Re: Help for Mare following extreme over-trimming to sole

Makendra Silverman - NS

Thank you Dr. Kellon and Sherry, the client has this information now and is subscribed to ECIR but is having trouble posting - so on her behalf I am posting an update.

This Saturday I brought the mare's toes back (trim) more and made a thin, soft DIM pad in her cloud boots. We've found she does best in a half pad made of an old felted wool saddle pad I had that is at the dorsal (toe) end of the boot. She HATES the cloud pads with the heel wedge that I expected her to find comfort in. She doesn't seem to like a cut-out or low section for P3 as one would think. Soles are looking good and owner is keeping arti-mud on them in boots and letting hooves air for a while and changing boots each day (she has a pair of Rx boots and a pair of Cloud boots). The great news is that she is doing better - moving around her small paddock (booted) and in and out of stall, flirting and bossing around th gelding next to her and the yearling colt on the other side. So nice to see her feeling more herself although not moving freely or fully comfortably, the pain seems to be much reduced, most likely from the info to follow:

I wanted to update based on a new (third) vet's input and see if anything is counter-indicated. This vet suggested some things I have not heard of before and it does seem to be helping.  
Here are the details from Sunny's owner who is getting mixed messages from the vets, me (based on what I learned here primarily) and is in need of guidance:
"Sunny is on bute 2 g a day, 1 pill of prascend a day, 2 scoops of thyro -l a day. Yesterday she was given IV fluids and DMSO. That made a remarkable difference in her pain level, after 2 weeks of agony she was walking to her water tank, pestering her herd mates and could rest comfortably without leaning backwards and see-sawing. I received the laminox today . 
Both attending vets say that Metformin doesn’t work in horses  so I’m stuck on that med. {Also all four vets consulted say that they don't know where to get Metformin). They are concerned that her extreme levels of pain and stress are causing her cortisol to go up and affecting her insulin. The treatment yesterday was a last resort to get her pain under control and it worked! She’s also got new DIM pads and she seems to be liking those. 
I’m wondering if I should stop bute and start the laminox and if it’s ok with all the other meds she is on . She will have new radiographs taken and have blood drawn to check levels of insulin on July 11. That’s the soonest they can get here. 
The vets have recommended a drug called pentoxifylline er. They want her on this because it still allows blood flow to the foot while she is on the high doses of NSAIDs. They explained it as changing the shape of the red blood cell to increase oxygen and blood flow. I have it but have not started it yet as I wanted to get feedback.
Thank you so much - from Makendra and Sunny's owner

Makendra and Arrow
Denver Colorado, 2021
Arrow's Case History:
Arrow's  Photo Album:

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