ADVICE FROMTHE VET LAMINITIS by GemmaCarmanMRCVS


and adepression at the level of the coronaryband.Itisvital to realise that it is abnormal forhorses and ponies to suffer frommild bouts of laminitis year on year.These cases oftenhave an underlying hormonal issue such as PPID or EMS, both of which are easily diagnosed (usually by asimple blood test) and thereare treatment options available forboth diseases.


X-raysare vitaltodetermine the position of the pedal bone within the hoof capsule


wherethe laminae totally fail and as aresult the pedal bone penetrates through the sole of the hoof.This is incredibly painful and usually results in symptoms of extreme pain such as sweating,ahighheartrateand an inabilitytostand on the affectedleg.


Underlying conditions such as PPID and EMS can be easily diagnosed byablood sample


Overview Laminitis is adisease of the laminae, which aresofttissue structures in the hoof.These laminae normally actlike “velcro”to hold the pedal bone in the correctposition within the hoof capsule.When the laminae become inflamed (‘Laminitis’), their strength is lost and thereforethe bond between the pedal bone and the internal hoof wall fails.This allows thepedal bone to sink and rotate towardsthe sole of the foot,causing pain and lameness. Oftentriggered by excessive dietarysugar intake,laminitis can also be caused by severeinternal illness such as sepsis,stress and weightoverload of aspecificleg


(“supporting limb laminitis”). Other underlying diseases can leave horses and ponies moreprone to laminitis such as EquineMetabolic Syndrome (EMS) and Equine Cushings Disease (nowknownas Pars Pituitary Intermedia Disease (PPID)). With prompt diagnosis and appropriate treatment, many horses and ponies with laminitis can recoverfully and continue to lead anormal lifebut in some casesitcan be life-threatening.


Specialist glue-onshoes can be useful in certaincases


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Clinical signs Classically involving both front feet,laminitis can affectany of the hooves,including the back feet. Initially,signsmaybeasvague as alow gradelameness or showing a“pottery”gait,particularly on a hardsurface.Itiscommonto find bounding digital pulses due to the excessiveblood flow to the laminae. These pulses can easily be felt with the correcttechnique; it is advisable to askyour Vettoshowyou how to do this.Itiscommonto find an increase in hoof temperaturein affectedfeet,although this can be misleading,especially onawarmday. When standing,mostlaminitics will “weight-shift”between affectedlimbs and exhibit aclassic “laminitic stance”, wherethey lean back onto their heels to relievethe pressureoverthe frontofthe hoof and toe. Very severe casesmaysuffer from“Founder”,


Diagnosis Many animals with sudden-onset laminitis showsuch convincing signs of laminitis thattheir physical appearanceisenough to make an initial diagnosis.Their level of pain and the timescale over which the disease has developed will dictate when/if radiographs (X-rays) should be taken.Your Vetwill assess the X-rays forvarious abnormalities, including rotation of the pedal bone or‘sinking’ofthe coffinjoint, as well as fluid or gas pockets which can accumulate in the laminar space. Certain casesmaybenefitfrom MRI if X-rays areinconclusive. Horses and ponies suffering from subtle,low-grade laminitis can develop deformations in the appearanceoftheir hoof capsule, including abnormal growth rings


Treatment Laminitis should alwaysbe consideredamedical emergencyand thereforeprompt and appropriate treatmentisvital.The mainstayof initial treatmentaims to relieve pain and provide anti-inflammatory treatment.This is most commonly in the form of oral Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as phenylbutazone (“Bute”). Other pain-relieving drugs such as morphine can also be used in more severecases.The affected horse or ponymustbekept on strictbox rest on adeep,clean, shavings bed. This is vital to preventexcessive movementand further damage to the laminae.Certain patients will benefitfromsole or frog supports, depending on their presentation. It is vital to promptly identify the causativefactorinthe onset of laminitis; whether thatbePPID, EMS, serious disease such as a retained placenta or aseverefoot abscess in the other limb.This then allows specifictreatment of the underlying disease. Somecases will benefitfrom specialist shoes such as glue-on shoes (e.g.Imprint®), wooden clogs or heartbar shoes; again this depends on their individual presentation and X-ray findings.


X-ray ofanormal hoof


APRIL 2017For the latest news visitwww.centralhorsenews.co.uk


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