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Laminitis is the inflammation of the laminae tissue in a horse’s foot that causes severe pain and lameness. The laminae is the sensitive soft tissue that connects the coffin bone to the hoof wall. It anchors the bone to the hoof and prevents the coffin bone from sinking through the sole of the foot or rotating under the weight of the horse. Inflammation and damage to the laminae can lead to excruciating pain. In more extreme cases, it may result in the bone's rotation within the hoof capsule.
by Dr. Keaton Massie, DVM
Sometimes, laminitis may become a life-threatening condition. Studies carried out in 2020 show that laminitis contributes to over 20% of equine euthanasia. I have had to deal with laminitis cases in a variety of horses. Any horse can get laminitis; however, ponies, minis, and overweight horses are the ones most at risk.
Stages of Laminitis
Like with most diseases, I’ve observed that horse laminitis builds up in stages. If the horse owner and/or farrier is observant enough, the veterinarian can be informed in the early stages to prevent major changes to the hoof.
Developmental
This is the stage where the inflammation of the laminae tissue just gets underway. The horse exhibits subtle signs, so it can be quite difficult to pick up at this stage. It goes without saying that this is also the best stage to begin treatment and management for a horse about to have laminitis.
Acute
This occurs during the first few hours to days when clinical signs of laminitis are observed. The horse displays signs of lameness, is reluctant to move, tries to stand more on its hind limbs (sawhorse stance), has swollen limbs, hoof capsule feels warm/hot to touch, and increased pulse in the lower limb. The coffin bone may be displaced or rotated during this phase, this event is known as Founder. If acute laminitis is observed early, there is much that can still be done to restore the horse to full fitness within a short time.
Chronic
Chronic laminitis may last for a very long time and is characterized by the rotation or sinking of the coffin bone, or being static over time. The horse exhibits continued or improved lameness, and abnormal growth rings may appear on the hooves. In very serious cases, the coffin bone sinks to penetrate through the sole of the hoof or the hoof capsule falls off. The extent of damage at this stage can be observed on a radiograph.
Horses at the stage of chronic laminitis can be difficult to treat. It is surprising though that some chronic horses are not lame and without x-rays, one would never have known about them. In cases where lameness persists and the horse continues to experience serious pain, we might decide to euthanize the horse.
Major causes of laminitis
Many reports have been written about the possible causes of laminitis. Over the years, I’ve observed quite a few myself. It should be noted that the approach to treating a laminitis condition also greatly depends on the cause of the condition. Some common causes of acute laminitis in horses include:
Underlying endocrine problems like Equine Metabolic Syndrome (EMS) and Pituitary Pars Intermedia Dysfunction (PPID). Digestive upsets as a result of high grain intake or access to lush pasture may cause this condition.
Severe systemic illness/infection
Retained placenta in mares after foaling.
Over-leaning on one limb due to injury on another limb.
Exposure to bedding with black walnut shavings.
Prolonged use of drugs that may impair blood flow, like corticosteroids.
Predisposing factors for Laminitis
As I mentioned earlier, any horse can have laminitis. However, overweight horses, ponies, and horses that feed on high-carbohydrate meals are more susceptible to it. Also, laminitis can become a recurring disease if not effectively managed. Therefore, any horse with a previous episode of laminitis is susceptible to another bout.
What are the signs?
Although laminitis can only be diagnosed by an equine vet; oftentimes it is you, the caretaker of the horse that first identifies the early signs of laminitis and can be that horse's initial savior. It’s good to keep a lookout for changes in your horse or any of these signs listed below:
Shifting weight between the feet when resting.
Leaning more on the hind feet in a sawhorse stance.
Rising temperature on any of the hooves
Increased digital pulses
Reluctance to rise or walk.
The earlier a horse can be diagnosed, the greater its chances of recovering quickly and fully.
When diagnosing laminitis, I usually observe the clinical signs being exhibited by the horse, its medical history, and most importantly a head-to-tail thorough physical exam. At our practice, we utilize a thermal camera to look for heat changes in the hooves. Also, multiple x-rays of the horse’s foot are taken to identify possible displacement of the coffin bone.
If you suspect your horse is experiencing a laminitic episode I recommend you not move them, put their feet in buckets of ice water or cold hose their feet and call me immediately for an emergency appointment.
Is there a treatment for laminitis?
There are many treatment options depending on the severity of the disease and the individual horse’s contributing factors. Many times, laminitis can spiral into an irreversible process that may lead to the perpetual lameness of the horse. While the horse can be restored to full fitness, it can’t be cured.
Treating laminitis usually involves a series of aggressive and urgent recovery steps. There is no one-size-fits-all treatment plan, as every treatment is tailored to each individual horse. That being said, the first and most important step in treatment can be taken by you. With any horse suspected of laminitis, getting the feet cooled off with ice baths, cold hosing, or standing them in a creek (this is the old cowboy method) is critical. Often times this can halt the disease in its tracks.
Treatment typically involves the following:
Diagnosing and treating any systemic disease (endocrine problems, insulin resistance, sepsis, etc.)
Dietary changes to foods low in non-structural carbohydrates (NSC) i.e., reducing foods with high sugar and starch content.
Anti-inflammatory drug therapy, like the use of NSAIDs (non-steroidal anti-inflammatory drugs) such as phenylbutazone combined with Dimethyl sulfoxide.
Cryotherapy by cooling the hooves can help to prevent further damage to the laminae.
Movement restrictions and use of mechanical supports. Provide deep bedding of shavings to relieve pressure on the laminae while walking. The horse should also be encouraged to lie down often.
Surgical options like deep digital flexor tenotomy may be considered in serious clinical cases.
The key to any recovery from laminitis is in the feet themselves. When addressing laminitis, regardless of severity, it is critical and possibly most important that therapeutic shoes are placed on your horse. Veterinarians and farriers should be at laminitic emergencies to discuss what shoes need to be put on that horse in the moment.
Prevention of Laminitis
The good news is that preventing laminitis doesn’t require any serious or extreme procedures. This might sound cliche, but the saying an ounce of prevention is worth a pound of treatment is definitely true for laminitis. I usually advise horse owners to regularly do the following:
Have your horse seen every 6 months by a veterinarian to identify metabolic/endocrine issues early.
Practice proper hoof care through regular farrier visits.
Ensure the horses have balanced nutrition. Use diets low in NSCs
Monitor your horse’s weight.
Avoid overgrazing lush pastures.
Always provide support for adjoining limbs when a horse’s limb is injured.
Finally, laminitis is a medical emergency, and I encourage horse owners to treat it as such. Early detection is critical for improving your horse’s chances of returning to normal function. Even though there are many ongoing studies to understand the exact causes and cures for laminitis, there is still enough information to diagnose and treat a horse to full recovery. If you have further questions or need consultations about equine laminitis, you can contact me.
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