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Case Study - Recurring Laminitis
Horse’s name: Touché
21 year old mare, DOB 4-21-79
½ Arabian, ½ Quarter Horse
14.2 HH
1050 lbs. approximately
Same owner since 1980
Primary use: as a back yard pleasure horse and lesson horse
First episode of laminitis: attending veterinarian Kevin May, DVM
Second episode of laminitis: attending veterinarian Kim Sergeant, DVM
NitrOxide
In the fall of 1998 Touché had colic surgery and an ovariectomy.
Two days
post-surgery she developed salmonella and 6 days post-surgical developed a
totally occluded thrombosed jugular vein. Touché was released to go home eight
days later. Approximately 3 months post-surgery Touché developed acute laminitis
in both fore feet with grade-4 symptoms. Touché was unable to walk without
forcing herself. Both fore feet were hot to the touch with strong digital pulses
medial and lateral. Her hind feet were negative.
The treating veterinarian, Kevin May, DVM, recommended Bute, Acepromazine twice
a day, and Banamine as needed for pain. Touché was fitted with Ric Redden
Ultimate Shoes on her fore feet, which were both causing her very noticeable
discomfort. A laser (850 nm Thor DD) was used daily to stimulate all acupuncture
points surrounding the coronary band. The Thor Cluster Probe with a 69 diode 950
nm 15 mw output was applied on both sides of the fetlock and on the heel and
front of the pasterns. Laser treatment was followed by electrical stimulation
administered using the Theroquine Electrical stimulator for 45 minutes on each
pastern daily.
Laser and electrical stimulation was administered by the San Diego Equine
Therapy Center. Treatment lasted for 30 days and resulted in an absence of any
detectable pulses within 60 minutes of each treatment. However, pulsing would
return the day following each treatment.
The Ric Redden Ultimate Shoes were re-bandaged in place daily. After
approximately 30 days, as the pulses decreased, therapy was reduced to every
other day, then every third day as pulsing ceased. Pulses were checked a minimum
of four time's daily for a period of approximately three months total. If
pulsing was detected, laser treatment and electrical stimulation treatment was
administered.
After approximately six weeks, the Ric Redden Ultimate Shoes were replaced with
reverse shoes with two wedge pads. After pulses stopped completely the pads were
reduced to one wedge and six weeks later were changed to a reverse shoe.
Radiographs were taken two weeks post-onset and again at eight weeks post-onset
by Gary Amaral, DVM. Radiographs showed zero rotation in either foot.
Touché’s diet at onset was changed from Alfalfa Bermuda mix to Bermuda Hay only.
The mare initially was in such pain and so depressed that she would not eat.
Alfalfa was slowly introduced back into the diet as she slowly progressed.
Touché was considered to be at a good weight and in good condition therefore
weight loss was not considered. She was housed in a deeply bedded barn stall for
comfort.
While Touches' laminitis appeared to be resolved, she never became fully sound
again. She was able to do very little exercise, hand walk, hot walking, or turn
around in very soft paddocks. While radiographs were negative of any
abnormalities, she continued to show discomfort, especially on hard and even
surfaces.
Second Episode Of Laminitis
On March 1, 2000 Touché’s head begin to swell around her right eye and cheek.
This edema would increase and decrease each day and did not appear to worsen.
Touché’s veterinarian, Kim Sergeant, DVM felt that a thrombosed right jugular
vein was the cause of the swelling. In April 2000 Touché’s head began to swell
on the right side to such an extent that this ½ Arabian mare had to wear a draft
size halter. At approximately the same time, Touché’s farrier had recommended
putting the mare’s shoes on normally.
Within a day Touché then suffered another bout of laminitis. She was a grade-3,
reluctant to move, with bounding digital pulses medial and lateral on both fore
feet, which were very warm to the touch. It was considered that her shoes were
causing her pain. Therefore, her shoes were gently pulled, toes squared off and
Ric Redden Ultimate Shoes taped back in place. However, this time there was no
noticeable pain relief.
Bute was given twice daily and Banamine IM for pain. Dr. Sergeant ran a full
blood panel and prescribed thyroid powder for a slightly low-functioning
thyroid. Laser and electrical stimulation therapy was applied as before, but
produced little decrease in pain or pulses.
After three days with no relief and symptoms worsening, ice therapy was
introduced. Touché’s fore feet were kept in ice water for 20-minutes at a time,
followed by 30-minutes out of the ice water, for up to eight hours per day. Ice
water therapy was able to provide some pain relief. Laser and electrical
stimulation therapy were also administered. Pulses would diminish or decrease
each day by evening, but would reoccur just as strongly the following day. The
mare became very depressed.
Due to the thrombosed right jugular vein and the increased swelling of the head
and face, Bute and Banamine IM were reduced. Ketofen was administered, but did
not seem to make Touché any more comfortable. Kim Sergeant, DVM took ultrasound
readings of the right jugular vein to assess blood flow and found it to be
massively occluded with essentially zero blood flow. Dr Sergeant also took
radiographs of both front feet and fortunately there was zero rotation in either
foot. Due to Touché’s substantial pain and increased depression, both the Bute
and the Banamine IM were increased. However, in addition to the the right-sided
swelling of Touché’s head and face, the left side of the mare’s head now also
began to swell.
At this point, nothing seemed able to halt Touché’s rapidly failing health and
depression. We felt helpless to stop her continuing downslide. Touché became
totally reluctant to move out of her ice water. While on a break out of the ice
water, she herself would replace her feet in the ice water. Her appetite began
to decrease. At this point euthanasia was seriously considered.
Response To NitrOxide
On April 26, 2000 we decided to try a new nutritional supplement called
NitrOxide. NitrOxide is a specially formulated combination of nutrients designed to improve
blood flow by promoting the body’s production of the vasodilating substance,
nitric oxide. NitrOxide is an all-natural product that contains no herbs,
hormones, stimulants, or drugs.
30cc of NitrOxide powder together with 1-ounce of water mixed to the consistency
of slurry in a 60cc syringe, was administered orally on the evening of April 26,
2000 on an empty stomach. All feed was held for approximately 60 minutes
post-dosage. Touché at this stage was barely able to move from her hay to her
water.
At 6:00 a.m. on April 27, 2000, 12-hours after receiving the first serving of
NitrOxide, Touché was found standing in her stall, her hind legs relaxed, and
comfortably bearing her normal weight on her front legs. She walked up to her
hay and walked around the stall almost normally. Her feet were no longer warm
and pulses were absent in both fore legs. A second serving was administered at
that time on an empty stomach. No other treatment was given that day or the
next. Pulses were checked around the clock with zero pulsing detected.
NitrOxide continued to be administered twice daily at 12-hour intervals on as
empty stomach as possible. As of today May 5, 2000, Touché has not had any Bute,
Banamine IM, Ketofen or any other painkiller since April 25, 2000.
Touché continues to wear Ric Redden Ultimate Shoes taped to her feet. On April
29, 2000 she was active enough to knock off one of the shoes, as a result she
had mild pulses on that foot. The NitrOxide was administered and laser therapy
was applied to the acupuncture points around the coronary band and simple ice
packs were placed on each foot while the other was being treated with laser
therapy. Immediately following laser treatment, all pulsing stopped and was not
detected again for two more days.
Upon the return of pulsing, laser treatment was applied in mid-afternoon,
following which pulsing was reduced, but not completely eliminated. NitrOxide
was administered that evening and within 15 to 20 minutes, pulsing was
undetectable.
Due to Touches' fiery disposition she is not a quiet patient when she is feeling
well. While still confined to her bedded stall she is a weaver and pacer and has
been bucking in place. Her activities have caused her to tear off her Ric Redden
Ultimate shoes numerous times, sometimes with mild pulses returning. However,
with the administration of NitrOxide and simple laser therapy, 20-minutes after
receiving NitrOxide, pulsing has diminished completely. At times it has seemed
as if she is in less discomfort than she continued to display between her first
and second attack of laminitis.
Prior to using NitrOxide I was beginning to feel like we were losing the battle.
Therapies that had worked so well during my mare’s previous attack of laminitis
were not effective enough. This time Touché was in such great pain and so
depressed, I began to feel nothing but euthanasia would stop her suffering.
We were graciously offered the product NitrOxide and Touché’s response was
nothing short of miraculous. Within 12 hours of first receiving NitrOxide Touché
was pulsing-free and found walking comfortably around her stall.
In the last 30 days Touché has not been given any medications or supplements
other than the NitrOxide. She is now bucking in her stall eager to get on with
her life.
Dana Meir
San Diego Equine Therapy Center
The photo of Touché taken after treatment with NitrOxide. A
"before" picture was not taken since euthanasia was seriously being considered
prior to administering NitrOxide. Touché was started on NitrOxide on April 26,
2000. This photograph was taken in August 2000.
NitrOxide™
2 lb. Tub
(30 day supply): $169.90
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