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Princess diagnosed with hind-hoof laminitis night before last

Amy Veatch
 

Princess, my 12 year old Kentucky Mtn Saddle Horse, was down in the pasture when I got home Wednesday evening.  Vet came out that night, we cold hosed her hind hooves (both had strong digital pulses, fronts only weak digital pulses), elevated heartrate but capillary refill and skin tent ok.  She wouldn't lift any of her hooves and her back and hindquarters are really tender (I had given banamine before vet arrived, so we started 2g bute Thursday morning and dosed Thursday pm and Friday am, along with remission, 2 scoops am, 1 scoop last night.)  It has been extremely hot here (98 degrees yesterday and the horses are starting to grow longer hair, so they are heat stressed).  She has been out in pasture so she can spend the daytime in the woodline where it's cooler by the (mostly dry) creekbed.  She hasn't been coming out into the pasture to graze until Sunset.  The vet returned yesterday morning and Princess was much improved, digital pulses gone, heart rate normal.  Princess is overweight, cresty neck (which stays even when she is thinner), fat pads on withers, back, hindquarters--she carries her weight on top, rather than her belly). Due to this, the vet felt comfortable diagnosing her with EMS without blood work.  She recommended confinement on deep shavings, soaking hay, Remission, bute 2X per day, and wants to start Thryo-L today to help boost weight-loss.  I haven't been riding her this summer because it's been so hot and she seems miserable with the heat.  I had the horses in the barn during the day earlier in the summer, but it got to the point where even with open windows and high-velocity and ventilation fans going, it was getting really stuffy for them in the afternoons, so I put them out 24/7 so they could get in the shade where it felt cooler than in the barn.  She does not like having her feet iced and really shifts her feet when I do this.  Yesterday I very gently rubbed green jelly (horsie Bio-Freeze) onto her back and hindquarters to see if that would help her, but I can't really tell if it did or not,  Should I still continue to ice her feet?  Yesterday it was ice packs taped to bell boots because she wouldn't lift her feet, but this morning I got her feet into rubber tub for icing.  She acts like it bothers her and she keeps lifting the iced foot (I did them one at a time) up.  Should I continue icing?  Is there anything I can do to help her back, hip soreness?  Her stance is fairly normal (and has been since the beginning--she doesn't park out behind or try to stand to far forward or back), so I uploaded a photo.  She was still taking very short painful steps behind this morning and shifts her weight between all of her feet when standing.  I sent off hay samples this morning, so should have results later next week.  Thanks,
Amy and Princess
--
Amy Veatch

Sherry Morse
 



LJ Friedman
 

Icing a waste unless this is laminitis from grain overload, etc.  most laminitis is from high insulin shown thru blood work 
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 

Kate Triplett
 

Amy, EVERYTHING that Sherry said!

I will add from personal experience with a big horse who would tie up in hot weather when he lost too much through sweating, soaking her down with a strong solution of magnesium will help the muscle soreness and cramping.

If you can't get magnesium oxide, use plain old epsom salts (magnesium sulfate). Sponge it into her coat over as much of her body as you can. The transdermal absorption is most efficient way to get the Mg into her bloodstream without the digestive upsets. Muscle cramping relief is very quick using this method. Look up "magnesium transdermal therapy"....

--
Kate and Bunny (Irish Draught broodmare "possibly" PPID) and Lacey (Irish Draught Sporthorse broodmare IR laminitis)
Homesick Angels Farm, WA USA
Joined August 2019
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Bunny
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Lacey
Lacey feet image files  https://ecir.groups.io/g/CaseHistory/album?id=95210
Bunny image files  https://ecir.groups.io/g/CaseHistory/album?id=95239



 

I have to question the claim that transdermal therapy is the most efficient way to get magnesium into the bloodstream. See: Myth or Reality - Transdermal Magnesium Therapy Your personal experience is not without merit; however, there is no good scientific evidence or physiology that can explain how magnesium can be absorbed through the skin more efficiently than oral intake. 

--

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005

https://scholar.google.com/citations?hl=en&user=3-I7UI0AAAAJ 

 

Amy Veatch
 

Thank you Sherry! I've been researching on the site and sharing articles with the vet. She thinks the body soreness is from 4 hoof pain and the suspected insulin issue affecting her entire body. We didn't test blood that night because the laminitis would skew the results, but will definitely test her once she's a little better. I've sampled her hay and submitted it to the lab, which should have it Monday. Our local extension service helped me with that. After reading up on endocrinopathic laminitis, I switched her from bute to devil's claw and ordered jiaogulan which will be here monday. She actually looks much better overall today and the body soreness is a lot better. She's very calm natured and seems pretty happy in her stall, so that helps.
--
Amy Veatch
https://ecir.groups.io/g/CaseHistory/files/1%20Case%20History%20Form%20and%20Instructions/Princess%20Case%20History.pdf

Kate Triplett
 

Kathleen, best I can tell you is that is DOES work, and very effectively, on both horses and humans.

My husband had evil horrendous leg cramps for most of his adult life. After he began rubbing on the MAG oil (we make if from our own MAG Flake) the cramping essentially ceased - very rarely will he have a relapse, and that's if he "forgets" to do it a couple times a week. My own experience with splitting migraine due to my injured neck knotting up - and we are talking about a golf-ball knot right under the base of my skull - is that within half an hour of rubbing in the MAG solution to the affected area, the muscles let down and the pain subsides.

YMMV, but I know what works for us.
--
Kate and Bunny (Irish Draught broodmare "possibly" PPID) and Lacey (Irish Draught Sporthorse broodmare IR laminitis)
Homesick Angels Farm, WA USA
Joined August 2019
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Bunny
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Lacey
Lacey feet image files  https://ecir.groups.io/g/CaseHistory/album?id=95210
Bunny image files  https://ecir.groups.io/g/CaseHistory/album?id=95239



Nancy C
 
Edited

My concern is that folks will get the idea that this soak can replace testing and determining how much magnesium and other minerals are needed. I have heard this in other circles. Minerals need to be given orally.

The retrospective study Kathleen posted is pretty overwhelming that the amount of magnesium that is absorbed is minimal, if at all.

It's gotta be in dietary intake to best help our horses. Magnesium Oxide works fine for the vast majority of horses.

Amy -- glad she is doing better today.
--
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

Jane Fletcher
 

I’ve heard of towels being soaked in water that has magnesium in it and draping that on horse muscles.


--
Jane, South East Western Australia
Nov 2016
Garnet and Bill

 

Hi Kate,

To be clear, I'm not discounting your personal experience. Our role is to communicate to the members here the best scientific evidence we know to be true. e.g., "Members and volunteers work to be clear as to solid scientific or medical evidence versus personal theory, observation, or experience in case-by-case support." Currently, there is not enough scientific or medical evidence (or physiologic explanation; there are no magnesium transporters in skin) to support transdermal therapy over oral. There is some evidence that magnesium can be absorbed through hair follicles and/or sweat glands - the horse may have an advantage over humans in this department - but it's pure speculation. There are no studies in horses

The point is that we (ECIR group), have an obligation to readers to point out that this is your personal experience and that there are no studies in horses to showing the effectiveness of transdermal magnesium therapy. If owners want to try it, there is probably no harm, but it should not replace oral dietary supplementation. I know you didn't suggest this, but you'd be surprised how suggestions can get misinterpreted; note the two posts in just the amount of time it took me to write this.
--

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005

https://scholar.google.com/citations?hl=en&user=3-I7UI0AAAAJ 

 

Eleanor Kellon, VMD
 

Re:  Mag

I think the major issue is the claim it is superior to oral supplements. Many other minerals also have documented uptake through the skin - iodine being the most familiar - but for whole body levels that isn't necessarily the best way to go. It does make sense that transdermal uptake would have more potent local effects than systemic ones.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Kate Triplett
 

quoting Dr. Kellon

"It does make sense that transdermal uptake would have more potent local effects than systemic ones."

And that is what I said - I personally use magnesium solution transdermally for muscle soreness and tightness. I did not mean to imply boosting systemic levels by using ONLY this method, I was addressing the physical discomfort of the OP's horse and a fast and safe way to alleviate that.
--
Kate and Bunny (Irish Draught broodmare "possibly" PPID) and Lacey (Irish Draught Sporthorse broodmare IR laminitis)
Homesick Angels Farm, WA USA
Joined August 2019
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Bunny
https://ecir.groups.io/g/CaseHistory/files/Kate%20and%20Lacey
Lacey feet image files  https://ecir.groups.io/g/CaseHistory/album?id=95210
Bunny image files  https://ecir.groups.io/g/CaseHistory/album?id=95239



Amy Veatch
 

well, I got her transitioned from Bute to devil's claw yesterday, but boy was she sore this morning, so I gave her a gram of bute.  I'm afraid to take her off it at this point since she was improving on it, along with the Remission.  Her body soreness had gotten much better, but she was a little tender on her back and was really hobbling around in her stall on those hind feet this morning.  Must have been too soon to change.  The Jiaogulan is supposed to arrive this afternoon, but I'm not sure if I should add it at this point? Thanks.
--
Amy Veatch
https://ecir.groups.io/g/CaseHistory/files/1%20Case%20History%20Form%20and%20Instructions/Princess%20Case%20History.pdf

Sherry Morse
 

Hi Amy,

I know it's tough to watch your horse be in pain, but you have to balance the 'wow I feel so good on bute' factor with the 'so I'm going to do something stupid' factor.  Which means sometimes letting them be sore so they don't make things worse thinking they feel better than they really do (hope that makes sense, but it's the same as us taking Advil, thinking everything is ok and then overdoing and ending up more sore the next day). 

My guess would be that what you're seeing as far as the bute working has to do with her overall body soreness more than anything specific going on in her feet.  Not sure if you have any equine body workers in the area but that would probably help her more than anything at this point.  



Amy Veatch
 

Thanks, Sherry.  I don't think she's at risk of hurting herself--she barely moves in her stall even on the bute.  The one possible benefit (?) of less bute is that when she's in more pain, she lies down more.  Seeing her take those tiny hobbling steps behind is so hard to watch.  At one point she just held up one hoof for a few seconds, like "wow, this really hurts."  And, she only pooped once last night and she should've pooped 2 or 3 times in that time period, so I'm worried that the pain is affecting her digestive system.  I'm worried about her hay--I've been looking up starch and sugar values and I don't think either of my local options (early season mixed grass featuring perennial ryegrass vs. mid-season mixed grass featuring crabgrass) are going to be low enough, so I'm preparing for a future a hay-soaking.  (Hay samples should arrive at lab today so I can pick the better option at least.)  Soaking in the morning is particularly hard for me because I leave for work fairly early (6:00am).  I've been reading on-line that unless it is particularly hot, some grooms soak hay overnight.  Any experience with this?  Overnight soaking would really be a tremendous help for me.  I'm thinking of setting up a muck bucked lined with a slow-feed hay net so I can just lift it out and let it drip a bit before feeding.   
--
Amy Veatch
Dunlap, TN (Southeast TN) Joined 2019
https://ecir.groups.io/g/CaseHistory/files/1%20Case%20History%20Form%20and%20Instructions/Princess%20Case%20History.pdf
https://ecir.groups.io/g/CaseHistory/photosearch?q=Princess

celestinefarm
 

Amy, 
First, regarding the bute, jiaogulan, etc.  Right now, you don't know what you are dealing with regarding active laminitis, possible concurrent abscesses, (and I'm really going out on a limb here, but I'll explain why in a minute) severe thrush in those hind feet. 
The photo you sent of Princess ( oh heaven's she's cute, I have had a bunch of chestnut Morgan mares over the years that look similar, love them) show hind feet with really tall heels.  Has she been trimmed to "help her gait" ? 
Her front feet from the photo are dished, I would be highly suspicious that she also has subclinical, now clinical laminitis in the front.  But those tall hind feet are making me suspect not just laminitis, but the extreme pain and picking up the hind feet( which is not typical of laminitis) is due to severe thrush and closed heels in the back.
Lavinia, help me out here, LOL. 

I would NOT put her on Jiaogulan until you know what you are dealing with. And I would resist the urge to give her bute, bute itself can cause digestive issues, including ulceration and can put horses off feed.  If she were mine, I would get the diet in order as fast as possible.( I know you sent in samples, in my experience here in Michigan, ryegrass is a high sugar/starch grass or hay, grown because it fattens beef cattle up quickly for market. Unless you get a test result that shows it's below 4% in starch, I wouldn't consider buying the ryegrass hay). Concurrently, her feet need attention. You need a good farrier who can start to appropriately trim her feet if you are not trimming her yourself.  Meanwhile, if you can get some good photos of her feet( xrays would also be warranted, but for now, photos on a camera or cell phone is fine) we can at least see what is going on with her feet. You can treat any possible thrush with gentle products such as No Thrush , which is a powder you puff into the crevices of the foot, and won't sting. https://www.nothrushshop.com/Treat-Thrush-Pictures.html

There are other gentle products that involves soaking , etc. which other members can suggest. Do not use treatments such as Kopertox,, peroxide, etc. as they are toxic to tissues, etc. Much better choices. 

This is just the first steps, but until she can walk on her feet and stand within reason, doing much of anything else is not going to do much at this point. #1 priorities is to get a definite diagnosis, get her diet corrected, and get her feet attention. 
You will find a lot of help here, don't get overwhelmed. 

--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .

Bobbie Day
 

Amy
I have been following your posts closely as I have had just about the same experience with my little mare. I can tell you that her last episode was literally breaking my heart. She couldn’t walk more than a couple steps at a time, it was so painful for her. she was fine when she came to us but I know now that I almost killed her with kindness and because she was rescued from the slaughter pipeline I wanted her to know she was loved!
Wow if only I’d known then what I know now. We can only get alfalfa here, no one grows grass hay except for one person that I just so happened to befriend, other than that we have to go out of state if we want anything other than alfalfa.
this last bout I thought I was doing everything right! She got hay below 10%, she got rinsed BP, no treats and her supplements were balanced. I actually remember having a couple melt downs here asking what I was doing wrong!
In addition to her IR she has really bad arthritis. I was at my wits end and actually set a date to have her euthanized.
I even downloaded a file here about when to know it’s time.
I think Dr.K said “half way attempts get half way results “ , so I took a breath and started rethinking my strategy.
Started rinsing her hay, rinsing the BP (per Sherry’s observation) we put her hay in a net, then payed that in the wheelbarrow, soak for at least an hour, take out and let it drip then spread out to dry. I stopped giving her any bute, she gets Uckele products instead. We put her on half a tablet of Prascend, stopped all the remission, and any other products she was on. Gave her injections for the arthritis, and now she’s doing better than she has in over a year (knock on wood). we rasp down those toes almost weekly but because she’s so thinned soled she’s in boots almost all the time.
I hope for the best outcome for you both, it’s heartbreaking and sometimes it seems like you’ll never see progress but as someone here recommended I started a journal and I wrote down everything, even the slightest gain it will help you see how she’s doing or what you need to change.
Best idea this group ever gave me, just know we’re here for you ❤️


--
Bobbie and Desi
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi

https://ecir.groups.io/g/CaseHistory/album?id=78821

Eleanor Kellon, VMD
 

Amy,

Morning is the worst time to evaluate them since they are usually worst then. That said, you may need to taper off the bute slowly.   Keep your 1 gram for the next 24 hour dose, then stretch it out to 36 hours, then 48. Keep Devil's Claw on board (what product and how much are you using?).

Yes, add the Jiaogulan now as long as you have the emergency diet in place. Give 1 tsp twice a day and keep an eye on her gum and tongue color but don't necessarily expect them to pink up until the bute is out of her system.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Amy Veatch
 

Thank you Dawn!  Her feet do look weird in the photos, I'll try to get better photos tonight.  In person her feet really don't look as bad as they do in the photos.  She doesn't have the really tall heels like our Morgans tended to have (I don't know if her hoof was turned a little, but I noticed that too and spent some time in with her yesterday looking at her feet trying to figure out why they photographed that way and the photo really isn't a great representation).  That being said, her hoof wall viewed from the bottom looks a little flared out on the sides, so getting the bevel put in there should help, I hope.  The farrier is coming out Thursday (that was the soonest available and it's a new farrier for us (40 years experience tho), my regular is out of town) to make sure she's balanced and trim and roll the edges to see if we can get the pressure off the hoof wall.  

Your hunch is correct on the thrush, as I did find it in both hind feet once she let me pick them up this weekend.  I cleaned them out with the hoofpick--which she wasn't sensitive about (which surprised me because I did--cautiously--dig around in the sulcus to make sure I cleaned it out).  I also use Thrushstop powder, so we're in concordance there and my experience has been that it clears it up pretty fast (my late PPID Arab was the king of painful thrush).  

I will definitely hold off on the Jiaogulan for now and we'll see what happens.  And the vet warned me that all 4 feet were probably affected, even though the digital pulses were strong on the hinds, but weak on the fronts--she was shifting weight between the hinds and the fronts and she's standing close-in behind and with a slightly wider stance in front.  No rocking back or trying to park out or stand under herself like she's trying to stand on a stump, though. And, her shifting has reduced, but just watching her take a couple steps to her hay in the corner of the stall this morning was painful, though. She doesn't move like a typically footsore horse, IMO, she looks like she's tied up (and has since Wednesday), but since its both feet, I'm sure it makes it look a little stranger than a horse with a single hind foot abscess does, for example.  And I was reading that hind foot laminitis can look a lot like tying up, EPM, or ingestion of a neurotoxin due to the altered gait behind.

Your point about the ryegrass makes sense (and I think I remember there's something about cool weather grasses having more starch and sugar due to them having to survive through the winter, or something along those lines).

Thanks for the support.  This is so sad to watch.
--
Amy Veatch
Dunlap, TN (Southeast TN) Joined 2019
https://ecir.groups.io/g/CaseHistory/files/1%20Case%20History%20Form%20and%20Instructions/Princess%20Case%20History.pdf
https://ecir.groups.io/g/CaseHistory/photosearch?q=Princess

Nancy C
 

Want to add my experience of being to the point of making a vet appt to euthanize my boy during teh time I was trying to take him off Bute.  We did not taper off.  He was in very bad pain from NSAID rebound, eg., withdrawing the bute too quickly.

After two, maybe three days, the day the vet was due to come to put him down, he bounded out of the stall as if to say "I think I'm feeling better now!". I cancelled the appointment and he lived for another fifteen years. Not saying it will be this dramatic for you but NSAID rebound can be painful. 

I cancelled the appointment and he lived for another fifteen years.

For more info on this and other areas of pain relief, see Dr Kellon's 2017 NO Laminitis! Conf lecture: Acute Care for Endocrinopathic Laminitis.

https://www.ecirhorse.org/proceedings-2017.php

Also, here's an older message with tons of back up sources from Dr Kellon. We've seen a lot of first hand experiences since 2005.

https://ecir.groups.io/g/main/message/59607

HTH
--
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