Update on Penny’s Laminitis.

It’s been a month since I first discovered Penny, standing head-down in the run-out shed with her fetlocks all swollen.

I documented in previous posts the treatments by the vet and by myself in our efforts to get her over the Laminitis and back “on her feet”, so to speak.

My last post was about a setback Penny suffered, after I tried to transition her back to the pasture grass.

This post is the latest in the series.

During the last week of July, I tried to transition Penny onto the pasture grass. I started allowing her to graze just a few minutes in the morning one day, then a little longer the next, then a little in the afternoon as well. By the third day she was again showing soreness and getting worse, rather than better. I immediately stopped allowing her to graze and started her back on the Bute, but I ran out of Acepromazine. I had to go out of town the first week of August, so I left her care and feeding in the hands of a very responsible young lady. By the time I left town, Penny was again on the mend.

I left instructions with the young lady to go ahead and feed her dry hay (grass hay – fescue and orchard grass), and to walk her for about 15 minutes every morning, if Penny felt like walking.  I told her it was ok to allow Penny to grab the occasionaly mouthful of grass, but not to allow her to graze. I gave her instructions to wet 1lb of alfalfa pellets and mix 1gm of Bute with it and feed it to Penny each evening, along with about 10 lbs (2-3 flakes) of dry hay. When I checked on her mid week, it turned out she was still sore and didn’t seem to be progressing. I told the caretaker to stop walking her, not allow her to eat any grass at all, and to soak her hay before feeding. She did exactly as I instructed.

Upon my return last Wednesday, Penny appeared to be doing much better, although she was still a bit tender on her front feet. No swelling at all was apparent and she appeared to be in good spirits. She would willingly walk around the pasture with me and looked to be in good shape. She was certainly better than when I left. I decided to discontinue the Bute and see how she did. 

Also, I received the Easyboot hoof boots and pad inserts I ordered the previous week. They arrived while I was gone. On Wednesday morning I fitted the boots on Penny’s front hooves. She didn’t fuss at all and they seemed to relieve a little bit of tenderness on her fronts.

I decided that after the previous week of being completely off the grass, I might try again to transition her back to the pasture, but much slower this time.  I allowed her to graze in the pasture for 15 minutes during the morning, while I cleaned her stall. Then back into the stall to be fed dry hay. On Thursday she seemed no worse than the day before, so I allowed her to graze for 30 minutes in the morning, then back to the stall for dry hay.

On Thursday evening Penny appeared to be getting sore again, so I decided to wait and see how she was in the morning, and determine a course forward from there.

On Friday morning, Penny was noticeably more sore than the day before, and I could see some swelling coming back into her rear fetlocks. No more green grass for Penny. I put her back on the Bute Friday evening and started soaking her hay again for 30 minutes before feeding it.

On Saturday, it was apparent that Penny will not be back on the pasture any time soon. She was almost as swollen and sore as when I first found her with Laminitis three weeks earlier. I could feel she was warm, probably had a fever. She seemed to want me to rub her head. I wonder that maybe she had a headache. She seemed to be feeling pretty poorly, and I felt bad for her. I started her back on 1gm of Bute morning and evening, but I’m out of Ace, like I said earlier. I decided to see how she did with just the Bute.

On Sunday she was about the same. On Sunday evening I decided to see if she would allow me to soak her rear hooves in cold water while she ate her hay. I placed her left rear hoof (the worst one) in a bucket of cold water. After her pulling her foot out of the water several times and me putting it back in, she finally let it rest in the water. I guess it just took a minute to get used to it. After that, it appeared the cold water must have been soothing, because she stood there for a full 30 minutes without moving her rear hooves at all. Never spilled, never moved.

This morning (Monday), Penny was noticeably better, and was moving around tenderly, but easily. She did not feel feverish and was in good spirits again. I noticed she had gotten her hoof boots off (I bought them a size large in the width for her, to accommodate the length of her front hooves and I need to shorten the cables a bit). Since she’s in a stall with a sawdust floor, I decided to just leave them off for now. I decided to see whether she would let me soak both her rear hooves. I placed each rear hoof into a separate bucket. I had a cold pack from our freezer that I placed in the bucket with the left rear hoof. She allowed that and again, once I got her used to the water, she never moved her rear hooves while she fed. I let her soak a full hour before leaving her standing there with her hooves in the buckets finishing her hay. I suppose she probably stood there in the water for at least another 15-20 minutes after I left. This afternoon I bought a large feed bucket, so I could try soaking both rear hooves in the same container and drop a large bag of ice in the water.

This evening I found her much improved again, and in good spirits, but could still see substantial swelling in both rear fetlocks. She seems to be doing very well with her front hooves, and I could detect no swelling. I decided to go ahead and just leave her barefoot again. This time she willingly allowed me to place both her rear hooves in the water in one large bucket.

I dumped in a large bag of ice and she never budged. It must have felt good, because I stood there for a full hour and only had to put one hoof back in the water once. She simply stood in place, soaking her rear hooves in ice water while she fed on the soaked hay. I watched her for a full hour, then left her standing there. There were still pieces of ice in the water when I left.

I’m hoping to find her doing better and see the swelling greatly reduced tomorrow morning.

Wish us luck.

This has been a rough couple of weeks for me, as well as for Penny. In my previous post, you read that on Friday, July 12, 2013, I found Penny standing head-down in the runout shed suffering from acute Laminitis. After initially stabilizing Penny’s condition, by aggressive vet care and keeping her off the rich, green fescue pasture, her swelling and discomfort abated and she seemed to be doing quite well. The vets were happy with her progress.

Last Thursday the vet x-rayed Penny’s hooves and determined that her coffin bones have rotated slightly, about 5 degrees in the left rear and 6 degrees in the other three. The vet opined that with careful trimming and management, she should recover and return to normal hoof conformation within 6 months or so.

The Images also revealed something I have suspected for quite a while, that Penny has unusually thin soles. I have been trying to increase the depth of her soles by keeping the walls trimmed and keeping a good “mustang roll” on the edges, but so far have met limited success. The vet indicated Penny might have suffered a previous bout of Laminitis, which resulted in the thin soles, or that it could be a congenital thing.

I have been doing some reading from Pete Ramey’s website, on hoof rehabilitation, and have learned I was doing some things wrong in my trimming technique. I plan to employ his instructions from here on out and hope to remedy Penny’s thin soles as much as possible. Time will tell.

Like I indicated above, by Thursday, six days after I first found Penny in trouble, the vets were happy with her progress. Her swelling was gone, except for a little puffiness in her left rear pastern, and she was moving well, exhibiting little discomfort. She was “out of the woods” and on her way to recovery. The vet told me to cut the Bute (Phenylbutazone) and Ace (Acepromazine) doses to once-a-day and continue another week like that, to wean her off the drugs. She told me to transition Penny back to the pasture slowly.

Things never seem to work out that easily for me.

When I went out to feed Penny on Friday morning, I was shocked to find that Penny somehow had defeated the latch on her gate and had spent the entire night out on 3 acres of lush green fescue pasture. She was already showing signs of swelling and soreness again.

Despite the setback, I continued with my plan to trim Penny’s hooves that morning, according to the advice of my vet. Penny was already over due for a trim when the Laminitis struck (I was going out to trim her when I found her in trouble).  In conformance with the vet’s recommendations and also the information posted by Pete Ramey on his website, I trimmed Penny’s hooves down to the sole without removing any sole at all. I rasped a good, rounded mustang roll on the toes and almost all the way around to the heel. At the heel I just rasped the sharp edge off. I cut the heels down sufficiently to allow the frog to be engaged in supporting the hoof. I find that if I rasp flat across the heels until the rasp touches the frog, that is about right.

Penny’s left front after trim

Since Penny’s hooves were already longer than I normally allow (I normally keep a running trim going, hitting her hooves lightly with a rasp about every two weeks, but had not been able to get out to work on them for about 6 weeks), ended up taking nearly 3/8″ off the hoof walls. With the mustang roll, her toes were shortened about 1/2″ or so. I noticed an immediate improvement in her movement. Trimming the hooves back to where the pressure was relieved from the hoof walls and placed more on the sole, relieved much of her pain. The stall I have her in has a muddy floor, which isn’t good hygenically (which is why I’d like to get her out of it), but is soft and supportive for the Laminitic hooves, as well as cooling. The pasture also has a soft, grassy floor with few stones and would be fine for her recovery. A horse in her condition would be at risk for injuring her thin soles and causing further damage and possibly abscesses on hard gravelly ground.

I went back to full doses of the Bute and Ace (1.5cc of Ace and 1gm of Bute twice daily) and by Monday the swelling and soreness was abating again. By Tuesday there was no swelling visible, except that little bit of puffiness around her left rear fetlock. She was moving easily and showing little discomfort.

I decided to start trying to transition her back to the pasture. I would have waited longer, but I have to go out of town again for a week the first week of August. I was hoping to be able to have her back on the pasture full-time before I left, as I will have no one to continue with the constant care she has required to get her through the Laminitis. I know the Laminitis was caused by her overloading on sweet-feed, and that she has never shown any problems on the grass pasture in the three years I’ve had her on it, so I thought I would be safe starting her back on the pasture by transitioning her over a few days, and I wanted to try it sooner than later, so I would know before I left whether she was handling it ok.

Grass has less sugars in it in the mornings, due to a night of little photosynthetic production. The sugars in the grass are higher in the afternoons. Also, grasses like fescue have growing spurts in the spring and fall, in which their sugar content are much higher than other times of the year. During the heat of the summer they tend to slow their growth and enter a sort of dormancy, during which their sugar content is much lower than during spring and fall growth. The high sugar content in the feed is what aggravates the Laminitis.

I have noticed that Penny’s pasture has turned a much lighter shade of green over the past two weeks, than the dark, lush green it had been. I concluded that allowing her to graze a little in the morning, then putting her back into the stall would be a good way of transitioning her back to the pasture. I also wanted her to be able to walk around and get some good blood flow into those hooves by using the frog as the hooves’ natural blood pump.

On Tuesday evening I let Penny graze after her normal feeding for about 30 minutes, then put her back in the stall. I did not give her any Bute or Ace. On Wednesday morning Penny was looking fine and there was no sign of swelling at all. She was still tender on all four hooves, but moving well. I fed her 1.5 pounds of alfalfa pellets with the Bute and Ace (I wet the alfalfa pellets and sprinkle the Bute on it and stir it in; she won’t take it otherwise), then let her out to graze for about 2 hours. I then put a grazing muzzle on her and let her remain on the pasture. The grazing muzzle greatly reduces the amount of grass the horse can take in, but allows water to drain out for drinking.

On Wednesday evening, Penny was showing no swelling, but was quite tender on all four hooves. I was hoping that was just from her walking around in the pasture on her tender hooves. I removed her grazing muzzle and let her graze for 45 minutes. I then put her back in the stall and fed her a couple flakes of dry grass hay (no Bute or Ace).

On Friday morning, I could tell Penny was noticeably more sore than the day before on all four hooves. However, there was no sign of swelling or fever at all. She was very careful in moving around, but was not as sore as when she first came down with Laminitis. I contacted the vet for followup and advice and was instructed to get her back off the pasture, go back to full doses of Bute and Ace, and continue to monitor the situation.

Today, Penny is pretty sore, but still moving around. She has a little swelling back in her rear fetlocks, but no fever. I reduced her alfaflfa pellets to 1 pound, morning and night, and will continue that, so I can continue to mix the Bute into it. I am also back to feeding her 2-3 flakes of grass hay, soaked in water for about 30-45 minutes before feeding (the soaking leaches sugars from the hay). I will continue to do this until all swelling and tenderness are gone before trying to transition her back to the pasture again. I won’t try to push it again. Patience.

Hopefully, over the next several days I’ll be able to get back to the point at which we had her last Thursday, before her great escape into the pasture caused the relapse. Yesterday I ordered a pair of Easyboot hoof boots from easycareinc.com, along with insert pads, as recommended by Pete Ramey. After I get back from my trip, I’ll put those on her and hopefully be able to start riding her again within a month or so.

Stay tuned.

Went out to check on the horses yesterday, after not seeing them for a week. First thing I noticed was horse turds in the barn where the hay and grain is stored. I noticed the lid was off the sweet-feed bin. I knew somebody had left the barn door open and the horses had been into the feed. When I walked into the pasture, the old gelding, that normally has to be caught, came trotting up to meet me, while my mare stayed out in the pasture in a run-out shed. I went ahead and haltered the gelding and trimmed his hooves, thinking Penny would eventually come on up. Nope. When I finished with the gelding she was still standing there in the shed. That’s when I knew something was wrong.

My worst fears were realized when I walked down to her and she never even looked up. I could see all four legs were swollen from the knees down and she was standing in an odd way, with her back bowed, sort of hunched up. I knew she had foundered. She looked bloated as well. I haltered her and got her to move a few steps, and she painfully made it out of the shed into the pasture. She immediately started grazing. She was hungry, which told me she had been standing there in the shed for some time. I walked back up to the barn and brought her a bucket of water, which she drained.

I figured she had gotten a belly full of sweet-feed and I was not only worried about founder, but also about colic, particularly with the way she was standing; she appeared to be bloated. I could hear her stomach growling, so that was a good sign, but there was no fresh manure in her vicinity. I was truly worried. A horse that is colicked and foundered is in a very bad way. Once out of the shed, however, she was grazing and moving around a little.

I contacted my vet. Her first recommendation was to get her off the pasture grass, as it tends to be high in carbohydrates (sugars). Apparently sugars exacerbate founder. I found a couple pipe fence sections and made a makeshift gate and shut her back in the shed. The vet also instructed me to take some grass hay and soak it in water for about an hour, then pour off the water and feed the wet hay to Penny. The water, she explained, leaches the sugars from the hay. By the time I had all that done, the vet was there.

The vet, a nice young lady named Katie, from Haymarket Veterinary Service, with her husband as a helper, took one look and pronounced it a serious case of Acute Laminitis. She administered an intravenous solution, about a quart of it, I think, which was to help wash the toxins from her system. It also contained a anti-inflammatory medication. Katie then put foam pads on both front hooves. Poor Penny could hardly stand on three legs while the vet attached the pads. She was certainly in a bad way, but at least she was still standing.

Katie gave me a container of Phenylbutazone, commonly known as “Bute”, and vial of Acepromazine Maleate with instructions to administer both each morning and evening. The Bute is to reduce inflammation and the Acepromazine Maleate is to dilate the blood vessels in the hoof.

This morning when I went out, Penny was still in pain, but she was moving around better. The swelling in her legs had gone down considerably. She had also passed a couple bowel movements, which was a great relief (no pun intended). This evening another vet (from the same office) came by to check on Penny. She administered another IV treatment of two quarts and put a new pad on Penny’s right front (the first one was slipping out of place). Penny’s temperature was normal, but her heart rate was still a bit elevated. We are hoping she continues to improve. The vet thinks we caught things early and it looks like she is recovering well. We’re hoping we were able to stop the process before her coffin bones begin to rotate. They will take X-rays next week, once we get the inflammation down and the Laminitis in check, to see where we are with that. If the coffin bones do not rotate at all, I may be back in the saddle within a few weeks.

Hopefully the fact that I have kept her in barefoot trim and kept her hooves in good shape will help in her recovery. We’ll see.

It appears, that since Penny is the dominant of the two horses in the pasture, Penny kept the old gelding from having access to the sweet-feed bin. He was apparently relegated to raiding the stack of grass hay bales left over from winter feeding. He apparently found the grass outside the barn more to his liking. He has shown no ill effects of the day’s mischief.

The sad part is that this pretty well seals the deal about whether I’ll be taking Penny on my Mexico-Canada ride. Once a horse has foundered due to feed, it becomes susceptible to founder and recurrence is not uncommon. Their feed has to be closely watched and regulated, but if that is done, the horse can have a full recovery and a long and trouble-free life. However, I couldn’t risk the chance of being a week or two out on the trail and have her founder or go lame. Her hooves are smallish as they are, and if they are weakened at all from this episode, she may have problems carrying a load on a long, rough trail. I can’t see how I could risk it…for her sake.

In the past two days, I have learned a little about Founder, also known as Laminitis. Most of what I will write here is from various sources on the Internet. I won’t attempt to list the sources (you can look it all up as easily as I did), and there may be some fine points I don’t have exactly right, but I think I have gained a basic understanding of it. I thought I’d share some of what I have learned, in hopes it may be useful information to someone.

Founder and Laminitis are the same ailment, but not precisely synonymous. From what I have read, Founder is essentially the culmination of Laminitis. There are different levels and causes of Laminitis, which, if left unchecked, matures into Founder.

Laminitis is the inflammation of the tissues surrounding the coffin bone in the horse’s hoof. The coffin bone is shaped somewhat like a hoof, with a toe and heel. The surrounding tissues, the laminae, keep the coffin bone firmly located in the middle of the hoof, and the hoof wall and sole attached to it and each other. When a horse suffers some sort of shock to its metabolic system, whether from feed, infection, or other cause, toxins may form in the bloodstream, which have the effect of causing inflammation in the hoof laminae tissues. This is the beginning of Laminitis, known as Acute Laminitis.

Inflammation in the hoof causes the blood flow in the laminae to be restricted. If the inflammation is severe, the loss of blood flow may cause the tissues surrounding the coffin bone to degenerate, or even die. This results in the tissues holding the coffin bone in place to weaken. This is severe Laminitis.  If the tissues weaken sufficiently, the weight of the horse causes the coffin bone to begin to rotate, pointing the toe downward into the sole of the hoof.  This is Founder. In the most severe cases the coffin bone may breach the sole of the hoof, creating an entry for infection.

In severe cases of Founder, it is not uncommon for abscesses to form in the hoof sole during recovery, due to infection from dead tissues surrounding the coffin bone. These must be cared for to avoid or reduce the chance of further infection.

There are two primary types of Laminitis. Acute Laminitis may be caused by a drastic or sudden change in feed, such as when my mare got into the sweet-feed bin and ate her fill. This was a shock to her system, because she is normally pastured on grass and hasn’t even tasted sweet-feed in more than a year. It may be caused by a change from grass hay to alfalfa, or even from hay to a nice, green spring grass pasture. The problem comes from the drastic change in the nutritive value of the feed, shocking the horse’s system. Of particular concern is the carbohydrate content (sugars) of the feed. Much depends on the susceptibility of the horse. Acute Laminitis may also be caused by things unrelated to feed. My family once had a mare who foundered due to an allergic reaction to fly strips in her stall. Horses may founder, as well, due to hard use on a hard surface, known as “Road Founder”.

Horses that have suffered founder due to feed conditions sometimes become more susceptible to future episodes, and must have their feed monitored and regulated to avoid recurrence of Laminitis. Horses that have suffered Laminitis due to causes other than feed do not seem to suffer this susceptibility. Our horse that foundered due to an allergic reaction fully recovered and never again had an episode. She became a wonderful trail horse, riding some extremely rough mountain trails, for days on end, for many years afterward.

A second type of Laminitis, known as Chronic Laminitis, tends to occur in overweight horses, much the same way Type II Diabetes tends to occur in humans. They develop a sensitivity to carbohydrates, which causes a low-level Laminitis on a chronic basis. The result of this is often seen in horses and ponies with elongated hooves, which begin to curve upward. The toe of the hoof wall separates from the sole, which becomes dished, while the heel continues to grow, pushing the toe forward and upward. If left untrimmed, the hoof eventually turns upward and begins to look somewhat like the horn of a bighorn sheep. In order to keep the horse from becoming permanently lame, constant care must be taken to keep the hoof trimmed, as it will continue to grow in this fashion.

While much progress has been made over the past few years, much is still unknown about the root causes and mechanism of Laminitis. However, with modern treatment methods, full recovery is possible, whereas there was a time when there was little hope of recovery from severe Founder, and euthanasia was a common prescription.

Upon discovering a horse is suffering from Laminitis, the first step for remediation is to call a veterinarian. Do not hesitate. The quicker you begin treatment, the greater the horse’s chance of full recovery. Secondly, immediate determination and correction of the cause is important. With my mare, the cause was her free access to the sweet-feed bin for an unknown period of time. This caused an overload of carbohydrates in her system. The veterinarian instructed me to immediately take Penny off the pasture grass, which is also rich in carbohydrates. Thirdly, it is imperative to reduce inflammation of the hooves. When my mother’s horse foundered, we made the mare stand in the muddy bottom of a running stream that came to about the mid-point of her cannon bones. We kept her there for about two weeks, as I recall. She fully recovered. Some horses will allow one to pack ice on the hooves, or will stand in a bucket of cold water. Standing in cool mud will help. Anything that serves to cool the hooves will slow or reduce inflammation. Additionally, the horse may be placed in a stall or run with a soft floor, such as bedding, sand, mud, or one site suggested pea gravel, which will give support to the hoof sole, rather than causing the horse’s weight to be supported by the hoof wall, as is normal. If the horse can move about, this is good, as the movement causes the hoof frog to help pump blood throughout the hoof tissues.

In most cases, catching Laminitis early, and interrupting the degenerative process, by eliminating the cause (whether feed, or other cause), reducing and eliminating inflammation, and making the horse as comfortable as possible by padding the hooves when necessary, full recovery may be expected. Even if the coffin bone has rotated, farriers have developed shoes and pads which support the hoof sole and protect it from further damage from objects, such as rocks, on the ground, and aid in the eventual recovery of the integrity of the hoof. While permanent lameness is still a very real possibility with Laminitis, advances in treatment, both on the part of veterinary services and farriers, have greatly reduced those odds. In most cases, a horse that is recovered from Laminitis, and that is carefully regulated in its health and feeding, may yet live a long, happy, and productive life, free from the effects of Founder.

Comments to add to my commentary, or to correct anything I got wrong, are welcome.