Welcome to Acu in Practice! This case is presented by guest contributor Dr. Katja Görts. Meet Malibu, a 20-year old Connemara pony gelding who had his first and severe laminitis episode in Dec. 2018 after galloping around on a frozen pasture. The onset was delayed.
He was diagnosed and treated immediately by his regular vet, who put on a cast after the lameness was progressively getting worse, even under optimized medication. The farrier had already tried “roller” shoes, but those made the situation even worse. Active rotation of the coffin bone was confirmed by two series of radiographs taken seven days apart. When I first saw Malibu in Jan. 2019, the laminitis had already been going on for four weeks. Malibu could barely walk. He had ++ pulsation on both front limbs, worse on the left side. His hindquarters were drawn underneath his body to shift weigh away from his front legs. His thigh muscles were tense and shaking. His lumbar area was feeling cold and also tense. The comb of his main was thick, hard and very stiff. He had fat deposits at his main, shoulders, at the side of his rib cage, in the lumbar area, on the base of his tail and periorbita region. In addition, Malibu had always had a tendency to be obese.
His pulses were deep, tight and weak with a slippery and strong wiry component. The tongue was big, swollen and lavender with darker spots, especially at the sides. It had teeth marks and was kind of stiff and wet. The Jing Well Points of the front limbs were empty and sunken in. The temperature of the hooves was evenly warm on all four feet.
Malibu’s conventional diagnoses: 1. Subacute laminitis 2. Suspected Equine Metabolic Syndrome (EMS). Though his blood values for glucose and insulin were within normal limits, all clinical signs were hinting to this.
Malibu’s TCVM diagnoses: Severe Qi- and Blood-stagnation with Heat (pain and laminitis) SP-Qi-Deficiency with Phlegm (fat deposits, suspected insulin resistance, impairment of the blood-vessel tight junctions in the feet).
Malibu’s first Acupuncture treatment mainly included points to resolve Qi- and Blood-stagnation + Heat: the Four Gates (LI 4 + LIV 3), LI 10, ST 36, and Bl 60 which also supports his lower back. Points were added to tonify the Spleen and Kidney: SP 21, ST 36, LIV 13, BL 23. Malibu was prescribed a TCVM formula for laminitis (Hot Hoof I by JingTang Herbal) as well as a single western herb to help his kidneys excrete the end products of inflammation and drug metabolism.
In agreement with the regular vet, the owner was advised to stable rest the horse and put him on a strict diet to reduce his weight and to help with the insulin metabolism. NSAIDs were reduced to the minimal needed dose to encourage the horse to lie down and get weight off his feet.
To be continued over the next 2 weeks…please stay tuned for parts 2 + 3!
This post is created by Nell Ostermeier, DVM, CVA, FAAVA and features a case written by Katja Görts, DVM, CVA, CVC, CVCH. The content is intended for informational use, not to replace medical advice. *Two of the attached photos (headshot and standing by fence) are from around the time of the first treatment.