Insulin resistance with founder and Cushings/PPID; poor hoof quality with stubborn white line disease; arthritis; persistent skin infections; history of EPM
I first met this 20 year old pinto warmblood cross gelding in 2022 when he became neurological after worming and, as his owner said, “his soul left his body.” His catastrophic reaction to the wormer turned out to be the result of an EPM infection with both S. neurona and N. hughesi. He was treated and we approached his lack of coordination and absent-ness with a standard neurological restoration and inflammation control protocol. He healed and “I had my horse back.”
In fall of 2024 his owner reconnected. He now was insulin resistant, had Cushings/PPID, white line disease resistant to all correction efforts, and severe chronic foot pain regardless of shoe-ing or booting strategy. His feet would not grow. His arthritis had worsened and he had a skin infection (“scratches”) on his lower legs that would not heal. He was miserable.
Video revealed a laminitic horse who stood parked out to take the stress off his inflamed lamina and walked haltingly with great difficulty. Pictures of his feet revealed the need for urgent corrective farrier work. His front feet displayed classic post-founder laminar wedges with long toes and collapsed heels. This misalignment creates torque on the damaged lamina, generating and sustaining the cycle of chronic pain and non-healing – the feet cannot heal in this misaligned condition.
Remote farrier consultation was used to support the on-site farrier in better management.
His diet was appropriate for a metabolic horse with Cushings/PPID (low non-structural carbohydrates, NSC) but lacked herbal scaffolding to stop his endocrine system from continuing to spiral out of control. Cushings/PPID is a disorder in which the pituitary (a structure in the brain) over-produces adrenocorticotropin hormone (ACTH) with the consequence that the adrenal glands, which are the target for ACTH, are driven to over-produce cortisol. The bodily changes associated with Cushings/PPID are believed to result from excess cortisol – the hay belly, muscle wasting, curly coat, and suppressed immune system. In horses who also have elevated insulin, uncontrolled Cushings/PPID exacerbates insulin elevations and the two together are major promoters of persistent foot pain. This synergy is why in metabolic horses with Cushings/PPID it is critical to bring values for insulin and ACTH into normal range.
An herbal supplement that is effective in lowering insulin and ACTH levels was recommended.
In horses with chronic foot pain, gut acidosis can be a potent trigger for greater pain. Gut support that targeted acid buffering was added. Supplements that control inflammation were added to his regimen to reduce foot pain and arthritis aggravation. A supplement that supports maximum hoof growth also was added.
But the critical issue for this horse was correct foot alignment – one cannot medicate or supplement away the pain in foundered feet with serious imbalance. Every step the horse takes on those feet further irritates the internal foot structures. Foot balance MUST be fixed. And to accomplish correct foot balance, one needs access to either a farrier expert in founder rehabilitation or a less experienced but open-minded on-site farrier willing to learn. Kudos to this gentleman’s farrier – she was willing to take advice and her thoughtful work made a huge difference (see hoof pictures).
What happened? His foot comfort steadily improved with reshaping and he became sound in his paddock without shoes or boots. He was started on long hand walks wearing boots and stayed sound. The white line disease receded as did the skin infections.
The videos tell the story.
The first video is from September 2024 when this gentleman could barely walk.
The second video is from January 2025. As his owner says in the video, he had not been able to run and buck like this for two years. He actually runs right out of one of his boots.
Two years of running and bucking pent up… now released….