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Lily suspected of ringbone

Kati Indigo
 

Even with our new trimmer who is beyond amazing Lily still is dealing with pain especially in right foot. Our trimmer recommended a lameness specialist. I send her the 3 different sets of x-rays & she suspects Lily may have ringbone in addition to the effects laminitis.

Our appointment with her is on Thursday. I will post new x-rays and the vets opinion afterwards.

Lily is such a trooper hanging in there with us.
--
Kati and Lily in Arizona member since October 2018

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Lavinia Fiscaletti
 

Hi Kate,

Lily definitely has significant ringbone - worst is the LF, where the joint looks like it may be fused to some degree. If her trim is much improved, she could be dealing with neuropathic pain from the damage caused by the laminitis, she may be harboring more abscess material that needs to exit. New rads at this point would definitely be a good idea as there has been a change in her trimming.

Would be great to see a set of new pix so we can see how the trim has progressed.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

Kati Indigo
 

Thank you Lavinia!
Curiously it's been predominantly her right foot that has seemed to give her trouble. But stuff flares up in her left here & there too.
We've been keeping her in boots with the Cloud inserts a lot. Lily also seems to benefit from bodywork with an osteopath who was actually the one who recommended our new trimmer. Our trimmer in turn suggested new vet. With that it seems we may have finally the right support team. 

I sent the new vet the blood tests & she thought Lily's ACTH test may have been influenced by seasonal rise since Lily seems asymptomatic.

Lets see what happens and hope for the best!

Thank you for your tireless suport!!!

I will keep you guys updated.


--
Kati and Lily in Arizona member since October 2018

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Eleanor Kellon, VMD
 

See message 235733 from May. Some people call the pastern joint arthritis high ringbone, or high articular ringbone. The bony changes located midway between coffin and pastern joint can set up and become painless but the changes involving the joint do not. However, none of this means she doesn't also have hoof pain.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Kati Indigo
 

Thank you for clarifying that Dr. Kellon. I remember you had mentioned arthritis. Thank God tomorrow is Thursday already with the vet coming. Last night Lily's right foot hurt her a lot again. Hopefully we can find out what causes her right one to hurt more than the left that shows more arthritic changes.
--
Kati and Lily in Arizona member since October 2018

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Eleanor Kellon, VMD
 

Did the left show more arthritic change on other films? Don't  see it on the ones in the files but the angle of the film is  bad.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Kati Indigo
 

I feel rotten & more confused after lameness specialist was there. Since the last x-rays in May Lily has gotten worse. Rotation got worse, she got bone spurs, ringbone. She seems since we changed trimmers that hasn't helped. I don't have copies of x-rays yet but despite my reservations I agreed to have clogs put on her.

The old trimmer had warned if we raised Lily's heel she would get worse. We did & she regressed. On top of that vet prescribed Equioxx.

This is not a good day.
--
Kati and Lily in Arizona member since October 2018

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Kati Indigo
 

Well I posted the x-rays and I wrote to my trimmer about my ambivalence.

She was not very encouraging saying if clogs don't work that ww may have to let her go since she's been not putting her heel down & buckled. It got better in recent months but now we're looking at more laminitis.

I am so sad right now.


--
Kati and Lily in Arizona member since October 2018

https://ecir.groups.io/g/CaseHistory/filessearch?q=kati+and+lily

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Nancy C
 

I just want to say hang in there Kati.  It's hard work. Hug your horse.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA

Eleanor Kellon, VMD
 

The core principles IMO with problems involving the feet and lower joints is to:

  • Align the hoof wall with the structures within including a normal palmar angle
  • Encourage heel first landing with a suitable base of support in the hind foot
  • Maintain an equal distance between the bones (joint space) in a joint, front to back and side to side - doing the first two points correctly will do this unless you have damage

Most devices used on the feet are not inherently bad. What's bad is ignoring the trim and failing to achieve the above goals.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Eleanor Kellon, VMD
 

She may be one of the very few where cutting her deep digital flexor tendon is in order. Discuss with your vet.

Also, from the September films her trim has never been corrected. No device can help until that is done.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Lavinia Fiscaletti
 

Hi Kati,

Know how hard you've been trying - sorry to hear it's been such a tough day.

The old trimmer warned there would be a decrease in blood flow if you changed the trim - that didn't happen. You got some needed increase in sole depth - a good thing - but other parts of the trim haven't been addressed well. Yes, there is  now rotation but she had bone spurs and ringbone before.

How is Lily feeling with the clogs on? Were any changes made to the trim before the clogs were added? Can you get some current pix up? As Dr. Kellon said, appliances aren't inherently bad or good - it's all about the trim they are attached to. Unfortunately, the trim still isn't where it should be to be optimal.

When was the last time you had any blood work run? Did you ever have the TRH stim test done to rule out/in PPID? Last Nov there was an ACTH result of 55pg/ml that was borderline. If she has PPID and that has not been addressed, it could certainly be a driving factor in the new rotation, esp. as you say she had gotten better in the last few months but things have gotten worse again recently as that would follow the seasonal rise timeline.

Hugs to you and  scritches to Lily.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

Kati Indigo
 

Thank you Dr. Kellon & Lavinia!

I didn't realize that issues were never addressed properly by both trimmers. I also, having no experience with reading x-rays, never realized that Lily had these other issues with bones to start. None of the attending vets ever brought that to my attention until now & Dr. Kellon mentioning arthritis in May. However prior to laminitis she had no lameness issues aside that 2 months after I got her she was dtill tenderfooted on the harsh desert terrain my horses get to roam around in.and we reluctantly shoed her which seemed to make her sound although she always landed on her toes first. I didn't realize then that is bad.

I am not certain what Dr. Kellon meant exactly with suitable base of support by hind foot to encourage heel landing or how to achieve equal distance between bones. Long story short, I forwarded Dr. K.'s message to trimmer who just like the first trimmer went into a negative barrage against you guys. Well my horse hasn't gotten better. Actually she has gotten worse. About a month ago I had mentioned to her I saw new laminitic stress lines developing & left foot losing concavity which she dismissed & blamed heat as well as claimed fresh growth underneath would be concave.

Unfortunately the farrier who put clogs on did not take toe back. Only trimmed slightly on heel & even out hoof. So no correction to a significant degree.

I also noticed that Lily's left foot is higher then her right. When we got Lily she had 4 different shaped hooves, the left front being almost a bit of a club foot. Naively I had thought it was just lack of proper care. Laminitis Trimmer 1 had left foot looking almost better than the right although we had too low heel issue. With Trimmer 2, now in hindsight Lily's left has gotten worse & under her care Lily developed more rotation again. With her dissing your input that's it for me. I don't care anymore that she inquires twice a day how Lily is doing. Seeing the newest farrier's lack of corrective trim despite rotation she saw on x-ray does not endure her to me either. I will see if she is open to input from you or I have to keep looking. If any Arizona people know someone good who comes to Laveen please private message me.

I cannot fathom letting Lily's flexor tendon be cut. And as long as trim is off I will not even consider.

BUT with the clogs on, Lily must have gone bananas yesterday. She went as far as running around, her attitude changed completely! I am unfortunately out of town but my roommate kept on updating me. By the end of the day she seemed ouchy & this morning she reported Lily being ouchy but also that she is walking around & exploring with great attitude. BUT she also got a prescription of Equioxx once a day. Would you recommend her NOT getting those at all? Because that could be masking pain & she ends up worse than before, right?

Onthe positive side, the clogs seem to help. But as Dr. Kellon says, if the trim isn't properly addressed nothing will really work. I will see if the new farrier is open to address issues as recommended by you. Or I have to keep looking.

I have a few hoof pictures I will try to post. The clogs are held in place with vet wrap so it will be hard to see. I had inquired about whether breakover point was in right place but since she did not take toe back at all, I seriously doubt it.

Thank you again.

Lavinia,s markups from May is addressing the issues with the trim, so I could forward those to the newest farrier, correct?


--
Kati and Lily in Arizona member since October 2018

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Kati Indigo
 

Lavinia - no new blood work but with everything draining $ that unfortunately will have to wait. I had forwardes blood work to newest vet. She thought the higher values could have been because of seasonal rise.
--
Kati and Lily in Arizona member since October 2018

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Kati Indigo
 

I added August 18 pictures and Sept 12 pictures which unfortunately I only took 2 which show clogged right foot & left foot clog prep with NO taking back of toe.
--
Kati and Lily in Arizona member since October 2018

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Kati Indigo
 

I realize I am in crisis mode. Fear has a grip around my heart. But initially Lily's first trimmer seemed to do the right things bringing her back from the brink of penetration in 2 short months. It was not unti in the spring time when Lily started having persistent pain in her right foot that led to new x-rays that we realized the trim may be part of it & when our trimmer 1 dismissed Lavinia's input completely we made the change. There was no way of knowing the 2nd trimmer was off too. She was concerned about Lily's toe down stance, we made changes by adding boots, pads, bi-weekly trims & increased walking. Lily got a little better but about  a month ago I also noticed new laminitic stress lines. I watched trimmer 2. She took back toe. She was engaged in Lily's progress on a daily basis. There were seemingly decreases in pain levels. But because Lily did not make a major improvement trimmer was the one who suggested properly marked x-rays by a lameness specialist to see if she had navicular. She wanted to contact vet prior to x-rayswith her concerns prior but didn't

Well Lily was fidgety despite nerve blocking & vet did not really mark the hoof wall the whole time that these x-rays look more like action shots & no one mentioned anything about navicular which trimmer suspected was underlying failure of drastic improvement. I am not sure they are the correct shots for that. Are they?

So both trimmers didn't trim the way necessary. Here we are exactly 1 year after the first laminitic x-rays with more rotation after changing trimmers. When trimmer 2 just gave me blowback after I forwarded her Dr. Kellon's concerns with the same "I know better" attitude as the first trimmer I decided to move on. But as the farrier who put on clogs did no corrections in Lily's trim I have no confidence in keeping her. So now what?

And what about the Equioxx? Lily prancing in clogs may be partially due to that possibly creating damage? But possibly clogs also created pain relief?

One option I am considering is the farrier who used to shoe Lily. I had him sometimes trim my barefoot horses and I really liked him. When he shoed Lily he had given her shoes that provided a better brakeover point. So he is quiet & deliberate. I don't know if he works with clogs although I know he has a wider arsenal of tools then just shoeing. But it is hard to get any feedback or opinion from him. He just does what he does quietly although he seems very good.

I feel almost back to square one but by the grace of God she has a little more sole. I am truly in crisis mode. Should I leave clogs on & wait, take them off & try former shoer? Try myself??? Thought scares me but others did it before.
I pray to God I need help.

--
Kati and Lily in Arizona member since October 2018

https://ecir.groups.io/g/CaseHistory/filessearch?q=kati+and+lily

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Lavinia Fiscaletti
 

Hi Kati,

First thing - please breathe. I know it's hard right now but it will help. It shouldn't be this hard to get the help needed to fix Lily's situation but unfortunately, it's too common a scenario as so many of the members here can attest to.

Please realize I'm on the outside looking in, so it makes it a bit easier for me to see things without the emotional filters in place.  Each trimmer has made positive advances with some aspects of the trim but lost ground on other aspects - neither one managed to get the entire trim where it needed to be.  Your first trimmer did an excellent job in getting things moving in the right direction, correcting some serious issues with the trim that were making it impossible for Lily to make progress. Unfortunately, that situation deteriorated when the individual couldn't get out of "rehab" mode so was knowingly sacrificing aspects of the trim (sole depth, heel height and HPA) to maintain a pre-set palmer angle.

The latest trimmer appears to have been making some progress on getting rid of that excess, bulbous toe material and adding to the sole depth and heel height that were lacking. What appears to have been problematic is that the toe length at ground level was starting to get away during this time. Plus, bony column rotation also entered the picture. This rotation was not caused by the latest trimmer, it just happened on this trimmer's watch.

The old farrier you are considering - was he the one who was trimming her when all the problems started?

Due to the time of year when the latest laminitis and rotation occurred, PPID has to be on the suspect list, esp. as Lily had an elevated ACTH level last year in Nov. You can't trim your way out of PPID-driven laminitis/rotation - you need to address the underlying PPID.

Temporarily, the clogs may be helping her feel more comfortable. Unless the trim is corrected, however, that will be short-lived as she will quickly outgrow their ability to compensate for the issues that are present. Because they are taped on rather than glued or nailed, you can remove them easily when they are no longer being helpful.

What dose of Equioxx is Lily on? Because she has arthritic issues, it may be an appropriate thing to do to some degree but only at the correct dose and with the knowledge that it may mask other pain and allow her to do too much. However,  it won't address the mechanical aspects of the rotation or the causes of it.

No, those rads were not the ones needed to assess for the possibility of navicular issues but honestly, I don't believe that is an issue anyway. If it is, it is way down on the list of reasons for Lily's discomfort.

I sent you a PM with a possible solution. Hang in there.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

Pam.palominopony@...
 

Not sure where you are in Arizona, but Paige Poss of Iron Free Hoof has relocated to Arizona.   She may be able to help with your horse or direct you to another farrier.  She is well versed in good hoof care.  She may have spoken at a No Laminitis Conference as well but I am not 100% sure of that.  Very nice person too.

Hang in there!   One thing you will definitely get a handle on is patience.   Somebody said that watching a PPID/IR hoof grow out is like watching paint dry.    It’s so true.   These horses teach so much!  

Pam in Va
12/10
Story IR. Roscoe PPID
Buttercup IR/Frosty PPiD both over the bridge 

Lorna
 
Edited

Oh, Kati, it would be so great for Lily, if you could get Paige on board!!

She has years of experience rehabbing laminitic hooves,and Lily would be in such good hands.

Go to Iron Free Hoof to get an idea of what she's about.

www.ironfreehoof.com


--

Lorna  in Kingston, Ontario, Canada
ECIR Moderator
2002
https://ecir.gro
ups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf


 

Kati Indigo
 

I know I mentioned Equioxx. The vet prescribed 1 pill for once a day for 2 weeks. I am still out of town for work until tomorrow but my roommate reported that especially Friday & Saturday Lily with the clogs had moved around more than before with attitude. But I really don't know how much of that would be Equioxx and which part the clogs. Oh I hope it's not doing more damage...
--
Kati and Lily in Arizona member since October 2018

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