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Bali Update and the perils of change

Mel V
 

I wanted to provide an update on Bali.  I updated her case history and uploaded a new PDF into the folder below.

I have been taking pictures to document each time we re-shoe her, but the interface to upload onto the ECIR folders is very cumbersome for me, so I've been documenting in my Google Drive and have made the folder of Bali Feet shareable.  I've largely been following the naming convention, but sometimes there are a couple of pictures of the same angles.  

Feb 17, 2020, I'd gone in for a workup thinking that the puncture had some scar tissue, and my vet said  she'd been suffering from low grade laminitis from a "no grain" diet change I'd tried,

This diet is advocated by a Dr. Geoff Tucker, who runs a facebook page  "The Horse's Advocate"... and a his lengthy blog https://theequinepractice.com/decomplexicating-equine-nutrition-introduction/ on nutrition. The long and short of this diet is that he recommends no grain, no supplements, and grass hay, alfalfa or alfalfa pellets and de-hulled soy bean meal (48% protein), Coolstance Copra or Whey if the horse needs more calories.  He is opposed to beet pulp, flax, and almost everything that is recommended for an ECIR horse here.  Well, the no-grain part is consistent.  I've thought of starting a spreadsheet comparing the recommendations, but essentially almost everything his diet recommends is on the "things to avoid" list here.  
He also has a nutritional "course" that you can sign up for and take, but I never took the course.  I have a couple of friends who are huge fans of this diet, but they do not have metabolic horses.

When I made this diet change, which is working quite nicely for my OTTB, I also had started Bali on Prascend, after the nail puncture/infection that triggered this entire cascading disaster for her feet/health.  We thought she was foundering last summer, but found the pocket of infection at Labor Day weekend. We'd tested her for cushings and she was off the chart (likely the pain). But, then when I switched to this Alfalfa pellet/SBM diet, I didn't realize I was triggering laminitis, and since she'd had that huge infection in her LF, then a massive abscess (likely a gravel) in her LH, I was blaming the lame steps on recovering from those to hoof traumas.  I also stopped the thyro-l as she'd lost quite a bit of weight on the Prascend and my vet thought it would be ok, she'd been on thyro-l since she was 8, and it does a fantastic job on her.  I've had 3 horses who I've had really good success with soundness using the very affordable Thyro-L as the only medication.  They go off it, laminitis, back on, comfortable.

With removing the alfalfa and SBM, putting her back on thyro-l and she went into the dry lots as spring was arriving early, the low grade laminitis appears to be gone, growth is looking normal.

I will  have her insulin, glucose and ACTH levels tested again later when the budget allows, and update her case history with results.  But for now, clinical soundness is what we were after, and that is where we are.  She does not flare up or get sore with 15-20 minutes of grass (after exercise usually) or a treat or two.   

She's currently getting the 7 shot Adequan series, she is 16 and I've found this helps.  Her last series was in 2016 or early 2017. 

Thank you for running the forum and while my vets and farriers didn't agree with 100% of the trimming recommendations suggested here, we have reached my end goal, which is a sound, happy horse.  It will be another 6 months to grow her foot completely out, but the new growth looks good.  
    
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Mel & Bali
Joined ECIR 2/23/2020
Purcellville, Virginia, USA
Case History: https://ecir.groups.io/g/CaseHistory/files/Mel%20and%20Bali
Updated Photos: https://drive.google.com/open?id=1YsoydAZGCqcWneSIfxh4dr2SBcXlMrFM  
https://ecir.groups.io/g/CaseHistory/album?id=241764

Sherry Morse
 

Hi Mel,

Sorry you got sucked into that but just as a note, given Bali's ACTH of 48 in February, if she were mine I'd bump her Prascend dosage up and then retest to see if she's in the normal range before the seasonal range.  That result at this time of year says that the Prascend isn't enough to control her ACTH and since she already has a history of laminitis making sure she's as well controlled as possible will hopefully prevent a recurrence this year.