Which L word? Laminitis.
I told you guys about Lily's diet and introductions to grass since we moved to Maryland.
|Lily grazing in the mare field this past September.|
Over the summer, I'd been mixing Lily's Triple Crown Low Starch pellets with Triple Crown Safe Starch forage. Because I like feeding low starch. As the grass in the fields dried out and the horses were started on round bales + square bales, I'd switched from the Safe Starch forage to Triple Crown's Alfalfa Forage Blend to keep weight on Lily as our training increased over the winter since she was already getting plenty of grass hay. I also gradually switched her over to Triple Crown Senior from the Low Starch pellet due to the Senior's higher fat percentage (10% vs the Low Starch's 6%), which allowed me to continue feeding a smaller amount of grain (6 lbs total a day.) Despite added molasses, TC Senior is only 11% NSC and Lily LOVED this feed. Over the winter I also started her on 2 cups a day of Healthy Glo Nuggets as a fat supplement when she started turning up her nose at rice bran oil. She would receive a beet pulp meal after rides and on days when the temperature was supposed to be particularly low.
|Lily eating a huge bowl of soaked beet pulp + TC Senior + forage for dinner.|
Of course I freaked. The only thing she was eating were the square bales that were being offered at night, and then I discovered that the hay from the square bales was not being spread out well. Candy is the herd alpha now: she is a huge black Oldenburg that came to the barn skin and bones, starved from another facility, and has gained weight beautifully over the winter. But as she has gained weight, she has turned into a bully. I have seen her get into kicking matches with some of the other mares, and more than once she has tried to attack Lily while I'm trying to get her out of the field. When the square bales didn't get spread out, Candy would park herself over the hay and chase all of the other mares away.
|Gracie, the Rocky Mountain horse that also lives in the mare field 24/7 is REALLY getting beaten up by Candy.|
|Candy damage on Gracie.|
I spent another week experimenting with her food, trying to figure out why she didn't want her grain: was it the fat supplement? The forage? Her other supplements? She gets Ex Stress, SmartMare Harmony and SmartCombo Ultra. Through elimination, I determined that she did not just dislike the forage - she HATED it. I still don't know why; there was absolutely nothing wrong with it: it was fresh, smelled great, wasn't dusty or moldy. But I eliminated the forage completely. She was still lackadaisical about her grain. And then I discovered that she had decided she didn't want any of her supplements, including the Healthy Glo that she had initially seemed to like so much. So I eliminated all of that too. She was JUST getting TC Senior as her am and pm meals, 6 lbs a day, plus an additional lb mixed with her beet pulp at lunch. She then decided she didn't want the beet pulp either. We started offering the TC soaked plus a flake of timothy and a flake of alfalfa at lunch.
Of course she dropped more weight during this process. Lily developed ulcers last year while on stall rest so of course I now started freaking out about ulcers flaring up due to the lack of forage in her stomach. I was worried because she was also having occasional loose stools along with the decreased appetite. So she was started on probiotics and UlcerGard and I added UGard back to her meals.
You can see why there has been some radio silence on my end in between sporadic filler-type postings as I tried to figure all of this out before the endurance ride, debating all along whether we should just scratch given all of the last-minute problems with Lily's eating. You do NOT want to take to an endurance ride a horse that is reluctant to eat at home. That's just begging for a train wreck. The environment at endurance rides is conducive to a lot of excitement, especially for horses green to the sport, and has been known to cause ulcers in horses that don't already have them just because it is a consequence of trotting for so many miles on end. You need them to eat while at the ride.
Finally, we had everything sorted out. Lily was eating her 3 meals a day, along with extra hay at lunch, and new round bales were delivered: these were nice timothy bales like the ones we'd been receiving all winter. Every time I pulled up at the barn, Lily was eating at the round bales.
Yes, I have a hawk eye for this mare's way of moving and can spot a single lame step from the other end of a 6 acre field. I can spot a stocked up leg on her from a baseball field distance away on her too. I want you to keep this in mind. It's going to be 3 years owning her this summer and I've already rehabbed her from two other lamenesses in the past, one from a puncture wound and one from a tendon injury. There is a reason why she is insured. Part of the reason why I like to go to the barn every day is because I literally worry that one of her legs will fall off if I'm away for one day. I'm not joking. This is a very defensive post because a rumor was already started at the barn by a person who doesn't know me and doesn't know anything about this sport, and I'm royally pissed off by it. First of all, I have owned horses for 20 years. I'm not a kid. 34 years of age is not a kid. Secondly, I am a licensed veterinary technician that went to school for my profession. I am required continued education to maintain my license. I have been working in this field for 7 years now, specifically in emergency and critical care. I can tell you right now that I know more than the average person about animal care. And thirdly, even BEFORE I was a vet tech, I have always researched every single thing I do with my horses: the supplements they get, the feed and hay they get, the training programs they are placed on based on the much-researched sport I decide to choose for them. A huge part of the enjoyment I get out of horse ownership is in doing everything right and researching the crap out of everything I do with my horse. Before my family had internet (yes, I can remember a time without internet. I'm that old), I read everything I could get my hands on about horses: every book, every magazine. Growing up I had ongoing subscriptions to Equus, Practical Horseman, Western Horseman, Horse & Rider, Paso Fino Horse World, and a full library of horse training books at my grandfather's house: I come from a family of horse people. My grandfather bred and trained Paso Finos, and so did my mom. I've read about endurance riding for years as I've wanted to try this sport since I lived in Puerto Rico. As we trained for the last 8 months, starting with a few miles at a walk and not adding trot sets until we could walk on the trail for 2 hours or more, I continued research on training for endurance, reading every bit of information out there from reputable sites like the AERC itself, endurance training books, and asking questions of other bloggers experienced in endurance with non-Arabs or Arab crosses. Hell, I went to the AERC Conference so I could learn more about the sport in person.
I pulled Lily out of the field that day and watched her walk. She had the slightest head bob on pavement at the walk, sound on soft footing. I trotted her in a circle around me on pavement and she had a marked head bob. Grade 3/5 lame on pavement at the trot, especially to the left. Grade 1-2 lame at the trot in a straight line on the grass. No swelling/scratches/anything on her legs, no tendon/ligament/joint pain on palpation. But she had marked pulses on both fronts, left worse than right.
Yes, an alarm bell did go off in my head. Laminitis? From the grass? But, it had been very muddy in the field with the random temperature changes. If this mare had been overweight, cresty, an easy keeper or even not in full work, I would have listened to that alarm bell more. Instead, since it had been muddy, I figured maybe she had an abscess she was working through. Plus, I was stupid and checked her pulses AFTER trotting her all over the place which will elevate a horse's pulse regardless and make them more marked in their legs as the blood flow from bare hooves is increased by impact.
I buted her and decided that, since we were 2 weeks out from the endurance ride, I'd just end the taper and rest her for the next 2 weeks. Several experienced endurance riders that I respect do this and I figured it would only help. She wasn't going to get any fitter than she already was and it would give her an opportunity to gain some more weight as well.
She responded well to 1 gram of bute once a day. I monitored her hooves and no abscess ever popped. I figured maybe she'd had an abscess that she re-absorbed. Sometimes that happens. The ground dried up with the increased heat and by Sunday Lily was trotting sound in the arena. She has also gained a little weight and looked like a rippling well-muscled beast.
Wednesday 4/16: I went to the barn to give her lunch and Lily was majorly head bobbing at the walk in the muddy field. I made her come with me and we made it all the way up to the barn with difficulty.
She was crippled walking down the concrete aisle to the wash stall. I wanted to cry. I rinsed off the mud that covered her legs up to her hocks and knees and that's when I saw the pink rings around her coronet bands. Yup, this was not abscesses. I checked her pulses on her legs: marked on her hinds, downright bounding on her fronts. I lightly rasped the bottoms of her hooves to check her white lines: no pink in there, thankfully. With bad laminitis, the white lines will be pink/bloody.
I wanted to punch myself. I should have been more careful, we should have introduced her to spring grass carefully, I should have gotten a grazing muzzle for now...I just didn't think this would happen, you know? Not with her breed, not with her current body condition, not with her level of work. Plus she'd been absolutely fine on summer and fall grass.
There is an empty stall in the main barn that had been offered to me if I ever needed it for Lily. I went back to the run-in shed and grabbed Lily's feed baggies that I'd set up for the week and unclipped my haynets from the run-in shed rings: I hang up haynets for the mares when the weather is going to be bad. I was going to need them now.
Walking back up the hill from the field, I met BO and told her what was going on. She gave me permission to use the stall and one of the hospital paddocks (they are dry lots) for turning Lily out while all of the other horses are outside.
In a daze, I did the emergency IR treatment that I'd read so much about in the past: Lily got to wear ice boots while munching on soaked grass hay, and I set up a bucket of soaked, rinsed, unmolassed beet pulp for her to eat for the week. Tough shit if she turned her nose up at it; she was going to have to eat it now. I never in my wildest dreams thought that THIS horse might have a metabolic problem. Sure, I'd always fed her low starch because it's the correct thing to do. But given the fact that she's mostly TB and a hard keeper, I never thought she might have a sugar sensitivity.
|I was astounded by how good she was with those boots. They were filled with cold water and ice. The hay in front of her had been previously soaked.|
I quickly packed her hooves with Epsom salt poultice, wrapped them and she got to wear her brand new Vipers for protection. Each time I picked up a leg, her other legs would shake in pain. :( She had a dose of bute and later some UlcerGard and probiotics since I knew she'd be stressing over being away from her herd. She HATES being locked up. She started pacing and screaming the second I put her in the hospital paddock.
The vet was coming on Friday 4/18 to do Lily's health certificate for travel to VA for the No Frills endurance ride next week. I called and told them I was changing the appointment to a lameness exam.
Friday couldn't come fast enough. We continued the IR feeding protocol and treatment in the meantime.
By Friday I had switched her to Magic Cushion packed into her hooves, covered with paper, with her Easyboot Gloves on over that. The Magic Cushion seemed to have made a huge difference in her comfort levels: she was much better, almost sound in boots. Still quite lame barefoot, but you could pick up her feet without her other legs shaking.
Dr. L has tons of experience with IR. She actually leases an Arabian mare that she brought back from founder due to obesity. The little mare now looks like an Arabian and they do competitive trail rides together.
She watched Lily walk and felt her digital pulses, confirming that her fronts were much worse than her hinds. Lameness only in her fronts by this day; she had been lame on all 4 legs when I brought her up from the field on Wednesday. She scraped her soles a bit to take a look and discovered quite a bit of bruising on both fronts and the right hind. Not as bad as in the photo on my previous post, but enough to make me gasp. (No photos; my phone has been bipolar lately when it comes to taking photos.) I do my horse's trimming. I keep an eye on bruising, especially this winter when the ground has been so very hard and frozen. Her soles were not like that a week ago.
Dr. L was almost as befuddled as I was. We went in detail over Lily's exercise regime and diet, and she agreed that this should not have been caused either by my training program or the way I was feeding her. Even after listening to Lily's lack of history with spring grass, she didn't want to call this a grass-induced laminitis. She said that this time of year when it's starting to warm up and there is so much mud, she does see sole bruising like this in horses that stand around in the mud a lot: their feet get soft. That did make me feel a little better. I asked if that could happen even if the horse was NOT worked over hard ground while their feet were soft (our most recent rides 2 weeks ago had been on flat land with hoof boots and the field had been the driest it's been in a while at the time). Dr. L confirmed that it could happen just from the horse standing in the mud for prolonged periods of time.
|The mare field this week.|
She didn't want to completely eliminate a grass-induced laminitis, however. We couldn't test for it at the moment because Lily was still painful and pain can create false positives in the insulin:glucose test. (I was relieved that my vet is so educated on this subject!) We will test, but it won't be done until Lily is sound again. I need to know. The test results will change everything about how Lily is managed on field board; I'm still not sure how I'm going to keep weight on her if she needs to live in a grazing muzzle. And if it's the mud, I don't know how to keep her off of it at the current barn. The entire field becomes deeply rutted and muddy when it's wet, even the run-in shed. They have no break from the mud and because it's at the bottom of the property, it can take up to a full week of sunny weather for it to dry up.
In the meantime, Dr. L offered radiographs. She said that based on Lily's pain levels (moderate), she felt that Lily most likely did not have any coffin bone rotation and we could just play it by ear if I wanted to. I decided to go with laterals of her front feet. I wanted to know for sure, and also as a reference for myself: I'd never had Lily's front feet radiographed.
Lily was absolutely stellar for this, standing on the wooden blocks like a pro. Again, my phone failed to let me take photos.
But I was able to get some of the rads:
|Left front on the left, right front on the right.|
Check out those awesome heel bulbs!
Now I need to go ask my barefoot trimmer friends what else I can do to help Lily's soles beef up.
For now, I am to continue doing what I'm doing with the hay and the beet pulp and Lily's treatments. She can have as much soaked hay as she wants; no need to limit the amount she gets as she is not overweight by any means. Dr. L said I can add a handful of TC Senior to Lily's beet pulp so she continues to be accustomed to it. The vet will call next Wednesday to see how she's doing. She's expecting her to be all better in another week or so, when we'll test for IR and determine what to do about Lily's turnout on grass. For now, she is going to be out in the larger dry lot behind the main barn, with access to a stall 24/7. She can come and go as she pleases, which is exactly the kind of setup she had at the FL barn.
She is still pacing and calling in this paddock during the day, but not as furiously as in the hospital paddock. When the horses are brought into their stalls in the afternoon, she calms down.
|Eating her dinner under the covered area right outside her stall. This drylot is huge. It's nice. I'm glad we can give her this setup right now.|
|Hay soaking in a muck bucket. It should soak for at least an hour and the sugar water dumped away from any grass or horses.|
|Beet pulp soaking|
|Since I can't get ahold of unmolassed beet pulp in this area, after soaking I dump the beet pulp in a colander...|
|Lily's dinner: soaked hay in the haynet, soaked hay in the box, Safe Starch forage in the deeper tub, and beet pulp in the smaller feeder. Beet pulp has 4 oz of ground flax seed added (a must for IR horses), a cup of Triple Crown Lite (a ration balancer for IR horses), her UGard, SmartMare Harmony and SmartCombo Ultra. She's eating her supplements again. Go figure.|
|Lily eating her dinner while wearing the Gloves with Magic Cushion.|
I bet you guys have never seen so many photos in a blog post of the same horse eating! :p
Moral of the story: no matter how hard of a hard keeper your horse is, always introduce slowly to spring grass, even if they've done well on summer/fall grass in the past!