Bonita: A Holistic Approach to Laminitis
When I built my new place in Fischer, Texas I expected to have the occasional overnight horse guest but I didn't plan on having hospital patients . that is, until I started helping Dr. Lu Ann Groves with a few laminitis cases at her barn in San Marcos. It was then that I realized just how much I missed working hands-on with these horses. Not long after, I had my first laminitis patient at my new place, a mare named Bonita. This article contains the first half of Bonita's case, which is complex and demonstrates just how difficult laminitis horses can be to treat. Be looking for the wrap up of Bonita's case in a part 2 article. I hope this case gives owners of laminitic horses the understanding that complex cases can be successfully treated with a holistic approach, and also that all aspects of the horse's health have to be considered when dealing with these kinds of cases.
Monday, September 29
Bonita had been under treatment by another clinic for about six weeks prior to arriving at my clinic. She had been treated with bute, acepromazine, isoxsuprine, gastrogard, and heart bar shoes with little improvement. When she first arrived I felt she needed both aloe vera and slippery elm for her stomach because she was very tight in her flanks and abdomen. I mixed the herbs with the probiotic acidophilus and gave the combination to her in a syringe. Bonita was not at all interested in the low-carb feed I offered so I mixed her a small bran mash, which she liked.
I know many people believe bran is terrible for laminitis cases because it has a high ESC (sugar + starch) but I have used it for years with wonderful results in all but the most extreme IR cases. Even though bran is high in ESC it also is high in many nutrients such as chromium, magnesium, manganese, and silica which all support carbohydrate metabolism.
Tuesday, September 30
Bonita had foundered on mesquite beans and interestingly she was worse in her back feet. I was pleased to see that the swelling had gone down and she was moving better. She had had 2 grams of bute on Monday morning but none since. I kept up the acidophilus, aloe vera, and slippery elm, and also added Q10. She was now hungry and eating the low-carb feed very well. I fed her the low-carb feed in 5 small feedings and she ate everything. I also gave her a very small bit of alfalfa and a couple of small bran mashes because the weather was so dry and hot.
Wednesday, October 1
This morning Bonita was not doing as well. She was holding up her right hind, which was her worst hoof. As I was standing on my head filing the clinches so I could remove the heart bar shoe on that hoof, I began remembering some of the less exciting aspects to working with laminitis cases (like removing shoes!).
I spent about an hour trying every boot and pad I had on her bad hoof and I trimmed it carefully to see if there was anything that gave her relief. She was actually happiest with no boot or pad and with her heel trimmed down. I put a poultice on the foot without a boot. My feeling was that I had to get her feeding program adjusted before I would see sustained improvement in her feet. I already had blood work showing that her glucose was high but was waiting to get the other test back to see if she was IR, Cushings, or both. I suspect I overfed her a bit on Tuesday. I gave her a dose of Thuja.
Thursday, October 2
Bonita was still sore and unfortunately the swelling her legs had returned. I focused on feeding her less and giving her more of the aloe mix directly in her mouth to support her digestion. I did not want her to lose weight or reduce her calories since this would only drive the IR. I also had water in buckets all over the pen so she would not have to walk far to drink. She had free choice hay but she was not eating as much as she should to meet her needs. Her manure looked fine so I was not worried about her being dehydrated. She had shade but preferred to stand in the sun. She did not eat very well but moved around a bit more than before and did not seem quite so painful.
Friday, October 3
Bonita had stabilized by this morning. I suspected the bute was clearing her system the two days previous. I worked up her case and started her on Apis 6c four times a day. I also added some KLPP to her probiotic, aloe vera, and slippery elm mix. She still did not drink as much as I would have liked and she got insulted when I added water to the tiny bit of low-starch feed I gave her. I also added a bit of Mg. I had just filled my barn with hay and was waiting for the tests to come back. I was very concerned that Bonita was not eating and that her glucose might actually be dropping too much, so I mixed her a pack of New Earth Bluegreen Algae diluted in XanGo juice. This seemed to jump start her system and she ate more hay than previously.
Monday, October 6
Bonita had finished flushing the bute out of her system and she was eating and drinking well. I kept her on Apis and moved her up to 30c twice a day. The swelling was down in her back legs so I considered stopping the Apis.
Her manure was a bit firm so I added some black sesame seeds to her low-starch feed and scored some Ontario dehydrated timothy hay pellets for her, which I gave in addition to her hay. She was not overweight and as a matter of fact was on the thin side so I wanted to make sure she got all the calories she needed each day.
I continued to focus on her digestion so she got aloe vera, slippery elm, KLPP, and New Earth Bluegreen Algae. I had her on Q10 and Xango for inflammation and considered adding wheat sprouts. Bonita did lay down over the weekend for a few hours so I was very happy about that. She moved around very slowly and when she stood she still lifted her back feet up high and shifted her weight. However, she had been doing this when she was on bute so I was not too concerned.
I did a Bowen bodywork session on her over the weekend and I worked on slight trimming changes on her RH. I have not been able to get the shoe off the LH yet.
October 10, 2008
Bonita slowly got better. She became very picky about her supplements so I felt her system was not able to do much cleansing yet. I did Bowen on her every few days to help keep her circulation going since she was not moving much. Her overall attitude was better and I continued to look at changing her supplements to see what she liked. I tried some apple cider vinegar to see if it would help clear her liver since she did not want the Q10 or sprouts. She also did not like her cubes wet so it was hard to get her to eat something she did not want. I gave her Nux Vomica 30c twice a day again to help her clear her liver.
October 27, 2008
Bonita has been a real challenge but she improved slowly. The Nux Vomica seemed to help a bit but I did not see much change from the apple cider vinegar. I went back to the Apis when some swelling returned in her hind legs but did not see any change. She continued to hold her hind legs up and did not want to move much on her own. Her appetite improved after she made it through the clearing of the bute but she continued to be picky.
I could not see a clear homeopathic remedy so I looked more to the nutrition to get her healthy enough to give me some clear symptoms. I offered her a Chinese herbal formula to help clear her liver and support her spleen. To my pleasure, she took this formula very well and after 3 or 4 days was moving a bit better and not picking up her legs. She was still not doing as well as I would have liked and the swelling in her lower legs was persisting. I gave her one dose of Sulphur 200c and began to decrease the Chinese herbs.
Within a few days Bonita was much better and I was able to remove the shoe on her left hind and put boots on her. I opened her gate and she went right out and walked over to the fence by the other horses. I was thinking we were finally on the mend when she started holding up her feet again.
I had received the ACTH test back and it was 3 times normal but she had been doing so well I did not start her on any Pergolide. With this last setback I felt it was time to give Pergolide a try. If she had a pituitary tumor I felt I might not be able to help her enough with homeopathy even if I got the correct remedy. I think her response to the Sulphur was curative because her overall attitude improved but if the pituitary tumor was causing steroids to be released into her blood then this would override the homeopathy.
Two days after starting Pergolide Bonita seemed a bit better. I still had her on the low-starch feed from Aussie Logic, the timothy balance cubes, coastal hay, 1 pack Essentials, 4 Relaxed Wanderer herbs, aloe vera, slippery elm, and 4 enzymes a day. Her appetite was very good so I assumed her digestive tract was doing well. She did not shift as much on her feet but did not venture out of the pen again. The swelling went down on her hind legs after she started moving much more after the Sulphur and has stayed down. I was very optimistic about her being able to recover.
As you can see, working with a case like Bonita's can be very complex. Yet, it's still possible to use a holistic approach to improve the quality of any laminitic horse's life. Watch for next month's article on part 2 of Bonita's Case.
About the Author
Madalyn Ward, DVM, owns Bear Creek Veterinary Clinic in Austin, Texas. She is certified in Veterinary Homeopathy and Equine Osteopathy.
Memberships include American Veterinary Medical Association, American Association of Equine Practitioners, American Holistic Veterinary Medical Association, Texas Veterinary Medical Association and the Academy of Veterinary Homeopathy.
She has authored several books and publishes at her blog.