Hello All, 

This question is about my mini mare Kate (PPID and probably IR). Her case history is updated and I just posted recent hoof photos. I don't have recent bloodwork on Kate because she is very needle phobic. She gets so worked up I wouldn't trust the ACTH numbers anyway and that is what happened during our latest vet visit. I will continue to work with her, but if anyone has specific advice it would be greatly appreciated. 

The main reason for my post is that despite making improvements to weight, diet, body condition and ACTH, Kate remains reluctant to walk on our gravel road. She has also had toe first landings on her front limbs at other times just walking in her dry lot. This means we have not been able to address the exercise component of the DDTE. We live in a very wet area (cranberry bog country) and for weeks (or this spring - months) at a time without an indoor arena the quiet gravel road is the most useful place to get exercise. So, I posted trim photos to see if there are any red flags there. Farrier comes Thursday morning, so I realize this isn't much time for a formal evaluation, but if someone thinks there is something going on with the trim I can postpone, but we are overdue by a week already. Any thoughts or comments are welcome. 

My other concern has been some deep sulcus thrush on her front feet. To keep her out of the mud I have been putting boots on during the day when she is out and then taking them off at night when she is in her stall. She steps heel first in the boots and I think that has helped her quite a bit and the thrush is improving. But even in the boots her walk on the road is slow and she seems to step with short strides in the back. 

My more serious concern is tendon/ligament issues in her left hind leg related to her PPID. This was one of the first symptoms we noticed that led us to her PPID diagnosis. I am concerned that this will remain an issue and prevent us from getting her enough exercise. She is incredibly smart and I would like to she her drive in a cart recreationally to help her get more exercise. But right now she walks very slowly and seems to twist at the knee occasionally on her left hind leg. I don't have enough experience with these types of injuries in horses to know if this is what is going on, or what I can do to improve it. I was hoping with her PPID under more control that it would help. Are their EMS safe supplements that anyone could recommend for this issue? Or other ways we can determine what is going on? Previous vets were never able to give us an answer and just prescribed NSAIDs that didn't really work. 

So, any thoughts about Kate's situation are welcome. I am committed to getting the exercise piece of the puzzle in place this summer. 

Thank you all in advance! 
Sarah 

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Sarah O. 
Rudolph, WI
2020