Re: "Inadequate pain management" and a horrible vet call later... feeling lost and heartbroken.

Lavinia Fiscaletti

Hi Krista,

So sorry you were subjected to this situation. As Dr. Kellon mentioned, although it may have been unsettling to the new vet, her response was unprofessional.

NSAIDs will suppress abscesses from maturing, so that may be part of the reason Holly Mae's issues in that department keep recurring. Once you stopped the Banamine, that allowed for the abscess to mature and start to drain but each time the NSAID gets restarted, that can slow the process again and cause it to drag out longer but never fully resolve.

No one likes to see their horse in pain and vets tend to want to make the pain go away asap so that the horse seems better. While decreasing pain isn't necessarily a bad thing, focusing only on that aspect - rather than actually removing the source - doesn't solve anything in the long run. Recently, Gabapentin has become the go-to drug for many vets, even tho there is no evidence it actually has any effect in non-nerve related pain. While the banamine/bute may help with some of the body-wide overcompensation pain, Endocrinopathic laminitis is not an inflammatory process, so it won't respond to NSAID administration. Also, long-term NSAIDs will interfere with healing and increase the likelihood of gastric issues. Switching to the j-herb was a good move on several fronts, as it will help to increase circulation, esp. to her feet. This will benefit by helping to finally mobilize the abscesses to actually exit and will speed up growth of her feet, which also includes adding sole.

I wouldn't recommend soaking her feet with those thin soles. Poultices or epsom salt paste wraps inside of boots would be a safer option that wouldn't compromise that sole depth.

Regarding the trim, her underrun heels need to be corrected in order to help keep the horizontal toe length in check and get the slightly broken back HPA's realigned. These issues date back to at least 2014 based on the rads in her album. Addressing those mechanical issues, along with the removing any of the underlying metabolic concerns that are driving the laminitis episodes, are what will actually fix her problems rather than just cover up the symptoms.

Allow her lie down as much as she wants to - just make sure she has water and hay within reach, if needed.

Hang in there.

Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

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