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

Jane&Ziggy

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After improving steadily for several weeks, so much so that I put him back on the track with Mattie (to eat the grass crisps), Ziggy is footsore again on his right fore.

He has also, just today, developed a really big crest. I swear it wasn't there last night.

He's back in his restricted paddock and spending most of his time in the shelter, given the heat. It has been 30 degrees in the field these last few days. I am thinking I should ask the vet back next week to test for EMS and Cushings. Would that be right? Is there anything else I should do?
 

carthorse

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Yes I'd ask the vet back to test because if it is either condition you'll struggle without the proper support. I think you also have to accept that he can't have grass at the moment, I know everywhere looks dried up but I'm not seeing the native ponies at my yard wasting away & that tells me that there's still enough feed value in it for their very efficient systems to live off.

With a recovering laminitic you need to be thinking months not weeks. I'd rule out turning him out on any sort of grass this summer, maybe 10 minutes a day in hand if he's not showing any symptoms or warnings, and I suspect what you're seeing isn't a new flare up but the original one never having fully gone.
 

mystiquemalaika

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Sorry to hear he has taken a step back J&Z :-(

If be looking at EMS and Cushings test but i would also want xrays of his feet to see exactly what is going on in there. Sorry if you have done that and I've missed a post. I hope you can get some answers soon, healing vibes for Z and hugs for you.
 
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Trewsers

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No advice, just sorry to hear he isn't right again. When I saw the title I wondered what was crusty!!! Lol
Lots of vibes for getting him back 100 percent.
 

joellie

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Sorry to hear about poor Ziggy. Yes I would deffo get him tested for EMS and cushings. They can get a cresty neck alarmingly quick.
 

carthorse

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I think you're right & you do need them. Cushings can be medicated, usually successfully for a decent length of time, & EMS can be managed & some drugs help BUT to do that you need to know what you're dealing with.

If you're getting x-rays on Monday is it possible to get your farrier there at the same time? That way if there is any movement he can trim accordingly & then check that trim with another set of x-rays. Copies of x-rays are better than nothing, but there's no telling what other changes have occurred in the meantime & trimming a rotation blind takes a brave or foolhardy farrier. Having said all that I really hope the x-rays show nothing has moved!
 
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Mary Poppins

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So sorry that he is poorly again. I think that I would be taking him off grass altogether for the whole summer. And I agree the tests need to be done.

I am in 2 minds about the X-rays. I think that farriers/trimmers can interfere too much and while his feet need to be supported by a comfortable surface, I am not convinced cuttting away more of his foot will help. Laminitis management is mainly about diet in my opinion. If you can cut out sugar (grass) and feed a high fibre diet with essential vitamins added, he should improve.

The success is all in how he moves and how sound he is. Even if he does have pedal bone rotation, there is nothing you can do about it anyway. You can argue that the X-rays will inform the trim that he needs so the foot is well supported, but I am not convinced that this really helps. I would be inclined to get really strict with his diet and leave his feet alone.
 

Star the Fell

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My vet sent the x-rays to my farrier (at my request). I needed to speak to a ‘foot expert’ to know exactly how bad they were. I actually found him better to speak to than the vet. He is very blunt and told me exactly what the problem was and we discussed a treatment plan which worked for both of us. The vet just threw suggestions out there, but wouldn’t actually TELL. Me which was the best solution of us.
As others have said, the x Ray is just a picture of the hoof at that moment in time.
We are going through another serious lami flare up at the moment, the worst she has had yet and it is heart breaking. Her recent test showed that her levels were three times higher than they should be so we upped the tablets by 50%. I have upped them again to try to deal with this outbreak.
It is so hard. I am facing the fact that I may have a pony that can no longer have grass.
I hope you get Ziggy comfortable soon x
 

Jessey

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I am in 2 minds about the X-rays. I think that farriers/trimmers can interfere too much and while his feet need to be supported by a comfortable surface, I am not convinced cuttting away more of his foot will help. Laminitis management is mainly about diet in my opinion. If you can cut out sugar (grass) and feed a high fibre diet with essential vitamins added, he should improve.

The success is all in how he moves and how sound he is. Even if he does have pedal bone rotation, there is nothing you can do about it anyway. You can argue that the X-rays will inform the trim that he needs so the foot is well supported, but I am not convinced that this really helps. I would be inclined to get really strict with his diet and leave his feet alone.
I disagree with this (respectfully of course) as the farrier can trim the foot to realign rotation, it's not just about support but physically correcting the symptom (rotation) so that the new foot grows in well attached and relieving breakover so each step isn't causing more damage.

I definitely think testing is worth doing, given they now say 90% of lami has an underlying metabolic/endocrine cause I would test any lami case that doesn't have a clear cause (eg got into the feed room the night before or worked excessively on hard ground right before etc). Given the relapse I would def want xrays too now, even if they just put your mind at ease.

Crests can appear very quickly, anacdotally it's when they change from soft to hard that things are happening, so perhaps it's that change you're seeing?

The ground is very hard at the moment, he could have had a way-hey moment on the track and on already damaged feet that can be enough to make them sore again, so if everything comes back negative that's another thing to consider.

Healing vibes coming Ziggy's way :)
 

carthorse

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So sorry that he is poorly again. I think that I would be taking him off grass altogether for the whole summer. And I agree the tests need to be done.

I am in 2 minds about the X-rays. I think that farriers/trimmers can interfere too much and while his feet need to be supported by a comfortable surface, I am not convinced cuttting away more of his foot will help. Laminitis management is mainly about diet in my opinion. If you can cut out sugar (grass) and feed a high fibre diet with essential vitamins added, he should improve.

The success is all in how he moves and how sound he is. Even if he does have pedal bone rotation, there is nothing you can do about it anyway. You can argue that the X-rays will inform the trim that he needs so the foot is well supported, but I am not convinced that this really helps. I would be inclined to get really strict with his diet and leave his feet alone.

Mary Poppins this really isn't the case with laminitis. A correct trim will realign the hoof capsule, as far as possible, to the rotated pedal bone, and this in turn will relieve a lot of strain on inflamed laminae. Since the strain increases inflammation & inflammation is what destroys the laminae (laminitis at it's most basic is an inflammation of the laminae) a correct trim is actually part of the cure. However to be correct the farrier must be able to see what he's trimming to, they daren't take a toe right back if they don't know where the bone is & likewise they don't want to drop a heel more than necessary. I've seen first hand, several times, the difference a correct trim to x-rays can make to a laminitic - it's as big a factor as diet & far quicker to kick in & give relief. Did you know that neglected feet can develop laminitis from purely mechanical causes?

It's completely wrong to say nothing can be done about pedal bone rotation, and it's that mistaken belief that has led to horses not getting the treatment they need & being pts. I ride a severely rotated welsh cob, to watch him move nowadays you'd never guess there was a problem, well maybe with the brakes but that's a different matter lol. He's shod with pads for protection, but if his toe get slightly longer than his ideal then I start seeing & feeling it & that alone stresses the importance of a correctly balanced foot when internal structures are compromised.
 

Mary Poppins

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Mary Poppins this really isn't the case with laminitis. A correct trim will realign the hoof capsule, as far as possible, to the rotated pedal bone, and this in turn will relieve a lot of strain on inflamed laminae. Since the strain increases inflammation & inflammation is what destroys the laminae (laminitis at it's most basic is an inflammation of the laminae) a correct trim is actually part of the cure. However to be correct the farrier must be able to see what he's trimming to, they daren't take a toe right back if they don't know where the bone is & likewise they don't want to drop a heel more than necessary. I've seen first hand, several times, the difference a correct trim to x-rays can make to a laminitic - it's as big a factor as diet & far quicker to kick in & give relief. Did you know that neglected feet can develop laminitis from purely mechanical causes?

It's completely wrong to say nothing can be done about pedal bone rotation, and it's that mistaken belief that has led to horses not getting the treatment they need & being pts. I ride a severely rotated welsh cob, to watch him move nowadays you'd never guess there was a problem, well maybe with the brakes but that's a different matter lol. He's shod with pads for protection, but if his toe get slightly longer than his ideal then I start seeing & feeling it & that alone stresses the importance of a correctly balanced foot when internal structures are compromised.
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?
 

Kite_Rider

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No disrespect intended @Mary Poppins but have you ever dealt with a bout of laminitis?
While I agree everyone should look at alternatives and not be bound by common practise I also agree that trimming can not ‘cure laminitis’ however as @carthorse pointed out trimming correctly often offers much more relief to a stressed hoof and I honestly can’t for the life of me see why that is a bad thing?
Surely the first thing to do once it’s off the grass is to make the horse as comfortable as possible?
I’m curious to know what these alternatives are?
 

Mary Poppins

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No disrespect intended @Mary Poppins but have you ever dealt with a bout of laminitis?
While I agree everyone should look at alternatives and not be bound by common practise I also agree that trimming can not ‘cure laminitis’ however as @carthorse pointed out trimming correctly often offers much more relief to a stressed hoof and I honestly can’t for the life of me see why that is a bad thing?
Surely the first thing to do once it’s off the grass is to make the horse as comfortable as possible?
I’m curious to know what these alternatives are?
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.
 

Kite_Rider

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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.
I’m not clever enough to explain about pedal bone rotation and how trimming can help but both carthorse and Jessey have explained it well, thankfully Ben has never suffered laminitis and I honestly hope he never does, it really isn’t as easy as just taking them off grass and getting rid of all sugar from the diet!
No one is talking about normal trimming, we’re talking about X-rays and trimming to take the degree of rotation into account to help alleviate any more stress to the inflamed laminae, it’s got nothing to do with extremes, or one trim fits all, or trimming to a horses way of going, I would be the last person to advocate a one fit wonder.
 
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mystiquemalaika

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Mary poppins I can see possibly where you are coming from In the respect of not trimming a foot for looks especially in some cases of lameness where the horse can and does grow a foot that helps them but it is a different thing entirely when dealing with Lami. The hoof wall separates from the laminae and flares for want of a better word. It is not that the natural growth of the hoof has taken this shape it is damage internally that can be helped and make huge differences by being trimmed in a way that helps realign the pedal bone to the hoof structure. This is why xrays are recommended as the farrier and vet aren't then going in blindly trimming foot away. Some Lami cases need trimmed weekly at the start of severe cases to make sure the hoof is kept as balanced as possible, a mere 2mm can make a horse horrible uncomfortable. This is of course all to be done along side everything else that helps, diet, exercise etc all in the bigger long run picture.
 

Mary Poppins

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I’m not clever enough to explain about pedal bone rotation and how trimming can help but both carthorse and Jessey have explained it well, thankfully Ben has never suffered laminitis and I honestly hope he never does, it really isn’t as easy as just taking them off grass and getting rid of all sugar from the diet!
No one is talking about normal trimming, we’re talking about X-rays and trimming to take the degree of rotation into account to help alleviate any more stress to the inflamed laminae, it’s got nothing to do with extremes, or one trim fits all, or trimming to a horses way of going, I would be the last person to advocate a one fit wonder.
No of course it isn’t. The route cause of the laminitis needs to be addressed and this is why Ziggy will be tested for EMS and Cushings. Medication can then be prescribed which will hopefully help. The sugar is the just the trigger.
 

Trewsers

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My own thought would be have the x rays done because to give the best chance of recovery I'd like to think between farrier and vet - that the x rays would enhance the chances of a sound outcome. I have no experience with my own horses of lammi, however, when they have injured tendons etc in the past I always like to see scans because it all helps recovery knowing what is what - not sure how relevant that is to lammi but just my opinion. I like to explore all avenues. If it gives more information of what is going on in there then why not. It's not like it's invasive.
 
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Jane&Ziggy

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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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