What next

Kandace Krause

New xrays and CH updates done.
K has been in vet clinic stince 2020/12/30 - Venograms show good blood flow to hooves.
She is in "Ultimate" boots, not any kind I can find online.  Can be seen in Xrays.  These boots are on with cast material, non removable between trims.  Here are four questions I need some kind of answers to.

Vet says boots to be left on until hoof growth cycle finished (6-8 months) Really???
The material on them can likely not get too wet.  Will require boarding for the next few months in this case.

Vet wants horse confined to box stall type area until growth cycle finished (6-8months)  Really??

When does exercise start?

Mare started on Metformin, how long should it be continued?  Vet saying at least this trim cycle and if boarded out the administration becomes a challenge.
My understanding was that as soon as horse comfortable to move they should be encouraged to do that movement.  Prior to this hospitalization horse was up to 10 minutes handwalking.  Sill I have no idea what set off this last round of severve lameness as no abcess has yet burst yet mare seems much more comfortable daily.

Kandace K Rocky Mountains, Alberta, Oct 2

Deb Walker

Hi Kandace - I am not an expert here by any means. But I am familiar with Ultimate boots. My horse was also at a vet school in October of 2017. Because his venograms were good, he was put in Ultimate boots and sent home the next day.

I certainly cannot argue with your vets, but if you would like another professional opinion concerning length of wear from the farriers at UW Vet School, Madison, WI, I am sure they would be willing to speak with you as they have used Ultimates extensively and have saved many horses lives whose owners were told to put them down.

This is my experience:

Ultimates put on, new x-rays taken, and Scotty came home the same day. The trailer ride to and from vet school is about 1 1/2 - 2 hours over lots of hilly country roads, and he handled it like a pro and walked off the trailer sound.

I was told to come back in 8 weeks to have the Ultimates removed. He was never in a box stall...he has a very large open barn that was/is fully bedded with shavings and he moved as he felt well enough to. Because we were going into winter, I kept him in the barn, so his feet were not exposed to rain or snow.

The one problem that did happen with the Ultimates: The cast like material was wrapped too high in the back, and he developed cuts in the skin above his heel bulbs. The new farrier that I was switching too came out and used a grinder to take down the excess material.

When we went back to the vet school in 8 weeks, he had grown 17 ml of sole!!! That is tremendous!!! I cannot imagine not trimming your horse within that time period.

He was trimmed, and against my better judgement, the farriers put him in nailed on rocker shoes.  I think it was only a week or two before I had to have my farrier remove those shoes, and then the journey to find something that would work for his feet and keep him comfortable began. It was a looooooooooonnnnnnng journey.

After about a year of struggling, and Scotty still trying to walk on his tip toes, my vet and farrier determined that his tendons and ligaments were not able to stretch to allow him to plant his front feet firmly. Back to the vet school for check ligament surgery. (Mind you, Scotty is around 40 years old...still handled it all like a champ.) He came home within the next day or two, and somewhere along the way, my farrier let his heels get too high and his toes too long...again. Back to the vet school to let them figure out the best way to trim him. It's been over a year since another farrier took over, and Scotty's feet basically look almost as good as they did when he was completely healthy. He still prefers his Cloud boots, without the Cloud pads, most of the time, but when the ground is soft I experiment with one or other or both boots off for a period of a few days...until he tells me he wants the boot back on.

Because of his age, I don't ride, but he gets lots of hand walks down the road. I let him choose the length of walking time...if he wants to turn around, we turn around. Of course now we have snow and ice, so that is over for awhile.

I can't imagine why they are keeping your horse for such a long period of time, nor can I remotely understand the timelines you have been given. But, I'm not the expert...just letting you know what worked, and didn't work, for us. I hope this is helpful.

Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:

Eleanor Kellon, VMD

That's the Redden Ultimates.  Did she have a tenotomy too?  They did a derotating and aligning trim according to what is supposed to be done with the Ultimates. Big kudos for that much. The heel elevation is not a treatment I personally agree with but in any case it is supposed to be a short term configuration, not 6 to 8 months. Lowering is supposed to begin when the horse reaches 10 days off pain medication and comfortable.
Eleanor in PA 
EC Owner 2001

Kandace Krause

Dr. Kellon,
I don't know anything about tenotomy so I would say not.  What does it test?
The heel elevation - as per my xrays?
They have asked me to return mid February for another trim and evaluation with xrays, but today when told venograms showed good blood supply they told me that time line, with the boots, nothing about elevations.
That horse could not move about until full re-groth cycle complete. Currently 72 hours off pain meds and getting more comfortable daily.  But what is comfort?  Willingness to walk?  She is no longer shifting from one foot to the other in her stall.
Other horses I know experiencing laminitis were given 10 days stall rest, but they were not repeating soreness like my mare nor were they xrayed and ponies have not much use and horse is unfortunately lost to colic, so I don't know how his course would have gone on long term.
Kandace K Rocky Mountains, Alberta, Oct 2

Kandace Krause

My Second reply please also read other one starting about tenotomy

I just googled Ric Redden and ultimate and found an ECIR post from several years back where member was told to GET THOSE APPLIANCES OFF.
As I am no expert on the xray thing I did not look, but I did see group had encouraged member to let her horse move as much as it wanted to in it's paddock safely.
This is the procedure I followed before, with Easy Care Cloud boots, wedged pads.  Horse was very happy in them.  After Dec 10 xray we switched LF hoof to flat pad (vet said just take off boot, but I wanted no 1 inch difference in height under feet to create a balance issue)  I also was taking boots off her feet, both, for 1 - 2 hours daily, with her standing confined in deep shavings to help dry her soles that are already on the thin side and let them toughen up.
Could these changes have casued Dec 30 relapse to lameness?
I am inclined to let her move but am worried as snow may ruin "casting" that is holding the wedges on.  I had hoped these would be a 4 week timeline, until next trim.
Kandace K Rocky Mountains, Alberta, Oct 2

Kandace Krause

Thank you, the information you have shared is invaluable.  I may clear up a few things first,
The horse has been kept at clinic for this two weeks partly because it's too hard for me to have her at home when she was in pain and also there has been a four day delay with the venograms.  Now I am expecting bad weather again and will not drive her home until roads good.  Like you, we have a long drive, although fairly straight roads with a gradual climb of 2300'.
I am also expecting winter to hit and deep cold will make care hard.  I don't have a barn, just a run in shelter that I can make a 12 x20 stall but once there is more snow I expect that these boots will be a problem.  I was hoping for four weeks and movement allowed as water is not in shelter either.
I am not sure that I will find a place to board at a price I can afford with the work I need done, medication wise.
Also as this horse is only 15 I am really hoping that she will be sound enough to ride.  It is not a good place for a horse without a job.  And no pasture board is possible with the IR.  I am glad to hear that Scotty wore his boots so long and sorry that when they came off the next step didn't keep him as well.
I really wish they had got me into these in September, maybe we'd be out of them now as the weather worsens.

Kandace K Rocky Mountains, Alberta, Oct 2

Eleanor Kellon, VMD

Tenotomy is a surgical procedure that cuts the deep digital flexor tendon. It's often done with the Ultimate application. Doesn't sound like one was done.

Yes, the elevation with the Ultimates. The standard recommendation is to trim to a zero palmar angle then elevate to 20 degrees with the Ultimates. This  is then progressively lowered when the horse is comfortable. Yes, comfort is willingness to walk. I've never heard of them being left on that long.

Don't turn out with the Ultimates on.

Eleanor in PA 
EC Owner 2001

Kirsten Rasmussen

Kandace, could you add this link to your photo album to your signature?

If you can block in your shelter and put an insulated water trough in it, you might be able to make your vet's instructions work without having to board out.  Can you drive close enough to the shelter to bring hot water from the house to the pole barn twice a day?  There is an active discussion in the Horsekeeping group right now on dealing with freezing water when you don't have power to heat it.  If you are soaking hay that also provides a lot of water to the horse, and they can apparently eat it frozen without problems.

Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Kandace Krause

On my PC link shows in my signature.  I will go there in a few moments and try pasting again.

We did decide this morning, that we are going to move the heated(by propane) water trough up to the shelter and that will give her the access she needs.  I think her attitide will improve at home with her paddock mate.  Unfortunately that means J will not get out for walks as K gets too wound up when she can't see her buddy.
I found a couple of great sounding boarding people who would do their best, but I work for free (LOL) and know what and when happens.

Hay not being soaked as you, Kirsten , felt all three were safe, except possible extreme IR needing below 7%.  The jury is still out on that, as we were down to 46.22 before this last lameness flare up.  K had blood drawn today for re-evaluation.  
As CH was changed yesterday to reflect more what was happening at clinic, here is a quick run down of her feed that I want her on, mostly ECIR recommendations but also I would request advise on whether or not I should start all at once or reintroduce slowly.  In clinic she has only eaten Timothy 2 hay.  She has refused Mad Barn Amino Trace + balancer, I hope because it was offered only on it's own (and it doesn'r smell good, even to me.)
18lbs safe hay
8 oz dry r/s/r BP (as carrier) divided
200 grams Mad Barn Amino Trace + divided
4 oz ground flax divided
1 TBSP flax oil  (for oil with Vit E)
2000 IU Vitamin E 
2 TBSP loose salt iodised/cobalt divided
5 - 7 grams magnesium oxide divided
I would also like to give her WIRX and G's Formula, WIRX for her IR but she has only tolerated at 1/4 recommended dose and slowly reintroduce G's formula as horse has had severe Diarhea for several years until she was started on this product.  She has been scoped for and small ulcers seen at line between squamous and non glandular stomach.
Drugs Prascend and Metformin.
Thanks again for your understanding of the frozen north

Kandace K Rocky Mountains, Alberta, Oct 2

Kandace Krause

Thanks again, Dr. Kellon
Okay, no turn out in Ultimates.  Get them lowered as soon as possible, with horses comfort level as guide.  Anything else?  I will bring her home tomorrow or next day, they told me to wrap feet with vet wrap to help her move from trailer to stall on snow covered slightly sloped ground.

No Tenotomy for sure.  Would putting the venograms up in photos be helpful.  Yes I am still going to try to get the picutes linked properly.
Kandace K Rocky Mountains, Alberta, Oct 2

Kandace Krause