Saturday, May 25, 2019

More on Laminitis—The Benefits of Vigilance

By Connie Paschall, RN

We really enjoy having Connie and Dexter with us at the Farm, and appreciate her expertise as a registered nurse—she will be co-leading a first aid class in our upcoming "All About the Prep: Safety and Readiness for Rider and Horse" camp. This is a very timely and interesting article which adds another useful tool to our equine health toolkit! -MG

Author’s note: 
The Wise Horseman at Freedom Farm monthly blog posts well-researched, timely tips and tricks for the care and training of our horses. How many read and practice the wisdom sent to us for free...? Well, I do. Allow me to add my story to the thread of articles here on grass laminitis prevention [select ‘laminitis’ from among the tags at right to call up the articles - ed.] -
  1. The action or state of keeping careful watch for possible danger or difficulties.
I have a dream. My dream is to have my horse Dexter out in a pasture, frolicking with friends and living a horse’s full life. However...

Connie and Dexter
Dexter is fat. Everyone knows Dexter is fat. Well aware of the risks associated with such an easy keeper, I regularly monitor for cresty fat along his neck, puffy deposits at the base of his tail, and changes in his coat. He has been clear of these signs for long enough that I recently decided to let him transition into pasture with a nice group of geldings, and all seemed well. Dexter liked his new situation and showed none of the signs of imminent grass laminitis. Then one day I checked his pulses and felt a strong, bounding pulse in his right foreleg—not a good sign.

So what’s this about checking pulses? Let me digress:

A practice—grooming as health check. When I was a child, learning horse care through the local pony club, we were taught that the most important part of grooming had nothing to do with a shiny coat and flowing tail. Grooming included a daily health check. I was taught to cast off my gloves and run my bare hands down each leg to feel for heat, lumps, bumps, and the digital pulse. I have made it a habit ever since, every time I see my horse.

Checking digital pulses refers to using your fingers (digits) to feel the pulses in the lower leg. As a regular practice, it is a very important horse health management tool which helps you identify pain or inflammation in the hooves, and potentially larger issues affecting your horse.

When taking digital pulses, you are feeling the blood flowing through the artery going into the hooves.  If there is inflammation in the hoof, then the blood flow is restricted and backs up in the artery creating a “bounding pulse”—the stronger the digital pulse, the more inflammation in the hoof. Sources of inflammation vary— injury, infection, a developing abscess, laminitis, etc.—but the bounding is a red flag that says, look closer.

Faint pulses are normal. It’s also normal not to feel any pulse at all. Don’t worry, it’s in there doing its job. Also, there can be some natural variation in pulse strength in different legs.  Horses are individuals, so checking pulses every day will help you learn your horse’s normal.

A bounding digital pulse is a red flag. The sensation to the horse who has a bounding pulse is comparable to a throbbing headache or an injured finger.  It is not an increase in the speed of the pulse, but rather an increase in its strength. A slightly stronger pulse is a concern; a strong pulse is an alarm.

Check again. If the pulse seems stronger than normal, make sure to check a few times before assuming something is wrong. Compare pulses in all four feet; compare pulse strengths against each other. Check all hooves for heat. Taking time to compare and contrast between legs and feet will make any abnormalities more apparent.

Stronger pulses in more than one foot indicates the possibility an even bigger problem: Your horse may be showing the early onset of laminitis—such as in Dexter’s case.

Back to my story—checking Dexter’s pulses.  On the day I discovered a problem with Dexter’s pulses, a bounding pulse was the only sign that something was going wrong. His right foreleg had a very palpable, bounding digital pulse, which, I thought, might be an abscess brewing. But as I made sure to compare all legs, I noticed that he also had a palpable, but comparatively weaker digital pulse in the left fore leg, which made laminitis more probable. I could not feel his hind leg pulses (which, remember, is normal).

While I was at it, I took Dexter’s heart rate and found it to be mildly elevated. Pain tends to elevate the heart rate, so I had one more data point. But I was relieved to note that, while he had heat in the right hoof, he was not lame and did not exhibit the classic laminitis stance—splayed legs, lowered head.

So in consultation with Mary Gallagher, I moved Dexter out of pasture and back to a dirt pen. Next I iced his hooves, gave him an anti-inflammatory, and called the vet. Mary also suggested he fast for 48 hours.

Dexter improved rapidly. The next day, his feet were cool and the pulses could not be felt. Whew! We had dodged a bullet, thanks to a habit taught to me as a child.

On that note, I conclude with:

How to take a horse’s digital pulse.

You may take the digital pulse in five locations between the suspensory ligament and the flexor tendon. Pulses may be felt from both the inside and outside aspects of the limb. Pick a favorite and stick with it until you are comfortable with the procedure.

Tips and tricks.
  • Use the flat tips of two or three fingers and slide from front to back until your fingers are in the groove created by the suspensory and flexor tendon. Your thumb has a pulse, so to avoid confusion, use your fingers.
  • Hold your breath and feel for at least 15 seconds. A resting horse heart rate is between 30 and 40 beats per minute and may be missed if you move around impatiently.
  • Check all pulses to determine if the strength of the pulses have different intensity. This is a diagnostic finding and valuable information to the vet.
  • Take a moment to determine heart rate while you’re there. Count the pulse for 15 seconds and multiply by four. Even a small increase in heart rate can indicate pain.
  • Check for heat by placing hands on two hooves simultaneously to detect subtle differences in temperature.
Daily vigilance saves the day!
Happy riding, from Dexter and Connie
Connie and Dexter take the most interesting walks...

Final note:
Two Wise Horseman blog posts which inspired Connie to share her story:  a case study of a gelding with insulin resistance who got severe laminitis, and a note about what to watch for in spring.


1 comment:

  1. Wonderful article Connie. Thanks for sharing your knowledge.