Winter Foot Pain In Equine Insulin Resistance

A. Many reasons why this occurs:

1. Cold Stress - Almost all of these cases of foot pain occur where it is cold. These cases appear to be slightly different from warm weather Laminitis flares in that they require a longer period of time (usually three weeks) to resolve but have less severe radiographic changes - we are investigating why this occurs.

a. We see most cases between Thanksgiving and Christmas: November 24 - December 25.
b. Hard ground/frozen mud/rocks protruding up encased in icy ground contribute to this problem - possible Allodynia of past Laminitis (makes overly sensitive feet) plays a role because its not all horses. These horses walk on rocky areas as if it is broken glass, while others are having no problems.
c. Cold causes stress, so Cortisol increases. Cortisol interferes with Insulin causing Insulin levels to surge to overcome it.
d. Less grazing - less continuous eating so there is more changes of Insulin rebounds on re feeding. Fasting times between meals increase, so as re fed, Insulin levels surge way beyond usual amount. Its like giving a shot of Insulin and the high level leads to Laminitis.

2. ACTH Seasonal Surge - in horses, as daylight shortens between September and December, ACTH hormone goes up. ACTH interferes with Insulin so Insulin levels surge trying to overcome it. Insulin Resistant horses are already on the brink and the added Insulin puts them over the cliff.

a. Cushing's horses with already high ACTH get a surge of ACTH on top if it and, again, over the cliff. Whether Pergolide can control seasonal surges is unknown. Many clients will up the Pergolide during this time to try to avoid a problem.
b. On horses we test, the ACTH has been normal! When we see them, the seasonal ACTH surge is over. Our theory: The cumulative ACTH surge of three months leads to problems, but when we test, the surge is over by then. We are working on trying to resolve the true cause. We can not rule out ACTH as a problem, but we can not say its the ultimate cause.
c. Combo Cause - The cold stress plus ACTH surge plus underlying Equine Insulin Resistance gang up to make the problem. I'd bet on this.

Heiro™  Stops Winter Foot Pain.

 

B.  What to do?

1. Go on Heiro™ twice a day for ten days, then once a day in usual schedule.

2. What we have had luck with:

a. Stall confine seven days - even if ok in three, keep in seven days.
b. Protect feet - packing with impression material, Soft Ride boots....
c. 1000 pound horse: One (1) Bute Tab in the morning and one (1) Bute Tab in the evening for three weeks in a row.
At the same time, one (1) Equioxx full tube in the morning and one (1) in the evening for seven days, then one (1) in the morning for the next fourteen days.
d. Avoid Black Hole - we have had a lot of improvement in ten days, and then I pulled off medications and two days later they got lame again and it took a long time to bring them back. Avoid this problem I had.
e. Radiograph front feet on day 1.
f. Farrier consult on radiographs, medications. Get their opinion of foot condition and their past experience with the horse - day 1.
g. These winter foot pain cases take a longer period of time to put out the fire, but thank goodness seem to go on and do well after.

Owners often ask about using Previcox Tablets (57 mg) in place of Equioxx Paste. Owners point out it is the same strength of Firocoxib, and is made by the same company but is more economical than the Equioxx. We recommend owners talk openly and directly to their Veterinarian.