URGENT: Laminitis suspected, possible abscess too? Already on ER diet ... what next?


Laura and Ero
 

Ero appears to be having a laminitis event. He's already on the emergency diet (for several months) and is getting Cloud boots today. Temp is normal, he's eating/drinking, but bounding pulse on all feet. 3 grams bute with 1/4 tube Ulcergard (per vet). He's up and down a lot in his stall. What do I next?!

Background:

Vet was called out on 5/21 after he was foot sore with hind-end lameness the day after a routine trim (5/20). He initially had only slight pulse and heat in RH. Right hind was hesitant to land and always wanted to be camped under body. Left hind was post-legged and looked more lame. Sore on fronts. Padded him with foam inserts and he was immediately more comfortable, but still not walking normal. Much easier to walk on arena sand. Xrays on Friday showed no rotation, but he was foot sore all on feet. Hand-walked on Saturday morning (to encourage movement for suspect abscess) while keeping inserts taped on feet until boots arrived. 3g bute and 1/2 ulcerguard for 3 days per vet (possibly longer). Later that day (5/22), he presented with a bounding digital pulse on all four feet and was up and down in stall. Bedded stall deep with shavings. Will try to ice, not sure if it's too late though. 

Upon further investigation, I was told by barn staff that he pulled off his muzzle on 5/13 (with some minor head injury: scrape and swelling) and likely had access to grass for an unknown period of time. For the past month he's been in a muzzle and eating with it on through the fence. As I reflect, he's also been a little ouchy this past month, preferring softer footing for light work. Was trimmed on 5/20 and he fell apart. 

Rads from vet are in photo album (the LF looks strange angled because he didn't have his RH on the block so it's bent). Both hinds are taken with the inserts still taped on his feet as vet didn't want to remove after application. Rads from March are also avail to see a comparison. Also included photos of his camped under stance, with outward rotation (only RH). He has a history of SI/pelvic issues and is often adjusted there, C6 and poll from chiropractor. CH is updated, I think I captured everything. 

I don't know what more to do for him or what to expect!? He's presenting with a variety of possible issues, but I'm fairly certain with the DP in all hooves and the access to grass a week ago he's having an event. Rads don't show rotation, but can it be happening now?

Lastly, I've been trying to move barns but now am afraid he's not able to stand, load or haul for the hour trailer rider. Plus the stress of a new barn for recovery might be too much. Should I plan to stay put for at least another month? He's already managed as best as I can knowing what I know since Oct  ... what more can I do? I've devastated as I've been trying to keep him so good with diet, dry-lot and muzzle, and exercise through his other injuries. :(   

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Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Eleanor Kellon, VMD
 

Using Gastroguard with phenylbutazone increases the risk and severity of colitis https://pubmed.ncbi.nlm.nih.gov/32697849/ . I'm sure you can see that the bute is doing next to nothing anyway. I would stop it and go with https://uckele.com/laminox-3lbs.html - 5% off with coupon code ECIR.

I think you have answered your own question about what's going wrong. It's the grass. Can you tack chicken wire up around the outside of the dry lot, or hot wires, or an interior border of an electric wire that keeps him far enough away from the fence? The emergency diet isn't supposed to be used long term. He would benefit from diet balancing.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Laura and Ero
 

Unfortunately, I’ve asked about the hot wire and/or another fencing type already, but it’s not been met with much interest — hence the plan to move. It’s hard to find a place with a large enough dry lot for adequate turnout in my area. I finally did find a place, but I’ve had to compromise on distance and price. Is he safe to travel an hour away in his current condition? He’s up more than down in his stall. Should I start hand-walking or stick to stall rest? I don’t want to aggravate the laminae, and get a more rapid DP again do I?

Ero was on a balanced diet, but with new hay coming in every other month I couldn’t keep up with testing so was advised here to continue soaking my hay. 

And as of about a month ago, Ero refused to eat his Equi-VM (including anything I added to it, hay too). Uckele sent a new batch and still straight refusal. The plan was to get to a new barn, test hay and rebalance, but continue to feed Flax, E, Salt, magnesium with soaked hay for now. I was able to get a sample of Vermont Blend Pro to try, but with this episode I’m hesitant. 

Can remove the bute/UG. Not getting strong support from area vets re: that protocol, and it’s hard to continue to go down this road alone. 

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Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Kirsten Rasmussen
 

That's a tough question, I hope you'll hear from others on it, too.  If he was mine, as soon as the digital pulses normalized, I'd move him.  In padded boots.  One hour is not long and you can drive slow on corners and brake softly.  He will likely want to run around his new area so keep the padded boots on and confine him to a small SAFE pen where he can see the other horses (hopefully they are near enough that he doesn't feel alone in a strange place) but can't gallop around.  And continue to soak hay and use padded boots when you arrive until he settles in, at least.  He might need the padded boots when he is eventually integrated with the herd, too.  Just use your best judgment and common sense.

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


Sherry Morse
 

Hi Laura,

If he's up more than he's down I'd plan on moving him and making sure he has his boots on and take the drive slowly so as not to throw him off balance.  I would not hand walk him unless you know exactly what you're dealing with (and at this point you don't).




Laura and Ero
 

Agree on the approach and greatly appreciate the perspectives on moving. My gut says the same thing and initially he'd be stalled with a solo turnout available. It's more of a sandy base so hopefully that offers more cushion as well. Because he's EMS with high leptin, we're not sure about turnout with another horse just yet either (mostly as he'll eat everyone's food). Today his DP is normalizing. It's still present, but not bounding. In addition to the boots, heavy bedding and driving slow, my trimmer proposed casting his feet for additional support (and then boot over them). Any experience or thoughts on casting?

I also had a pre-scheduled baseline Glucose/Insulin and Vit E re-test for tomorrow, but given he's stressed and has bute in his system, I'm going to hold off. Will reschedule once at the new place for a few weeks. 

I've not gone through this before, so trying to understand what's next, what to watch for, expect. How long to wait until he's ready for walking, turn-out, (who knows on riding). I'm not pushing him, but he also needs to move as he has SI flexion and contracted muscles in his hind-end (working with an osteopath). This issue is the priority thought so I'm curious to see if he presents an event line in his hooves and am expecting he'll be 'rested' for several weeks, possibly for a full hoof grow cycle (9-12 months)? 


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Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Kirsten Rasmussen
 

Casting would definitely add an extra layer of support. 

As far as exercise, as soon as he is off pain meds you can evaluate how comfortable he is walking.  If he doesn't need any encouragement to walk beside you then handwalking is fine.  Putting off turnout with other horses is a good idea since you have that option.  After 6 months of healthy hoof growth (when the event line is in the bottom quarter of the hoof, approx) he should be ready for reintroduction to regular work.

If you add jiaogulan to his diet his hooves will grow out faster, but they will need to be trimmed more often.  It is also an adaptogen that could relieve some of the pain.

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