( ADVICE FROM THE VET ) Laminitis – A year round problem By James Evans BV L
aminitis is an extremely painful inflammatory condition of the feet in which there is weakening of the sensitive tissues (laminae) that bond the hoof wall to the pedal bone within the horse’s hoof. It can affect any horse, pony or donkey of any age or sex, at any time of the year. Laminitis results in weakening of the supporting lamina within the hoof, leading to rotation and/or sinking of the pedal bone. In severe cases, it can lead to penetration of the pedal bone through the sole of the foot.
WHAT CAUSES LAMINITIS?
There are many different reasons for the onset of laminitis and these can be broadly categorised as follows:
1. Hormonal: Recent research has shown that Equine Cushing’s disease (Pars Pituitary Intermedia Dysfunction (PPID)), and Equine Metabolic Syndrome (EMS) cause most cases of laminitis in the UK and around the world. 2. Carbohydrates: Too much sugar and starch (e.g. spring grass, excessive concentrates). 3. Toxic: infections and severe inflammatory issues, such as a retained placenta aſter foaling, endotoxaemia, some types of colic or severe pneumonia can induce a bout of laminitis; 4. Mechanical: Too much length of toe, over-zealous foot trimming or improper shoeing, fast or prolonged work on hard surfaces; supporting limb laminitis due to foot abscess, fracture, joint infection, or soſt tissue damage in the opposite limb. 5. Stress: Any stress, such as overworking unfit horses, a dramatic change in environment and/or frequent travelling, particularly for overweight animals, can trigger laminitis.
A recent study by the Animal Health Trust, in collaboration with the Royal Veterinary College and Rossdales Equine Hospital, funded by World Horse Welfare, showed that:
• laminitis was more than twice as likely to develop in horses/ponies that had recently gained weight; obesity is a risk factor for laminitis.
• horses/ponies that had a history of laminitis were more at risk at developing the disease again; • horses/ponies with lengthy recovery periods aſter the previous bout of laminitis were more at risk; • horses/ponies who were lame or foot-sore aſter routine shoeing were at increased risk • there was a higher incidence of laminitis in horses/ponies who had longer than 8 week cycles between routine trimming/shoeing; • native breeds to the UK and Ireland showed an increased risk of laminitis.
SIGNS OF LAMINITIS
Laminitis usually affects both front feet but can sometimes affect one foot, and occasionally hind
Recurrent abscesses are more likely to occur in feet compromised by chronic laminitis. Image courtesy of Dr D Pollard, AHT
16 MAY/JUNE 2019
A pony with laminitis shiſting weight from one foot to the other. Image courtesy of Dr D Pollard, AHT
feet. In most instances the affected animal will shiſt its weight from one limb to another, will be reluctant to move, may lie down and there is oſten excessive heat in the hooves with a strong ‘digital pulse’ felt at the back of the fetlock (the palmar or plantar digital arteries). Ask your vet to demonstrate how to feel for pulses if you are unsure. Lameness will be exaggerated when turning on a hard surface. In cases of chronic laminitis, there will be changes to the hoof. Signs include horizontal ridges around the hoof, which are wider at the heels, and an overly flat or convex sole. An abscess can present similar clinical signs to laminitis, such as lameness, excessive heat in the foot and a bounding digital pulse, but usually only affects a single foot. However, recurrent abscesses are more likely to occur in feet compromised by chronic laminitis. In milder cases, there may be only a slight change in the animal’s gait, with the horse moving in a ‘pottery’, short-striding or ‘stiff’ fashion. These animals will go on to deteriorate further, unless they are rested and treated promptly.
etMed, BAEDT , MRCVS DIAGNOSIS
Diagnosis can frequently be made by clinical signs alone. X-rays are oſten required to determine whether there has been any rotation or dropping of the pedal bone. It is essential to involve your farrier in discussions with your vet, working as a team, and sharing the X-rays to help determine future trimming and/or shoeing plans for your horse.
When trying to evaluate whether there is concurrent hormonal disease, blood testing for PPID or EMS may need to be delayed until the horse/pony is comfortable again, as severe pain and inflammation during an acute laminitic episode could cause false positives to be seen on blood tests. For this reason it is oſten necessary to re-test bloods once the laminitic episode has resolved.
An x-ray showing a horse with a rotated pedal bone
TREATMENT
Laminitis is an emergency: your veterinary surgeon should be contacted as soon as a case of laminitis is suspected. Pain relief is a key part of treatment and usually involves the use of non-steroidal anti- inflammatories (NSAIDs) such as phenylbutazone (bute) or flunixin. A recent study also described paracetamol as a useful short-term adjunctive analgesic when treating laminitis alongside NSAIDs. Acepromazine (Sedalin)is also sometimes prescribed to reduce the blood pressure in the laminar vessels.
The horse should be stabled immediately and foot support is a vital part of the treatment to limit movement of the pedal bone and to reduce pain. A deep bed that extends all the way to the door should be provided to relieve pressure on the feet. Twice daily monitoring of the feet and digital pulses is essential.
Discuss with your farrier therapeutic trimming and/or shoeing to relieve pressure on the toe and to prevent further damage to the feet. The use of frog supports, such as Lilypads or TLC Frog Supports, or frog and sole combined supports, such as dental impression material or styrofoam pads, may be helpful. Imprint shoes are also
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