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Laminitis Treatment - Pippin

Case 2 Pippin 11.2hh 8yr

old skewbald welsh pony mare

Veterinary treatment: Ali Mead
attended the pony and applied taped
on frog supports, visiting every day
until, and when, the remedial work
took place; the mare was stabled in a
deep straw bed, and put on a high
fibre diet including soaked hay. A low dose of ACP and potent non
steroidal anti-inflammatory drugs
were administered (arquel and
finadyne). She was lying down when we arrived, and when persuaded to get up, managed to without putting the right fore to the ground. She would not weight bear on the right fore.

Farriery Treatment: Digital nerve
block on the right limb was
administered to enable treatment to
be carried out. The right fore was
worked on first; - remodeling with
reference to x -rays was carried out.
When the deviated distal dorsal
border was cut away, pus, blood and
serum flowed out. The shoe was fitted without removal of any sole or wall depth in the toe quarters, but total removal of the deviated distal border of the hoof wall. The flange of the shoe was removed to the sides, leaving the toe open but bridging the sole and reinforcing the flange at the quarters. When the shoe was fitted, she was willing to lift the left fore. The left fore was treated similarly. The hind feet were not affected as severely so did not need shoes.

Condition on first visit

Resected toe after treatment

Result:  Improved digital alignment,
infection draining, and the pony able
to walk on all feet. 14/5/05 Pony had
not improved, and remained non
weight bearing on the right fore. The
frog plate was removed as pain was
expressed throughout the whole solar and frog region. The foot was being poulticed, some serum was draining from the resected toe.

Owner: Hayley Gough
Vet: Ali Mead, The George Veterinary Group

Visit 1
Condition: Acute Laminitis
Date: 12/05/05
Materials: Imprint Therapeutic shoes x 1 pair, surgical spirit, Imprint
Adhesive, Imprint Shoe Freezer

Report: The pony is a chronic
laminitic that ten days previously had
escaped into a lush corn field, she
subsequently suffered an acute
laminitic attack, and was re-shod with conventional steel shoes a few days later. She was very distressed and deteriorated after being shod. Her feet were X- rayed, showing the
pedal bone distal fringe remodeled
and in a poor position in relation to
the hoof capsule.

Visit 2

Date: 31/05/05

Interval: 3.5 weeks
Materials: One 3” x 4” Imprint plus
shoe and accessories
Report: The pony had taken
approximately 2 weeks to really turn
the corner and was critical for
sometime. The foot had been
poulticed to draw out any infection
which was not very forthcoming.

Antibiotics were used as a last resort

to control the infection in the right
fore foot.A further fault at the coronary band became evident. The right fore shoe was removed by the veterinary surgeon and the foot was re X-rayed showing the sole had prolapsed further and the hoof capsule had rotated around the pedal bone, however, the digital alignment was good.

Treatment: X rays were compared, a
little heel removed and then a shoe

fitted intact with its frog plate but
barely in contact with the frog as any
loading on it appeared to induce pain. The concern was that without the frog plate there was potential for further prolapse. To alleviate trauma to the critical right fore, the left fore was not re-shod, as it appeared comfortable.

Result: The pony walked much more

Visit: 3

Date: 06/07/05

Interval: 5 weeks
Materials: A pair of Imprint shoes
and accessories.

Report: The patient’s comfort had
improved markedly; she was shod at

Town Forge. There was approximately 10mm growth at the heel of the left fore, (eight weeks), and the under-run sole of the right fore was ready to peel away. Alison Mead the veterinary surgeon prescribed ‘Founder Guard’

Treatment: Re-shod both fore feet
with complete Imprint shoes, trimmed hind feet.

Result: Much improved prognosis; the right fore was no longer infected.

New horn growth 3 months later

Visit: 4

Date: 31/08/05

Interval: 8 weeks
Materials: A pair of Imprint shoes
with self tapping screws in each heel
for extra grip, plus extra thermoplastic Imprint granules.

Report: The pony was further
improved, she had lost more weight
and the hooves had dried and
hardened. There was still a significant
amount of dorsal wall missing in both feet. The right fore in particular, which had previously been deeply infected, had undermined the hoof wall across the toe.

This portion of the hoof had
grown down approximately 25mm

and was ready to be removed. The
feet were long at the heel but the
pony moved well.

Treatment: The feet were trimmed to balance and debrided. The shoes were fitted with extra Imprint granules (thermoplastic particles) around the toe encapsulating the exposed laminae, replacing the distal hoof wall, as the underlying structures were hard and dry. Care was taken to ensure ample clearance of the sole forward of the frog.
Result: The pony appeared
comfortable and left the forge with
four shoes and rebuilt hoof capsules.
Judging from the new horn growth, it is possible that the pony may
regenerate normal hooves within the
year, assuming there are no further set backs, e.g. another attack of laminitis. Meanwhile she is enjoying comfortable feet, albeit partially prosthetic ones.

Owner’s comment: Pippin has a new lease of life; she is behaving like a youngster again.

Right fore side view

Right fore rebuilt and shod

Front feet rebuilt

Although both cases featured received remedial farriery treatment within days of the onset, x-rays revealed the dramatic and rapid devastation already occurring inside. However, as soon as treatment was implemented, there was immediate pain reduction (except in the foot with the added complication of the deep infection, until it was resolved using antibiotics). With continued careful management these ponies should make a total recovery. They are good examples of how the owner, vet and farrier relationship are vital to the successful management and recovery of the patient. Both cases are typical of a realistic course of events that follow acute laminitic attacks, owners must be prepared for

a roller coaster ride on the way to recovery. Thankfully all cases are not like these, and especially if recognised early enough can be resolved quickly. Veterinary surgeon Richard
Stephenson, from Pool House Equine Clinic said: “Over almost two decades of treating laminitis I have used a wide variety of pads, heart bars shoes, sole packs etc. to provide frog support before adopting Imprint Shoes as my first choice treatment for both rotational laminitis and distally displaced pedal bones. “With these shoes I find that I can see an immediate improvement in the movement of the horse after fitting - often up to one Obel grade.

Last year I had a number of laminitics

that were particularly badly affected in

 the hind feet. Imprint shoes proved invaluable in the management of these cases which I might previously have considered to have a very poor prognosis. “The system is easy to use and means that there need be no delay between diagnosis, X ray and shoeing.” The system is now routinely used in veterinary hospitals and universities in a number of countries.
It will come as no surprise that the
European Design Show, London,
featured the Imprint Therapeutic Foot
Care System alongside Formula One
Mercedes, as one of the best inventions in Europe over the last two years.

Reproduced by kind permission © 2006 Horse Health Magazine

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