Fancy & Founder

 

October 2008 Postscript

10/2005  

These pictures are of a young arabian mare named Fancy and her devoted owner. Fancy has the unfortunate honor of being my first in-progress founder diagnosis... I've dealt with many horses that foundered in the past, but Fancy was the founder that I recognized before her vets did... she was my first. Honestly? I wish there hadn't been a first. I wish Founder was so rare that I'd have to travel to study it first hand. Unfortunately Founder results in the deaths of more horses than any other condition except colic.

Diagnosing Founder

I am NOT an expert on Founder, but I want to help owners identify some of the causes and symptoms. The important things to notice in these pictures are the lush green paddock , the cresty necks and extra weight that both horses carry. The owner has spared no expense to give these horses an ideal life. They have a "great" irrigated pasture, a grassy paddock and get the best grass rye hay combo fed twice daily. They are ridden frequently and get the best supplements. They have custom saddles and a devoted guardian.

If this sounds familiar, see SaferGrass.Org . http://www.safergrass.org/ for comprehensive information on hay, grass and pasture management, particularly as it relates to Founder, Cushing's and Insulin Resistant horses.

...

What Went Wrong?

Part of the problem is that these horses have it too good. Susan Evans Garlinghouse, DVM, MSc, who defines herself as a Equine Nutrition and Research Geek and who is respected for her excellent research of beet pulp as a food source, came up with a great Body Condition table: http://www.shady-acres.com/susan/conditionscore.shtml . According to Susan, both of these horses would be somewhere between a 7 (fleshy) and 8 (fat).

The owner was quick to point out that the grass in the paddock wasn't rich because they hadn't fertilized it for years, but she didn't know that anything green is usually "lush" to a laminitic horse. They have a grazing pasture of a few acres carefully tended by her husband that is "rich", and the horses are usually out in it for a period each day.

Mowing this paddock to make it shorter and less available would only stress the grass, increasing the sugars and hazard.



Fancy's Case, First Discussion, Sept. 29 2005

I first talked to Sabra on the telephone for more than an hour on September 29th about her two Arabs, a mare and a gelding. The mare, Fancy, is out of the same bloodlines (Judy Browns Arabians in Livermore) that Cagey, my friends Gravel Crunching Poster Boy, is out of. These are horses that are perfect barefoot candidates, horses known for having great feet .

Fancy had been lame for several weeks when her vet X-rayed her front right foot and blocked the nerves in both front feet but couldn't isolate the source of her lameness. He did notice that her heels were slightly contracted. Both horses were shod until recently by a farrier known regionally as a good farrier. His apprentice, a good friend of Sabra's, took over shoeing two months before the lameness started. I asked Sabra if the apprentice had made any dramatic changes, and she said no, that she was doing a great job.

I explained that contracted heels change a horses gait and can make them sore, but usually not so dramatically lame in such a short time period, and stated that what she described to me sounded like abscesses and / or founder. She replied that her gelding was "sensitive to sugar" but insisted that she understood founder, and she didn't feel it was diet related. More importantly, her vets (from two separate offices) both agreed that it didn't appear to be a diet related lameness. They had X-rays done of the front right foot, and the x-rays looked good.

Sabra made an appointment to have me come pull the horses shoes the next morning. She called early to cancel after talking to her farrier, who had made several unsuccessful attempts to take horses barefoot in the past, and based on her experience, convinced Sabra to at least wait until the ground got soft.

Her farrier's concern didn't surprise me. Most farrier's don't understand what it takes to set up a foot for barefoot comfort; unfortunately their training doesn't cover this very obvious service. Every sound "can't go barefoot" horse I've taken the shoes off of has been immediately sound barefoot, comfortable in paddock and stable conditions, and is able to exercise normally in boots such as Epics. Most don't need the Epics full time after a month except for in emergencies.

Sabra repeated that she wanted to take her horses barefoot and said "You haven't heard the last from me!" Her dilemma was that she really wanted her farrier, a dear friend, to learn barefoot techniques so that she could continue to work with her horses.

I'm thrilled to work with farrier's, but am skeptical because a shoeing farrier invests a lot of time and energy into shoeing and the tools needed to do it, they make more money shoeing, and... well, those of us who really get into the barefoot farrier business quickly realize that shoeing isn't necessary. Her friend would need to go back to school and learn a new trade. That's a tough decision. If a good barefoot trim was easy to do, everyone would be doing it.


October 21st, One Month Later

Sabra called me up distraught that her horse was getting worse, not better.

She said that the vet came out shortly after our last discussion and had determined that the only thing that could be causing Fancy's pain was contracted heels, so he made "deep bleeding opening cuts" into the tissue in either side of her frog between her heel buttresses and has prescribed aluminum 2 degree wedge shoes that had the heel buttress support beveled at 45 degrees to force the mares heels to spread when she weighted her heels.

The mares discomfort continued to build, and Sabra knew she needed to do something to help her mare. She called me as a last resort.

I had a hard time envisioning the shoes as she described them, and asked Sabra what she wanted me to do. "Can you come take them off and let me know what you think? ". I agreed to schedule her for the beginning of the week.

 

October 24th, 2005

What I discovered appalled me...

First off, the mare stood in a very typical Founder Stance, and had all of the physical characteristics of a founder prospect.

She was carrying lots of extra weight, had a cresty neck and was on a green grass paddock and was grazed regularly on a lush green pasture.

When I walked up to inspect her feet, the first thing I noticed was a "founder ring" immediately below her coronet band (picture, right), an indication that capsule separation had occurred.

Opening cuts and beveled buttress support

This mare had been very lame before the vet performed his "procedure"; she was unable to bear weight comfortably on either foot. What was the vets procedure?

He decided that contracted heels were causing her pain, so as Sabra had described, he cut deep into the tissues at the ends of the collateral grooves, drawing blood and making large "V" shaped notches along side her heel buttresses.

Then he prescribed the a 2 degree wedge shoe - elevated 2 degrees in the heel - with a 45 degree heel support "slider" so that the heels would be levered apart if the mare weighted her heels. These would cause discomfort for any horse, but on an already lame mare? The are torture devices

"Are your vets both certain that this isn't founder?" I asked again.

"They took x-rays several weeks ago when her front right was bothering her, and he said there's no rotation. I asked if he could do more x-rays and he said we didn't need them. If I ask for more he'll know I pulled her shoes and I'm afraid he'll be mad that I'm questioning him." she replied.

"Get more X-rays, of both feet this time! This looks exactly like Founder. Use a different vet if you need to. You need to rule out founder."



When I removed the shoes, I discovered that the heel buttress had been trimmed flat. When the flat surface was mailed to the steep slope of the wedge shoes, it meant that all of the mares weight was supported on a thin sliver of heel on a ramp designed to wedge her heels apart.

The shoes and trim were a torture devise the mare couldn't escape from.

My stomach literally turned over. I wanted to throttle the people responsible for this. Removing the shoes also revealed a bulging sole, and my worst fears were confirmed. "Were her feet like this when your vet was here?"

"He said her feet were flat."

"You need to get X-rays as soon as possible."

We put Fancy's new Soft Ride boots on with Supra core pads, and Sabra called her backup vet to arrange for X-Rays.

The next day she called to confirm that my suspicions were correct, Fancy had foundered. Sabra and her farrier are going to take steps to get this mare sound again. Sabra has all the information she needs to make this happen - I wish them well!



Who are the experts??

The sad thing about this story is that Fancy's owner tried to do all the right things. She went to the local "expert", and he misdiagnosed what was happening with Fancy, and suggested a radical procedure that "had helped dozens of other horses". She has a good farrier, but her farrier wasn't able to convince the vet that her suspicions about founder were worth considering.

What are Owners suppose to do in a case like this? The only thing we owners CAN do is to educate ourselves so that we can use our care givers (vets, farrier's etc) as resources, not as our only choices for information and treatment. We turn our horses over to them willingly, so anything they do is, ultimately, our responsibility. We can't expect them to have all the answers all the time. We have a choice of vets, farrier's and body workers, and if you feel one isn't able to provide what you need, you owe it to your horse to look elsewhere.

You don't need to grill your caregivers, but they should understand that you need to educate yourself, that you need to ask questions and request additional diagnostics; you are the one paying the bills. Will that service providers feelings be hurt? Will they get mad? Will you lose their friendship? Hopefully not.

So back to the question... who ARE the experts? I know more about founder than some people, but I don't consider myself an expert.

I feel that the real experts on founder and laminitis are the owners, vets and trimmers who successfully manage horses with founder and laminitis... people who have restored their soundness. If you have a laminitic horse, you need to consider becoming an expert on your horses condition.

Best source for Nutritional Education & Consulting? Dr Eleanor Kellon, DVM at www.drkellon.com 

Dr Kellon is the saint and savior of the IR, Cushing's and Laminitis world... she offers fantastic consulting and super on-line classes in nutrition and feeding special needs and performance horses.

Free Yahoo Groups Provide Information & Support

In order to get the most value from these groups, be prepared to take pictures and upload them, and provide concise information related to your horses feet, environment and diet Here is an example of how to take good pictures.

Dr Kellon's Equine Cushing's group has the highest membership and, I'm told, some of the best expertise you can find. Dr Kellons web site, www.drkellon.com, is the best resource for nutritional information out there!

My Whole Horse Health group has a diverse membership that includes vets, bodyworkers, trimmers and owners, and is focused on the broad range of topics that support horse health.

The third group, Barefoot Horse Care, is a barefoot trimming and equine management group.

Each group has it's resident experts, and everyone is very helpful. Each site has a Links page that lists many valuable resources. Reviewing some of the information and asking the members of these groups for support is the best first step.

EquineCushings@yahoogroups.com http://groups.yahoo.com/group/EquineCushings/
Whole Horse Health email group at http://pets.groups.yahoo.com/group/wholehorsehealth/
Barefoot Horse Care email Group http://groups.yahoo.com/group/barefoothorsecare/

Safergrass.org

http://www.safergrass.org/ A necessity for anyone who is dealing with foundered horses. This site explains how pasture management is a vital consideration for laminitic & foundered horses

Other Founder, Laminitis & Diet Links
Ramey on Laminitis http://www.hoofrehab.com/end_of_white_line_disease.htm#laminitis%20update
Spot Laminitis Early http://equisearch.com/magazines/Equus/spotlaminitis_032305
Bayer Laminitis Page http://www.yourhorseshealth.com/health_care/laminitis.html
DR Susan Garlinghouse on Beet Pulp - www.shady-acres.com/susan/beetpulp.shtml

Laminitis Treatment: Natural Perspective by Joyce Harman DVM and Madalyn Ward DVM http://www.hoofcare.com/article_pdf/HoofcareHarmanWardNat418EC.pdf
Professor Chris Pollitt is the absolute expert in Laminitis:  http://www.uq.edu.au/~apcpolli/
His publications: http://www.uq.edu.au/%7Eapcpolli/chrispollitt_publications3.htm

Finding the right vet

All vets are human, and while they all know about founder, their knowledge may be biased, outdated or limited. Founder is considered a fatal disease because while we know a lot about it, some of the common "treatments" are worse than the disease! Fight founder by informing yourself abd AVOIDING it. Not all vets are founder experts, as this story illustrates, so your best bet is to shop around. As on the above email groups for references and assistance Good luck!