Warning on Nitroglycerin ointment: You can do more harm than good if you use nitro on a stalled horse. Anything that increases blood flow into the feet, such as nitro, or the type of trimming I am advocating, must accompanied by the horse being kept moving. Long periods of inactivity in a stall, or being allowed to be left laying down for hours on end, can result in more blood pooling in the feet and possible re-foundering.
Also--if you have low or normal blood pressure, getting this stuff on your hands can make you faint. It is something to reserve for emergencies only.
Correspondence re nitroglycerin ointment;
|Re Nitroglycerin ointment--I have long been interested in this
as something that can stop an acute founder attack dead in its tracks. Two posts I
received on founder from Nanette Chastine:
Subject: Re: Founder
Now here is the interesting part: One thing that our veterinarian has discovered that we keep on hand, is nitroglycerin ointment. Research has found that a small amount placed on the arteries in the feet (the ones where you feel for the pulse in the feet), immediately upon onset of founder, can arrest the founder within about 10 minutes. The nitro will open up all of the blood vessels, allowing the toxins to be removed quickly. The pain will almost immediately increase to begin with since everything had been constricted before the nitros application. However, the horse will revert back to normal stance within a matter of minutes. Unfortunately, this doesn't work on chronic founder cases or cases where the onset of founder is well established. If you want more information on this, I can send you the name, address and phone of my vet, and you can get your vet to contact him.
Well, need to go, hope to hear from you again.
I have put out some queries on the internet about laminitis, and got back some interesting responses on nitroglycerin ointment being able to knock out an acute attack in 10-15 minutes by addressing the real problem, a lack of circulation. There is more pain for a couple of minutes as the arteries begin to open up, but then they get much more comfortable, and it minimizes damage. The ointment has a very quick, brief and local effect. You rub it onto the coronary band. I was looking for a magic bullet to have on hand if Max has another founder, and this sounds like it may be it. This stuff has to be given immediately, within the first day of acute founder. Not much use later on, but great if you catch it in time. I am enclosing a copy of Nanette?s post to me. I called her vet. They are in the Atlanta, Georgia, area. Her vets are Dr. Hancock and Dr. Marcella. I spoke with Dr. Marcella. He prefers to give ketoson i.v. prior to putting on the ointment to kill the very transitory pain from the rapidly opening arteries. This pain is similar to the pain you feel when you warm your half-frozen hands up after getting inside from a really cold day. He tells me there is still controversy over how often you use it, and whether to shave the hair off first. Also that some people were administering it i.v., but he thinks the ointment giving a local effect is all you need and less traumatic.
He also suggested that I have Max tested for a pituitary adenoma, the tests being ACTH and DEX Suppression tests. This tumor causes elevated levels of cortisone in the blood. Other signs: proclivity to laminitis, low thyroid, longer curlier winter coat that is slow to shed, higher urine output, some loss of muscle and vision, tougher cases of rain rot, and a pot belly. He just said these signs keep getting worse slowly over a long period of time. The drug he uses to treat it, Permax, reverses these signs and makes them less founder-prone. This stuff is expensive, though--$100/month.
Anyway, the pertinent phone numbers: Chapel Farms Arabians--770-253-0355 Vets (Dr. Hancock and Dr. Marcella)--770-945-6001. I am also sending copies of a couple of other responses to my query on nitroglycerin ointment. I got a response from a German equine vet who uses the ointment in conjunction with a lot of other drugs. He puts it on a different spot. His approach also sounds rather involved, and not something you could attempt on your own. This was bad news, really, as I had hoped I could have something on hand that I could use immediately. Being out in a remote area, I can't just get Indian Creek out at a moment's notice, which is something I miss! I am still hoping for a magic bullet. Dr. Marcella also feels that the autumn grass is almost as bad as the spring grass, which I did not realize. This amounts to a whole lot of confinement for my poor old moose! Marcella thinks keeping the paddock mowed, and feeding lots of low-carbohydrate hay, would be good as well.
Below are two posts I received from a German vet who uses Nitroglycerin ointment in conjunction with many other drugs. Nanette's experience is that the nitro will work all by itself, though.
Subject: Re: Nitroglycerin ointment--Rx for Laminitis?
I am using Nitroglycerin ointment ("Neos-Nitro" , human med. preparation) on several laminitic horses during acute episodes with seemingly good results as an additional therapy. I am applying the ointment at the level of the prox. sesamoids bid over the vessels. With shaving the hair off I will get a skin reaction after about one week such that I have to quit - at least with the ointment I am using .
C. A. Bingold, DMV, Fachtierarzt f. Pferde
Sorry for not answering for such a long time. The excuse is my moving to a new
practice area near Frankfurt, Germany. I stick pretty much to the protocol described
at the original publication in the Equine Veterinary Journal sometime early last year
(1996). I do shave the area over the vessels at the level of the proximal sesamoid bones
and apply a 5cm string of the ointment medially and laterally on both forefeet bid. To
keep the ointment out of the bandage material I cover the ointment with plastic foil. This
will be repeated as long as the skin tolerates it - usually about 1 - 2 weeks.
Basic therapy for an acute case is as follows:
I look at Nitroglycerin as an additional beneficial building block of my therapy. Alone - as the other pharmaceuticals also - it will not have much effect. If I get acute cases without much previous damage to the hoof within the first 24 hours, they are mostly under control after one or two days. The treatment will be continued for at least 1 week, in most cases 2 weeks or depending on the changes longer.
Cortisone: NEVER USE CORTISONE IN LAMINITIS!!! Cortisone is absolutely contraindicated in laminitis. It aggravates or in certain instances causes laminitis.
Christian A. Bingold, DMV, Fachtierarzt fur Pferde
Here is another response to my query on nitroglycerin ointment:
Subject: nitro from Rivas
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