Sunday, June 15, 2008

"Laminitis" mystery solved?

You know I've been dealing with a mysterious lameness on Limerick's left fore for the past three weeks. Initially, due to the location of the lameness and the symptoms, I thought she was having another bout of laminitis, which just crushed me.

After a vet visit, watching and waiting for the symptoms to manifest more strongly (which they never did), negative blood test results for conditions that include laminitis as a syndrome, and more watching and waiting, my farrier may have finally given me the answer.

While waiting for my farrier--whom has become quite popular at my barn!--I asked a vet to do a quick flexion test on Limerick. He is not my vet, but he's the guy that vaccinates and deworms all the horses in the stable, and is also the vet that we made the emergency call to on Sunday night. He was just finishing up with another horse.

Sure, no problem, he said.

First, he flexed both of Limerick's front legs quickly to see if she would react in pain. She tried to jerk her left leg out of the vet's hands but stood still when he flexed her right leg.

Then came the hoof tester. No response on the right hoof, perhaps a teeny tiny response on the left hoof.

He had me trot Limerick in a straight line over the asphalt outside the barns.

Yup, she's definitely off on that left fore, he said.

I explained that I wasn't sure if the lameness was a leg or hoof issue. A flexion test would help determine which.

He held Limerick's left foreleg in a tight flex, knee and fetlock at hard angles, for a full moment. As soon as he let go, I pulled Limerick into a trot straight down the asphalt. She was horribly lame. Her left leg was stiff and completely unresponsive and her head bobbed up and down like a buoy on stormy seas. Poor baby!

I explained to the vet what was going on, recapping the history of her lameness, then said that I just wanted to see for sure if it was her left foreleg that was bothering her. When I lunge her, she is stiff and lethargic, reluctant to move into a trot without a lot of demanding and hollering on my part. Once she finally sighs, gives in, and breaks into a slow trot, it can be hard to determine exactly what is bothering her. On one hand, the source of the pain seems to be obvious--her left fore. Yet on the other hand, every muscle, every tendon of her being seems unwilling to move.

And to compound things further, there's the Whee-I'm-free-in-the-pasture! gallop I busted her doing a couple weeks ago. A truly laminitic horse would not be galloping about in such a careless, joyful way.

The vet smiled. "Let your farrier take a look at her," he said, the lines on his face twinkling.

I thanked him for his time.

A few moments later, my farrier watched me walk Limerick in a straight line. Then he had me lunge her in the indoor arena. True to form, she moved off at a decent walk but was reluctant to trot. My farrier crouched down close (alarmingly close!) to the outside of the lunge circle and watched Lim carefully.

Back at the barn, he began to pull the shoe off Limerick's left fore. Her eyes went wide and, settling back onto her hindquarters, she tried to lift her hoof out of his grasp. It reminded me of the semi-rears she would do when she had laminitis and it was oh so painful for her when we had to clean her right fore hoof, leaving her inflamed left fore hoof to temporarily support 65% of her body weight.

"It's okay, baby," I said to her. I drew her head close to my chest and stroked her cheek. I whispered gentle nothings into the fuzziness of her right ear. She stayed still for me but I could see her right eye against my stomach, whites flashing, soft brown pool darting around, thick lashes curled upwards.

That hurts! No more, please!

Realizing he had hit a sensitive spot, my farrier worked gently, carefully pulling the shoe away little by little. Finally, it was off.

On her sole, where the toe of the shoe had been, was a discolored spot.

"Is that an abscess?" I asked.

"Possibly, but I don't think so," he said.

"More like a bruise, then?"


He pulled the shoe off her right fore. This time, Lim was quiet.

She had been wearing natural balance-type shoes, with an extended toe area. My farrier showed me the shoe that had been on her left fore hoof. There was crud and dirt packed beneath the toe. The location lined up with the spot of discoloration on her sole.

Apparently the mud and crud of the pasture had seeped beneath the toe, forming a spot of hard pressure. Over time, this caused the sole to become sore and bruised.

"So it's like having a rock in your shoe!" I said.

"Exactly, a rock and a shoe that you cannot remove."

It would explain the on-and-off digital pulse, the on-and-off heat, and it would also explain why she was generally negative on the hoof tester--the hoof tester is not applied to the shoe itself, and the bruising was right beneath the toe of the shoe.

But that left me with one more question.

"Why is she positive on the flexion test?"

He responded that she had been compromising for the pain in her toe by standing and moving unnaturally. The unnatural biomechanics were not visible to me unless she was trotting, but it made sense. As my farrier has taught me over the past few months, even the slightest forced deviation from the natural, normal biomechanics in the equine foot will create soreness that will radiate throughout the horse's entire leg, and eventually the body.

That explained Lim's overall stiffness on the lunge line, and the horrible lameness she experienced in the flexion test.

Let's go back to that rock in your shoe, the shoe you cannot remove. Imagine the rock stays in the toe of your shoe. What will you do? You will start walking more on your heel, or on the side of your foot. Over time, your leg, then eventually your back, will become very sore from this altered state of travel.

Limerick was fitted with a shiny new set of aluminums, this time with a regular toe.

Today I'm going to lunge her and see if she's better. If she is, I'll probably cancel the vet visit for Tuesday.

All sorts of horrible scenarios were going through my head--low-grade laminitis, a stubborn, deep abscess, is a huge relief that it is most likely something so simple.

1 comment:

BansheeBreeze said...

woo hooo!! thank god that's all it was! amazing how much trouble a little dirt and debris can cause!!