December 3, 2008

Royal- Worry and Sleepless Nights

Click to enlarge photos
Royal ~ The Love of My Life!


Royal has always been the horse I could depend on. He's my army tank, perfect feet, perfect attitude, healthy as a horse, the one that just keeps on rolling with his beautiful, heavenly gait, day after day.

Suddenly, he is now suffering laminitis in both front feet, on 30 day stall rest just for starters, on Banamine twice a day, Ace twice a day. He has rolled wooden shoes screwed to his once upon a time, perfect feet.
As soon as we had the diagnosis, we did five days of ice/water soaking of his front feet for 15 minutes three times a day. Near the end of the process, Royal would just pick up his feet and plop them in the bucket. He seemed to know we were trying to help him.

The alarm went off when Royal was being such a quiet babysitter for Shadow. Royal is an active boy, always flagging that tail as he runs to the upper paddocks on a regular basis, or prancing his way down to the arena.

I've kept a detailed chart of the accumulating time bombs along the way. It seems things keep getting worse, the list of possible causes is getting longer.
I'm an absolute worried wreck and nearly living in the barn round the clock.

If you read through my panic post and see red flags along the way or have any suggestions, ... I'm listening!

I love this boy!

Late last August, a new young vet made a routine call to the barn. She recommended Royal be given some medication for those annoying "can't see 'um" fly bites. A short time later, Royal blew up the size of a house. He looked like he was a big roll of bubble wrap. I later learned the medication was potent steroids given several times a day.

Later, my regular vet came by and ran x-rays of his feet to get a base line in case of further problems. The results were ... perfect feet.

Then blood tests were run for insulin resistance. It came back positive. However, on second opinion, I learned that steroid overdose can cause artificial metabolic syndrome and excess weight and bloating. Whatever the cause, he now has laminitis.

Royal's menu is now 16 pounds of soaked timothy hay a day, along with 1 cup of Purina Low Starch feed with his usual vitamin/mineral supplement. (He's a big boy, almost 17 hands and big boned.)
Even though Royal's thyroid is normal, he was put on 4 scoops of Thyro-L daily to lose the weight.

Three weeks later, he has developed laminitis. X-Rays were done, again. It shows rotation in both front feet, numbering 7 in the right front and 10 in the left front. Now, he is in serious condition.
My farrier says he has seen this before. He believes the steroids started the process and the thyroid has caused the laminitis. He recommends slowly bringing him off the thyroid, since his new diet will bring down his weight. He believes to continue the thyroid for another 2 months will cause further problems.

Now, I don't know what to do about the thyroid medicine. The vet says to give it to lose weight fast and the farrier says no, that it is risky.

Both my vet and farrier are excellent. Just differing opinions. And I don't know what to do.

I've been reading Victoria's very similar problems. She sure has kept me together through this trial. I'm so glad to see things are on the mend with Siete.

My thinking, at the moment, is Royal does not have insulin resistance, and I'm very concerned about the effects of the thyroid and the laminitis.

My vet was here this morning and we discussed this thoroughly. He sees no relationship in the timing of the medication and the laminitis. He'll be back again, tonight and we'll be doing more blood work to run another test for the insulin resistance.

In the meantime, I'm going in circles, checking Royal constantly and worried sick.

If any of this is familiar to you, if you agree or disagree with my thinking, please post a word or two.
If you have suggestions ... any help is greatly appreciated.

Right now, I'm back to the barn ...


  1. He's a beautiful boy and a wonderful horse. I'm sorry but I have no idea what is going on with him. I sometimes think the farriers may know what is happening more than the vets do though, especially when the problem involves the feet. I'm thinking that if he had no problems before all the medication maybe that is the cause. But I'm not a vet or a farrier, I guess a lot of research into his condition is one way to go to understand it more. My best wishes for you and Royal.

  2. First, let me just say that Royal is stunning!! Absolutely a gorgeous horse. And...laminitis, unfortunately I am up-front and personal with it. I would tend to agree with your regular vet about the thyroid meds - they can be quite hazardous if given improperly. And yes, steroids can cause laminitis, but usually only in very large doses. But, if that were the cause he would be very cautious in admitting any liability for obvious reasons. The young vet probably jumped the gun initially and could possibly have instigated the process. But, what's done is done. Soaked hay will leach carbs and the low-carb grain is quite tasty and filling so it satisfies hunger. Keep on top of the toe length for sure. Bobbed toes is a benefit, but only after the initial pain and soreness is controlled. Question - why the ace? Just to calm him and prevent unnecessary movement? Otherwise, can't figure out why he's on that? Banamine will control pain and inflammation. You can attach styrofoam on bottom of feet for cushioning or, better yet put a pile of sand inside the stall and Royal will probably stand in it. Sand fills in nooks and crannies and has a very soothing effect as it "supports" exactly where it's needed. Later, discuss with your farrier the use of aluminum natural balance shoes on the front only, and have him bob and square the front toes. This increases breakover and relieves pull on the tendons in the back of the foot/fetlock area which are attached to the coffin bone which is what is affected in founder. You can also have the farrier put on a "banana shoe" to increase sole thickness. This works amazingly well and will put more hoof between the coffin bone and the ground. So much can be done - ask your vet to contact Dr. Ric Redden in Versailles, Kentucky. He is "the expert" in laminitis - bar none. He's very helpful and you can order products off his website or by phone. Sorry to be so wordy, but in cases like this - time is of the essence. One more thing, ask your vet if he has ever done a venogram. This is a fairly new treatment option, but can increase blood flow to the hoof which is essential now. Good luck and I will keep you and Royal in my prayers.

  3. Well you already know the "no sugars" for laminitis.
    Vitex (chastberry) can help with the insulin resistance.
    I know that a lot of people cringe when they hear "let your horse go barefoot", but I think that with horses whose hooves are already comprimised that is the best thing for them-use boots if they are too uncomfortable.
    We have found in our rehabbing horses that a good 'balance trim' with the toes not left too long makes a world of differnce, sometimes immediately after the trim. It is important that the hoof be set up to grow at the angle that it is at the top portion of the hoof. The toe left too long will cause a continual stress that keeps tearing the hoof wall from the lamine.
    Read Pete Ramey's work at . There are a bunch of great articles that should help.
    Good luck with Royal.

  4. Grey Horse Matters:
    Thanks for your support! I, also, keep saying I'm not a vet, or farrier, ... just Royal's mom. Lots of research ahead, and I'm grateful for an excellent farrier who really cares. Seems it's always been said to trust your farrier with the feet.
    I just hope I make the right decisions.

  5. C-ingspots:
    Thank you, thank you for all of your very detailed info. Gives me additional direction and confidence at this time of decisions. Thanks for the reference to Dr. Rick Redden website. Going to check that out, pronto. Will also check out the venogram.

    About the Ace: apparently, I was told, that it increases the blood supply to the hoof. We have 3 more days of that. Royal doesn't need it to keep him calm, fortunately. He's such a good boy through all this.

  6. Cactus Jack Splash:
    Thanks so much for your advice. Poor Royal will never see another carrot, apple or sweet feed, again. Will relay your advice on the hoof trim to the farrier. Thanks for Pete Ramey's website. Appreciate your advice!

  7. Sorry your beauty is suddenly so ill. I'd second the Pete Ramey website. Although I don't have personal experience with severe laminitis, my trimmer has studied with Pete and really believes he is keeping pace with advancing technology and studies.

    I have read that magnesium is a good supplement to combat laminitis. My pony had very mild laminitis brought on likely by too much weight when he first arrived here. As part of his rehab, I put him on Smart Pak's Smart Balance supplement for insulin resistent horses and it seemed to help manage his weight very well. (Although much was likely do to being able to control the amount of hay he was eating by feeding him in isolation) The Smart Balance has a high magnesium content. (Check that I have the right M mineral name - I sometimes mix them up)

    The website has alot of information on managing sugars although can be quite technical.

  8. Ranchette:
    Thanks for the info! Will check out your suggestions! So glad things worked out for your pony.

  9. So sorry to hear your news! Your lovely Royal man is such good hands and you are dong a fabulous job of research. He is getting the best loving care from your heart and head!
    Hang in there, take care of you too!Praying for you BOTH!KK

  10. Hang in there - all the information and differing opinions can be so overwhelming! You're doing all that you can do for your beautiful boy. And he understands that you're helping him, fortunately, so he's being a good patient. Having the farrier and the vet at odds is really difficult. Have they talked to each other? The funny thing about Siete feeling better is that I know I will never take it forgranted again and I'll probably always be worrying about a recurrence. As my old vet in California used to tell me, "Horses are accidents waiting to happen."

  11. All Horse Stuff:
    Thanks sooo much for your encouragement. Sure does help!

  12. Victoria:
    Your vet is right, something will happen eventually. I thought Royal was the exception.

    My vet and farrier have been here at the same time when doing x-rays and applying the blogs. The two of them discuss things back and forth, but the final decision is always the vet.

    It is later in the day that the farrier will call and give me his thoughts, not wanting to confront the vet. As he says "remember, the vet always makes the final decision".

    I have my chart of questions, voice my doubts, give my own ideas. However, I don't want to be a problem when Royal is the issue and I want to keep everyone on the same page.

    THE issue is the thyroid. That is causing me real stress ... since I'm the one to make the final decision. What if I'm wrong, either way.

    Thanks for hanging in there with me!

  13. oh dear...poor shadow! I am glad to hear he is being great about being taken care of. When my horse was badly injured I got opnions from everyone about what was best. I had so many vets consulting. I just went with my gut though because I knew my horse better then any of them. You poor thing. I have never had a horse with laminitis, but my best advice it just go with your gut.

  14. OnTheBit,
    Many thanks for your advice. Good for you to get several opinions from vets for your horses injury.

    I usually trust my gut feelings, but right now I'm get too many gut feelings, that I'm in a well worn circle. That is why I appreciate all of you for your comments and experiences.

  15. When I saw that head shot of Royal my very first thought was "Black Beauty." He sure is handsome.

    Fortunately, I don't have much personal experience with treating laminitis. I'm sorry to hear your boy is having such a rough go of it. I'm glad he's a good patient though; my boy has a small abscess above his heel, and while he'll let us soak it he won't let us wrap it. We're starting to get creative.

    I'll be checking back for the day you can tell us he's all better! He is in good hands with you.

  16. Jackie,
    Thanks for the compliment about Royal. I'll tell him. He'll love that!

  17. Hi again, I just caught your comment on my blog. So...about the thyroid meds:
    First a question about the excess weight - is it just all over the body evenly distributed "fluff" - or, is it in distinct locations such as 1) cresty, hard neck
    2) localized in girth area
    3) fatty deposits near tailhead??

    If fat is an all-over-the-body type, I would definitely suggest stopping the thyroid meds because they're probably not needed and could cause potential harm. The diet itself will alleviate excess weight. But, if the fat is localized in these specific areas only, then there is a fairly good chance that equine metabolic syndrome/insulin resistance problems might be involved.
    Your vet could have a dex suppression test done on Royal which would positively rule out Cushings disease, but this test can be risky because it involves administration of a fairly large dose of dexamethasone, which is a steroid and if I understand you correctly - may have at least in part caused his laminitis episode in the first place. I'm sorry if I've confused you further, but cushings and equine metabolic syndrome/insulin resistance are 2 distinctly different reasons/causes for the same end result - Laminitis - and they are treated with different medications depending on the definitive diagnosis. Your vet needs to find out what caused his reaction in the first place and then decide which medication - if any - Royal should be on. This, of course is in addition to dealing with the pain, separation of laminae, or any coffin bone rotation that your horse may have. I think you said that the x-rays showed no rotation of P3 (coffin bone)?? If so, that is a VERY good sign.
    Hopefully, this is helpful and I haven't confused you further. :)

  18. C-ingspots,
    Thank you, thank you! That has been a tremendous help!

  19. Royal is absolutely gorgious.

    I am afraid I don't know much about horses but I can offer you best wishes and good luck thoughts to be sent your way.

    Thinking of you, hugs from Meg and cats xxx

  20. Ask your Vet About: pentoxyphyline, it makes the red blood cells more bendable so that they can get through the inflamed vessels in the hoof. I had a mare with a mild condition (in relation to an illness) who was put on this and it never became worse. And you should get a second opinion any time you are second guessing a vets choice of treatment. the peice of mind is worth the expense.

  21. I have no suggestion. I'm neither a vet, nor a farrier.
    All I see is that you're doing your best for Royal and I hope you'll succeed in together.

  22. Oh I'm soooo sorry to hear about Royal's laminitis. I was only discussing this with my own vet yesterday, as Merlin suffers a little with sweetitch, which is caused by midges (no see-ums).

    I've heard of this injection, it's been doing the rounds here, and everything I've heard is bad. My vet told me in no uncertain terms that he will not prescribe it, as a client of his lost her horse to laminitis within two weeks of having it.

    Please may I use a link to this page on my forum, so that I can warn others that this danger is in fact real?

    Personally, I would try and get Royal off all strong medications, but that's because I have a general mistrust of them. Yes your vet has the ultimate say, but your farrier has only ever studied feet, and so may have the greater knowledge.

    I wish you all the luck and good fortune with this. Royal is a strong boy, so lets hope he can pull this one off. I've heard of worse cases pulling through.

    Take care

    Kim x

  23. I just stopped by to see if there were any updates ... Poor Royal and poor you! You must be an exhausted mom at this point :( sending healing thoughts and desperately hoping you'll have good news to share soon!
    Sue and the gang

  24. Kitten's Mother:
    Thanks for your support. Sure is needed right now! Appreciate it so much.

    Thanks for your advice. Agree, a second, third and fourth opinion is needed about now. This sure brings on the anxiety!

    Le Chaval Endiable'
    Thanks for your encouragement. It sure helps!

  25. Kim:
    Thanks for your info about other problems like this. Please do add this to your forum. If it is of help to anyone that would be great.

    And ... if anyone has gone through this and has suggestions, please have them post a note here. Would appreciate that!

    My vet is great, but in this case I think my farrier is right on. The meds are making Royal worse.

    So, with more information, I'm going to start going for my own gut feeling. I know this boy!

  26. smrp,
    Thanks for the encouragement from the gang. Yes, I am exhausted and heart broken to see my boy in this situation. He's always been so healthy. I'm keeping the faith that things will work out, but I'm sure fighting for him.

  27. Praying things are going a bit smoother.
    Sincerely, Kacy

  28. Very scary indeed. I know, I have a lot of experience with laminitis, both clinical and subclinical.

    There is lots of new research in this. Many of the older treatments are being replaced.

    Janow took thyroid L for years. It ws part a s very successfull management regimen for his feet. He got 1 tsp to 1.34 tsp daily. Thyroid is not very stable over time, so batches vary. I calibrated each new bottle with his heatrate. He was very ridable, able to gallop cross country without discomfort.

    Laminitis is a circulation problem. Decreased blood flow results in inflamation. THe cold treatment decreases inflamation and also decreases circulation which promoites more inflamation as soon as the cold is removed. I was told not to by two vets.

    The treatment that seemd to provide the most sustained improvement was hand walking. I walked him for 15 minutes of each hour for 10 hours, two days in a row. That was the hugest help.

  29. Sorry for as such a spastic comment! I had a 7th grader trying to get ready for school after a family weekend away. He let his laundry pile up in his room all last week. When I reminded him to put it by the washer so it would get washed, he shoved it under the bed with the intention of doing what I said AFTER he skated. Then he forgot, until Monday morning and had no clean clothes.
    Life goes on, even in laminitis.

    I feel for you, I really do. I have been through it. There are so many differing opinions on this because there is so much research currenly going on. That your best friend is in such pain makes it harder. You have to think with your brain while your heart is ripping out.

    I had a good summary article, I'll try to find it.

    Advice is conflicting. Ice, or never ice.

    Stall rest, or walk walk walk.

    Give Isoxsuprine, or never give isoxsuprine.

    pad the feet, or stack the heel, or cut back the toe........

    Like I said, the best thing in my personal experience is very very very frequent handwalks.

    The worst thing, from Janow's point of view, is social isolation while infermo. Contact with other equines is paramount to spiritual strength.

  30. This is what I have found to be most helpfull. A summary of current research:

    its pretty technical. A lot of the non-tech friendly info is oversimplified to the point of losing value.

    One of the things this says is that postive results have been seen in non-cushings horses when given pergolide. You cannot/should not so the dexamethasone test when a horse is in the accute phase, but you already knew that. Animal Heatlh Pharmacy can compound pergolide for you for about $20 a month, if you need it.

  31. Just checking for updates. You know you can always email if you want.
    Taking care of a laminitic horse can take the whole day. Please remember to sleep and eat for yourself.

  32. Cara,
    Thanks for all your helpful info and the website!

    Royal is still on 30 day stall rest. He sure wants his old life back.

    You are so right ... caring for him starts early and ends late. I have one more run to the barn, yet, this evening to give meds and his last serving of sloppy soaked timothy and then lights out.

    Thanks for your email! It is comforting to talk with people who know what laminitis is all about.

  33. h no. I just wanted to post a few words of encouragement and well wishes. I do hope and pray that his condition improves quickly.

    Hang in there.

    Poor sweet Royal, get well handsome!

    New Mexico

  34. OM Gosh Marvel I can't believe it is a week since I checked in here, I did after you indicated that there was trouble brewing but life just gets in the way, I know you know all about that.

    I am so sorry to hear that Royal is such a sick boy, I have never had any experience with laminitis but I know it can be a worrysome painful problem. All I can offer I am afraid is my best wishes, lots of rubs and hugs for Royal and positive vibes. (((((Hugs))))


  35. I'm still hanging in there for you and Royal. Here's hoping the best for you both.

    Lots of love and good wishes

    Kim x

  36. Just checking in, hoping for good news. I have been through this three times. I think it is the most painful desease that a horse can have.

    Veterinary knowledge and pharmacology are makeing huge breakthroughs on this and the recovery rate is soaring.

  37. Checking in to see if you have made any progress. It is hard, the Arabian mare that we took in two and a half months ago and were rehabilitating started colicing last night and I am terrified we are going to lose her after all her valient struggles to put on weight and get healthy.

    Just wanted you to know you are all in my thoughts.

  38. So sorry to hear about your boy! Hope everything is ok, sending positive mojo your way.
    Michelle and Jasper

  39. You said it all when you went back to the steroids and weight gain. IE: thyroid and Cushings. I hope he gets better soon and there is no permanant damage! Poor Royal, I'd be worried sick too. He's such a nice horse! Take care and I hope all goes well with him.

  40. I was wondering how Royal is doing. Any updates??


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