Laminitis complications - need advice

[aliszar1]

I have a mare that foundered (while in foal) in July of 2004. We are still battling with this mare's soundness. She foaled and once the baby was born she was doing well. She was reset 2 weeks ago. The day before reset she was sound. The same shoes with wedge were used. After the reset the mare can barely move. Her left foot is worse than the right. The farrier told me he cut off a bunch of dead hoof, and that she may have an abscess under her frog. Some days she is a little better than others. I called him and he still feels it is an abscess and we should let mother nature take it's course, now he says the abscess is under the coffin bone and too risky to dig out. But, it has been 2 weeks now. She had a considerable amount of toe cut off when reset. I am worried and tired of seeing this mare in pain after she had come so far, and was basically sound. She has no digital pulse. Help! My farrier doesn't really want to take any action, and though he has done a pretty good job with her I just feel like something needs to be done for her. Thanks.

[Dave Purves]

Call the vet, you need to find out what is really going on. As good as your farrier is, without x-rays, ultrasound, or MRI, he's taking an educated guess.

Dave

[aliszar1]

I am very VERY remote. Our vet did many sets of xrays and just does not know much about founder and he says call the farrier. The farrier has seen her xrays and set her accordingly and shoed her by her xrays. He is educated in shoeing laminitic horses. This is a case that has been going on for 14 months now. Should I just ride it out as he says? 2 weeks seems a long time to me for her to still be shore from being trimmed too short. She was fine until the reset so it has to be related. Do you think we should insist the farrier come out and do something?

[NHFarrier]

First, find a new vet. Your farrier and vet should both be educated on laminitis, so when a situation like this comes up they can make good decisions for your horse.

An abcess will make a horse terribly sore until it is open, and abcesses are very common on foundered horses. If there was a long period (8 weeks) between the previous shoeing and the new shoeing, she may be sore trying to adjust to her trim. There may be additional rotation since the previous shoeing and the wedges/shoes that were "comfortable" before, are not anymore. You need a new set of x-rays to be certain.

As for "insisting" your farrier come out and do something.....that is probably a bad way to approach him. You need the x-rays for him to make the best decision. Right now, he is doing what he thinks is best so I would go with it, if he really is well-educated on laminitic horses.

[aliszar1]

Yes, he consulted with another farrier in Colorado the time prior to this reset and he suggested to let her go long between resets, so she went about 12 weeks. When he reset her he said that it had been too long inbetween. Her feet were long, now they are very very short. I am thinking she is sore from the extreme trim. I have not put her back out (she is too sore) so I don't think there is anymore rotation, she has stayed inside in her heavily bedded stall since the reset because she was so sore the next morning. How long does an abscess take to heal? She has had a few since she foundered but not really that many. 2 or 3, but after they opened up she was fine in a day or two. There is no other vet around, we are very remote. We would have to haul her 80 miles to another vet. I am wondering if we should put the rail shoes back on so she is at least comfortable.

[Rick Burten]

If indeed it is an abscess, your farrier has NO business trying to decide where it is and then opening it.

It sounds like too much foot may have been removed at the trim. It may well be that with the amount of foot removed, the shoes are causing pressure on the sole corium from the bottom, and p3 may be pressing on the corium from the top.

It is nigh on to impossible for there to be inflammation, infection, etc in the feet and there not to be an increase in the digital pulse. Regardless, the shoes need to come off so that a better evaluation of what is going on can be made.

If the wedges are in the form of a full pad and the trim is excessive, then the pads themselves can be causing pressure on the sole and making her quite uncomfortable. If the wedges are just under the branches of the shoe, then she may be prolapsing her sole because there is no support for the inner structures of the hoof capsule.

After removing the shoes, I'd begin the styrofoam protocol or one of the other foam pad applications to provide support for her feet.

If indeed it is bi-lateral abscesses, then only after they vent will she start to be comfortable again. This can occur quickly, or take quite some time. I do not advise soaking since this will over soften the hoof and could result in other damage. Also, if it is abscesses, then the styrofoam, etal, will not help remediate the issue, but will at least support those structures that need the support. I would allow her free access to a clean, flat paddock and allow her to choose how much movement she wants. She does need at least some movement to help maintain her systems.

Even if you wanted to transport her at this time, I'm not sure that she could well handle the trailer ride. If that is the case, you need to make arrangements for another vet to come to you.

Depending on what is going on, the rail shoes may be of benefit, but as things currently stand, it seems to me that they will be of little value.

Before you try and treat the problem, you have to know what the problem is.

[aliszar1]

Thank you Rick, I will relay this info to my farrier. She is somewhat better today but that is how it goes, some days much better then very sore the next. I have been giving her bute/banamine paste per instructions from my farrier but would like to get her off of that as soon as I can. She is otherwise very bright and eating well. Thanks again. I hope he will come and remove the shoes. It is also very hard to find a good farrier around here and he is supposed to be the best.

[aliszar1]

The farrier just called and said to give her until this friday, and if she is not feeling better then or sound, then he will pull the shoes and do something different. So guess that is the plan. Thanks all.

[calshoer]

I think your farrier may have completely misunderstood the whole reason behind leaving them longer between shoeings. I do it on sore soled horses when I suspect laminitis, and she is probably chronically laminitic.
The reason to leave the shoes on longer (at least once) is to allow the foot to grow more sole for natural protection of the coffin bones. Coming back after 12 weeks and removing all that protective extra growth is NOT the idea.
I would get the shoes off at once, as she may have sole pressure and could begin abscessing soon, draining anywhere in the foot. . Then get the horse into either taped on styrofoam ,or a dense Podiatry foam (purple podiatry foam from EDSS, or OSHA products foam), or into DEEP loose sand.
Then let her grow more foot again. And when she gets trimmed or shod again do not remove any sole in the front half of the foot . Not even the dead layer. None. Leave it all there. And it is important to leave a little (1/8 to 1/16 inch) hoofwall sticking out beyond the toe corners in the front of the foot before it is fitted with a shoe to avoid getting her trimmed close again. And your farrier should NOT in any cir***stance go digging for an abscess. If she abscesses from this, it will usually find a way out. The only thing the farrier should do to provide a posible drain track is rocker the toe back at the bottom edge of the toe to provide breakover and ,and so any sole abscess can drain there without compromising the sole integrity. Removing dead sole "flaps" that cover sole abscess has killed many a foundered horse. The flap of dead sole over a sole abscess acts like a bandage, and is essential.

Patty