Thursday, December 4, 2008

Understanding the Relationship Between Colic, Laminitis and Founder.

Some of you have asked me questions that I’m going to try clearing up. To explain this topic in the best way I know how, I’m going to take you back and forth in time a little bit. My time! Just warning ya. Hang on and when you come to the end, you should have a way better understanding of these conditions. If not, let me know what the sticking points are and I’ll try to do a better job in a later post.

Is colic and founder the same thing? No

Can colic lead to founder? Yes

Does founder mean certain death for a horse suffering with it? No

Is shoeing and stall rest the cure for founder? No, not in my opinion and in fact the exact opposite of what we should do.

Clear as mud? Keep reading, it gets worse. Just kidding.

Colic, as most of us know, is another term for bellyache. That’s pretty simple. When a human baby get colicy, we’re simply saying, he has an upset stomach.

So now I want to share a story with you about how confusing the terms colic and founder can get you into serious trouble with your horses and why we all should know the difference.

About 13 years ago, I was just getting back into horses and I purchased my mare, Missy. Before that, I didn’t have much involvement with horses for about 10 years and I never really had a good understanding of colic and founder and had never heard the term laminitis back then. If I did, I let it pass as a complicated thing I would probably never need to know about anyway. I was wrong about that and if that line of thinking sounds familiar to you, please read on.

Me and Missy in 1998

One afternoon, Missy began showing signs of a bellyache.

Now this wasn’t my first experience with colic. My last horse that I lived with back in 1979, was an Appy gelding named Joe. He had gotten into the grain barrel and ate about 25 pounds of sweet feed. (Yes, sweet feed…I know why not just feed them a carton of Hershey bars every day.)

Joe and me in 1979 (Don't laugh at the tack, it was the 70s.)

I came home to find him thrashing around on the ground. Scared out of my wits, I called the vet, I was told to keep him walking. So I walked with him most the night, crying and pleading with him to get up every time he tried to lie down. I blubbered things like, “Don’t you die on me!” It was a very dramatic and overwhelming situation that I will never forget.

Later I was actually told by other horse people including my farrier at the time that my horse had foundered. He hadn’t foundered, but this advice created further confusion of the terms in my mind.

At the time, I didn’t know it would have been okay for him to lie down, just not to roll while he was down there. I made that poor boy walk for hours, but he got through the episode with no further complications that I was aware of. He was a lucky boy and walking him was the right thing to do.

He was also fortunate not to have twisted his intestines when he was thrashing around on the ground. That can happen when they are allowed to roll around on the ground in an attempt to relieve the pain. It’s typically referred to as “twisted gut.” And to visualize that think of balloon animals and how the artist twists the long balloon tubes to create the figures. One twist like that in a horse’s gut and there are only two situations that follow: surgery and/or euthanasia.

So here I was many years later with my beloved mare, Missy, in the same situation, but I was never certain what the cause of her bellyache was, just that she had one. I had switched from sweet feed to mixing my own grains and I added rolled corn which if it isn’t used fast enough can mold. That was just one thought. I don’t do that anymore either.

I called the vet for Missy and explained that I thought my horse was foundering, should I keep walking her, I asked. “NO!” was the response, DO NOT WALK HER!

Well, I couldn’t figure that one out, walking Joe was the right thing to do for him when he “founder!” Right?

Well, Missy was not foundering, she was colicing and yes, I should have been walking her, but the vet had heard “founder” and her advice not to walk her was correct.

So when the vet arrived and determined that I was ignorant. She tubed Missy and my sweet mare pooped for us and seemed fine afterwards.

After that experience, I decided I’d better do some research. So I purchased a big fat veterinarian’s handbook. I tried to figure it all out from that. But it was boring to read and over my head.

So back to now. We know that colic is a bellyache and a horse should be walked and helped to relax. Yes, it’s okay to let them lie down and rest, but not roll. If the colic is from impaction, pooping is always a good sign. If you walk the horse until it poops and seems to feel better, I’d say you got them through it and just keep an eye on them for awhile to make sure they’re behaving normally again. Watch for signs of acute lamintis. That would be sudden tender-footedness or simply look for a ring around the hoof to grow out from the coronet band a few weeks later. That would mean that yes, the horses laminae was affected during the event.

Okay, so as for founder, we need to discuss laminitis to figure out what causes founder and to discuss laminitis, we need to know some basics about hoof anatomy.

First, laminitis is simply the term for inflamed laminae. If you hit your fingernail with a hammer, it not only hurts like a sonofagun, but your finger feels pretty warm afterwards. Well, laminitis is not quite the same thing, but that was a fun analogy and would have related better to mechanical laminitis. Another time!

What is laminae? Well, if you look inside a hoof, you have the coffin bone. That bone is attached to the inside of the hoof wall with laminae.

Think of the laminae as a Velcro fastener. The outside of the coffin bone is covered with dermal laminae, the soft side of the Velcro.

And the inside of the hoofwall is covered with epidermal laminae the rough side of Velcro. The two sides zip together creating a very strong attachment of bone to wall.

The epidermal laminae (wall side) doesn’t actually have a blood supply, but the dermal laminae does and when something goes wrong with that blood supply, the dermal (sometimes called “sensitive”) laminae becomes inflamed and hurts!

At the onset of that inflammation, whatever the cause might be, we’d refer to it as the acute phase of laminitis.

What do you do if you can catch it at this stage. Try to extinguish it. First response for this is to get the hooves under cold running water (That’s what I’ve heard and read anyway.) and call the vet. DON’T walk the horse! (Whether the cold water is the right thing to do, I’m not sure, but it sounds right for now.)

Causes of laminitis could take me days and pages to describe. But it can be caused by mechanical means – shoes, sudden pounding ride on pavement, termed road founder, but mainly, it’s organically caused, or dietary. The horse ate something or a lot of something that he shouldn’t have. That would be considered “organically caused” laminitis.

So back to Joe the Appy who got into the grain barrel. What took place was that he ingested a bunch of sugary grain suddenly.

When that sugar (fructose) made its way to what is referred to as his “hind gut” where fermentation of food rich in fructose takes place, the bacteria that is a normal part of the digestive receives a sudden gusher of the food it thrives on.

In order to handle such a huge influx of all that yummyness, the bacteria must begin reproducing at an alarming rate in order to digest it all. That sudden increase in the population of fructose loving bacteria now enters the blood stream. Weeee!

We all know that blood flows throughout our entire bodies, but for horses whose hooves have a fairly complex circulatory system in order to function properly, blood is the nourishment for the dermal (sensitive “bone-side”) laminae.

But with this new development of 25 pounds of sweet feed in one sitting sent to the hindgut causing the bacteria to reproduce like mad and take a ride on the bloodstream subway, the blood isn’t enriching the laminae any longer, it’s poisoning it. Make sense?

Instead of a nice normal blood supply that the laminae is accustomed to receiving from the heart, it’s now dealing with blood that is out of balance. Inflammation is the first sign that the sensitive laminae is in serious trouble.

Now the horse is in the acute phase of laminitis, but let’s say no one notices and really we normally wouldn’t catch it here. It’s sudden and passes rather quickly.

Like with Joe. He got into the grain barrel when I wasn’t home. He probably did suffer a minor bout of laminitis shortly after the colic. Any major disruption in a horse’s normal life can cause that. But I wouldn’t have known it even if he could have put a big sign on his butt that said “My feet are ON FIRE!”

There was no sign of lameness and likely there wouldn’t have been because his hooves were locked into a pair of steel shoes. But he didn’t founder, if he had, there would have been lameness eventually even with shoes. What should I have done in that case? First! Get rid of the shoes and DON’T force him to walk if he’s not comfortable doing so.

So here’s something to ponder while we’re talking about diet. What happens when a horse doesn’t ingest a huge amount of sugary feed all at one time? What if we are just feeding a few pounds of sweet feed every day?

The horse may not be showing any signs of lameness, so he must not be suffering from laminitis. Right?

Well, no. The constant influx of too much rich food can cause what is referred to as sub-clinical laminitis. That is laminitis with no sign of lameness. The dermal laminae is not doing as well as it would be if the nourishing blood that was circulating through it was well…healthier.

If your horse were in that situation and:

a.) say you go out for a local competitive trail ride one day. Your horse appears healthy and gets a daily work out in the arena, and has shoes on! You figure he should be able to handle a 25 or 30 mile ride. But then he comes home with serious lameness from that ride. After a week of rest, he get’s better and is lame off an on from then on.

Or b.) what if your horse is pregnant and is dealing with a hormonal shift or imbalance that also has an affect on her body in addition to the her sensitive laminae that isn’t feeling so well and she starts to gradually show signs of lameness.

Or c.) a combination of situations or events that are heaped on top of hooves that are already not doing quite as well as they could be, but we aren’t noticing anything out of the ordinary and we just keep doing what we’ve always done, because it’s worked so far.

What I’m saying is that one thing might not cause the laminae to go into the acute stages of laminitis, but a combination of conditions could bring it on and then we are left scratching our heads trying to understand what happened.

Next: What is founder? Well, let’s go back to our Velcro, or laminae and the blood supply it’s receiving is not enriching like it should be. In fact, the dermal laminae is being poisoned. It is becoming weaker. Either suddenly or over time - depending on the situation.

What if we’re taking about a long term condition of a horse who is not on the healthiest diet he could be on? The signs would be lameness off an on, sometimes on trail rides, or after working for a few hours in the arena.

Have you ever heard someone say, “I think he’s just lazy and starts limping to get out of work, because he only limps when…”?

I have. Horses are smart, but in the wild showing signs of lameness means: I’m probably going to be someone’s dinner soon and the herd will kick me out because they don’t want a horse tagging along with them that has a “BBQ” brand on his butt. Some of that mentality never leaves our domestic horses, so trust me, when a horse is lame, he’s genuinely hurting.

So the blood supply to the laminae is no longer nourishing it as much as it could be which means the dermal laminae will start to weaken and begin loosing its attachment to the epidermal laminae. The cells the dermal laminae normally generate go willy nilly! It’s been suggest that as the lamellar attachment is lost in the front of the hoof, and cells are being generated like crazy in the back of the hoof, what results is a hoof that appears long in the heel and shorter in the toe. A founder hoof.

If nothing is done to turn the horse’s situation around, the laminae attachment is eventually simply going to fail. And that is often when a vet will tell you, your horses coffin bone has rotated.

The dermal laminae loses its grip on the other side of the Velcro. It will essentially die. The coffin bone rotates (possibly). That’s founder.

Coffin bone rotation is a controversial thing with natural hoofcare practitioners and I won’t go into that here, but it may or may not happen.

Okay, so then there is chronic laminitis, which is really a foundered hoof that just isn’t getting any better. It could get better if the right things were done for it, but because it can take months and sometimes years to improve that horse’s situation, euthanasia is normally the next step.

There are other causes of founder. Such as “road founder” but I really believe that anything other than organically caused laminitis is not the true cause of founder. I believe a horse who is dealing with sub-clinical laminitis for a period of time and then is put into a second or third situation, trail ride, pregnancy, someone tossing apples over the fence in the fall or when temperatures are just right for grasses to be full of sugar, that horse is set up for full-blown founder.

I want to touch on one more topic for a bit in this long post and that is grass founder. Or acute laminitis caused by letting a horse out on rich pasture in the spring and fall.

Grass is one of the most natural, best sources of nutrition a horse can get. When I purchased Missy, the folks who boarded her would lock her in a stall night and day for weeks at a time during the spring to keep her off the lush green grass.

When I got her, she was a skinny little thing, with a shaggy coat and kind of pathetic looking really. I had no idea that bringing her home and letting her eat the lovely grass on the dairy where we lived at the time would cause her to bloom into a really lovely mare.

Missy, within a few months of coming home, leaves her thin, shaggy body behind.

Before I got her, she was standing in a dark stall, 24/7, getting grain and hay twice a day which they thought was better than letting her eat that wonderfully nutritious grass? NOPE! You can’t fault them for being careful and you only know what you know at the time.
But that logic is backwards in most cases and here is what we need to know in order to understand “when” grass is dangerous.

Grass and grazing on it, isn't necessarily dangerous just because it’s spring, or because it’s wet, or it’s tall, or lush, or green and pretty, or anything of the other reasons I've heard from horse people. In fact, that’s likely when it’s the best thing for a horse! Just not suddenly and for 24 hours a day when they're not accustomed to eating it.

It’s dangerous during times of the year when we are experiencing sunny days and cold nights! Which coincidentally is Spring and Fall, normally.


Because on sunny days grass becomes little sugar manufacturing plants. Grass is busy generating the stuff it thrives on.

Now if we have a sunny day, and our grasses are generating all kinds of nutrients and sugars, and at night the temperature stays above 40 degrees, the grass will then respirate that excess (toxic levels) of sugars out and keep only the good stuff!

It keeps what it needs to be nutritious and healthy and gets rid of the toxins.

So the next day, the grass is safe. Maybe not safe for an obese horse with Insulin Resistance (IR) issues to be tossed out onto all day, but for a healthy horse, it’s probably not going to hurt him especially if he’s slowly acclimated to it.

But what happens when the night time temps dip below 40 degrees is that the grass plants CANNOT respirate the toxins out. It goes dormant for the night. And the next day when the sun comes back out, the grasses go back to work, generating more fructose - sugar.

After a few sunny days, followed by really cold nights, when I look out at the grass I see the Oompa Loompas marching around out there and their song starts running through my head! Yours too?

So there you have it as best I can explain it and what seems right in my mind. When a horse founders, you’ll eventually see white line separation at the surface of the hoof and that leads to other issues that we can get into later, like White Line Disease and abscessing. I believe all of those issues go hand in hand. If your horse suffers from one of those conditions, chances are another one was in place, we just didn’t realize it.

Here’s the million dollar question: Can any of those conditions be the result of poor trimming and shoeing?


Missy and Rich having a moment not long after we brought her home.

PS: In the next post, I’ll talk about choke and my Arab, Pearl, who is prone to choking. Choke is often confused with colic.


Rachel said...

Wonderful, wonderful, wonderful!

You can imagine how completely freaked out I was being a beginner adult with her first real horse - when that sweet mare colicked within 24 hours of getting her home.

I was CLUELESS how to help her, and our vet (you may know him since we're local) suggested exactly what you did for colic.

And it went pretty much like yours with Joe... me and my mom out in the pitch black in a thunderstorm until 2:30am walking with a horse and begging her to live.

She did and that night is forever engraved in my mind as when we truly fell in love with that amazing mare.

There seemed to be no food issue - but she was agitated about leaving her herd and paced for nearly 24 hours... sounded like a stress colic episode?

I didn't know to look for signs of laminitis... could that happen from a stress situation like that?

And another question - are ponies more prone to founder? I keep hearing about these rescue ponies and founder comments...?

Thanks so much for the enjoyable and educational post!

Pat said...

Hi Rachel!

You are so nice!!

Yes, I'm pretty sure I know the vet.

And yes, stress could be the cause of colic, abolutly and that's a good point. If she wasn't drinking or eating during all that pacing especially. Sometimes moving a horse making sudden diet changes can also be the culprit.

About ponies, that's a great question. I find that some ponies can look like the mini in my pasture (as round as he is tall) and never have an issue with laminitis. But some must be on a dry lot much of the time because they can founder so easily.

As you can see, it sounds like I'm using those 2 terms interchangeably, laminitis and founder, but really I'm not. But to confuse the issue, if you looked at a foundered horse that hadn't improved in years, was still very lame, and you commented that he had chronic laminitis, you'd be correct to say that.

Founder is chronic laminitis, but laminitis, especially in the acute stages or sub-clinical isn't founder. Does that make sense? That's just my take on it anyways. Other experts might not agree, but that's how I keep it straight in my mind.

I think it's the same for horses as ponies. Some are more susceptible than others. And once foundered, like Cricket, you have to be diligent to keep an episode for reoccurring.

Thanks for your great commmetns! Keep them coming!

Mustang Heritage said...

Thank you
My poor rescue mammoth has had laminitis (god knows how long) she arrived severly over weight, crest almost fallen and poor hoof care.
Let me expalin poor hoof care quickly: the hoof care wasn't there and caused her legs to twict out at the knee.
I can seriously strangle people, and the worse part is her previous owners were colleage professors, but blamed the org sead owner for her state!
I have had her 8 months and she doing great, slow but still worrys me. we had a scare a few days ago and found 3 pebbles in her front hoof. I celebrated because in 8 months she finally got pebbles in her feet, which means concavity! yahoo!

Pat said...

Yep, I've seen equines become cowhocked and twist out at the knees due to long toes. The cool thing is that when you begin correcting the problem, the joints can often be corrected as well.

The problem I think that is mostly the cause of this situation is that people simply don't look down at the feet. They see the animals mossying around in the pastures looking fat and sassy, and all too often the feet are overlooked until it's too late sometimes, unfortunately.

Mustang Heritage said...

sissy didn't mossey back then..she hobbled. stumbled, trip you name it.
The owners sadly were beyond ignorant. Just lazy, she was in a pen. Her manners were dangerous, didn't want any one touching her feet. she smash you into the fence. she about 800 or more pounds of mad donkey,LOL
She actually really sweet old lady, she 12. laid back and loves to to work (walks whatever)
she gets upset if she can't get out to work.
once i get my site up again, i love to have you review her.
The big girl is really close to my heart and i can't imagaine any one ignoring her for so long.

Rachel said...

This will sound kooky, but I was a ballet dancer for years and we have certain injuries we're susceptible to. And if I think I understood better your distinction between laminitis and founder based on some of the injuries and symptoms we dancers can get in our limbs too.

For some reason, I have a hard time associating "acute" being the beginning stages of something...

But I will know better what to look for if there is ever a problem with my girl again (really hoping not!)

She's pretty stumble-footed, but it's been chalked up to laziness. Because once she sees something she likes, she's a sure-footed gal. Or if she has a kid on her back, she would hurt herself making sure she didn't trip.

(and yes, you are right - she paced all night and through the next day without drinking much/any water and she'd not had much food prior to that... Dr. Grubb wasn't sure she'd make it).

Pat said...

Hi Rachel,

My husband read that post and he said it made sense, but it was confusing. It is a bit confusing I admit.

When I was a kid, I was barefoot, the majority of the time thru the summer months and much of the winter as well. Like many in my generation, I could run down our gravel driveway and although I could feel the rocks under my feet, the rocks didn't cause pain, unless I hit a really sharp one, then I might have winced, but I'd adjust the weight-bearing area of my foot to negotiate the sharp rock with the least amount of pain.

I think barefoot horses do pretty much that same type of dance on the rocks.

I notice as I age though, (and have worn shoes most of my waking hours, the bottoms of my feet are not so tough anymore. Also, I've read that as we age, the amount of padding on the bottoms of our feet dissipates and we begin experiencing pain when walking even on smooth surfaces or after we've been sitting for awhile. I've been noticing that more and more these days.

In my way of thinking of the term "acute" it's not just referencing the "beginning stages" but when the situation is at the most inflammed or painful, which coincedentally for most conditions would be near the beginning.

Of course, I realize you and most other people are aware of what the term "chronic" means, but just to clarify, if the situation isn't resolved and becomes on-going, then we're dealing with a chronic condition. Usually, when a hoof is in chronic pain, or dealing with chronic laminitis, to me, that could (and is) interchangeable with the term "founder." And I believe the pain is not as intense as when the horse is in the acute stages of laminitis, although the pain is enough to cause obvious discomfort, "chronically":0)

If your mare is tripping when she's not 100% focused on her feet or her destination, she might be dealing with flare or DTA, divergent toe angle. That's pretty common with farrier pasture trims and can lead to other more adverse conditions.

A while back, your husband called a couple times to arrange an appt., and although we didn't quite get connected at that time, I'd be happy to work something out with you via email if you'd like for me to come evaluate your mare's hooves for you and see if there is anyway I can help her.

Stumbling can be a fairly serious problem. Years ago, I was given an older Arab and I was leading him down a muddy trail one day on our way home from a short trail ride. He was a stumbler (trick knee I think) and when he lurched forward to catch himself during a stumble, his hoof caught the back of my leg with such force, (just above my ankle) and shattered both bones in my leg. I was sitting out in the woods alone and had to wait until someone happened along the trail to get help.
(Cell phone? Pagers were what people carried in those days.)

Rachel said...

I guess I meant kind of the difference for a dancer between having chronic shin splints, to having minor stress fractures and then being susceptible to them over and over again depending on what kind of work you're doing and what kind of surface you're doing it on.

Just because you have a stress fracture, doesn't mean you have shin splints, and the other way around as well. But the symptoms can be similar and issues can be present at the same time. That's a crappy allusion though, haha.

The acute thing... When I was in "acute" kidney failure, the beginning was NOT worse than the later part. So I guess the pain thing I would assume would worsen, rather than being at the beginning stages.

I'll just have to memorize it and get it straight in my head :)

Since our girl was very skinny when we got her, other horse people said she was tripping because she was conserving her energy rather than picking up her feet well.

But bring out a set of trot poles and she's perky and does that nice high arab trot.

I'll see if I can email you and we can connect that way! :)

Pat said...

Wow, acute kidney failure. You been through some pretty rough stuff, my friend.

I'm not familiar with dancer injuries, but it sure could compare I would imagine.
I know my gelding has splints in his splint bones, which I'm told is no big deal and I have no idea why, unless they're from kicks. He's never worked hard a day in his life! He's a big spoiled tubby boy. But their lower leg bones and ours are a bit different in their placement.

As you likely know, they have 2 bones that are on either side of the cannon bone and that are fussed to the cannon. I'm told those are the remains of their other 2 toes when horses had 3 toes. (I never know how another person feels about evolution, so I'm tentative about bringing that up.)

Back to the acute thing, I've heard of acute kidney failure. Would "acute" in that context mean "rapid onset?" That's basically how it's used with laminitis. Sudden onset, short period of time, and as I've listened to vets and other practitioners they seem to equate it to the period of most severe inflamation. But it's possibe we are all on different pages of the same condition!:0) Who knows.

Maybe in certain conditions the term is used differently?

It's great chatting about this stuff though. I love it! I love your questions. I could talk about it for hours, but most people prefer I don't:0)

megan colleen said...

Hey Pat -
My apologies on commenting late in the game. I've been trying to register for classes for the alst several days. I am going to be experimenting this semester with working a full time job, a part time job, and goign to school part time too. These are the times I'm glad I have just a dog to care for and not something larger. ;)

That being said, my school offers blacksmithing classes. I am curious about taking them but probably won't follow through due to a case of severe asthma. I admit part of my curiousity is due to reading this journal as well as Fugly's. :)

Anyway, I thought I'd let you know that you are definitely influencing your audience! Perhaps not in the ways you intended but you are at least opening my mind up to possibilities.

As for colic - I lost my favorite horse to colic. I wish I had had your advice when it happened... maybe he wouldn't have died if we had? Sweet Morgan gelding named Raven - I rode him in parades when I was a kid, and he was my "bicycle" as I could ride him on our dangerous country road and my parents didn't worry.

We were pretty much just told dont' let him lie down. We didn't walk him as much as we should have. He mostly just stood there in pain. I was only 11 at the time and it hurt so much knowing that at the end of the day my dad was planning on having the vet out to put Raven to sleep.

I have a tattoo now in his honor on my left shoulder - its of a raven in lift off - and whenever I feel lonely or sad i pet my tattoo the way i did him

(he also gave the BEST horsey hugs!)

So thank you for the education... :)

Pat said...

Megan, that was truely a testimonial that caused a lump in my throat.

Your tattoo is a lovely tribute to Raven. Losing a good friend is so difficult, but having something to turn to when you need a reminder of his life is good to have.

I’ve lost several wonderful critter friends in my time and each one with regret of what I could have done differently. I have a lock of hair from each one.

I know I will suffer the heartbreak of losing others, but it’s worth it to me to have them in my life for the time that they are here.

Thank you so much for your kind words. All my best to you in your busy life! I can’t wait to hear about the horses who will be part of your future.


Just Me said...

Hi, Interesting post.

I worked in the medical field for over 20 years. The definitions of "acute" and "chronic" do not change with the condition, and you appear to have a pretty good working grasp of the terms.

I think your "spring/fall" comment about grass should be revised because if we are going to use the "40-degree at night" parameter, then depending upon location that may or may not be within those two seasons.


Pat said...

Hi Just Me,

Thank you for your comment. I agree that I should be more specific about night time temps. I will try to revise that comment. I really appreciate the feed back on any of my blog posts. This blog is many years old. Of course, it was the thing before we could create our own websites and pre-facebook. I have changed some of my thinking on certain topics and have learned more about some of the topics I covered here. But I will say here in the Pacific Northwest, Especially West of the mountains, the day/night temps are very similar in the Spring and Autumn. We often experience sunny days followed by cold nights. That may not be the cause of founder in all equines, but we definitely need to be mindful especially the more sensitive ones. Also that is a fairly simple rule of thumb that anyone can understand as horse husbandry seems to get so over-complicated causing many horse owners to close their minds off to learning more about what can go wrong and just do what they've always done. I like to keep it as simple as possible and easy to remember because that works best for me.