Laminitis recovery – rehabilitating a collapsed foot

Horse Welsh Section C mare.

Equine Podiatrist Helen Stowell 

Background.   After a yard move from one side of the country to the other, the owner had been unable to get consistent hoof care for this mare.  

The mare had history of both excess weight and laminitis from a previous loan home, so her diet and bloods were already being monitored prior to the first trim appointment and she’d been prescribed ertufliglozin with good results (an initial insulin reading of 300 had been reduced to 98 by Oct 24). 

The feet became very overgrown and despite best efforts, the owner was unable to get the regular hoofcare that the mare needed from her new yard.  So the owner made the switch to a more local EP.

First trim December 24

At the first trim appointment  it was obvious that the feet were both laminitic and overgrown. There was very little vertical height to the feet.   The perimeter of the sole was bulging below the level of the white line and the walls were collapsing forward and out.  The assessment was that P3 was sitting very low in the hoof capsule and the sole was vulnerable.   The excess toe was hampering the mare’s movement and she was uncomfortable on hard surfaces.  

Right fore  – Nov 24

Right fore  – Nov 24

Right fore  – Nov 24

It was decided to trim every 3 weeks, trimming to bring the hoof walls back in, whilst leaving as much height as possible, so her soles had some relief.  She was yarded on woodchip surface, fed soaked hay and a small hard feed.  

February 25 blood results

By the February her blood results returned a surprisingly high insulin reading of 231 despite her management.  So the hard feed was re-examined and it was decided to cut out the balancer as it had a number of potentially unhelpful ingredients. 

March 25 trim

The walls were starting to recover some weight bearing capability.  The toe was still producing laminar wedge and sole, whilst less prolapsed, was still stretched thin and showing signs of being under excess pressure.  The trim was applied to keep a rim of height around the perimeter of sole, whilst controlling the length and flare of the walls.  By this stage she’d rediscovered her movement and was trotting / cantering  her wood chip yard with typical Welshie flash!  

March trim lateral post trim

March trim Dorsal post trim

March trim Solar post trim

By April blood tests confirmed we were back on track, with the insulin now down to  52.2, a remarkable improvement.

The summer was very dry, with hardly any rain from March till September.  So in the early part of the summer especially,  we had to manage ground and surfaces carefully as the ground hardened quickly whilst her soles were still vulnerable.

Again the bloods continued on the correct track, by 1 July 25 her insulin was down to 17.3 – within normal range. 

As the summer progressed and her comfort improved, she rejoined her herd, living out on a packed mud surface. Unbooted /barefoot and comfortable.   The trim cycle was lengthened to 4/5 weeks. 

Happily, by the end of the summer we could see that the walls had both strengthened and straightened.   The concavity of the sole returned – indicating that P3 was better suspended in the hoof capsule.  The frog structure and function improved. The growth rings were growing out, and notably the breakover of the toe was now sustaining itself.

Had the firmer ground helped the hoof capsule restore its function?

August trim lateral  August trim dorsal  August trim solar 
Dissapointing photo!  Was trimmng at liberty in her paddock.  At this stage the toe was maintaining its own breakover – no longer elongating the walls are much more upright – weight bearing more effectively The widest part of the foot is moving back towards the heels, and the sole is not encasing the frog as much

The last set of photos is her November post trim compared to the previous year’s trim. About three weeks short of 1 year’s progress.  The mare has grown out one hoof capsule.

 Nov 25

Nov 25

Nov 25

 

Right fore lamintic  – Nov 24

 

Dorsal Right fore –  Nov 24

Solar Right fore – Nov 24

The mare has now been given the all clear to start in hand and light ridden work.