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Recently confirmed chronic laminitis- what to expect/look for, and tips?

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  • Recently confirmed chronic laminitis- what to expect/look for, and tips?

    My trimmer was out the other day and confirmed that my horse has chronic laminitis. I'd expected it for a bit now, but it still stinks to have it confirmed. It started a few years ago when he had a violent reaction to his rabies vaccine that I now realize was an acute laminitis episode. At the time, I didn't know laminitis could be caused by a vaccine. Last year, due to the reaction from rabies, we skipped that vaccine and only did EWT and West Nile. Spread 2 weeks apart and with an injectable antihistamine ahead of time, the EWT was the first vaccine and seemed to be fine. West Nile was the second one, and I noticed even with the antihistamine he had an increase in respiration for an hour or so, but nothing severe. Over the following two days he busted out in hives and became sore on his right front. I knew the hives was vaccine related, and suspected the soreness was also but not confidently. He's always battled lameness issues off and on and even when he's abscessed he's never been sore, so I wasn't totally convinced the feet were the issue. Over the following year, though, he's been sound consistently but I've noticed stress rings here and there on his hooves and would be a bit tender in front. A few weeks ago I noticed he was trotting around and looked uncomfortable. I didn't notice anything with the feet that day other than that, and didn't see him for the following week and a half (I'm only able to be there once a week or less right now). LAst week I noticed his toes were looking like they were a bit further forward than ideal, and he had some stress rings. That combined with his soreness prior led me to be concerned about the laminitis thing, and address it to my trimmer thus bringing about the diagnosis the other day.

    I haven't really mentioned much to my vet other than his vaccine reactions, and since his diet is pretty simple anyway to address other issues, she didn't have any real input to offer. It wasn't a huge topic of concern last month at his wellness exam. She's coming back in May though for more vaccines and to draw blood, so we'll be talking about it then for sure.

    I've never dealt with laminitis before, and have apparently been managing it well enough since it seems this isn't a new occurance and he isn't dead lame. As such, I want to make sure to continue to do things right for him (or change things I've been doing incorrectly!).

    He's a 24 y/o Arab, lives outside 24/7 with my mare in a dirt paddock. They get a grass mix hay that is grown on the farm, and are fed hay 3-4 times a day. It works out to be almost free-choice for them, and they happily clean it up. He's a body condition score of a 4-5 and passed his wellness exam with flying colors last month (save for some thing on his eye that isn't too important and I forget its name since I hate eyeballs, and a heart murmer that I've always known about and hasn't gotten worse from what she told me about it). He's currently on 3 quarts of hay stretcher twice a day (can't remember the weight off the top of my head). For supplements he gets Cosequin SP, DynaPro Probiotic (4 ml/day, 6ml/day during stressful situations), and 1 oz Dynamite. He's not on any other grains due to a wheat allergy (for whatever reason, he can tolerate the hay stretcher) in addition to some wierd metabolic thing where too much starch/carbs/something causes him to get stiff in the back and then his stifle slips out. He was on Empower Boost at 2 cups/day, but he got way too fat on it even when dropped to one cup. When he was working this summer, I had him on Dynamite HES at 1 cup/day for protein, which was helping his muscling (he's never maintained muscling, even when he was younger) but I had to take him off of it due to the wheat bothering him. He's barefoot and trimmed every 5 weeks. Stress triggers for him that seem to be causing flare-ups are so far identified as: vaccines, deworming, spending more than 2 or 3 days in the barn. Probably more triggers, but not yet identified.

    My trimmer suggested keeping his diet as forage-based as possible and agreed with his current diet when I told him, as well as proper trimming, as much movement as possible, eliminating triggers (my vet already refuses to vaccinate him). He mentioned possibly needing boots for trails/hard ground if he seems to be bothered. Apparently the new hoof growth coming in is looking good and the way its supposed to, and he only has minimal hoof wall separation. Trimmer is confident that if we continue to manage and eliminate triggers, we will be able to stay ahead of the game at this point.

    Any suggestions, tips, etc that you might have would be great. I've already started researching here. I don't think I have to change his lifestyle drastically, and I maybe don't even need to stress about this too much, but this horse is my "once in a lifetime" horse so I'd pretty much do anything for him. Since we grow our hay on the property, I'll most likely be getting an analysis this year if the barn owner doesn't do it first.

  • #2
    If you suspect that your horse is laminitic, you really need to get a good vet on board. You need a diagnosis, which would come from a vet and not a trimmer.

    My senior gelding was laminitic, too. After years of treating each episode as a stand alone issue, I got hooked up with a great vet who diagnosed my gelding with a metabolic issue. Getting that under control was important and he never had another laminitic episode.

    Find a good vet and look into metabolic issues.


    • #3
      Not to sounds snippy, but a trimmer can't "diagnose." That's what doctors do.

      Find the Yahoo cushings/IR group, or go here: http://ecirhorse.org/ And good luck, if you do have metabolic issues it is a challenge but can be dealt with.
      "Here? It's like asking a bunch of rednecks which is better--Ford or Chevy?" ~Deltawave


      • #4
        Test the hay! Even if the initial episode was vaccine related, he will now be more prone to episodes, which you reeeeally want to avoid. I would have bloodwork done, just to make sure there isn't anything metabolic related.

        Lots of thinking will be needed, to make sure you know every single trigger, and so you can avoid them! Trust your gut, it WILL be right when your horse is feeling sore, even if you are feeding "safe" food, or doing things by the book.

        Good luck, and I hope for your mental sanity that you never have to deal with repeated episodes, and that not vaccinating will be the solution. Ask me how I know... :-(
        "On the back of a horse I felt whole, complete, connected to that vital place in the center of me...and the chaos within me found balance."


        • #5
          I agree with the other posters, especially as he is getting older. I'd suspect IR, maybe Cushings. If that is the case, he'll need specialized diet and perhaps medication as well. A knowledgeable vet can help.


          • #6
            First Jingles & AO ~ Second ``` wise to have vet test for IR ...

            First Jingles & AO ~ for your horse and you during this uncomfortable time ~

            Second ~ have vet test for 'reasons' IR or Cushing ``` simple blood draw and
            and often a diet change or modification and meds ``` allow 'soundness' to
            return ~

            Try not to worry just be 'vet' pro-active ..... blood tells the story ~
            Zu Zu Bailey " IT'S A WONDERFUL LIFE ! "


            • #7
              Is the "weird back stiffness and stifle slipping out" thing PSSM? I'd dive into a little more research if I were you, or ask your vet to clarify exactly what's going on here. These are some pretty large and significant issues you're tossing around, and I think you should be working more closely with your vet. Understanding metabolic diseases is hard and overwhelming at first, but in this case, knowledge really is power.
              Somewhere in the world, Jason Miraz is Goodling himself and wondering why "the chronicle of the horse" is a top hit. CaitlinAndTheBay


              • #8
                You are off to a great start and already doing a LOT of the things that will prevent future episodes, but definitely get your vet on board. I would say it's almost impossible to successfully manage a laminitis risk horse without all three - a knowledgeable owner, vet, and farrier. It is definitely better to manage it and avoid flareups than to deal with them, and horses can go on for many years without getting worse if they are well-managed.

                The only other thing I would add is that until you and your vet have done more of a workup and determined what all is going on with him, I would avoid giving him steroids for any reason as there is a good chance that will be a significant trigger for him as well.


                • #9
                  The second you suspected that he was having another laminitic episode, you needed to get your vet.

                  Your vet can can also confirm your farrier's opinion. Your vet has the ability to take radiographs and to diagnose causes and possible treatment options depending on the diagnosis.

                  Trimmers can make observations from the outside. Not sufficient!!!! Nor are trimmers adequately equipped to do the supportive shoeing that is sometimes very necessary.
                  Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

                  Remember the horse does all the work, we just sit there and look pretty.


                  • Original Poster

                    I'm not one of those people who runs to the vet for every little thing, and to be quite honest when my vet was out a month ago and we were talking about his issues, her assessment was that there was nothing they could have done for him about the issues he's had so far that I wasn't already managing just fine. That isn't me in denial about anything, it was her honest words after hearing his situation. Believe it or not, having my vet involved every time my horse just looks or steps funny isn't necessary. I've got a pretty good grasp on him and what works/doesn't work for him, after almost 10 years of dealing with numerous issues with him.

                    His stifle/back issues are very closely related I believe to PSSM, and without intensive testing my vet agrees. I usually describe it as something close to PSSM because it is the easiest way to describe it even though some of the symptoms aren't exact. When I made the connection years ago that the excess grains were causing the problem and consequently eliminated them, his issues stopped. Having him out 24/7 in a paddock with a slight incline, managing his workload appropriately, and supporting him with adequate protein/fat goes a long way for him to keep the issues from happening and we haven't had an incident with his stifles in a couple of years now.

                    Due to that and his wheat allergy, his diet is carefully managed with the only exception being that I haven't gotten the hay analyzed yet. His hay, however, doesn't seem to be causing a problem here. I believe the recent flareup was mostly due to him being inside the barn for a while with the snow and wind, that was the only thing that has changed for him recently and he is sensitive to "little" things like that.

                    I will be talking with the vet about this when she comes back out, since his flareup was minimal and has been the only one in a while I really don't see the reason to have her come out immediately for this. If she feels a need to draw bloods to test for metabolic issues then for sure that is what she'll do, though in Feb she had no concerns about Cushings with him at all. At the time she didn't think x-rays were necessary for him, I did ask as we were also doing a first exam on my other horse at the same time. I'll definitely re-inquire about x-rays at this point and see if it is necessary. Treatment-wise, we need to be extremely careful about medications etc with him as he is extremely sensitive to them. Steroids in the past have made him very sick, so there is no chance of doing that- due to his past reactions, I have no doubt it would be a trigger for him. Whether people agree with it or not, I DO go with my gut instinct a lot with this horse- I've never been wrong (unfortunately), even during the times science has said it should be otherwise.

                    Thanks for the suggestions, guys.


                    • #11
                      Chronic laminitis IS a symptom of Cushings, even if there are no other outward signs. If you don't have another reason for the laminitis (e.g. broke into the grain room, broke out onto the pasture), then I would test for Cushings and/or IR. I seem to recall (from the immense amount of info on the IR/Cushings Yahoo Group) that horses with Cushings can be sensitive to other systemic treatments (e.g. deworming), so it is possible that a laminitic flare after a vaccine is related.

                      If not Cushings, though, I would still pursue a diagnosis of "chronic laminitis"...certainly the farriers will chime in on this thread, but it seems to be either related to hoof form, or metabolic in nature (or both)....

                      To be honest, your description of your treatment for him: reducing grain and keeping him in 24/7 turnout with hills has helped - also support the concept that it could be metabolic in nature. (e.g. reduce the sugar, increase the exercise).

                      A Cushings test is only about $80. Worth every penny.


                      • #12
                        Originally posted by S1969 View Post
                        Chronic laminitis IS a symptom of Cushings, even if there are no other outward signs. If you don't have another reason for the laminitis (e.g. broke into the grain room, broke out onto the pasture), then I would test for Cushings and/or IR. I seem to recall (from the immense amount of info on the IR/Cushings Yahoo Group) that horses with Cushings can be sensitive to other systemic treatments (e.g. deworming), so it is possible that a laminitic flare after a vaccine is related.

                        If not Cushings, though, I would still pursue a diagnosis of "chronic laminitis"...certainly the farriers will chime in on this thread, but it seems to be either related to hoof form, or metabolic in nature (or both)....

                        To be honest, your description of your treatment for him: reducing grain and keeping him in 24/7 turnout with hills has helped - also support the concept that it could be metabolic in nature. (e.g. reduce the sugar, increase the exercise).

                        A Cushings test is only about $80. Worth every penny.
                        I completely agree with this. As someone who has had one founder for "no apparent" cause test revealed differently. Send the blood work to Cornell it is the best for this sort of testing. Please check out the yahoo group mentioned above it is invaluable.


                        • #13
                          Get your hay tested for NSCs, and in the meantime you need to soak it for at least a half an hour, then rinse it well, to get rid of sugars. And the absolute second he looks like he is having a laminitic episode, you need to stand him in ICE water for as long as possible. I would also invest in some Soft Ride boots to help him through the laminitic episodes--they are an absolute God-send.

                          Definitely check out Dr. Kellon's IR/Cushings group and get your horse tested, as Arabs are very much predisposed to IR.
                          Topline Leather -- Bespoke, handwoven browbands & accessories customized with Swarovski crystals, gemstones, & glass seed beads. The original crystal braid & crystal spike browbands!


                          • #14
                            You need a new VET!!!!!!!!!!!!!!

                            Go to www.ecirhorse.com and join the yahoo group that was mentioned. Laminitis, especially chronic = there is an underlying metabolic problem that MUST be addressed, like yesterday. You may need to special order it but the best thing you could do for this old boy is get either Ontario Dehy Timothy balance hay cubes (soak but do not drain because they have vitamins and minerals added to be a complete ration), or Triple Crown safe starch forage as his hay. Feed nothing but that. If you cannot get those, then soak and rinse your hay to leach the sugars out of it.
                            Good luck, and keep us posted. Once again, your Vet is completely incompetent and you need one that actually knows how to diagnose and treat this horse.
                            RIP Sasha, best dog ever, pictured shortly before she died, Death either by euthanasia or natural causes is only the end of the animal inhabiting its body; I believe the spirit lives on.


                            • #15
                              I agree that a vet is the one who can confirm laminitis, not a farrier. Sounds like your horse has a lot going on, but especially if he has already seemed sensistive to starch in the past, there is a good chance that could be a major contributor to whatever is going on now. It really is crazy how sensitive their systems to be to changes, as even a difference in NSC content of the same pasture can cause a horse to founder.

                              I recently wrote a little blog article about starch in horses, but I also posted a link on there to a really interesting study that was done about the horse's amylase and ability to break down starch. It kind of helps explain one of the reasons why they have those problems in the first place. If you're interested in equine nutrition, you may find it interesting!

                              Good luck with your horse! Sounds like you are doing a great job trying to cover all your bases and I hope your vet can help clear things up!


                              • #16
                                I learned that a laminitic can quite often have a flare between the months of August to November even if nothing in their life, environment, or diet changes, so that might be something to be on the lookout for. It's called seasonal rise - the cortisol levels affecting insulin resistance, blood glucose and insulin levels. Some horses aren't bothered, some are. I also learned that Seasonal Rise affects some horses all fall and winter from August to about April. It is suggested to start a horse on Pergolide in August and then wean off after December, or April, according to your horse's Seasonal Rise pattern.

                                I also second the www.ecirhorse.com website - I'm a new member myself as I just had a pregnant mare suffer a nearly life-threatening vaccine reaction that culminated into severe laminitis. There is an overwhelming amount of information, tips, and ideas on there, and an active community board.
                                Practice! Patience! Persistence!