Help for a friend

Doodle92

Doodle92

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Apr 6, 2021
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Not sure if this should be vet or hoof care.

Vet and farrier involved but wondering if anyone has thoughts. Sorry it’s long.

Horse is a 10yo warmblood. Around 16.2. Bought 2 years ago. 5 stage vetted. To event and show jump. Bought from reputable dealer.

First summer various bruised soles, not quite right episodes. Lost a lot of weight (put down to sharing with someone who couldn’t manage him, yo feeding him very little. Share stopped/yard moved so they managed as they liked and improved). Last summer again lameness and not quite right. Spooked on the road then became properly lame. Various attempts at rest, box rest etc. Then had work up and diagnosed with navicular. His feet are terrible. They are huge and splayed. Very flat, soles are convex. His feet must be double the size of robins and about half the height. His legs are covered with lumps and bumps. Definitely a link between hard ground and lameness.

With X-rays farrier was able to trim more. He had special pads put on which also raise the heels. He was always shod 5 weeks without fail. I’m not sure what the pads are called but they have a sort of Mercedes car star over the frog. That was late august.

Huge improvement. When I saw him after he was actually striding out in walk. All very positive. Shoeing now costing £200. But worth it. He went back to vets and they were pleased with him. Decide not to event but he should be fine for BS as on a surface.

Horse then moved north so a new farrier. Old farrier and vet consulted with new farrier. He had several lighter months and then came back into proper work the beginning of this year. Back to jumping going BS. Did one show and jumping well. He would randomly refuse before and now back jumping like it was all very easy and double clears.

2/3 weeks ago he got an abscess on one front foot. Treated by vet. Cleared up and shoe back on. Thinking oh well these things sometimes happen. Then on Sunday past another abcess on the other front. Vet again. However soles so thin that it very quickly bled and bled a lot when released. He is still being dry poulticed and it is looking much better and he is much sounder but still sore. Of course he has no shoe so hard to tell. Vet wants foot dressed for a while longer.

Each abcess has been a mirror imagine. Down the inside aspect of each foot. And at the same point. Best guess (of vet and farrier) is that the pads have changed the weight balance of the foot. The weight is going down the inside of each foot. It is relieving the issues with the navicular/pain down the heels but causing damage to the hoof in another area.

Along with this he has always been skinny. They can put some weight on him but he then drops it occasionally and very quickly. He is the same build and type as robin but when I saw him the other day I was really concerned how skinny he is. He has no muscle. He is ridden correctly (when not lame). He is fed what should be a good diet (although I’m not sure what) and on ad-lib hay. He is grumpy for his rugs and stuff. I have suggested ulcers a few times, he is fed various ulcer supps but never been scoped.

If Robin was looking and acting that way I would be seriously worried. They are my really good friends and very stressed about what is happening. They are beginning to worry at best he will never be up to work and at worst there will be a horrible decision.

He is on full livery at a very experienced yard and everyone is a little stumped as to what is going on with him.

Anybody got any thought of what we have missed?
 
What does their vet think about the weight loss? Just a thought but could pain from his feet cause weight loss too?
 
Yes absolutely the pain has added to it. Vet has suggested a feed regime. He will get a little more weight, still be skinny, then it all drops off so quickly again. He was looking great for a while and now just looks terrible again.
 
The horse sounds like there is more than one “thing” going on.

Muscle waste and repeat abscess could indicate Cushings, even if the horse does not have a Cushings coat. Has the horse been tested?

The horse could have a massive case of ulcers from the stress of the leg/hoof issues— front or hind gut or both, which causes weight loss.

Cancer might be another reason.

From the description of the hooves, without pictures, maybe a new farrier would be helpful.

Does the owner have access to an equine university or hospital, where the horse could receive a more thorough, in depth exam with better equipment than the local vet has?
 
He went to the hospital for the work up. Where they found the navicular. He then went back there for the check up. The farrier at that time is very experienced but I was slightly surprised he didn’t raise the feet issue sooner. (I don’t want to be horrible to any farrier but he dosnt seem terribly proactive) They knew his feet were rubbish but when farrier saw the X-rays he could then work to them. I think he shod the horse twice with the new pads and trim before horse moved north. The new farrier was recommended both by the vets who diagnosed and the new vets. New farrier has shod him since November. I think it is the farrier the new vets work with.

He hasn’t had abscess till these 2. Just the random “bruised feet” who CG was actually navicular. There is some hope that it is all the damaged crud coming out. It is just bizarre they are such a mirror imagine.

I will mention Cushings. He is clipped but they did say he had grown a thick coat this winter.

You are right. There is a lot more going on, it’s just what. I have mentioned ulcers a few times. They feed ulcers supplements it not ulcer treatment.

New vet had mentioned more X-rays but wants to wait just now till latest abcess more healed and the horse is more comfortable.
 
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I don’t think the new vet has seen him before the first abcess. So about 3 weeks ago. There has been no need as he was doing well.

(Edit as I wrote the wrong word)
 
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We always hope the farriers that vets either recommend or approve are worth their salt — I’ve learned the hard way that isn’t always the case.

After I posted, I also thought of pneumonia possibly developing due to all the stress and a weakened immune system. Certainly not the root cause but it could be developing. A good friend lost her IR/Cushings horse to pneumonia, following repeated abscesses. When the vet checked the horse on the day they decided to PTS him, his lungs were full of crap.

Again, not the root cause but the sooner your friend can get to the root cause, the better the chances of recovery - even if it means taking the horse elsewhere — if that is even possible.
 
Did they have an mri? It’s really the only way to truly know what’s going on in the feet. Navicular diagnosis any other way is just a term for general heel pain, mri can tell you if there is also soft tissue involvement, ddft, annular ligaments, suspensories etc.

Jess had a loose navicular diagnosis from blocks and X-rays. She had 18 abscesses in the front feet over the next 2 years, repeat work ups just gave the same answers. I never did the mri as insurance wouldn’t cover it. We’ve tried all kinds of foot management methods, often a change would help for a while then she’d deteriorate again. Ultimately I’ve retired her as i couldn’t keep her consistently sound and I simply wasn’t willing to wedge her to get 2 good years out of her when it’s known to cause more problems than it solves in the long term. She is shod with natural balance shoes and flat pads now and that keeps her relatively comfortable but she still has off periods even as a field ornament.

If money were less of a consideration, I would have mri’d and sent her to rockley farm (if she wasn’t completely adverse to living with mares). They have a huge success rate for reversing navicular/ddft injuries.
 
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As well as testing for PPID get them to test for EMS too, some of this sounds very familiar to me from dealing with EMS and PPID. If it is EMS then the "good" diet may actually be adding to the problems as the sugar levels are probably too high for him - even decent hay can be too high. Like others have said I suspect you have more than one thing going on here, but if metabolic issues are at the root then nothing will be more than a sticking plaster on a gaping wound until they're under control. The big splayed feet, very thin convex soles and repeated abscesses say EMS to me, the lameness, inability to cope with hard ground and weight loss could "just" be side effects. With feet that splayed and abscesses is there white line separation?

I would get tests done, get more x-rays from all angles for foot balance and maybe consider a second opinion from another vet practice if nothing is found. If this farrier isn't keeping his feet back then get another one in, and maybe a 5 week cycle is too long. Stop all jumping until this is resolved, even if he's happy to when sound it's not, imo, advisable.
 
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Thanks everyone you are all brilliant. I’ll try and answer everything.

I don’t think they need to change vet yet. The diagnosis was done by one vets. The horse then moved over 100miles north due to her job. He was diagnosed the end of august and knew she was moving in October. So he got the new shoes on. Saw that vet again. Was shod again and immediately moved north. Vets were very positive he would be totally fine to doing BS but probably not cope with the ground BE.

Initially it was all going well. Due to job (newly qualified paramedic so busy) and move he had a fairly easy life, came back in to work. Started jumping. First show a month ago and I was actually quite impressed at how he was going.

It has been since then the abcesses. One in each foot. So the vets first time of seeing him was the first abcess. Then 2 weeks later (which is now a week ago) the second one. He was so lame it was impossible to do anything more at that point other than treating the abcess.

I don’t think he had an mri. He was diagnosed I presume from blocking and X-rays. New vets don’t want to X-ray quite yet while he is still sore with the abcess. I think the plan is to do them shortly. They have asked for the initial X-rays to be sent over which was meant to have been done already. I get a horrible feeling initial vet just wanted a quick fix and patch him up. I will not use those vets but it is done now.

Im not sure about white line separation. The abcesses are on the inside of the foot, more or less in the middle between toe/heal and frog/wall.

I asked if he has been tested for Cushings and it was negative. I’ll mention ems.

It’s clear there is a lot going on. I was quite horrified when i saw him on Thursday. When I first met him I was horrified and I suggested various things. They moved yard away from a difficult situation, and he put on 100kg and the next time I saw him I didn’t even recognise him warming up!

Now he is back to awful. He is now 100 miles away and I rarely see him. I can only suggest so many times to treat him for ulcers.

He is not insured but the money is there. I don’t know anything about the vet up there.

Yes everything is just a sticking plaster. They are beginning tk feel very despondent about the whole thing. They have had him 2 years and it has been one lameness after another. He has “crap feet”.

His legs are covered with lumps and bumps and scars, random swellings etc. maybe his legs are just done.

He is such a nice horse but he is clearly miserable. I wish I bought suggest something else to them. Hence the post.

I don’t think there is a hospital that far north so it would be approx 200miles to Edinburgh.

Re stopping jumping. He has been lame so hasn’t been jumped. And I can honestly say he was fine. He looked so much better. So much more fluent and did 2 lovely double clears making it look easy.

(Ps I realise I am being confusing. My friend is the mother. The daughter has the horse (the paramedic) up north. Although friends with the daughter too)
 
(Sorry another add on!)

I last saw him around 6 weeks ago. We went to the beach. The difference in him was amazing. He was striding out in the gravel/tarmac/hard and I commented on how much happier he looked. I had last seen him just before diagnosis when I looked after him. I was so concerned about him. It really was like chalk and cheese and I too thought the issue was now being managed well. It’s a shame things have fallen apart again.
 
The trouble is if he loves jumping he may be doing it despite being uncomfortable, the adrenaline may override it, but whenever he jumps he lands with all his weight on a front foot and from the sounds of it both fronts are badly compromised. He may not realise it but he is doing damage since his soles aren't in a condition to take that and hold the hoof. His legs may or may not be a problem, but his feet certainly are if he has thin convex soles.

I'd get another PPID test done. @lauren123 had clear blood tests with Sox, but a different type of test showed a very different result. And get her to speak to them about testing for EMS, or even simply managing him for a few months as though he has it and seeing if that makes a difference, though testing would be better and then he could be medicated if needed.

ETA grass is now coming through which is a nightmare if dealing with EMS, and box rest is very difficult too due to the lack of activity. Heads you lose, tails you lose 😢
 
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He was refusing and being sticky jumping before the diagnosis. And yes I agree there will have been a degree of woohoo I havnt done this for a while. We really did think that they had sorted the issue. Vets advice was he was fine and he would be fine to jump. Obviously we now know it wasn’t fine. He was brought back in to work slowly and she wasn’t doing anything she was given the ok to do.

The wheels have fallen off in the last 3 weeks. Looking back the show was 3rd march. So almost a month before the first abcess. I will mention again about ppid.
 
And EMS, I think that's at least as likely as PPID.

I wasn't saying the poor girl wasn't following vet advice, but I do think that advice was bad.
 
Yes I am beginning to think the same. I was surprised when the vet said he would be good for BS but I didn’t speak to the vet and so the information was second hand. I was trying to work out how to save the video to show you but I’m being thick. But it also shows the dramatic weight loss 🙁
 
Glasgow a few miles further away than Edinburgh. I didn’t know there was one in aberdeen.
 
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