Cresty and footsore, aargh! Help - UPDATE for vet visit

Mary Poppins said:
That is certainly one point of view, but not the only point of view. I believe the ‘cure’ for laminitis is found by looking at the reasons behind the laminitis is the first place (EMS, cushings) and then addressing the trigger factors (sugar). And I also believe a change of diet (eg taking a horse off grass completely) can provide quick relief of pain. Trimming cannot cure the laminitis, and often harsh trimming does far more harm than good. It is wrong to say all laminitic horses need corrective shoeing and trimming. This is one path that owners can choose to follow if they wish, it is not the only option.

How would you define a neglected foot?
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Of course anyone will be looking for the cause, and if it's metabolic trying to manage (not cure, you can't cure) it. Sugar is not the only trigger though, not even in the most basic "fat pony" laminitis, you could remove nearly all sugar & still have laminitis present. With a bad laminitic taking off grass is not going to provide a quick fix, to think so makes me feel you've never had dealings with a bad or persistent case because if you did you'd soon learn otherwise. The whole reason behind x-rays is so that a trim doesn't do harm, any farrier trying to do otherwise would be acting rashlt verging on negligently. At no point did anyone say all laminitics need corrective shoeing or trimming, but the fact remains that without x-rays you don't know, hence the need to get them.

Mary Poppins said:
It can be a bad thing if too much of the hoof is cut away, or it is cut away at the wrong angle. This can leave the foot more sore than it was before. You cannot put the hoof back on once it has been taken off. What does ‘trimming correctly’ even mean? Each horse is unique and what may suit one horse will not necessarily suit another. Having an idealogical idea of how the perfect hoof should look can mean that horses feet can be trimmed in a way that does not suit their way of going.

It is my opinion, take it or leave it. Thankfully Ben hasn’t had laminitis, but if he did I certainly wouldn’t be rushing to have a trimmer intervene before I had taken him off grass completely and cut all the sugar out of his diet.
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And again, the whole point of x-rays is to ensure the angles are correct. I do wish you could have seen my farrier & vet working together with a digital x-ray machine & trims, maybe then you'd realise how critical a correct trim is for a laminitic & also how quickly it makes them more comfortable - not cured, but in less pain while everything is got under control & also minimising further mechanical damage. If you really can't see this then I pray that you never have to deal with a bad case of laminitis, whatever it's cause.

Jane&Ziggy said:
Thank you all for your support and sympathy,

I want the x rays to see what is going on, especially as one foot is much worse than the other.

I have to say that short of putting him in the shelter for the entire summer there is no way for me to take him off the grass. I don't have a sand paddock or school where he can go. Even the thought of doing that gives me palpitations; not just because it's awful for him, but because it is way more work for me and we have business changes coming up that will require my full attention. I am really hoping I don't have to do this.

At the last trim, when he was recovering well, my trimmer took his toe back quite sharply and he was very much more comfortable afterwards. I can't possible get my trimmer out with the vet, alas - he has such a busy schedule he can't do drop ins. But I will send him the x rays - it's less than 2 weeks to the next trim.
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It's a shame you can't get the trimmer out with the vet, but at least they can liaise & the trimmer be sent copies of the x-rays. If it's only minor adjustments to x-rays then it may be that your vet will be happy to do them there & then, or better yet no adjustments will be needed. I really hope it's the latter, though if he was more comfortable with the toe taken back sharply I would wonder if there is a degree of rotation - don't panic if there is, it really isn't the end of his working life.

Depending what the x-rays show & what treatment is needed could you tape him off an area in front of the shelter & either cover it in woodchip or muzzle him when he has access to it? If he doesn't need complete box rest that might be a better option for both of you.

Fingers & toes crossed for you, I know just how worrying this is & how it seems to take forever to move forward x
 
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@carthorse said trim is part of the cure, and as big a factor as diet etc, not that it's the whole cure.

Realigning is only necessary if there is rotation or mechanical defects such as long toes etc adding further stress on the laminae but you can only know that for sure with an xray. Lower grade lami, before rotation occurs, often doesn't need a specific trim (but still need a good/correct trim) but if there's unaddressed rotation and/or mechanical defects the recovery is inhibited or recovery time is greatly increased by the continuing mechanical stress placed on the laminae even after dietary or endocrine triggers are removed.

The cases you've been involved with @Mary Poppins, where trim made them worse, were they xray guided trims? If not, it kind of makes the point that xrays are necessary to do it well.

I feel you on the extra work @Jane&Ziggy, it's huge, but I would recommend aggressive treatment to expedite recovery and by that I mean go full force, serious restriction of movement and diet (as you did in the initial stages) to get him back on the right track asap and hopefully in just a few weeks you'll be able to start going back to a more normal routine, though you've still got 9+ months (after removal of triggers) of foot to grow out before things can really get back to normal. Going with gradual or partial reduction until you see changes just seems to draw things out in many cases. Aggressive treatment often results in a shorter recovery period.
You're on sandy soil like me and in this heat it won't take long to create a grassless paddock, with another horses help, go for Timothy haylage if soaking hay is too much (it's killing me right now) and get some frog supports on to minimise further damage, you can make them yourself and duct tape in place for now and they won't do any harm even if not strictly necessary, I'm sure your vet will help you figure out a plan of attack on Monday tho. Anecdotally, lots see improvement with the addition of salt and magnesium to the diet if you don't do that already :)
 
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Nothing to add re advice - but just wanted to say hugs and healing vibes to Ziggy and so sorry you are going through this. Xxxxx
 
Well the vet visited and took x rays, which I will post tomorrow. Ziggy stood like a post on the blocks, no sedation required, and didn't even flick an ear when the vet took bloods for the Cushings/EMS test.

Vet said right foot was worse than left (we knew that) and needed the toe taking well back (I knew that too) and his view was that the current occasional lameness is mechanical, probably because Ziggy's toes have grown long enough to throw the foot out of balance, rather than caused by Cushings or EMS. He told me to watch the grass (yes, I've learned that too) but not to be too worried.

I'll be interested to see what you all think of the X rays when they arrive :)
 
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That's good that he feels its more mechanical. The ground is so hard that any trotting could cause a concussion effect.

Are bloods back to rule out ems/ cushings?

If one foot is worse is this the one that you tend to get flare / separation with'
 
So now you likely know what you're dealing with & hopefully when the trimmer comes out & balances the feet to the x-rays you'll find he's a lot more comfortable. Can he come out soon, and maybe trim more often if the vet thinks this is mechanical? Like the vet says I'd watch the grass too, obviously his crest suddenly going hard isn't caused by overlong toes, but it's a good sign that he doesn't think what this flare up is. I'll be interested to see the x-rays, and thanks for the update.
 
newforest said:
That's good that he feels its more mechanical. The ground is so hard that any trotting could cause a concussion effect.

Are bloods back to rule out ems/ cushings?

If one foot is worse is this the one that you tend to get flare / separation with'
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He only took the bloods today, I don't know how long they'll be. And yes, this foot is always the one that goes flat and long-toed.

carthorse said:
So now you likely know what you're dealing with & hopefully when the trimmer comes out & balances the feet to the x-rays you'll find he's a lot more comfortable. Can he come out soon, and maybe trim more often if the vet thinks this is mechanical? Like the vet says I'd watch the grass too, obviously his crest suddenly going hard isn't caused by overlong toes, but it's a good sign that he doesn't think what this flare up is. I'll be interested to see the x-rays, and thanks for the update.
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I am still watching the grass and mindful of your advice! He is in from 6 am to 8pm and out on short grass crisps overnight. He is still cresty but not fat, which is odd.

I wish my trimmer could come more often but he just can't. The vet said to me, in a stage whisper, "I know I'm not supposed to say this, and I'm not saying anything, you understand, but you could get a rasp and touch up his toes yourself." I think I might ask my trimmer to bring me a rasp when he comes and show me what to do!
 
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I have a rasp in case mine chips anything off.
My farrier is positive about my input and brought a rasp with him I could buy.

If the neck has gone cresty you could try massaging it. Give it a jiggle and have a good feel to define the difference between any topline and the fat.
It's an abnormal fat deposit, it's a sign of ems, lami, but this might not be the case for you. It could be because he's had lami before and puts fat here?
The cob has two abnormal fat pads on her sides. She still had these when she was a condition score of one!!!
She was overweight when arrived and this never went.
 
How attached are you to your trimmer Jane? I think that, under the circumstances, if he really can't come more often I'd be looking for someone else & explaining to him that you really don't want to but Ziggy needs more frequent visits & if he can't do that you need someone who can. That's just me though, and maybe if you're braver than I am and happy to use a rasp then you'll cope.

Management wise it sounds like you're doing a good job so keep it up & hopefully he'll improve with a good trim :)
 
Odd fat pads on an otherwise slim horse are often indicative of a metabolic issue so I think the testing is a good idea even if he doesn't think it's specifically causing the current issues.

Hopefully your trimmer will be happy to show you the ropes and between you, you can keep those toes in check :) My farriers have always given me old rasps, they like them new and sharp and a lot will have a new one weekly. I find new rasps a bit too sharp, they bite more and you can take a lot off in one swipe so I prefer their discarded ones as they are a bit duller, it might take me a few extra swipes to get the same result but I'd rather that than taking too much and as they don't bite so much you don't need so much muscle for each swipe :)
 
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If you do decide to rasp the toe yourself in between visits then it might be useful to get photos of just trimmed feet so you know what angle to take them back to. Where there's rotation you sometimes have to take & keep toes back quite a long way to achieve a correct, comfortable foot balance & it's easy to lose sight of that when too long looks normal - you don't want to leave it until he looks wrong again because that means the laminae are being stressed. I have to admit I'd be very wary of rasping a laminitic foot myself. If there isn't movement then I'd be asking why the trimmer has allowed the toe to get too long that it's contributed to the problem.
 
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carthorse said:
If there isn't movement then I'd be asking why the trimmer has allowed the toe to get too long that it's contributed to the problem.
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To be honest he did take them back hard 3 weeks ago, as short as I have ever seen hem. For 2 weeks they looked great and then suddenly the right foot went long and flat - it has always been prone to do this. I will have deep speech with my trimmer when he next comes.
 
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I am sorry I have nothing to add and there are some on here that has such a good level of knowledge and experience and I have none on this subject,
Just hugs to you and Ziggy
 
@Jane&Ziggy this time of year I sometimes have to have my laminitic done every three weeks, in fact I was looking at them today & wondering if I'd have to bring him forward a week. It's very rare his fronts do more than 4 weeks.
 
When Jess was having what ever her bad thing was, she was rasped (2 or 3 swipes) every 4 days, it kept her much more comfortable. I've eeked it out over the last 18 months and I'm now doing her every 4 weeks for the most part, but sometimes she'll need a tweek before.
 
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