# Laminitis and sunken pedal bone- prognosis?



## Kokopelli (16 April 2017)

My poor boy had a reaction to steroid injections in his hocks last week and came down with laminitis in all four feet. Xrays have shown in all four feet, although worse in hind, very mild sunken pedal bones. 

I've fortunately never had experience with lami before and keep forgetting to ask the vet, but what is the prognosis for a case like this? He seems pretty happy in himself but has a few other problems. He's 11 and I hoped to start competing him in dressage again.


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## OLDGREYMARE (16 April 2017)

Please go to the Laminitis Site and perhaps join their fb page Friends of the lamintis site,there you will get all the help you need by people with huge experience of horses going through what your poor horse is going through,Really.


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## Andalucian (16 April 2017)

So, you're in the acute phase of laminitis, due to steroids. It's scary to have to deal with this, but take it very seriously and you will recover fully.

Shoes off.  Absolute box rest on deep shavings, soaked hay only is ideal.  Bute if extremely painful, but it's a balance as you don't want them to feel false comfort and jump about.

What you're aiming for here is to keep him quiet, treating his feet as gently as possible until the inflammation subsides, in this period he is in danger of the pedal bones moving more, so be absolutely strict on the management.

Call the vet first thing Tuesday and ask for detailed advice, they should have already done this, you shouldn't be in a position that you don't know what to do, acute laminitis is a known, but rare, side effect of steroid injections, so they should be only too keen to hold your hand regarding care when this happens.

In my experience, the acute phase when caused by steroids can last longer than conventional laminitis, keep positive, but be prepared to wait.

Once laminitic growth is seen, expert trimming will be needed to bring the pedal bone back into balance.

Wishing you both a successful and speedy recovery.


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## Kokopelli (16 April 2017)

Thanks for advice both. He's on box rest for the next month at least until our second set of xrays. He's on a deep bed and has been on bute since last week although we're slowly cutting it down until he's on none.
I've completely changed his diet so he's on as low sugar as possible. He's also having bromide to keep him chilled as he is being a bit of a silly ******.

Fingers crossed he recovers, it's very mild so hoping we caught it early enough before any lasting damage may be done.


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## Andalucian (16 April 2017)

Perfect, now the difficult bit is waiting. Stay positive.


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## PorkChop (16 April 2017)

I have had one that came down with laminitis after steroids, the first week she was awful, poor thing.

However it did resolve itself, hang on in there.  I used frog supports as well.


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## Kokopelli (16 April 2017)

Farrier is coming this week not sure what he'll suggest shoeing wise. Vet also coming Friday so can ask anymore questions then. It's been such a tough year with him, just as he starts coming right another set back.


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## PorkChop (16 April 2017)

Kokopelli said:



			Farrier is coming this week not sure what he'll suggest shoeing wise. Vet also coming Friday so can ask anymore questions then. It's been such a tough year with him, just as he starts coming right another set back.
		
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Frustrating isn't it - mine didn't have any shoes put on until she had recovered.  She was in for a month on ACP.


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## Goldenstar (16 April 2017)

Has he got frog supports on ? If not I would get some .
It's  extremely bad luck .


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## JillA (16 April 2017)

http://www.hoofrehab.com/DistalDescent.htm   - well worth a read. Meanwhile support, support and more support for the soles as they are all that is stopping P3 dropping through until the laminae heal. Deep conforming bedding, Styrofoam pads then either heartbar shoes or boots and pads and the prognosis is usually not bad. Get your farrier and your vet to collaborate, but TBH I wasn't happy having shoes nailed on to a sore foot, even heartbars, and eventually persuaded my vet that boots and pads were the way forward. Good luck, if you follow the The Laminitis Site protocol he has a very good chance of a full recovery, as mine did.


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## Jericho (16 April 2017)

Oh my goodness I could have written your post myself as more or less than same thing has happened to my 11 yr old. Slight rotation in rear hooves and one front and sinkage on all those three. This came on suddenly (or the acute stage as there was no other signs) 2 weeks ago. We are doing exactly the same as you - deep bed, shoes off, he had putty in his feet to start with to cushion them but thats off now. 2 danilon a day and 1mg  of sedan (to dilate the blood vessels) twice a day, soaked hay, minimal movement. He has improved slightly as in he couldn't walk the first few days but he is still sore to walk now. I feel it is going to be a long slow process and have been told to expect setbacks along the way. The vet did say there is no reason that he won't return to work but it will be about 6 months and sinking of the pedal bone isn't the death sentence it used to be akthough the hooves will always be compromised now and have to be managed accordingly.
I am sorry to hear about your boy, its heartbreaking, and I want to cry every time I look at him. He competed in his first BE going double clear 3 weeks ago, cant believe it has happened so quickly.


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## Tyssandi (16 April 2017)

Kokopelli said:



			My poor boy had a reaction to steroid injections in his hocks last week and came down with laminitis in all four feet. Xrays have shown in all four feet, although worse in hind, very mild sunken pedal bones. 

I've fortunately never had experience with lami before and keep forgetting to ask the vet, but what is the prognosis for a case like this? He seems pretty happy in himself but has a few other problems. He's 11 and I hoped to start competing him in dressage again.
		
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My horse has sunk and rotated and I lost her but it was infection of the pedal bone that was the  thing that got her.  I will send you my link


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## AdorableAlice (16 April 2017)

A friends HW hunter went in for hock injections recently, blood tests showed sugar levels were far too high use steriods.  He was sent home with instructions to strip a lot of weight off and represent when he was lighter.  That was done and the bloods tests were in the normal range so they did treat him.

Did your horses have the blood test pre treatment ?


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## Kokopelli (16 April 2017)

He didn't have blood test pre treatment but he had a year off and came back into work in Jan, we were going to medicate then but he was too fat and vet didn't want to. We got his weight right down and he was looking really good, vet was pleased which is why we went through with it. He's had them before and has never reacted but I do think a combination of spring grass and steroids are to blame. We're going to test for ems and cushings too just to make sure we're covering all bases.


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## AdorableAlice (16 April 2017)

Kokopelli said:



			He didn't have blood test pre treatment but he had a year off and came back into work in Jan, we were going to medicate then but he was too fat and vet didn't want to. We got his weight right down and he was looking really good, vet was pleased which is why we went through with it. He's had them before and has never reacted but I do think a combination of spring grass and steroids are to blame. We're going to test for ems and cushings too just to make sure we're covering all bases.
		
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Very best wishes and I so hope he will be ok.


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## ester (16 April 2017)

It is really bad luck, most recent research indicates that intra-articular steroids rarely set it off but quite possibly as you say a combination of things = perfect storm/enough to tip over the edge. Is this your little grey boy koko?

As always Andalucian gives excellent advice, patience and there is no reason he shouldn't make a full recovery keeping him as comfortable as possible in the meantime. But worth checking the bloods too. I was very pleased last year I had checked F (he is 24 now) for cushings again because he ended up having IA steroids into a hock, injectable into his annular ligament and cream on his nose!


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## Britestar (16 April 2017)

Ask your vet about getting him onto Aspirin. Its more effective than acp for improving the circulation. 

Its totally recoverable, just make sure you have vet and farrier working together, and stick to your guns. 

Mine had toxic laminitis, both back feet sunk, and rotation in all 4 feet. It took a long time, but he came back to as good as he was before - if not better


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## noblesteed (17 April 2017)

Sorry to hear this. My boy always has a very mild laminitic reaction to hock steroids. 3 years ago when dignosed with spavin my vet had warned me about this risk because he's had lami in the past, so he is always given a weeks pre-injection laminitis style 'starvation' period then injected then 2 weeks laminitis-style box rest. This worked on first 2 occasions but last set of injections he was a bit pulsey in just his hinds and needed 4 weeks. Aside from that he was fine, sound, happy. Last summer he got laminitis in his hind feet due to grass so I think the hind feet are now much more susceptible. In March just before his annual steroid injections were due my farrier found mild separation again in hind feet so vet and I have now decided that he can't have any more steroid injections  He's now remedially shod on his hind feet for lami. Currently trying to decide what to do next as cushings test negative


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## Kokopelli (17 April 2017)

Yeah it's my little grey, he's had KS surgery, a year in the field and was just coming back into work like an absolute dream, absolutely typical. In hindsight I probably should have kept him off the grass altogether after the injections but I just didn't consider the risk. 

Vet and farrier are working well together so fingers crossed he's on the best course for a full recovery


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## Kokopelli (23 April 2017)

Louie had been doing really well but unfortunately he seemed to have another attack yesterday for no apparent reason as still on box rest with restricted food. Back on bute and waiting until next week for another set of xrays. Fingers crossed we've avoided more structural damage


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## ester (23 April 2017)

damn , he doesn't seem the type generally (which is why I asked if it was him) but that would definitely make me want to test. 
What did the farrier suggest? It is one of the things I think from what I have read I would consider sticking imprints on for, I know Blackcob did with her mare.


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## Kokopelli (23 April 2017)

We took bloods on Friday so hoping to get results this week for them. When the farrier saw him he was quite happy with his feet so put on shoes that offered more heel support as he did seem so comfortable even off but and xrays were very mild. However, if the xrays show any more changes we'll go back to the drawing board and go from there.


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## Kokopelli (27 April 2017)

Xrays today were clear!  We'll reassess in two weeks and he may be able to start going out again. Just awaiting results from the cushings test now


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## Pearlsasinger (27 April 2017)

Excellent news!


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## Hexx (5 May 2017)

I lost mine to this two years ago - although it may have been a different story if the vet had his act together and actually diagnosed the laminitis rather than deciding it was a bruised sole - even after both me and the YO questioning him on the correctness of the diagnosis more than once.  My horse had been on high dose steroids for cancer/IBD.

By the time he was x-rayed, about 5 days later (after seeking a second opinion and reporting the first vet for negligence) both pedal bones had rotated 11 and 13 degrees respectively.  

We went on an aggressive treatment regime - cut all hard feed from his diet (which was hard to do as he had lost a tremendous amount of weight with the IBD/cancer), soaked hay - which he wouldn't eat, shoes with frog supports and a bed that took 21 bales of shavings to make.

Sadly, the rotation increased and I made the decision to put him to sleep.  When the farrier took his shoes off to give to me, we found that the pedal bone on the right and come through the sole - so it was the right decision to make.

Koko - I am pleased your boy has picked up - may he continue to improve.


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