# Laminitis ðŸ˜”



## Setterali (4 November 2018)

Hi all, this is my first post on this forum. Sorry if itâ€™s a long one.
My boy who 17 yrs old and  a 16.1 ID x cob, heavy set with enormous feet came in with laminitis in June, he wasnâ€™t particularly overweight at the time.  Vet came out and said it was a very mild attack so box rest, bute and soaked hay until digital pulses had disappeared and then stand in for 30 days on a deep bed. He was getting a handful of non mollassed happy hoof, top spec light and magnesium. Vet said I was doing everything right. No need to X-ray at that point as it was mild. He sprung two abscesses when he was in also, which were treated and cleared up. 

I followed all the advice and gradually reintroduced him to grass with a grazing muzzle. He was out for half an hour every second day gradually building it up to out everyday for 2 hours. 

A fortnight ago he came in absolutely crippled, still had grazing muzzle on. Vet came out and tested for cushings which came back clear, he showed no pain with hoof testers and vet says he has really good thick soles and good strong feet, feet X-rays show that he has 10 degrees rotation on nr side and 15 degrees on offside. 

Heâ€™s been fitted with heart bar shoes as heâ€™s never not worn shoes. Vet gave me a 50/50 diagnosis and told me that if there was no change after being shod twice then there wasnâ€™t much point in keeping him going, because heâ€™s so big and his conformation means all his weight is in his fronts.

My farrier says his feet are in fantastic condition and to keep doing what Iâ€™m doing, so again heâ€™s on complete box rest with the same feed and supplements and soaked hay. I suppose what Iâ€™m asking is has anyone else managed to get a horse back from this far gone? 

X ray pictures included and a picture of my gorgeous boy

Thank you to anyone who takes the time to read this or reply, any input gratefully received xx


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## Setterali (4 November 2018)

Oh I must also add when he was on turnout I was checking digital pulses daily before and after he went out. There were none present on the day he came in crippled.


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## Pen (4 November 2018)

Sorry that your lovely boy is suffering with laminitis at the moment.  My 16 year old cob is just recovering from a prolonged period of laminitis caused in her case by EMS.  She had rotation in both fronts although not quite as much as your boy.  Does your boy show any EMS signs like cresty neck or fat pads?  I personally would drop the Happy Hoof and swop the Top Spec Lite  to Top Spec Zero as the Lite seems to have alfalfa in it and the Zero is just oat straw.  Fingers crossed that your boy improves.


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## meleeka (4 November 2018)

I think your vet sounds unnecessarily pessimistic and itâ€™s certainly possible to come back from that with regular shoeing and xrays. 

Did you have the normal cushings test where itâ€™s just a case of blood being taken? If so, ask for the TRH test. There are many cases of horses testing negative to the normal one, but that doesnâ€™t mean they donâ€™t have it. Have a look at the Equine Cushings group on FB and youâ€™ll read about lots of cases like this. 

If thereâ€™s an underlying reason for him getting laminitis, you arenâ€™t going to get anywhere until you find out what it is.


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## skint1 (4 November 2018)

Sorry to hear about what you and your gorgeous boy have gone through. 
Last year my horse had a long period of various degrees of lameness, some of the time he seemed laminitic, even when not on grass.  I thought it was all kinds of things. In the end in desperation I asked for the senior vet at our practie to see him, nerve blocking had isolated cause of pain to his hoof,  I wanted scans of the hoof done after x-rays had revealed nothing we hadn't already accounted for and the vets felt that wasn't necessary and I was getting a bit arsey about it all.  Anyway, she tested him for PPID/EMS and he did need Prascend, he's now on 1 a day and doing really well (knock wood). Might be worth a try with your boy?  I hhope it all works out xx


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## ester (4 November 2018)

I'm curious that the vet has said he has thick soles, as they don't look particularly so on xray but that might be the shoe skewing the view.
Hooves are great with healing but to correct the rotation you are waiting for a better connection to grow down and it does seem harder/more complications with the bigger horses. 
Has testing for other metabolic issues been suggested?
As it stands it would seem to me that as he was still muzzled there is something going on that means he is potentially going to need grass free turnout in the future. 
I'd switch out the topspec, can you feed a powder or do you need a nut? 
I wouldn't feed happy hoof to mine either, I find weisencobs by agrobs an excellent carrier for a vit/min supplement and anything else that is required. 

Is he currently comfortable on the heartbars? I only ask because if mine wasn't I'd have imprints put on if I could as opposed to nail ons.


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## Nari (4 November 2018)

Like ester I'm not seeing thick soles here, in fact I can hardly see any sole depth. Has your farrier seen these x-rays & what does he think of them? 

I think your vet is being very pessimistic, and to say if two shoeings doesn't do the trick it isn't going to work is, to me, ridiculous when looking at something this severe. You're looking at a very lengthy period of box rest to regrow foot, probably more x-rays so your farrier can keep the trim spot on & so relieve pressure & further damage, and a fair dose of luck BUT if you are lucky it can be done. You're probably always looking at a horse that will need careful management & good footcare though. I'd also want tests for metabolic issues & even though the PPID test came back clear I'd be asking for a prascend trial to see if that helped. I'd also be wondering if this is all new rotation or if the majority of it is from the so called mild attack that your vet said didn't merit x-rays & what you have now is maybe a little bit more rotation and/or bruising on low & rotated pedal bones.


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## ester (4 November 2018)

Yes I forgot about the two shoeings things, you're waiting for the hoof to grow down, that doesn't happen in two shoeings.


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## Setterali (4 November 2018)

Thank you to all who replied, I asked the vet about further tests and she said that as he has improved from losing a bit of weight that she doesnâ€™t feel itâ€™s necessary. He doesnâ€™t have any particular fat pads and heâ€™s never been cresty. She talked about cushings tests and said all cane back clear. Will phone and ask what she tested for.

We have had an unusually hot summer up here and vet says that itâ€™s probably been a flush of grass thatâ€™s caused it, plus the big bugger had worked out how to get maximum grass with his muzzle on.

He seems very comfortable with his heart bars, Iâ€™d say heâ€™s improved if Iâ€™m honest. Heâ€™s due to come down to one bute a day on Wednesday. So will see what he is like then.

The only other thing that springs to mind that may have brought on the second attack is the fact the he hadnâ€™t had any magnesium for approximately 4 days prior as Iâ€™d run out.

My farrier has seen xrays and discussed with vet about shoeing and releasing pressure in his foot. Heâ€™s due to come back in four weeks. I asked if sooner would help and he said that the foot wouldnâ€™t have grown enough.

Will get different feed and wean him across as I wasnâ€™t sure what to give him. 

Iâ€™ll speak to the vet about different metabolic tests as I want to give him every chance possible.

The vet did say even if there was a even a slight degree improvement in 15 weeks it was worth continuing with him.

Iâ€™m prepared to keep him in a bare paddock with hay for the rest of his life if thatâ€™s what it takes.

The saddest thing for me is that heâ€™s standing in his stable the picture of health, his coat is shiny, heâ€™s alert and interested in everything going on. You wouldnâ€™t know there was anything wrong to look at him.

He barely has a digital pulse at the moment in comparison to when he first was lame so I suppose thatâ€™s a positive.

Thanks again to everyone. Will definitely call vet for a chat and see what else I can do for him.


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## Carrottom (4 November 2018)

ester said:



			Yes I forgot about the two shoeings things, you're waiting for the hoof to grow down, that doesn't happen in two shoeings.
		
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I agree that 2 shoe cycles is unlikely to fix things but improvement could be shown, maybe this is what the vet meant. Mine had heartbars fitted and redone twice (5 week intervals) and ex-ray showed significant improvement.


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## Setterali (4 November 2018)

Yes I think this is what the vet was getting at, she said it could go either way. Iâ€™ve got the winter on my side as my horses will likely be in now till at least the end of April possibly may depending on weather. 

My plan is to keep on with shoeing with xrays every so often till then and see where we end up.


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## Pinkvboots (4 November 2018)

Setterali said:



			Yes I think this is what the vet was getting at, she said it could go either way. Iâ€™ve got the winter on my side as my horses will likely be in now till at least the end of April possibly may depending on weather.

My plan is to keep on with shoeing with xrays every so often till then and see where we end up.
		
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Will your horses have no turnout at all until April?


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## Nari (4 November 2018)

I think it's the trim that will make the degree of rotation look less, the rotation itself doesn't really reverse. I can remember seeing x-rays of one of mine & I thought there was no hope there was so much rotation, the farrier was also there & trimmed him to the x-rays then we took more x-rays to see if the trim was optimal or more could be taken. The after x-rays were incredible, it was hard to believe there was so little time between them. No rotation had been reversed, but the hoof wall had been realigned to the pedal bone to alleviate pressures & that made a huge difference. The horse was not badly trimmed before, it wasn't like we were working with a neglected or badly cared for foot, but a correct looking foot was no longer correct for that horse. @Setterali if you can have your farrier there when x-rays are taken so that he can trim with them in front of him, then take more x-rays & if needs be adjust his trim further then you have the best chance of helping your horse. Try to get your vet & farrier working together if you can, both of them have a valuable role too play in his recovery.


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## Setterali (5 November 2018)

Pinkvboots said:



			Will your horses have no turnout at all until April?
		
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Sorry I never made myself clear.
Iâ€™ve got 9 acres for my two horses, they are generally out all year round! 
I was trying to say that this year Iâ€™ll keep them in at night and my lami boy can stay in on box rest for as long as is needed until April to give my lami boy a chance to improve. 

My older boy chooses to go out if he wants, some days heâ€™s only out for half an hour others three hours. 

Iâ€™ve got a dry paddock that the lami boy can go into if and when the vet says itâ€™s ok.[/QUOTE]


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## Setterali (5 November 2018)

Nari said:



			I think it's the trim that will make the degree of rotation look less, the rotation itself doesn't really reverse. I can remember seeing x-rays of one of mine & I thought there was no hope there was so much rotation, the farrier was also there & trimmed him to the x-rays then we took more x-rays to see if the trim was optimal or more could be taken. The after x-rays were incredible, it was hard to believe there was so little time between them. No rotation had been reversed, but the hoof wall had been realigned to the pedal bone to alleviate pressures & that made a huge difference. The horse was not badly trimmed before, it wasn't like we were working with a neglected or badly cared for foot, but a correct looking foot was no longer correct for that horse. @Setterali if you can have your farrier there when x-rays are taken so that he can trim with them in front of him, then take more x-rays & if needs be adjust his trim further then you have the best chance of helping your horse. Try to get your vet & farrier working together if you can, both of them have a valuable role too play in his recovery.
		
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Yes I discussed this with my farrier and thatâ€™s what we decided, so just before the third shoeing Iâ€™ll arrange them both for the same time and we can see where we go from there x


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## Nari (5 November 2018)

Setterali said:



			Yes I discussed this with my farrier and thatâ€™s what we decided, so just before the third shoeing Iâ€™ll arrange them both for the same time and we can see where we go from there x
		
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Is he still on his first set at the moment? If so I'd try to get the vet & farrier together for x-rays for when the second set go on rather than wait for the third. Getting the trim spot on can make a huge difference to how comfortable they are and also help to minimise ongoing damage so the sooner the better really.


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## Setterali (5 November 2018)

Nari said:



			Is he still on his first set at the moment? If so I'd try to get the vet & farrier together for x-rays for when the second set go on rather than wait for the third. Getting the trim spot on can make a huge difference to how comfortable they are and also help to minimise ongoing damage so the sooner the better really.
		
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Right ok I never thought of that, will organise vet and farrier for next time and see how things are going x


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## Nari (11 November 2018)

@Setterali , how's he doing now?


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## fusspot (12 November 2018)

Sorry to hear about your horse.Please ask your vet about doing an EMS test.My Sec D was fully fit,just done the regionals and came down with Laminitis.Vet was shocked as he had absolutely no signs,did Cushing Test-negative,she wasnâ€™t convinced it wasnâ€™t something underlying as I was very strict regarding Lami precautions.Ended up doing the glucose test,vet arrived late but he was still over 200-should Be below about 40.Sorted him out and kept him right through diet and soaked hay for last 3 years.He started getting recurring abscesses and slight lameness on and off.I got the vet in,we re tested for Cushings again which was negative again. She took a resting blood which also has a new one which tests for something else-apologies cannot remember the name-apparently If this one thing is low that shows EMS, if itâ€™s high then itâ€™s not.His came back low.He was getting a permanent low grade Laminitis with the abscesses. He was muzzled and took every precaution,no turn out on frost etc....He started on metformin and was sound within 4 days with no abscesses now for 6 months.I still control diet etc but he leads a normal life. Sadly sometimes it is just genetics that can cause it but would definetly look into other causes metabolically- it was only because the vet I had was very knowledgeable on it all that she pushed to find out what could be causing it as in her words-on paper-you are doing absolutely nothing wrong.Good luck and I am sure yours will be absolutely fine.


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## pippixox (13 November 2018)

Hows he doing?
I agree with ems test. My friend was unlucky: had a loan pony who would go laminitic even without grass (on woodchip pen all winter) so tested and she had ems... once on metaformin tablets she could actually cope with grass.
She also had a huge warm blood who was on box rest after an injury and managed to get laminitis! Again tested positive for ems


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## Setterali (15 November 2018)

Hiya, quick update on Sebastian!
Heâ€™s doing really well down to one bute a day and very comfortable. Digital pulses are negligable for the moment which is positive. Vet has glucose tested, which came back fine and the cushings test also came back clear. Iâ€™ve discussed medicating him but vet says no need as he is improving with the measures taken for the moment. She has recommended testing again after next set of xrays xx


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## Pen (15 November 2018)

Great news.  Glad Sebastian is comfortable.  That's the first step on the road to recovery.


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## Setterali (22 January 2019)

Hiya
Sebastian presented hopping lame yesterday morning. He hasn't been on any bute for weeks, had no digital pulses at all until yesterday morning. I thought it was the end of the line however,  vet and farrier came out.  I was hoping for a whopper of an abscess.

Farrier took his heartbars off and mentioned bruising on his sole where pedal bone is pressing. Vet xrayed to see what was going on inside.
There doesn't appear to have been anymore rotation 15 degrees on offside front however the vet commented that pedal bone has dropped slightly. She also said there looks to be a build up of fluid on his wall that would cause similar pain to an abscess. This would account for overnight lameness. His near fore 9 degrees rotation has had no changes what so ever.
Vet has said she thinks he's got a fighting chance however there isn't much room for the pedal bone to drop before it comes through his sole.

I don't know what to do. My heart is telling me to stick with it but my head is saying it's time to call it a day. I keep my horses at home so can set up a track system for grazing or can have Sebastian on a postage stamp paddock. Realistically is this enough for a horse who has spent his entire life living outside?
Vet said she believes I'll do the right thing by him whatever decision I come to.
I think I'll give him another couple of months and see where we go from there.

He's getting very very stressed now when my old boy goes out, which isn't helping.
He's a happy boy other than that and shouts for his morning hay, demands attention and loves his grooming time.

Sorry for going on but I'm all over the place and don't have a clue what's the best thing to do. 
Bloody phone won't let me upload xrays. Will keep trying.

Thanks to anyone who reads this and can offer advice x


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## Pinkvboots (22 January 2019)

So sorry you have had a set back and it makes you feel so crap I know, but I think in your situation I would seriously consider calling it a day, if the pedal bone is that close it must be so painful, I'm so sorry I hate laminitis I lost my mare 2 years ago to it she also had a set back and was doing so well, then out the blue she become extremely lame even on 6 Bute in 24 hours so I made the decision to let her go the next day.

I know exactly how you feel it's horrible but I actually felt a sense of relief afterwards knowing she was no longer in pain, again I am so sorry if you want to talk to someone about it I am happy to talk or try and help you just message me xx


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## Leo Walker (22 January 2019)

I carried on with mine until the pedal bone was at risk of coming through his sole and then I decided enough was enough and he was PTS the next day. The stats for recovery once the pedal bone starts sinking are pretty bleak, especially in these big cobby types. How close are we talking? It was less than 5mm in my case. There was a chance we could have brought him back from that but it would have been months of recovery and then a life of never touching grass again. I was heart broken and agonised over it, but looking back now I 100% did the right thing and if it ever happens again and theres sinking I'm going to PTS at that point rather than drag it out.


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## Leo Walker (22 January 2019)

I think the problem is every one assumes horses recover from lammi. I did. I knew it wasnt nice but genuinely thought treated properly he would recover. Other peoples horses recover. I almost couldn't believe it when he didnt. I thought I must be doing something wrong, or that something was happening that I wasnt aware of. I even sent him to a special rehab yard so they could give him tiny amounts of hay hourly and all sorts of stuff. Made zero difference, other than me knowing he was getting brilliant care. So dont feel you have failed him in anyway. Laminitis is a god awful thing and sometimes they cant be saved.


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## holeymoley (22 January 2019)

Iâ€™m going through almost the same as you just now. Youâ€™ve both come so far so I wouldnâ€™t give up just yet. Mine has 11 and 15 degree roatation and has had heartbars on for 2 weeks. Thankfully he didnâ€™t have any sinking but can understand if you decide to pts x


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## Equi (22 January 2019)

Im so sorry you are going through this. There is a point in these situations you have to decide quality of life in the long term. If he is getting an attack in the middle of winter with no grass is very worrisome. Do you really feel comfortable keeping your horse in a stable/off grass only being allowed to eat barely anything for the rest of his life? You also have to consider your own situation..the stress im sure you feel every morning when you walk in and touch his leg (which im sure has become almost like an OCD thing) and in constant worry of any sort of pulse/heat/limp? 

Could he come back? Yes, but i doubt he will ever be 100% able to be a normal horse again. If money is not really an issue you could maybe talk to Rockley and see how they feel. 

We will support you whatever you decide to do though.


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## Amymay (22 January 2019)

I too would be in the call it a day camp.

Sorry xx


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## Setterali (22 January 2019)

I'm struggling as the vet is unable to tell me if it's a lami attack or the fluid in the hoof wall that's causing the lameness. My farrier said pressure of fluid would present like an abscess and that probably why he went lame overnight, he opened up the wall and said the fluid would seep out over the next day or two. Sebastian is comfortable walking around his stable on two bute a day. Farrier didn't reshoe yesterday as he said he thought it better to give him a day or two to see if lameness subsided.


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## Setterali (22 January 2019)

Oh also meant to say that his digital pulse this morning was markedly improved since farrier opened up hoof wall.


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## Equi (22 January 2019)

Re-assess in a few days, hopefully it was just a blip. Did they mention where the fluid may have come from or why?


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## Setterali (22 January 2019)

Nope vet couldn't answer that as thay was the first thing i askes. Farrier is due Friday will see how he is when I walk him out of his box x


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## ester (22 January 2019)

Have they postulated why the fluid was there?

I'd be quite concerned that there has been no improvement and now sinking since I think mid october?

sorry just saw you answered the first one. It's not something I've heard of before unless a different abscess presentation.


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## Setterali (22 January 2019)

The farrier said it was weird when he opened The foot. He said all he did was open the laminae. I expected fluid to dribble out like it would with an abscess. But farrier says it should seep through laminae. My farrier was trained by the Ferries so I'm confident in his knkwledge and what he's doing.


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## Setterali (22 January 2019)

I'll try to get xrays uploaded and take a picture of where farrier opened foot tomorrow.


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## meleeka (22 January 2019)

Did he have the TRH test for cushings? I think if he were mine Iâ€™d want him on a trial of Prascend before you decide what to do. You literally have nothing to lose by the sounds of it. Theyâ€™ll be an improvement quite quickly so itâ€™s not a case of waiting for months to see a difference. I would have expected him to be more improved than he is by now.


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## Setterali (22 January 2019)

Will phone vet and ask if we can try him on it x


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## Pen (22 January 2019)

So sorry to hear that Sebastian is having a setback.  Have you considered consulting a barefoot practitioner with experience in Laminitics?  That's what I did and he turned things around for my little cob.  Its so hard watching them when they are so lame and trying to do the best for them.


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## Setterali (22 January 2019)

No haven't considered that as yet. My sister really struggles to get a barefoot farrier and she's in the same area as me. Will look into it though xx


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## Pen (22 January 2019)

Oh I know all about how hard it is to get a good trimmer!  Which part of the UK are you in?


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## Equi (22 January 2019)

Setterali said:



			No haven't considered that as yet. My sister really struggles to get a barefoot farrier and she's in the same area as me. Will look into it though xx
		
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Hence why i mentioned Rockley. They may have some life saving advice, or even want to have him with them...it just depends on your money situation.


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## Setterali (22 January 2019)

I'm in east Ayrshire in Scotland x


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## Pen (22 January 2019)

Oh I'm in Scotland too.  I'll pm you.


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## ester (22 January 2019)

you might find this old thread helpful 

https://forums.horseandhound.co.uk/threads/serum-from-bruising-causing-same-pain-as-abscess.633949/


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## Setterali (22 January 2019)

Thank you very much I'll have a good read through xx


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## holeymoley (22 January 2019)

Setterali my boy was shod by one of the Ferries 2 weeks ago, they are worth their weight in gold.  Is it possible the liquid is similar to the build up you can sometimes get when the pedal bone comes away from the laminar wall? I agree I would be concerned as to the sinking, especially after 2 months.


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## Setterali (22 January 2019)

Farrier just said it was a serum like liquid, I've yet to see any. He said I didn't need to poultice as it would drain away on it's own x


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## holeymoley (22 January 2019)

Iâ€™ve re-read your posts and see heâ€™s negative for ems and cushings. It may be worth testing again. What does he get fed hard feed-wise? Iâ€™ve stripped my guy completely back, itâ€™s amazing what can contribute/hamper the recovery time.


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## Setterali (22 January 2019)

Hiya I've got him on  1 stubbs scoop of top spec zero split into two feeda with magnesium supplement he also gets equivite orivinal vitamin supplement. Hay soaked overnight 3 nets a day. So literally nothing. Vet says his weight is fab and she wouldn't want him any thinner. Don't know what else o can do.


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## holeymoley (22 January 2019)

Ah, nothing obvious then â˜¹ï¸ I was using dengie chaff and then read that alfalfa isnâ€™t good for laminitics, have since swapped to top spec zero and pink mash. I was worried about what the bute may be doing for the length of time he was on it hence the mash. I also fed magnesium and a zeolite powder (toxin remover) but have cut everything out as discovered he was having good days and bad days. So far so good ðŸ¤žðŸ». I also put leg wraps on during the night when itâ€™s cold. 

My guy tested positive for insulin resistance but I do think itâ€™s been the warmer weather this year. Even up until the last week or so itâ€™s been extra mild up here and the grass has still been growing. I know itâ€™s a very personal opinion but if he had relief from the farrier today I would still keep going. I thought about put my boy to sleep when he couldnâ€™t move at all at the start and I heard of his rotation, but he still had his look in his eye.

Apologies for the grammar I blame predictive text on the phone! If youâ€™re on Facebook laminitis chit chat is a really helpful page with encouraging stories.


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## Setterali (22 January 2019)

I think that what is making it more difficult if I'm being honest. He's still a very happy boy and is moving well in his stable. Will definitely see how he is after a few days x


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## Setterali (22 January 2019)

I'm going to ask vet to run bloods again as if there is anything at all I can do to stop it getting worse then it's worthwhile x


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## villager (22 January 2019)

My 20 year old Connie cross mare now recovered from intense Laminitis attack last July. 30 days stall test in deep bedding. 4soaked small hole hay bags 4x day. She needed to lose weight so hay is weighed plus her blood test showed Cushings. Surprising how much a flake varies in weight! No pellets only complete vitamins . 
X-rays were clear right from day 1. Started daily  Prescend 1/4 tablet increased 1/4 more each week until now she has 1 tablet per day for life. She is ridden daily withlight walk- trot lessons a week and hacking- no more than 1 hour each time. There is some sole sensitivity and ferrier May put pads on for the winter. She loved to eat grass, apples , carrots, . Vet stressed strictness of diet including no grass ever again.  I liken it to a diabetic diet. Itâ€™s all become the new normal for her and she no longer looks for treats or pulls  to stop for grass. Being this rigorous in her care, if she had another setback at 21plus years and on, I would not have her in stall rest for another month or more. I would opt for euthanasia. Itâ€™s a very time consuming illness that needs vigilance .She lives outside my kitchen window in/out grassless paddock . Vet said catching it so quickly helped . Weâ€™ve had 14 horses over the years and this is the first bout Iâ€™ve experienced yet the more I read , it is a common occurrence. Best of luck,


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## windand rain (23 January 2019)

Sounds like the serum is from the breakdown of the laminae and once its drained it should heal but it will be slow. His weight and size wont help but keeping him as still as possible will help was he sedated at first so he lay down a lot as this is often crucial for survival and recovery. Keeping still is probably more important than feeding as most people know what to do about feeding but a lot of people including vets dont realise the importance of keeping as still as possible. I hope you get a positive recovery I have only studied laminitis in ponies so not had to deal with large horses with it and I know it is much harder to get the weight off their feet.


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## Twohorses (23 January 2019)

I am so sorry you are having to experience this

My avatar horse came close to checking out with founder in 2012.  Degree of rotation is measured by TWO methods:

1.  I can tell from your numbers, your vet measures from the ground.  I might have doubted the large degrees were it not for the x-rays you posted.

2.  My lameness vet measures FROM THE DORSAL WALL.  My horse's x-Rays looked almost as bad as yours.  His rotations were 8-9 degrees on the LF, 5 degrees on the RF so still equally as life threatening plus his insulin numbers were more than three times higher than what is considered "high/normal".

3.  He did not wear shoes in the beginning.  I kept him in therapy boots and pads for turnout and brought him in at night to a stall that has mats with ~4" of shavings.

3.1. He did de-rotate but foundered again, a year later, IN THE FALL.  (I can't get the bold feature to work, thus the caps

4.  While this horse still has thick hoof wall, his soles have become thin.  I am fast forwarding to what has helped this horse in ways that is nothing short of a Bibilical miracle for hooves.

4.1. EquiPak CS by VetTec and aluminum "Natural Balance PLR Flat" shoes.  He is only shod and packed on the front.

EquiThane CS (CS for copper sulfate) goes into the hoof as a liquid and solidifies in less than four minutes, BUT the horse needs to be kept in the stall a few hours to let it cure to a really solid form.

5.  My farrier trims both my horses every five weeks.  The IR horse generally has enough hoof to nip off, even in the winter.   This coming Monday will be the fourth re-set since using Vetec's EquiPak CS (EquiThane).  I have no idea how long we will keep my horse's hooves packed in this product -- it can sometimes be forever, it just depends on the horse's hooves.

Well s*** #%%^***.  I tried to upload pics of the packing and one of the hooves -- they are closeup pics and this software tells me the files are too large!  I am sorry as they would have been stellar examples of how well the EquiPak works.


6.  FWIW, I have never heard of serum leaking out of the whiteline, unless your horse is still dealing with an abscess and has developed more infection in that area?

7.  Diet.  Diet can always be tweeked and stripped.  I feed my horse a vit/min supplement that does NOT have added iron, does NOT have grains and has a 4.25% NSC rating.  I mix it in Timothy pellets & water with his other supplements.

He also receives an extra 2,500 IU of human grade pure Vitamin E (no selenium) from HorseTech.

7.1. I am able to buy hay by the year so I have his hay tested every year.  I buy local orchard/fescue/Timothy that always comes back between 8.1% & 8.9% NSC value, which means I don't have to soak it.

7.2. He has been in remission since 2015, therefore goes to pasture without a muzzle since 2015.  He has six acres to himself plus access to the barn & hay during turnout.

8.  BE CAREFUL with too much bute - it certainly does beget ulcers over an extended period because the horse is already stressed -- ask me how I know this

9.  My point to all this is --- as long as your horse's eyes are telling you it wants to keep fighting and you have the financial means to keep going, then keep going.  You can always find another vet or take the horse to a university if there is one close by.  At least that is how we do things in the U.S.  I don't know if your country has government regulations in place where they take control of a horse's welfare if they "think" they need to

I have enough money in my loyal broke to death trail horse to buy a high caliber Dressage horse, plus a year's worth of lessons to learn to ride some level of Dressage.

I'm afraid I will lose this post, so I will come back and edit with the links to the EquiPak and HorseTech's products that I use.

https://www.vettec.com/equi-pakcs-160cc-pour-pad

https://horsetech.com/high-point-grass

https://horsetech.com/equine-supplements/selenium-vitamin-e-antioxidants/vitamin-e-supplements

*** Its a LOT of work and expense on your part but there is hope.  I am hoping my horse's story can be of help to you

Wishing you the very best in his recovery


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## Twohorses (23 January 2019)

Ok -- The pics of one hoof on my IR horse, with the EquiPak are in post #24 of this link.

What looks like a hoof cadaver sitting on the foot stool is actually the hoof pak coming off in one piece.  The actual hoof is pictured right after the trim and before being re-packed with EquiPak CS and nailing the Natural Balance aluminum shoe back on.

This is also a laminitis thread but another forum --- if the mods allow links to other forums --- if not, I understand

If this link does open and you see the pics, you will see why I don't understand the files being too big for this forum's software to upload.

https://www.chronofhorse.com/forum/...nic-abscesses-whose-been-down-this-road/page2


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## Nari (23 January 2019)

If he's still bright & happy I'd take it one day at a time, I always feel if they're prepared to keep fighting & aren't a completely lost cause then I will stand & fight with them. I agree about asking the vet for a Prascend trial. My big lad couldn't have bute or any NSAID because they upset his gut too badly, but that meant he spent a lot of time down which may well have saved him. It's a fine line.

I'm keeping everything crossed for you x


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## Leo Walker (23 January 2019)

Twohorses said:



			8.  BE CAREFUL with too much bute - it certainly does beget ulcers over an extended period because the horse is already stressed -- ask me how I know this

Click to expand...

I would be a LOT more worried about not providing pain relief than I ever would be worried about ulcers. Ulcers can be treated. They can also be cause by pain and stress alone.


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## holeymoley (23 January 2019)

Leo Walker said:



			I would be a LOT more worried about not providing pain relief than I ever would be worried about ulcers. Ulcers can be treated. They can also be cause by pain and stress alone.
		
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Definitely. Sort the primary problem first and deal with any consequences after or you may not have a horse to deal with is the way I see it. Sounds harsh but had thought along these lines regarding ucers due to bute and thrush due pads and box rest, however in the grand scheme of things they are trivial in comparison to acute laminitis.


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## Twohorses (23 January 2019)

My words were "extended use" --- use of bute past the intolerable threshold of acute pain.  Some people get carried away with the use of pain killers and feed them when they aren't really needed 

 My point was to alert the OP to not plan on keeping the horse on bute forever, under the guise of making him feel better.

There is a product called Equiox (or the dog version called Previcox) that we use.  They are identical products, work every bit as well as  bute, and are not nearly as brutal on the stomach as bute

FWIW, it was ME who questioned the vet about PTS'ng my horse due to the pain of founder --- I was not about to let the horse (regardless of the bute he was on and icing his hooves 2X/daily) to needlessly go on, if there was no hope.  It was the lameness vet who said the horse still had plenty of fight in his eyes and to give him a few months.  Those few months were up in November, 2012 -- the horse had made a remarkable turnaround, developed ulcers from the long term use of bute, and we still live with ulcer flare ups, even though he is running and bucking around his pasture because his hooves are packed in EquiPak

Everything I have posted is based on my own experience with my IR horse.  He will live with the ramifications of serious founder for the rest of his life.  Which I never thought he would make it coming seven years, he will be 24 in August.  Every day he greets me with his ears forward & eyes bright is a gift but it has been a grueling & expensive road to recovery.  He would be rideable for very light hacks if I could still ride.

IMHO, getting hung up on the bute portion of this thread should not be the main issue --- figuring out what works to de-rotate the coffin bones, develop a strict diet plan,  method/hours  of turnout time should be foremost.   

While ^^^^that varies from horse-to-to since the key word is metabolism,  the bottom line is frequent trims by a farrier who specializes in corrective work, a good lameness vet, a diet with the lowest NSC value possible yet still gives the horse all the needed vitamins/minerals.

Also FWIW, horses are not safe from founder or laminitis in the winter.  One can Google "cold weather laminitis" and get any number of scholarly and scary articles regarding the subject.


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## Leo Walker (23 January 2019)

Of course they arent safe from laminitis in the winter. Who said they were? But you really do have to ask why you are keeping a horse in such pain going. Is it for them? The answer to that always has to be no. They have no comprehension of life span. They live in the now. When the now is agonising pain, and the future is a limited life of constant restriction, then you have to question if its acceptable to carry on.

Only 30% of horses recover once the pedal bone sinks. That means 70% dont make it. I dont know, but I'd imagine the odds are worse in heavy, cobby types. Its certainly what my vet told me. 

Previcox isnt licenced in the UK for horses so isnt an option, or at least wasnt a couple of years ago when I last looked at horse painkillers. Mine had to have something so strong that he could only take it for a limited period or he would damage his liver and kidneys. He was still dog lame. That is how painful laminitis is.


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## Setterali (23 January 2019)

Right so here's where I'm at. I've spoken to the vet and we are going to 're do blood tests. There's no point fighting a battle if I've not got all the evidence. I'm not getting him shod with heartbars again as 1. They havent made a difference
2. I'm actually beginning to wonder if that's why his feet have gotten worse.
I feel he may stand a better chance of recovery if his feet are trimmed every 4 weeks but left natural. Hes on a deep straw bed as hes a mucky bugger and i would be a bag of shavings a day (which realistically i cant afford, it's barley straw so won't do him any harm if he has a munch) I've messaged a barefoot farrier who specialises in laminitis and will hopefully have him look when he returns from his trip.
I may well be making the wrong decision for my boy but his chances of recovery are slim to none so at this point it's worth trying anything possible. 

Long term if I can get him back to any kind of soundness I plan on making a track around my field and also killing all the grass off in approximately 1/2 acre so he's got a bare paddock i can feed hay in when need be. He will be out in the day and I'm at night all year round. His field mate will be on inside of track and outside bare paddock for company. Still can't upload bloody photos argh


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## ester (23 January 2019)

I don't think 4 people/posts of 61 is people getting 'hung up on bute'.

The VMD site is broke so can't tell if the situation re equioxx has altered.

OP have you considered imprints? I ask that as a usual barefoot advocate BTW.


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## Setterali (23 January 2019)

Oh I also meant to add that if the only way to keep my boy pain free for the rest of his life is with the use of painkillers and bkx rest then I will have him pts as I don't think that is any quality of life for any animal xx


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## holeymoley (23 January 2019)

Op I think that is a reasonable course of action. What about pads for a bit once you get the shoes off? Mine had pads and frog supports initially for 6/7weeks.


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## Setterali (23 January 2019)

I will discuss pads with farrier and see what he says. Don't think there is anything else I can do. 
He's a happy smiley boy shouting for breakfast, dinner and hay moving around his stable fairly comfortably at the moment.


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## ester (23 January 2019)

I think it will be wise to have pads and boots on hand if you do take shoes off, ads wise the EPS pads are probably the most conformable 
https://www.equinepodiatrysupplies.co.uk/product/pair-eps-7lb-pads/

boots depend on hoof size but there are more 'therapy' options.


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## Setterali (23 January 2019)

Thanks for the information. I will order some and get them in asap. He doesn't have shoes on at the moment as farrier was reluctant to show when he was so sore. He's coming back on Friday so will discuss options with him then x


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## holeymoley (23 January 2019)

Mine were quick ones made by the vet- basically lteeth imprint clay you get for getting a mould of your tooth(sorry canâ€™t think of what itâ€™s called) that was put round and over the frog to mould to its shape and then spongey foam type stuff that was cut to the shape of his hoof. Then placed on the underside and wrapped with duck tape. After 7 weeks they were pretty grim inside!


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## windand rain (23 January 2019)

My vet made some out of an old  foam backed carpet we had lying around they worked brilliantly. Now my first aid is the duck tape nappies to all four feet until the vet arrives it supplies support while still being slightly breathable


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## Setterali (23 January 2019)

finally managed to upload recent xrays, these were taken on Tuesday without shoes or any trimming as farrier didn't want to trim until vet advised him xx


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## ester (23 January 2019)

Thanks for getting those up, the right one is quite worrying farrier certainly doing best thing to have xrays to work from.


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## Pearlsasinger (23 January 2019)

A straw bed will not be very supportive, the usual advice for laminitis is a deep shaving bed.  I am sorry you and your horse are going through this but tbh, I would call it a day now.  What quality of life has he got now?  Or is he likely to have in the future?  It is very rare for a heavy horse to recover from sinking pedal bones.  I think your vet and farrier are doing you a dis-service by not being very frank with you about the prognosis.


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## Nari (23 January 2019)

The only thing I would say, having dealt with a big horse with rotation & sinking, is to get some supports on asap because a straw bed isn't enough (to be honest I'm not convinced any type of bedding is enough with a big heavyweight). There are various types of supports that can be fitted without shoes so be guided by your farrier who should also fit them to make sure they're right (plus if he's sore the chances are you won't be able to) but we always went for a type that supported the whole sole & they were taped firmly in place so that they conformed to the sole rather than moving around giving uneven support. I'd be ringing the farrier first thing in the morning, if I'm honest I'm shocked he's left him with no support.

If your vet & farrier aren't ready to give up then they must feel there's a chance. Sole can thicken below even a dropped pedal bone, and nowadays the view is that sole depth is as much or more of a factor than degree of rotation.


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## holeymoley (23 January 2019)

It looks as if not only he has rotation but twisting too? My boy has had this too. 

Iâ€™m afraid I disagree with pearlsasinger on this one. I spoke to my vet about pts and he didnâ€™t think it was time so if you really trust your vet and your boy still has spark I would go with them.  What age is your guy op?  

I donâ€™t think straw is the best bed for them, you need something that will really support and mould to the hoof. I use nedzbeds and small flake shavings. Sawdust/wood pellets might be better.


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## Leo Walker (23 January 2019)

With mine he had a massive shavings bed. Both my vet and the second opinion vet said no to pads. I cant remember why now as it was all such a horrible blur, but they definitely said not to. He was trimmed to xray with vet and farrier there a few times and then we tried remedial shoeing. He did improve briefly then went back to how he was. Mine was also bright in himself and a happy little pony. Thats what made it so hard. Mentally he was fine, he just kind of dragged the worst leg around like it wasnt really part of him, right foot in his case as well. 

Once the pedal bone got to the stage your xrays show I managed to catch him in his stable when he thought no one was around, and he was head down miserable. He perked up when he saw me but that was it for me. 

Its so hard when you are living it. Even afterwards I felt horribly guilty for a long time. But now on reflection I wish I'd called time much, much sooner.


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## Leo Walker (23 January 2019)

Nari said:



			If your vet & farrier aren't ready to give up then they must feel there's a chance. Sole can thicken below even a dropped pedal bone, and nowadays the view is that sole depth is as much or more of a factor than degree of rotation.
		
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My vet was happy to carry on indefinitely. He said he had had pedal bones come through the sole and they had recovered. That was not something I ever wanted to be responsible for any animal going through.


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## Twohorses (23 January 2019)

Leo Walker said:



			Of course they arent safe from laminitis in the winter. Who said they were? But you really do have to ask why you are keeping a horse in such pain going. Is it for them? The answer to that always has to be no. They have no comprehension of life span. They live in the now. When the now is agonising pain, and the future is a limited life of constant restriction, then you have to question if its acceptable to carry on.

Only 30% of horses recover once the pedal bone sinks. That means 70% dont make it. I dont know, but I'd imagine the odds are worse in heavy, cobby types. Its certainly what my vet told me. 

Previcox isnt licenced in the UK for horses so isnt an option, or at least wasnt a couple of years ago when I last looked at horse painkillers. Mine had to have something so strong that he could only take it for a limited period or he would damage his liver and kidneys. He was still dog lame. That is how painful laminitis is.
		
Click to expand...

1.  You would be surprised the people who think their horse is safe from founder when winter gets here.

2.  I do not recall saying my IR horse is currently in pain.  His hooves are not as healthy as they once were but he is not in pain.  He sees the vet 2-4 yearly for evaluation and blood work.  His pedal bone(s) did not sink.  He was severely rotated but he did not sink.

3.  Does this look like a horse in pain?  This was August, 2018 on his 23rd Bday.  Perhaps you missed the part of my post where I stated it was me who asked the vet about PTS'no him when he foundered in 2012 and the vet said to wait a few months.  Good thing I did -- he looks pretty happy in this foto


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## Pearlsasinger (23 January 2019)

Leo Walker said:



			My vet was happy to carry on indefinitely. He said he had had pedal bones come through the sole and they had recovered. That was not something I ever wanted to be responsible for any animal going through.
		
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Some vets don't know when to call time, others don't care so long as you are paying for their time. 
 I used to have a very nice small animal vet, who removed my elderly cat's eye.  The wound was extremely slow to heal and the cat lived in the bathroom with a cone on to stop her scratching.  The cat went for tests to find out why the wound wasn't healing properly and the vet told me over the phone that she had heart problems and fluid on her lungs.  I asked if we should make the decision to pts.  Vet  said no we can treat it and prescribed tablets.  Cat had always hated taking tablets and was no keener on these.  After 3 months living in the bathroom with no improvement I eventually had her pts and have always wished that I had insisted that day of the phone call.  The same vet was almost in tears when pts a different young cat with a terminal condition.  He just didn't like that aspect of his job.


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## ester (24 January 2019)

Twohorses said:



			1.  You would be surprised the people who think their horse is safe from founder when winter gets here.

2.  I do not recall saying my IR horse is currently in pain.  His hooves are not as healthy as they once were but he is not in pain.  He sees the vet 2-4 yearly for evaluation and blood work.  His pedal bone(s) did not sink.  He was severely rotated but he did not sink.

3.  Does this look like a horse in pain?  This was August, 2018 on his 23rd Bday.  Perhaps you missed the part of my post where I stated it was me who asked the vet about PTS'no him when he foundered in 2012 and the vet said to wait a few months.  Good thing I did -- he looks pretty happy in this foto

Click to expand...

It might be helpful to know that in the UK the term founder is only used if the pedal bone penetrates the sole, we use laminitis otherwise but I know in other countries founder is used for nonpenetrating cases.


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## Leo Walker (24 January 2019)

Twohorses said:



			1.  You would be surprised the people who think their horse is safe from founder when winter gets here.

2.  I do not recall saying my IR horse is currently in pain.  His hooves are not as healthy as they once were but he is not in pain.  He sees the vet 2-4 yearly for evaluation and blood work.  His pedal bone(s) did not sink.  He was severely rotated but he did not sink.

3.  Does this look like a horse in pain?  This was August, 2018 on his 23rd Bday.  Perhaps you missed the part of my post where I stated it was me who asked the vet about PTS'no him when he foundered in 2012 and the vet said to wait a few months.  Good thing I did -- he looks pretty happy in this foto

Click to expand...

This isn't your post and my comments weren't about your horse being in pain now  in fact I'd go so far as to say that your horse being fine now is irrelevant. Rotation can be corrected. in the majority of cases sinking cannot, and the OP is dealing with sinking in a big heavy horse. The same way that recommending bute is stopped isn't helpful or relevant. The OP is a long way from even considering that. Shes at crisis point with a horse in a lot of pain.

Its a godawful situation to be in. it was made much harder for me by reading posts like yours and believing all horses can be saved and recover. They cant. It was an awful shock to me when I read the stats and faced up to the reality. If I'd known earlier then I would have been better placed to make hard decisions. My horse looked very happy and well, but that doesn't mean he wasn't in pain and suffering. You need to balance how much you are prepared to put them through and what the prognosis is.

I really, really, really, really hope the OPs lovely horses does recover, but if they dont its not from lack of trying. Sometimes really wanting something to be just isn't enough.


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## OldNag (24 January 2019)

It's a really difficult.  We lost one in similar circumstances to yours, was doing really well and then suddenly started dropping so we did call it a day.  Having nursed another through recurrent attacks too, I now would firmly look at quality of life over quantity.  If you think he wouldn't be happy on the sort of regime you'll realistically need, then there might not be much of an option. I really feel for you, laminitis is an awful condition. Fingers and everything crossed that he does come right x


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## Pinkvboots (24 January 2019)

Setterali said:



			Thanks for the information. I will order some and get them in asap. He doesn't have shoes on at the moment as farrier was reluctant to show when he was so sore. He's coming back on Friday so will discuss options with him then x
		
Click to expand...

If his still in pain he shouldn't be shod or be trimmed, my horse was in foot support pads for 2 months and was almost sound until her feet were trimmed and shod.


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## Pinkvboots (24 January 2019)

Leo Walker said:



			This isn't your post and my comments weren't about your horse being in pain now  in fact I'd go so far as to say that your horse being fine now is irrelevant. Rotation can be corrected. in the majority of cases sinking cannot, and the OP is dealing with sinking in a big heavy horse. The same way that recommending bute is stopped isn't helpful or relevant. The OP is a long way from even considering that. Shes at crisis point with a horse in a lot of pain.

Its a godawful situation to be in. it was made much harder for me by reading posts like yours and believing all horses can be saved and recover. They cant. It was an awful shock to me when I read the stats and faced up to the reality. If I'd known earlier then I would have been better placed to make hard decisions. My horse looked very happy and well, but that doesn't mean he wasn't in pain and suffering. You need to balance how much you are prepared to put them through and what the prognosis is.

I really, really, really, really hope the OPs lovely horses does recover, but if they dont its not from lack of trying. Sometimes really wanting something to be just isn't enough.
		
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This is so true my mare looked a picture of health her coat shone when she had laminitis but her feet told a very different story.


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## Setterali (25 January 2019)

Morning all
Vet has been and has agreed to leave his shoes off, she's taken bloods to test again for EMS and cushions TRH levels. I know there is a slim chance of recovery but unless I've thrown the everything I can at this I won't have him pts. Farrier is due out this afternoon to trim his feet. I know lots of you think I'm prolonging the inevitable but even with a slim chance I'm taking it. Xx


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## Leo Walker (25 January 2019)

If you can find the cause and fix it then the chances are higher, and given his age cushings seems really likely. Mine was 6 and negative for EMS and IR etc so nothing to fix for him sadly.


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## Haniki (25 January 2019)

OP, sorry I haven't read all this thread but there is a really supportive group on Facebook called 'Friends of the Laminitis Site'.
I have found it really helpful as I have a laminitic pony (caused by undiagnosed Cushings).
I use Easyboot Clouds for turnout.
Good luck with your horse.


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## Pearlsasinger (25 January 2019)

Setterali said:



			Morning all
Vet has been and has agreed to leave his shoes off, she's taken bloods to test again for EMS and cushions TRH levels. I know there is a slim chance of recovery but unless I've thrown the everything I can at this I won't have him pts. Farrier is due out this afternoon to trim his feet. I know lots of you think I'm prolonging the inevitable but even with a slim chance I'm taking it. Xx
		
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And whose benefit is that for?  HIs or yours?

I really hope that he recovers but it does seem extremely unlikely.


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## scats (25 January 2019)

What a dreadfully sad situation OP, but I have to say that if he was mine, I would be calling it a day now.

Best of luck though.


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## meleeka (25 January 2019)

Pearlsasinger said:



			And whose benefit is that for?  HIs or yours?

I really hope that he recovers but it does seem extremely unlikely.
		
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I think thatâ€™s unfair. OPâ€™s horse isnâ€™t isnâ€™t going to care whether he gets pts this week, next month or whether it  even comes to that. sheâ€™s  already said heâ€™s happy enough in himself. He may get better, which the vets seem to think a possibility, but the only person that has to be happy with the decisions she makes is OP. Sheâ€™s the one looking at the horse in front of her and sheâ€™s the one that has to live with her decision long after weâ€™ve all forgotten about this thread. I totally understand wanting to try everything possible before making the call. 

OP - I had one recover from worse but she was only little. A cushings diagnosis would be good in this case.


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## holeymoley (25 January 2019)

I noticed my guy has been a bit sore the last few very cold mornings/days. -6c. 

Depending on test results you could try metformin?


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## CavaloBranco (26 January 2019)

OP, I haven't had to deal with laminitis but I just wanted to send you (((hugs))) You are doing your very best for your boy and will make the right decision, I'm sure. Thinking of you x


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## Setterali (26 January 2019)

Pearlsasinger said:



			And whose benefit is that for?  HIs or yours?

I really hope that he recovers but it does seem extremely unlikely.
		
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I appreciate your comments, however this horse has been a lifeline for me, he's cost me practically nothing in all the years I've owned him. Just for avoidance of doubt I'm not a naive wee girl who's playing ponies. I've had and worked with horses for approximately 30 years. In all that time I've never had a laminitic, Sebastian is the first. I've kept him successfully all these years without laminitis. Something has changed internally for this to be his first ever bout at the age of 17. 
Yes to a certain extent I'm doing this for me because you know what I'm not giving up until I know I've done my absolute damndest for this horse. 
I'm also doing this for Sebastian as I know him better than anyone and he will tell me when he's done. At this moment in time he isn't so I'll keep fighting for him. 

If it comes to it I will not hesitate as his welfare comes before my feelings. I've been this way with all my animals whether it be a guinea pig or a horse.


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## Setterali (26 January 2019)

holeymoley said:



			I noticed my guy has been a bit sore the last few very cold mornings/days. -6c.

Depending on test results you could try metformin?
		
Click to expand...

Yes the vet mentioned that. Depending on  what bloods say of course.


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## Pearlsasinger (26 January 2019)

meleeka said:



			I think thatâ€™s unfair. OPâ€™s horse isnâ€™t isnâ€™t going to care whether he gets pts this week, next month or whether it  even comes to that. sheâ€™s  already said heâ€™s happy enough in himself. He may get better, which the vets seem to think a possibility, but the only person that has to be happy with the decisions she makes is OP. Sheâ€™s the one looking at the horse in front of her and sheâ€™s the one that has to live with her decision long after weâ€™ve all forgotten about this thread. I totally understand wanting to try everything possible before making the call.

OP - I had one recover from worse but she was only little. A cushings diagnosis would be good in this case.
		
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Unfortunately, horses often DON'T show how much pain they are in.  I feel very sorry for OP but I feel more sorry for the horse.  I have had to deal with 2 horses who foundered, one a Welsh A who managed to clear up a discarded bag of sheep creep feed and the other, a 17hh Shire who was misdiagnosed by an incompetent vet.  It is nearly impossible to keep their pain under control and ime very few horses enjoy box rest.  

The vet involved in this case should have done the TRH test and tests for IR/EMS immediately and should be honest with the owner about the prognosis in a big horse with a sinking pedal bone.  Prascend made a lot of difference to a mare that I had with a persistent hoof abscess but it isn't going to lift a pedal bone back in the correct position.  If the vet thought Cushings was the cause Prascend should have been given when the first bout happened.

LW has related a horrendous experience with her cob, who was nowhere near the size of OP's horse, because the vet 'kept trying'.  IMO, it isn't fair to the horse or the owner.  Vets are the people who have the experience and emotional detachment to make a judgement about  individual cases, not the owners who have probably and certainly, in this case, never seen anything similar.  IMO, vets have a professional responsibility to be honest with owners not just keep on charging for treating a hopeless case.  

I was very appreciative when my vet told me when my heavy mare had colic, that because of her age and size, she would not recommend surgery.  That was fine because I wasn't intending to put her through it anyway.  Fortunately the mare recovered after 36 hrs of muscle relaxants and pain-relief.

OP, I am sorry to be so plain-speaking but it is from experience of what you and your horse are going through now.  I hope you do get a better outcome than ours.


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## Setterali (29 January 2019)

Update

Sebastian has tested positive for EMS, his levels were over double what they should be.

He started on metformin powder this morning.
Ive changed his bedding across to shavings which should help.

I spoke to the vet and farrier and asked outright if they felt I was being selfish keeping him going. My farrier does not mince his words. They both said they felt there was the chance of a decent outcome and that as I have my horses at home I'm in a enviable position regarding on going care when he eventually vets turned back out.

I have made the decision  that if we have another episode I will have him pts as his welfare does come first. At the moment though I feel he deserves a chance.

I'd like to thank everyone who replied to my posts and took the time to read his story so far. I'm grateful for all opinions whether I agreed with them or not. I'll try to keep updating as we go xxx


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## ITPersonnage (29 January 2019)

Sounds like a good plan, Metformin does work and has helped my mare massively. I wish you and the horse the very best of luck.


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## meleeka (29 January 2019)

A diagnosis is a positive step. Hopefully the medication will help him. Wishing you the best of luck.


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## ester (29 January 2019)

Thanks for the update. That gives you something to work with. I strongly suggest you join the ECIR group for advice. 
https://www.ecirhorse.org/

https://ecir.groups.io/g/main


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## _HP_ (29 January 2019)

Ecir and/the laminitis site are bth excellent for advice and support.
I would also ask your vet about prascend trial. Cushing's test aren't the most reliable.
Keep extra regular trims to get that rotation sorted....barefoot is usually best for that because it can be done more regularly, more easily. Boots and pads for protection is required.
Good luck


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## Nari (30 January 2019)

Metformin can help a lot in the short term. Longer term I've found NoMetSyn to be a fantastic product. It's sold by EquiLife, which is the sales arm of The Laminitis Clinic, and as well as having a fantastic product they will also give you a lot of good advice if you want it, and it's practical advice based on hands on experience with a large number of severe cases rather than theory that just isn't practical.

Good luck with him x


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## holeymoley (6 February 2019)

OP how is your boy this week?


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## Setterali (6 February 2019)

Hiya, he is less sore and only on one bute a day now, so he's improving at the moment. He's eating the metformin powder so that's positive. I'm keeping everything crossed he continues to improve xx


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## Bertolie (14 February 2019)

Have only just come across this thread. My heavy cob mare succumbed to laminitis at the end of June 2018. Xrays showed rotation and sinking of the pedal bones in both fronts. She has been on box rest since (nearly 8 months), on a deep shavings bed and on a very strict diet. Like the OPs vet,  mine advised that heavy breeds didnt always do well with recovery but said as long as she was happy and bright to give her a year for the hoof to grow down and then see where we are.  Cushings and EMS tests came back negative to everyone's disbelief, with Liphook stating they were an excellent set of results! Imprint shoes were recommended but her feet are too big, however Andrew Poynton has been making lightweight heart bars for her and we have seen some improvement since they have been on. I still have no guarantees that she will make a full recovery but as long as shes happy and bright we will fight on.  Thankfully she is an absolute saint on box rest otherwise we may have had to rethink.


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## teaspoon66 (14 February 2019)

_HP_ said:



			Ecir and/the laminitis site are bth excellent for advice and support.
I would also ask your vet about prascend trial. Cushing's test aren't the most reliable.
Keep extra regular trims to get that rotation sorted....barefoot is usually best for that because it can be done more regularly, more easily. Boots and pads for protection is required.
Good luck
		
Click to expand...

Definitely recommend the Laminitis Site and look up Hoof Geek, she's ace!  

From experience I'd recommend 

No shoes and really regular trims to realign.  
Soaked hay (make sure there's no rye in your hay as even soaking won't remove the sugar)  Mine was on ad lib soaked meadow hay, as much hay as she could eat.  She never ran out. Over 6 months she lost 50kg in weight (she had been diagnosed with ems) and she was NEVER muzzled.  Anyone who suggests a muzzle unfriend and block from your life!  
Support the feet with deep shavings but leave the stable door open and restrict to moving around the yard.  Movement will help with the recovery.  
EVA foam mats (from Argos or B&Q) are cheap and great for padding the feet.  Use duct tape to secure, or inch wide cows tail tape for tiny feet! 
Stop feeding any mixes and take it back to straights.  Mine couldn't tolerate alfalfa or sugar beet (even though it's recommended for laminitics) so we ended up with copra plus (through trial and error) I've found a balancer she can cope with. 
Make sure salt is available.
Laminitis seems like a death sentence but you know the cause, so once you're over the initial trauma you can look at managing that cause.  Just think of it as keeping his sugar levels as stable as possible.  Grass is highly variable eg when there's a frost the sugar level rises or short stressed grass has more sugar than longer tougher grasses.  Simplify everything then you can spot any changes.  Best of luck


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## Setterali (15 April 2019)

Update

Vet has been this afternoon. After all these months of hard work she has suggested that's as he has been bute free and digital pulse free for a fortnight. He is ready for a set of front shoes, as he is tender walking on stony ground but sound walking on flat ground. A fortnight after being shod she has said he can have very limited turnout and see how he goes.
So cautiously optimistic that things are going in the right direction for my lovely patient big horse xxx


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## ester (15 April 2019)

What are you shoeing him with?


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## meleeka (15 April 2019)

I was holding my breath opening this! Glad itâ€™s a positive update


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## holeymoley (15 April 2019)

Some good news. Will you be using the ferries? They have managed to get my guy from 11 and 13â€¢ down to 1â€¢ and when new hoof grows down it will be 0â€¢. Heâ€™s been sound for nearly 6 weeks ðŸ˜


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## Setterali (15 April 2019)

The vet said just normal shoes as she wants to lift his soles. She doesn't think there is any point using heart bars again as he doesn't need them. 
My farrier trained with the ferries so I'm comfortable using him. 
Interestingly my vet said that she wasnt going to xray as the amount of rotation could not be fixed. The best we could hope for was that he came sound without bute which has been the case. I always thought rotation could be fixed?


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## Zuzzie (15 April 2019)

Having read some of the posts on here, I just wanted to emphasise that a Cushings test will not always be definitive. My horse had 2 tests and both came back negative.  He did, however, test positive for EMS.  He was put on a trial of Prascend and within 6 weeks was a different horse - more energy, sleeker coat etc.  All sugar was cut out of his diet. Grazing muzzle used for turnout.  His weight was reduced.  He is now 25 and is hacked out 5 times per week and doing well.


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## holeymoley (15 April 2019)

Setterali said:



			The vet said just normal shoes as she wants to lift his soles. She doesn't think there is any point using heart bars again as he doesn't need them. 
My farrier trained with the ferries so I'm comfortable using him. 
Interestingly my vet said that she wasnt going to xray as the amount of rotation could not be fixed. The best we could hope for was that he came sound without bute which has been the case. I always thought rotation could be fixed?
		
Click to expand...

How bizarre. Perhaps sheâ€™s meaning the bone can never be put back in to position as such? But yes you can â€˜correctâ€™ it by rebalancing the hoof.


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## Setterali (15 April 2019)

Yeah I think that's probably what she meant, she says that the farrier has done a great job with his feet and they look really good now. Obviously his soles are soft from standing in on a shavings bed for as many months but she reckons they will harden up with some turnout x


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## meleeka (15 April 2019)

Setterali said:



			Yeah I think that's probably what she meant, she says that the farrier has done a great job with his feet and they look really good now. Obviously his soles are soft from standing in on a shavings bed for as many months but she reckons they will harden up with some turnout x
		
Click to expand...

 Has anyone mentioned diet for hoof health?  Mine has very soft soles but there was a noticeable improvement once on Farriers Formula.


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## Setterali (15 April 2019)

Yes the vet did mention it might be worth supplementing him with something. I'm feeding him at the moment.

Top spec chaff zero
A handful of happy hoof (non molassed) he wont eat without it.
Metformin twice a day
A general vitamin supplement
Magnesium
Salt. 
Will swap vit supp for farriers formula.

I feel mean as he is very thin. Every rib is visible. Vet says he looks worse as he has barely any muscle after being in for so long.


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## holeymoley (15 April 2019)

I feed formula 4 feet with topchop zero and mineâ€™s got quite hard soles. We do in hand walking on concrete now (vets advice) and he happily went over a stoney path the other day much to my horror!


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## Nari (17 April 2019)

That's fantastic news!

I agree about the rotation can't really be fixed, but realigning the hoof capsule to the pedal bone can significantly improve comfort & give the impression that the rotation has been reversed on a first glance at x-rays.

Mine was shod with pads & putty so he still had some support, important when a shoe lifts the foot off the ground. It might be worth discussing this with your farrier.


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## Setterali (18 April 2019)

I discussed pads with the vet but she says as he has a touch of thrush from being in so long she would rather not use anything for the moment as she doesn't want to make it worse. I will definitely speak to farrier and see what he recommends. I'm waiting for him to get back to me. Hes a bloody nightmare!!


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## Nari (18 April 2019)

Fair enough. My only concern, particularly with him being a big boy with big feet, is the lack of support, but I don't know all the specifics of his case.


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## Setterali (18 April 2019)

No you are right, I have the same concerns. I will discuss further with the farrier when I eventually get him to come out and see what he thinks xx


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## KrujaaLass (27 April 2019)

How is sSebastioN doing now


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## _HP_ (27 April 2019)

Setterali said:



			Update

Vet has been this afternoon. After all these months of hard work she has suggested that's as he has been bute free and digital pulse free for a fortnight. He is ready for a set of front shoes, as he is tender walking on stony ground but sound walking on flat ground. A fortnight after being shod she has said he can have very limited turnout and see how he goes.
So cautiously optimistic that things are going in the right direction for my lovely patient big horse xxx
		
Click to expand...




Setterali said:



			The vet said just normal shoes as she wants to lift his soles. She doesn't think there is any point using heart bars again as he doesn't need them.
My farrier trained with the ferries so I'm comfortable using him.
Interestingly my vet said that she wasnt going to xray as the amount of rotation could not be fixed. The best we could hope for was that he came sound without bute which has been the case. I always thought rotation could be fixed?
		
Click to expand...

So glad your horse is pain free...that's great news.
I would be cautious of shoeing now...shoeing can mask pain. I would wait u til your horse can cope without shoes before deciding whether or not to. The shoe may raise the hoof off the ground but a compromised hoof needs all its components to help support it, including the sole. 
I would insist on xrays to make sure all is well inside. Rotation absolutely can be reversed, in that, with the correct trimming and care, a whole new hoof can be grown around the structure correctly. It's a very old fashioned view to say there's no point on xraying IMO.
Whatever you do, just have pulse checking on your daily routine. That's usually your first warning sign.
Best of luck


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## JillA (27 April 2019)

Normal shoes to lift his soles??? Normal shoes would surely leave his soles unsupported and prone to collapsing. Boots and pads are what you probably need to support his internal structures and bony column while the laminae aren't holding everything in place. Saved my horse - started with fairly thick ones and progressed to thinner and thinner - but yes, you do need x rays to know what is going on inside. It's all here http://www.thelaminitissite.org/


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## Pearlsasinger (27 April 2019)

I have only just caught up with this thread.

I am glad that the vet finally found what was behind this attack of laminitis and is now treating the underlying cause.  I wonder why it took so long.

All the best to you and Sebastian.


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## windand rain (27 April 2019)

I am another don't shoe in fact I would still have him on box rest for at least another 3 weeks, it is recommended by Robert Eustace that they stay on box rest with limited movement for 30 days post being pain free and off all drugs having got this far I would be very cautious about doing any movement until he was pain free off drugs for quite a while he is a big horse and it takes a long time for the laminae to heal.


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