How to Spot & Treat Laminitis

How to Spot & Treat Laminitis

The laminae are interwoven, sensitive ‘leaves’ of tissue which suspend the pedal bone within the hoof. Laminitis is inflammation of these laminae which weakens them and can result in sinking or rotation of the pedal bone.

Facial Crest

Key Signs of Laminitis

Feeling for a digital pulse. Run hand down limb to the fetlock & gently roll your fingers across the skin on either side at the back until a “tube” is felt to move under the skin. This is the vascular bundle. Gently hold your thumb/finger over until pulse can be felt. Normally this is very subtle but can be felt to “bound” strongly in laminitic horses.

Laminitis is characterised by lameness involving one or more feet which is often rapid in onset. Both front feet are usually affected, but hind feet can be involved as well. Occasionally, laminitis occurs in only one foot, often as a result of excessive load bearing due to a severe lameness of the opposite leg. Affected horses show a characteristic, ‘pottery’ gait landing with the heel first. The condition is much worse when the horse is walking on a firm surface or when turning. When resting, they often weight shift and stand with the hind limbs placed further underneath the body.

Physical examination usually identifies an increase of the digital pulse and often (but not always) the foot feels hot. Application of hoof testers to the sole in front of the frog will result in a painful response.

Laminitis

Common Causes of Laminitis

  • Equine Metabolic Syndrome (EMS): seen in obese horses and ponies which are insulin resistant, i.e. they have an abnormal response to sugars in the diet. This increases their susceptibility to laminitis; particularly when they are exposed to foods high in sugar and carbohydrate such as grass, cereals and molassed feeds. Typically horses with EMS have fatty deposits and “lumpy” areas on the crest, along the sides, back and on the bottom, almost cellulite like!
  • Equine Cushing’s Disease: mainly seen in older horses and ponies with an enlarged pituitary gland. This results in an overproduction of hormones including ACTH, a steroid like hormone. Having Cushings disease has been shown to increase the chances of a horse suffering laminitis by 5-6 times. Currently the test for Cushings is free for horses and ponies which have not been tested previously. This offer lasts until the end of Octiber 2015 and is well worth testing your older horse or pony if you are worried about laminitis. Other symptoms of Cushings include long or curly coat, which is shed slowl or retained into the summer, fat pads above the eyes, increased thirst and urination, patchy sweating. Not all horses with Cushings show all symptoms and sometimes the first symptom to be noticed is laminitis.
  • Endotoxaemia/septicaemia: toxins are released into the bloodstream, this can be from damaged intestines ie colic, entererocolitis, or another septic focus such as a retained placenta or metritis.
  • There is an unproven relationship between high doses of steroids administered to your horse and laminitis; normal ‘safe’ doses carry a very minimal risk.

To be certain of diagnosis we would need to carry out a full examination and will also ask about diet. Blood tests for EMS and Cushing’s Disease are advisable as approximately 80% of horses will have one or both of these disease underlying the laminitis. Radiographs are invaluable in assessing the severity of laminitis, providing prognosis information and guiding treatment with remedial farriery. We may want to take radiographs as they provide invaluable information on the position of the pedal bone and help with remedial farrierery. X-rays can usually be taken on the yard with a portable machine to minimise stress and discomfort for your horse.

Treatment of Laminitis
Horses with laminitis should be kept as comfortable as possible on strict box rest, with a deep shavings or sand bed, preferably with rubber mats underneath. Pain relief will be provided by your vet in the form of an anti-inflammatory painkiller.

Many horses with laminitis are overweight and a specific diet should be discussed with your vet. In most cases, it will involve an individual diet programme, with roughage and feed that is weighed out specifically to ensure it is the correct amount for your horse. Laminitic ponies will often be on low energy and sugar rations, such as soaked hay and low sugar chaffs. Addressing the diet of laminitic ponies is vital to help prevent further episodes. Underlying conditions such as EMS, Cushings or systemic disease should be treated if present.

Despite all efforts, some horses experience unexpected relapses and early detection of these can be essential for your horse’s survival. Discuss with your vet how to detect the early signs of laminitis and ask them to show you how to feel a digital pulse.

Laminitis

Hoof care is vital in the treatment of laminitis. In the early phase, the goal is to stabilise the pedal bone. This can be accomplished to a certain degree by transferring weight back towards the heels using foam pads, or other material to support the frog. Keeping the horse still and encouraging him to lie down will reduce the pressures through the laminae.  In the chronic phase, the goal is to minimise further rotation and to continue supporting the sole, bars and frog with trimming and the use of specialist shoes.