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Lavinia : new hoof pics after trim farrier back Monday

Lori Ricigliano #281987 Hello Lavinia could you please review these new pics of mya . The farrier trimmed her on august 5th according to your last markups . She seemed a bit better at first & now is struggling again especially with her left front . She has been doing more of this stretch stance & may be loosing some weight . She prefers to put weight on her right front even though according to X-rays it is worse. I think she may be having an abscess in her left front starting ? Farrier is back out this Monday august 22. coujd you give me some guidance as what to do to make her more comfortable with her trim ? I have to update her file - we are on very little thyroid & only a gram of bute a day . I have added phytoquench- mag ox - vit e - triple crown Timothy cubes - still rinsing /soaking hay - waiting on hay analysis - metformin bid - 1/2 tab prescend - rsr beet pulp - acetyl argentine- flax Thank you lori -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND
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Sherry Morse #281989 Hi Lori, Are you weaning her off the bute? If she is trying to mobilize an abscess the bute will inhibit that from clearing and that could create the scenario you're seeing right now. Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891
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Lori Ricigliano #282036 Yes - we are almost weaned off of bute - we are close now to removing it completely toggle quoted message Show quoted text On Aug 21, 2022, at 7:34 AM, Sherry Morse via groups.io <sherry_morse@...> wrote: Hi Lori, Are you weaning her off the bute? If she is trying to mobilize an abscess the bute will inhibit that from clearing and that could create the scenario you're seeing right now. Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND
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Lori Ricigliano #282040 Farrier will be at my Farm later today after 1 pm central (Mon 22) to Update trim if you have a chance to look at the files - thx you lori toggle quoted message Show quoted text On Aug 21, 2022, at 11:44 PM, Lori Ricigliano via groups.io <Riciglianofarms@...> wrote: Yes - we are almost weaned off of bute - we are close now to removing it completely On Aug 21, 2022, at 7:34 AM, Sherry Morse via groups.io <sherry_morse@...> wrote: Hi Lori, Are you weaning her off the bute? If she is trying to mobilize an abscess the bute will inhibit that from clearing and that could create the scenario you're seeing right now. Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND
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Kirsten Rasmussen #282072 Hi Lori, Sorry, not Lavinia. Did she have a trim yesterday and did she feel better after again? It really looks to me like your poor girl has had a lot of abscessing and possibly another waiting to exit at the coronary band on her LF. The best thing you can do is encourage those abscesses to blow even though it is very painful. The usual poulticing and Epsom soaks might help. She should also be on the herb jiaogulan to increase circulation in her hooves to help with that. Mad Barn and My Best Horse both sell it. The NSAIDS block it's effects but since you are weaning her off them the jiaogulan should help. Give 1 tsp 2x a day 20 min before a meal. Her gums should turn noticeably pinker; if they don't, increase the dose by 1/2 tsp increments until you see an effect. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Case History Shaku's Photo Album
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Lori Ricigliano #282076 Thank you I did get her trimmed & we found an active absess at the toe on her right front which we could open by squaring the front of her hoof . It surprises me she stands more on her right than her left front - her left front seems to cause more pain to her but her right front has the active absess ? The left front was dry . We lowered the heels a bit on both & put her back in her cloud boots. She seemed a bit more comfortable & stood quite a bit before laying down . She was active eating - she can be fussy with her supplements though . I have gotten the jiaogulan so I will try that . The mare has gone from 2gr bute am & pm to now 1gram am per day & am trying to get her off that . I worry about the epson soaks as I don’t want to soften her sole or hoof too much - don’t want to get solar penetration- you can see in her files her coffin bone esp the right has a pretty severe angle . Thoughts ? Thank you Lori toggle quoted message Show quoted text On Aug 23, 2022, at 9:21 AM, Kirsten Rasmussen <kirstenrasmussen3@...> wrote: Hi Lori, Sorry, not Lavinia. Did she have a trim yesterday and did she feel better after again? It really looks to me like your poor girl has had a lot of abscessing and possibly another waiting to exit at the coronary band on her LF. The best thing you can do is encourage those abscesses to blow even though it is very painful. The usual poulticing and Epsom soaks might help. She should also be on the herb jiaogulan to increase circulation in her hooves to help with that. Mad Barn and My Best Horse both sell it. The NSAIDS block it's effects but since you are weaning her off them the jiaogulan should help. Give 1 tsp 2x a day 20 min before a meal. Her gums should turn noticeably pinker; if they don't, increase the dose by 1/2 tsp increments until you see an effect. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Case History Shaku's Photo Album -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND
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Sherry Morse #282077 Hi Lori, One housekeeping point - can you please make sure you delete the message you're replying to as it's easier for people on digest to read if there's not multiple copies of the messages. As far as tapering off - it should be a 10 day process to wean off bute. Have you read https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf? If she's down to 1g AM & PM you can stretch the time between doses out to 48 hours for 2 doses and then go to .5g every 48 hours for 2 doses and then stop. If you want to replace the bute with Devil's Claw see information on how to do that here: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/Pain%20control,%20switching%20from%20Bute%20to%20Phyto-Quench.pdf Again, the sooner you can do that the better in terms of resolving those abscesses. Can you post pictures of the current trim? Did her toes get brought back? Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891
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Lori Ricigliano #282086 Hello - I’m sorry about the reply messages - I’m not sure how to delete the message I’m replying to? im not a good computer friendly person - difficult for me to understand, unfortunately. as to the mare I have her on phyto-quench with devils claw already - she doesn’t like eating it unfortunately. So with that I should just stop the bute according to the referenced article I should - but I’m having difficulty in her eating the phyto-quench?? Hints on how to get her to eat that ? with epson salt soaks in warm water is that safe ? I don’t want to soften her sole and risk a solar penetration because her sole gets too soft? Also I read somewhere in the digests here that I SHOULDNT give the devils claw plus by uckele as it has yucca and As she is an IR mare that’s not good ? What devils claw product should I give then ? She does eat the uckele devils claw plus when I offered it to her separately before I got the phyto-quench . I’ll get some new pics uploaded to her file hopefully by tomorrow- I hope my farrier backed the toe up enough - he doesn’t believe in what I’m doing & would prefer I put her down - even though she stands 75% of the day nickers when she greets me and does eat her soaked hay - she walks stiffly in her cloud boots and has that stance - so he believes she is “done” & should be put down . This just destroys me personally- I feel like I’m fighting a loosing battle & im the only one who thinks we can overcome this . She is on metformin & I need to now get the second blood test to check her glucose & insulin levels - but she is better that she was when he first trimmed her a month ago - so I believe she is getting better . -- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 MYA CASE HISTORY : https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History OLIVER CASE HISTORY LINK: https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER OLIVER PHOTOS: PEND
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Sherry Morse #282092 Hi Lori, You managed to delete the original message here so you're ok. For the PQ with Devil's Claw I believe it can be dosed using a dose syringe if needed (I don't use it so don't have experience with that but I think some of our members have done that). Have you tried offering her a very small amount to see if she's willing to eat it? I would not soak her feet unless you know she has an abscess ready to blow. You can use poultice instead. Uckele does a Devil's Claw without yucca but you need to call them to order it. You can also source straight Devil's Claw and use that. I believe both My Best Horse and Mad Barn carry it or you can look at a product like Equimins Liquid DC (https://www.rideawaystore.com/en-US/Equimins-Devils-Claw-Liquid-Joint-Supplement/r50190180.htm) If your farrier is not on board you may need to look for a practitioner who is willing to work with you or consider taking up trimming yourself. It certainly does not sound like she's ready to give up right now. Her stance is fairly typical of a horse who is in lot of pain. In our experience getting the toes shortened will help with that immensely and the effect is pretty much immediate. Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891
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Martha McSherry #282158 Hi Lori, I was looking at your case history and thinking it needs some updating. And there may be some things we missed initially. The only way I could catch up is by re-reading all your posts. The case history is so that we don’t need to do that - if everything is in the case history, we know we won’t overlook something while digging through the posts. Not that we’re lazy or don’t enjoy reading but our expectations are that we will find what we need to know in the case history. If you need help with the case history, let me know privately and I will try to work you through it. If she’s still on Thyro-l, would taper her off. It’s highly unlikely she has an actual thyroid issue and she does not need to lose weight. If she’s still on any amount of bute, it should be discontinued over the next few days. You have tapered her down to 1 mg, I read in your posts, which in my mind is a “standard” dose. She would be much better served by PhytoQuench and Devil’s Claw. Once her trim is in order, you can use jiaogulan. I noticed in the case history that she is on what appears to be an omeprazole derivative. Is she still on that? The combination of NSAIDs and omeprazole has fairly recently been shown to be a bad combination, resulting in likely colon damage. It’s likely heal itself after NSAID removal but that may be part of the stance she shows. I understand why they are prescribed together but that happens to be faulty thinking. NSAIDs do nothing to help metabolic laminitis, if they even diminish the pain temporarily, which would be unexpected. You need to focus on diagnosis, diet and trim at this point because fixing those is what will help the pain. She is eating soaked, stemmy alfalfa hay. Alfalfa can make some IR horses foot sore so I would change to a different forage for now. She doesn’t need poor quality hay. She needs the best hay possible to heal, with low sugar and starch. Alfalfa is generally low in sugar and starch but I think you should eliminate it from her diet while you’re sorting things out. If she were mine, I would switch her to TC timothy balance cubes at least until she starts to gain back some weight and I could locate hay with an ESC+starch of <10% and balance its minerals appropriately. The beet pulp you feed her should be rinsed, soaked and rinsed again until the rinse water is no longer brown. It seems that you are adding granulated salt to her diet but there is no mention of our recommended vitamin E and ground flax. For a refresher, please see the welcome letter I sent you in late June. Have you done blood testing since starting her on metformin? If it hasn’t decreased her insulin, I would consider dropping it. Normally, we don’t start metformin until dietary changes have been made and tested for effectiveness. It isn’t generally effective over the long term so it’s important that all your management ducks are in a row before putting it in place. While you’re testing her insulin again, I would suggest testing the ACTH. You had mentioned that the blood sample was saved quite awhile before submission which is a little unnerving. The glucose level suggests the test is fine but I would do it again to be sure. There was some discussion about starting her on pergolide anyway but I don’t know if that happened. -- Martha in Vermont ECIR Group Primary Response July 2012 Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR) Martha and Logo
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