Relevante - Insulin spike and I may have goofed on latest trim


Lynn
 

I had a vet visit scheduled for May 27 for vaccinations, blood draws and radiographs among other things. Sometime between the vet visit and my time with Relevante a few days earlier, he had a lightbulb moment. He figured out how to push the bottom of the animal enclosure-grade mesh fencing I had installed on the inside of his paddock straight out the other side and ate the grass along the front of his paddock. When I arrived for the vet visit he had a slight crest and was foot sore in his front feet. My vet used the hoof tester and found him reactive in both front feet. We weren't able to do radiographs because he couldn't stand on the wood blocks. ACTH and insulin was pulled. 
Insulin - 22.39 ulU/mL
ACTH - 15.9 pg/mL - the lowest its been since he was diagnosed
I went to work with my 30 percent vinegar/salt solution and killed the grass a foot out from his fenceline and every speck of green inside his paddock that had sprouted up due to rain. His crest has receded and things seemed on track. With boots on the front feet I was able to hand walk him and he appeared to walk normally.  
He was trimmed June 17. My farrier and I used the blueprint of a consult markup I did with Lavinia in May. Her markups included the following direction...

LH sole: Again, Solid blue lines run along the perimeter of the sole plane. The wall outside of them is detached and standing well beyond the sole plane , so needs to be removed. Lime lines are the same as on the dorsal sole plane view. Pink hashes are frog tags to remove. Blue hashes around the toe indicate to add a bevel to the underside of the foot.

RH dorsal sole plane: Same idea as the LH, with the lime areas being the flaking bar material that needs to be removed. Solid blue lines run along the perimeter of the sole plane, with the blue hashed areas needing to be brought inward and out of ground contact.

I think I may have taken that too far. He acted sore during the trim and kept wanting to lean back when my farrier was working on the back feet. I attributed a little of that to some residual soreness on the fronts from his sugar binge. However, his back feet were definitely sore from the trim. Once the trim was done he would periodically hold up the right hind in particular. Today when I went out (June 18) he was still quite sore to the point I couldn't ride or even hand walk him. I put his Soft-Ride boots on all four feet but had to have help getting the boots on the back feet because he couldn't/wouldn't lift them.  I wasn't able to get photos ...I'm guessing since I can't really see or get photos - but I'm thinking I may have been overzealous regarding this part.....Solid blue lines run along the perimeter of the sole plane. The wall outside of them is detached and standing well beyond the sole plane , so needs to be removed.   Even with the boots on he finally chose to go out into his paddock but was gingerly lifting the back feet.   I feel horrible. Is there anything I should/need to do?  My case history is up to date.

Also, my farrier had the following question....he wanted a better understanding of how you move the heels back without taking anything off the bottom.
If Relevante survives me it will be a miracle. 

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Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

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Kirsten Rasmussen
 

Hi Lynn,

I had a similar problem with Shaku at his last trim.  I did a fairly big corrective trim all at once and he was sore after, both fronts and hinds.  I felt awful, too, but after a couple days he was back to normal.  Taking a lot off at one trim can do that.  It would be much better for you (and me!) to work on it between trims with a couple swipes of the rasp every day or 2.  That way the change is more gradual and they have time to adjust.  And uf you see them getting more tender it's easy to stop without having caused too much pain.

As for Relevante's insulin, 22 uIU/ml is still very good and nowhere near high enough to be causing pain.  It's possible it had come down if enough time passed between grass and vet visit (how much time was there in between?), but it's also possible that is not the cause of his sore front feet.  I understand from Dr Bowker's experience his horses seem to shed sole on occasion for no apparent reason, and his horses can be quite thin soled from time to time.  If R has thin soles that could be one possible reason for sore feet, especially if adding boots really helps.  Is Relevante booted all the time or just for riding and when he is sore?   I think the best thing is to post new hoof photos, and consider getting radiographs done.

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


Lynn
 

Hi Kirsten, Thanks so much for your input. Regarding your question about insulin/timing....he ate the grass along his fence line (yes he pushed the bottom of the fence out along the whole front of his paddock) May 25/26. My vet came May 27 and when I got to the farm to meet him , I found Relevante with a slight crest and sore front feet which were reactive to hoof testers. Thankfully as you say, despite his binge his insulin came back okay.  i was able to get in a good spray before the next set of rains came. It was a deluge for several days causing more grass to spring up so I think he might possibly haven't a few more mouthfuls. I do the think the soreness he is experiencing now is due to what we did during trimming. As far as boot usage goes, when he is in his stall/paddock he doesn't normally wear boots at all unless he is having a problem. When we ride i have him in the Cavallo Trek boots. I have ridden him with just front boots on but I guess I feel better with 4 because we often cross streams which have rocks and not all the trails on the property are grass covered ....I think about things like stone bruises etc. I do have the vet scheduled to come out in August (the soonest i could get him) to do radiographs and other stuff (more vaccinations/teeth float). When I checked on him today  - he was still acting a bit sore but better than yesterday.  I'm going to go back out in the next day or two with the hopes of getting photos to post.  And yes, my farrier and I are talking about touching base in between the 4-week trims and evaluate how to maintain what's been done.
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Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

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