Lily 4th trim in 6 weeks & supplements


Kati Indigo
 

Lily came down with laminitis on July 27, 2018. We had wasted a whole month with her then vet giving her bute & unfortunately shoes elevating her heel. After they wanted to euthanize her on August 29th we took matters in our own hands, pulled shoes & gave her laminox since August 31. She has been getting Phyto Quench since early September along with Remission, flax seed & Horse Tech Arizona Copper to balance hay. We cut out all alfalfa and she only eats Bermuda hay Orchard hay in small quantities Timothy pellets and the before mentioned supplements.

In regards to emails I came across I read Dr. Kellon say that Phyto Quench is not meant for long term. We are almost done with our 2nd 5 pound order which she got since September. Should we stop? Also Remission I heard negative comments. Is there anything we should add or subtract?

Our regular barefoot trimmer kept postponing wanting to trim Lily. Finally we found James who came to the trade by trimming his wife's laminitic horse almost 20 years ago. Lily's first trim was not until 2 months after laminitis onset.Since September 25 she had her 4th biweekly realigning trim this week.

In the middle of September Lily developed an abscess in the right front. As her coffin bone in the xrays practically looked like it could could penetrate the sole at any moment we only washed her legs & hooves but never soaked her feet to avoid weakening the sole. Abscess took about 3 weeks to release through coronary band. Shortly thereafter she went lame in the left foot presumably from abscess, which took another three weeks before it released through coronary band and heel bulb. None-the-less she still shows lameness in the left foot and in addition she developed another abscess in the right foot which seems to drain through the heel bulb near the Frog. Our trimmerJames said at this point he didn't think Lily should still be lame. But she still shows discharge on heel bulbs as well as the underside of her sole has opened up on the left foot draining a little bit of liquid.

None of the Vets had done blood work, but. She did not look typical for Cushing's. The
Two different sets of x-rays I included in the case history are from August and September before she had the realigning first trim.

I very much would appreciate your input!

Kati from Arizona member since October 2018



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Kati and Lily in Arizona member since October 2018


Lavinia Fiscaletti
 

Hi Kati,

So sorry to hear that Lily is still having such a hard time of it. You must be wanting to tear your hair out.

Here are the links to her case history and photos:

https://ecir.groups.io/g/CaseHistory/filessearch?q=kati+and+lily

https://ecir.groups.io/g/CaseHistory/album?id=77277

I've added these links to your signature so that they will automatically show up on future posts.

There is nothing really wrong with Remission, just that it is an expensive way to supplement some magnesium and chromium - which you may or may not need. There isn't enough of anything else in it to support a flea. If you are using the AZ Copper Complete as a supplement, you don't need it as the magnesium and chromium are already in that.

How old is Lily? Are you soaking the hay if it hasn't been tested? She could be IR and/or PPID. Really recommend that you get blood work done so you know where you stand on that front - insulin, glucose, leptin. If she is older than 10, recommend adding an ACTH to that. We recommend sending the samples to Cornell as we have found them to provide the most consistent results. Discount shipping labels are available:

https://ahdc.vet.cornell.edu/test/Index.aspx

https://ahdc.vet.cornell.edu/Shipping/

If she is PPID, she will need to be on meds to control the disease in order to get better. It's good that you aren't soaking those feet as the soles are still extremely thin. Your trimmer is correct that Lily shouldn't still be lame - IF the causes of her laminitis have been removed and the trim is mechanically correct.

Sorry to say this but from the two latest hoof pix in her album, unfortunately, the trim is definitely part of the problem. The toe is way out in front of where it should be and the bottom of the foot is being lowered regularly. It appears as if there is very little sole between Lily's coffin bone and the great outdoors. These issues are part of the continuing abscessing problem. Need to back up the toes but not touch ANY other part of the foot, esp. on the bottom. In the Sept 2018 she was severely sunk - which means her bony column is sitting much deeper inside the hoof capsule than it should be. It is going to require a lot of extra overall vertical height to have enough hoof capsule to be able to encase all of the bones inside - much more than is needed in a healthy, normal horse. I think that a new set of radiographs would be a good idea at this time.If you do that, please have a read here for tips on how to get the most from them:

https://ecir.groups.io/g/main/wiki/Getting-Good-X-rays

I'm assuming she is still in boots and thick pads except for brief periods to allow the boots and feet to air? Wrapping the feet in diapers first, to help keep them drier and to absorb any drainage, would be a good idea as well (it looks like you were doing this already in some of the earlier pix).

How much time does she spend up on her feet? If you could possibly get a more complete set of hoof pix, I can do some mark-ups for you to help guide the trimming to where it needs to go. Here's what is needed:

https://ecir.groups.io/g/main/wiki/Hoof-Related-Photo-Instructions

If she can't stand for pix, you can take the needed views while she is lying down.

Hang in there.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team


Kati Indigo
 

Hi Lavinia!


Thank you for the quick response. I posted some photos from yesterday. And as I reread your email I realized that you were referring to the newer photos, although they are a month old. The November 9 ones I posted today are after the 4th trim. We scheduled the vet for Nov 13 to take new x-rays, do the blood-work that none of the vets ever suggested. Lily is 20 years old. I had asked the first vet if we needed to test for Cushing's but she thought that Lily was asymptomatic for that.


If based on the newest pictures you think Lily's trim is part of the problem I will let James know. Once we get the new x-rays Tuesday I will post them as soon as possible and forward your markups. I know on Tuesday when he trimmed he thought he didn't need to take much off her toe.


Should we reorder Phyto Quench at this point or does Lily no longer need it? We've been giving it to her for about 2 months since we took her off bute.


The vet told me to not feed Lily breakfast before the blood test but I know you recommend not to fast. So should I just ignore vet and let her have her free access to hay? Will vet know to order the accurate tests if I tell her insulin, glucose, leptin and ACTH? I told her Cornell and she said that's who they use anyway.


Thank you again! I will post any updates.


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Kati and Lily in Arizona member since October 2018

https://ecir.groups.io/g/CaseHistory/filessearch?q=kati+and+lily

https://ecir.groups.io/g/CaseHistory/album?id=77277


Kati Indigo
 

I posted before but got no answer in regards to Phyto Quench. We have been giving Lily Phyto Quench for approx. 2 months after we stopped bute. I read Dr. Kellon respond to someone that PQ was not supposed to be given long term. Should we stop or do I need to reorder. Any feedback is appreciated!

For the blood-tests coming Tuesday my vet wanted Lily to not have breakfast before. Do I just ignore that and let her have hay? Will vet know to order the accurate tests if I tell her insulin, glucose, leptin and ACTH? I told her to send it to Cornell and she said that's who they use anyway.

Thank you
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Kati and Lily in Arizona member since October 2018

https://ecir.groups.io/g/CaseHistory/filessearch?q=kati+and+lily

https://ecir.groups.io/g/CaseHistory/album?id=77277