Severe front lameness please help

[Dancer12]

My 20 year old QH mare has had undiagnosed heel pain 5 years. She has done well on isoxsuprine and shoes with heel pads on an angle determined by the vet and farrier. Several days ago she developed severe lameness in both front feet. 1 gm of bute did nothing. Her usual vet was out of town, back-up vet said she had strong pulses in front feet and was suffering from inflammation in both feet. She has no symptoms of founder. He injected Banamine Thursday saying it would help whatever the inflammation is, and I have given paste Friday and Saturday with last dose due tonight. She can barely walk.
Please help us ! Thank you so much !

[Roy Amaral CJF]

She has no symptoms of founder.

Sounds like the symptoms to me. "inflammation in both feet" AKA laminitis.

Talked to your Farrier yet? How about the regular Vet? I'd call NOW if you haven't allready.

[calshoer]

She has no symptoms of founder.
Strong pulses and reluctance to move are CLASSIC symptoms of laminitis, the cause of founder! What symptoms is she mssing for the vet to not understand that?
The shoes need to get pulled and the horse should be placed in taped on support, such as construction grade styrofoam,or lily pads, or a whole rolls of gauze under the frogs. The vet should have done that when he was out there because inflammation in the foot IS by definition laminitis and WILL founder the horse.
And he should have recommended Xrays to have as a baseline taken that day, not later on after the damage is done and you have nothing to compare to.
Since she is in pads you have no way to get enough support to the frogs which is vitally important.
So Give her a SOFT , DEEP place to lie down and let her do that when the drugd wear off. I recommend Straw at least a foot and a half deep, or a full foot deep of shavings. Even though the banamine does reduce inflammation, it also Keeps her on her feet more which causes more mechanical damage inside them. So when it wears off just let her go down in the deep bedding and give her feed and water where she can reach it.
Get the farrier out asap (tomorrow....because this was an emergency when she first had symptoms) and get those shoes OFF so you can tape sopmething onto the feet for support. The EDSS website has free information on how to use styrofoam blocks. Go that that site and to the "tech help" section into "free downloads"and look for the styrofoam instructions. When the farrier gets the shoes and pads off, do NOT under any cir***stance allow the toe to be shortened from the bottom,except to rocker the end it. Then tape on something for support.Or give her a *deep* sand open to live in for now. And find another vet.
And find out why she got laminitis. At her age it is probably metabolically related ,so for now get her on an emergency diet.....NO grain, No senior feed, NO fresh grass, nothing sweet, no Oat hay.
Feed mostly just Grass hay. And to help insure the grass hay is lowest in sugars, soak it in water one hour and drain off the water before feeding.Soaking in water leaches out some of the sugars. iI you have to feed alfalfa keep it to a minimum. Also did your mare have any changes in diet,turn out, or get any vaccinations in the 48 hours prior to the lameness? just fishing for answers to help you.
Patty

[Dancer12]

Thank you for your replies !!
Yes, the farrier was out on Wednesday also. He checks on her regularly. The vet said no rings, her back feet are not up under her, and she had no sensitivity in her hoofs, which is why he said no symptoms of founder. However, he said if it was founder, the Banamine would fix her up.
Yes, I have been trying to think of any other source. She has had no vaccinations since mid-August, no change in diet or turn-out. She does not get to go out with the other horses per the vet, so I put her out in a pen every night for a while. I have worried about isoxsuprine over such a long term, but have been told it would not cause any problem.... Second week of July she was trimmed too short and also had new shows (the hi-heeled ones with heel pads) so had some bi-lateral lameness going on then. The stable manager went out to check on her, scared her, and she ran out on the rocks. We have bad rocks. She is very good and calm and has never run -or walked- out of the stall. I worried that she had been bruised then, but she improved, has been OK in the meantime, then this dramatic downturn.
One of the other horses in the barn has white line disease, which I had never heard of, and the vet said if my horse did not improve on the Banamine they would have to "dig around in her hoofs".... which I don't like the sound of at all.
The regular vet will be there today.
Thanks so much for your input.

[calshoer]

Yes, the farrier was out on Wednesday also. He checks on her regularly. The vet said no rings, her back feet are not up under her, and she had no sensitivity in her hoofs, which is why he said no symptoms of founder. However, he said if it was founder, the Banamine would fix her up.
He is not fully informed.
Laminitis caused by metabolic issues (equine metabolic Syndrome....google it) sometimes does NOT exibit the classic "standing up under themselves" stance, nor do those horses always hoof test sore over the toes. Sometimes they hoof test more sore in the heels.
The coffin bones in these are usually slowly sinking, and a lot of the pain comes from a weakening of ALL the conective tissues in the foot , not just the laminae in the toes. As well, you will not see rings until later when the foot grows out some .
As to the "banamine fixing her up" , banamine may reduce the pain ansd some of the inflammation but does NOT address the vital need for mechanical support to the whole bottom of the foot to help prevent or limit the bone movement. Getting support on the feet is most important in the first HOURS. The longer that mechanical support is withheld, the more damage is done and the less the chances of recovery.
Any veterinarian or farrier who does not understand the importance of offering some kind of emergency support taped to the feet at the first suspicion of laminitis is grossly remiss in his or her job.
In my opinion Mechanical support is MORE important than the drugs in increasing the chances for recovery later.
Since it is apparent the vet who saw her does not understand what may be really going on, do NOT under any cir***stance let him "dig around" in the feet! I know a horse who had this same problem , had sunk the bones close to the ground with very little sole, and the vet nearly killed him when she went "Digging" and exposed the coffin bone with the first swipe of the knife. GET X-RAYS today to see where the bone is and how much sole is left before anyone goes trimming anything. . and get the shoes off and tape some mechanical support on those feet TODAY.
And go to the Yahoo.com look for "groups", join EquineCushings group and start reading about Equine metabolic Sybdrome. And go to Safergrass.org and read about carbohydrates in forage. Something as simple as a new batch of hay or weather changes can cause these horses to have laminitic episodes.
Patty

[mwmyersdvm]

You really need to listen to Patty on this one. If your veterinarian would like some assistance, I can help. Banamine is not going to "fix up" a case of laminitis.
Actually I see quite a number of misdiagnosed "heel lameness" that are actually low grade chronic laminitis. They are dificult to diagnose unless you are very familiar with podiatry measurements of properly taken radiographs. Additionally, venography may show these cases up, but not very many veterinarians are familiar with this procedure.
If you or your veterinarian or farrier need assistance on this case I can be reached through the consulting area of this site.

M. W. Myers, D.V.M.

[Dancer12]

Hello, you folks have been so nice to assist me. The regular vet did nerve blocks and x-rays. He diagnosed heel pain, now bilaterally, instead of right only. He said joints - coffin? - need to be injected, I guess with steroids.... She grows virtually no heel and he says all her weight is on the worst possible place because it is distributed opposite of how it should be. He says it puts full weight on the coffin bone and also pulls all her muscles and tendons. She tries to tiptoe.
Please let me know what to expect if joints are injected. Will she have immediate improvement? Or does it take some time - days - to work? He also said 2 grams bute for 10 days as well as usual isox. I am to call the ferrier and have him put the shoes back on depending on how well she does after the injections. If she is still quite lame, how will I know if injections didn't work or if it is because she has no shoes on? Also won't her feet hurt after injections so having shoes put back on will hurt? It is after 1 AM on a work night so you can see her pain is literally causing me sleepless nights.
Thank you so much.

[Phil Armitage]

I agree with everyone suspecting laminits. I am wondering if a sore coffin bone joint would show up as heel pain and what are the odds of this being in both front feet? It does not hurt to error on the side of caution and tape 2" foam blocks to her feet. They need to be applied properly and this can tell your Vet and Farrier alot if they undertand what they see when the blocks compress. I am not convinced your Vets prognosis is correct. Laminitis causes pain primarily in the toe and horses will shift there weight onto the back of there feet and cause heel pain, but may not founder or show any signes of sorness in the toe, the lamina could be insulted higher up. Can send a Vet and farrier for a loop trying to figure it out. Horses can have mild laminitis, inflammation of the lamina and not founder so not showing the typical founder stance, rings and rotation or sinking.

Good luck, sounds like a complex problem and may need to be refered to someone with more knowledge and experience.