Equiox did nothing for her. Meclofenamate worked very well for her. But after a year of Meclo—she’s gotten just cosequin ASU Plus and it seems to really work for her.

[QUOTE=tarynls;8922492]
Use Play-Doh to ‘dam’ off the area where you don’t want Equi-Pak. The Play-Doh easily comes out after the EquiPak sets up.

Large frog support pads: http://www.centaurforge.com/Castle-Large-Cushioned-Frog-Pad-Clear/productinfo/46500/

Hope this helps.[/QUOTE]

Thank you! Yep, I was going to try clay just because I have some on hand. Nice to know play-doh works too.

Yeah, for a while this summer I put him on Bute-less daily pellets. One of his other issues has been chronic anemia, and one possible cause of chronic anemia is chronic inflammation. So I tried the bute-less for aobut 60 days. I’d say I did see some improvement on his comfort level. But then I was reading about how it shouldn’t be used if ulcers are suspected … and since anemia is one of his issues and I’ve never had him scoped for an ulcer, I figured I didn’t want to bring on something new!

With my other horse, I had used both MSM and Cosequin before finally switching to Previcox. I swear Prev is a wonder drug, and may consider that with this guy as well. (An option, not saying going straight to it.)

[QUOTE=ladymcts;8922880]
Yeah, for a while this summer I put him on Bute-less daily pellets. One of his other issues has been chronic anemia, and one possible cause of chronic anemia is chronic inflammation. So I tried the bute-less for aobut 60 days. I’d say I did see some improvement on his comfort level. But then I was reading about how it shouldn’t be used if ulcers are suspected … and since anemia is one of his issues and I’ve never had him scoped for an ulcer, I figured I didn’t want to bring on something new!

With my other horse, I had used both MSM and Cosequin before finally switching to Previcox. I swear Prev is a wonder drug, and may consider that with this guy as well. (An option, not saying going straight to it.)[/QUOTE]

Yeah—I haven’t seen much improvement in past horses with bute-lesss. The ulcer potential is a prob too.

If investing in supplements I think HA is the most effective. I went with the ASU + because avacdo soy saponins in lab studies on humans reduced pain, reduced amount of NASAID human subjects with severe degenerative arthritis were using. the HA and ASU have compelling studies behind them for reducing pain inflamation and chondroprotective.

Cold hosing is you fairly “free” best anti-inflammatory. Hose the legs and hooves every time you are there.

Won’t hurt to put a draft on high fat low starch and a Vit E supplement either.

Here are some fun PO rads. Do what you can now to address it and it shouldn’t be too difficult to maintain. I didn’t understand the need for the continued maintenance that would be needed and was too slack about things when he seemed better. Use pads and keep him in them. Do the tildren or osphos. Try the equibone. Keep him on softer ground…no limestone. Get good advice from a good vet and an even better farrier and follow it. This has been a huge learning experience for me and I’m now full of heartache and guilt.

http://s36.photobucket.com/user/lamepony/media/5b468152-1479-408a-a490-1357b60d6965_zpsxivfdfjs.jpg.html?sort=3&o=0
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I used to feed Safe Choice until my horse came up with Laminitis in June. Although vet said it was due to grass, same grass he’s always been on, they don’t eat constantly I have some doubts. Anyway I researched and researched and although it is more expensive the least amount of NSC (non structural carbohydrates) are in Triple Crown Feeds. Check it out, the Low Starch one is the least and then the Senior is next. Anyway, I change all mine over to Triple Crown because they offer the lowest NSC percentage.