New lameness after making progress


Stephanie
 

Hi, 
My mare came in quite sore yesterday morning and I felt like her hooves were warm but did not find a pulse. She foundered in late June but had been making steady progress and was walking well. I soak her hay at night but have not been able to arrange soaking the morning hay at my boarding barn. She has also been pacing the fence line at least two nights this last week because of being turned out alone but i was able to bring her in one night. The remnants of Ian came through where I am in Maryland last Friday through Tuesday and with the mud in her paddock and problems with barn staff putting her boots on too loosely, I made the decision to turn her out without boots thinking the mud would cushion her soles and also to prevent straining her pasterns from stepping out of one boot and not the other or having one boot or both twist or slipping in the mud. She did have swelling in August I think because of being in her small paddock with one boot sideways. I've asked that she be walked out to her pasture with a muzzle on because there is grass in the walkway and she always tries,  but I discovered she was being led out without it and it's possible she's been getting a few mouthfuls - worst case scenario is since Sept 1st twice a day but I can only hope that has not been happening. Fortunately, my farrier was scheduled for yesterday and he trimmed her as well as recommended stall rest and also said some packed mud in her hooves might have caused discomfort. She shows an abcess line at the level of the part of her left hoof that marks the growth since she foundered so this could be a factor also. Last, I did find a bale of hay that is greener than the other bales from which she is fed and she got two flakes from this bale but soaked. And Friday night was the coolest so far in the 50s. So, I don't know how to determine if any one of these is causing the new lameness or if it is a combination and I don't know what to change. I've soaked her left front and reconfirmed with the barn manager that she cannot have any grass at all when she is being led in and out. I started a one quarter increase in Prascend based on recent bloodwork ACTH at 58.9 so she is at one and a quarter to increase slowly - she's been on one since late June. When do i change it to 1 and a half? A week? Also, is it safe to soak her hay overnight so it can be fed in the morning when I am not there? Is mold a risk? Also, do I soak her hooves in cold water if they feel warm to me or does that inhibit the circulation and worsen her pain? Any other ideas are most welcome. I am posting photos today to my CH. 
Stephanie in Maryland 2022
https://ecir.groups.io/g/CaseHistory/files/Stephanie%20Bella%20Vita 


Sherry Morse
 

Hi Stephanie,

1- at 58.9 her ACTH is not well controlled on 1 pill per day.  She should probably be on at least 2mg/day during the rise but we are now on the tail end of it so you could put her up to 1.5 now and test her in a month and see how she is or wait until we're completely out of the rise (December/January) and test her on the current dose and see if she's needing more year round.  

2 - is there a reason you can't soak all her hay at once and leave the morning hay set up for the barn staff?

3 - without pictures it's impossible to comment on the trim but she could well have abscesses mobilizing at this point in time.




Kirsten Rasmussen
 

Hi Stephanie, 

It is safe to soak hay and feed it the next morning.  I soak 24 hrs of hay every night.  If the weather is warm and humid, the hay might smell a bit fermented the next am, but it shouldn't mold that quickly.  Hang the nets or put them on a grate so try can continue to drain and get good airflow overnight. 

One bale of hay that is different could affect her insulin, so yes that's a possibility for a temporary laminitis flareup.  She could also be sore if she overdid the exercise running around on her damaged hooves overnight.  Have you had xrays of her feet done?   Can you post a full round of hoof photos as described here:
https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help
Soaking for abscesses is usually done with warm water.  Cold water soaking might help temporarily alleviate pain the same way icing helps humans with pain from injuries, but I don't think it's indicated even if her hooves feel warm.  You could try and see if she likes it.

The Chastetree berry in the Cushings Calm supplement can interact with the pergolide and reduce its effectiveness.  The Cushings Calm should be stopped.

What was her most recent insulin?  The last 2 were slightly elevated but no where near causing laminitis.  I suspect you are dealing with abscesses mobilizing, and residual pain from the damaged hooves that still need to grow out.  Possibly thin soles if mud packing in is painful.  Photos and xrays will help us sort this out with you.

I hope that got all your questions.  Can you add Bella's age or approx date of birth to your Case History when you add the new bloodwork?

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


Stephanie
 

Hi Sherry,

Thanks so much for your thoughts. I did add a quarter of a pill last week and don't see veil symptoms so yesterday I started a pill and a half. I will re-test in November.

I soaked her hay am and pm all summer because I was off from teaching, but she went back on full care September 1st and the barn manager has just said no, even though I offered to set it up. However, with Bella's new lameness I was ready to move her to a new barn so I know this week it is being soaked in the morning. I did have hay test results, but maybe I should re-do them because new hay was bought for the winter and I didn't think about it because it was from the same supplier - I'm wrong on that one. 

My farrier and vet both said abcesses could be cropping up so I am soaking. I can only get one picture that I took from the weekend to load on my Google drive so I put it just now in her album, but I will keep trying with the others that show her right side and these are body shots. Her trim I feel very confident in because my farrier has followed ecir for a long time. Am I supposed to put pictures in the case study or is it ok it is in the album? What I have is in the album. 

She is much better after three nights of stall rest, but the vet suggested five days of Bute, 2 grams a day. She had 1 gram Sunday night, 1 Monday morning, 1 Monday night and 1 this morning. Is that ok? I just was panicking. Thanks again!
--
Stephanie in Maryland 2022
https://ecir.groups.io/g/CaseHistory/files/Stephanie%20Bella%20Vita 


Stephanie
 

Hi Kirsten,
Thanks so much for the info! Do you mean soak for an hour and let it drain overnight or soak overnight for 10 hours - ish? Also, where might I get a grate? My idea would be like a grate from a fire pit right?
Thanks so much!
--
Stephanie in Maryland 2022
https://ecir.groups.io/g/CaseHistory/files/Stephanie%20Bella%20Vita 


Kirsten Rasmussen
 

Soak for 1 hr and let it drain overnight.

I use a wagon like this: https://www.amazon.ca/Gorilla-GOR400-COM-Removable-400-Pound-Capacity/dp/B01BECQBZ0/ref=pd_lpo_3?pd_rd_w=80zM5&content-id=amzn1.sym.bc8b374c-8130-4c45-bf24-4fcc0d96f4d6&pf_rd_p=bc8b374c-8130-4c45-bf24-4fcc0d96f4d6&pf_rd_r=ZGGK4VHDXPXA4CFBRAST&pd_rd_wg=1TU0k&pd_rd_r=1c791500-a1d6-429b-96f2-4436132a1abf&pd_rd_i=B01BECQBZ0&psc=1
Then I don't have to carry the heavy wet hay nets either.  But there's so many things you could repurpose to make a free grate.

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

Snickers' Case History
Snickers' Photo Album