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Laminitis

Laminitis Laminitis is one of the most distressing conditions that can face horses and their owners. Sadly it is also extremely common, reportedly affecting 7.4% of horses/ponies at some point in their lives. A detailed discussion of the disease process itself and all the available treatment is an enormous subject. Indeed research is ongoing worldwide to better understand the processes that go on with laminitis. To this end the British Equine Veterinary Association is currently undertaking a large evidence based study to evaluate various treatment strategies for managing laminitis. As a horse owner it is important to understand both the triggering factors for laminitis in order that they can be avoided and the signs of laminitis so that should your horse succumb treatment can be initiated promptly. CAUSES OF LAMINITIS The causes of laminitis are numerous and the following list is by no means comprehensive but should serve as a practical guide. Excessive intake of grass rich in fructans Excessive intake of grain/high carbohydrate foods Retained Placenta Cushing's Disease and Metabolic Syndrome/Peripheral Insulin Resistance Drug Induced Severe lameness of another limb Road founder Colic/diarrhoea Excessive intake of grass rich in fructans This occurs under two scenarios. Firstly the classic "too much spring grass" and secondly often happens when a hard frost is followed by a bright sunny, but cold morning. Under these conditions the grass produces fructans, a type of sugar, by photosynthesis faster than it can be used up in growth. This results in an accumulation of fructans in the grass which can act as a trigger for laminitis. Excessive intake of grain/high carbohydrate foods This results in sudden and severe changes to the bacterial population of the horse's intestine. Subsequent release of bacterial toxins into the blood ultimately causes laminitis. A horse escaping and finding its way to the feed room is the commonest way this happens but inadvertently feeding the horse twice or simply giving the horse too much food also occurs Retained Placenta If a mare takes an undue length of time to cleanse post foaling then laminitis can result. Heavy draught breeds are particularly susceptible. For guidance on this subject please see the sections of this website dedicated to the mare and foal. Cushing's Disease and Metabolic Syndrome/Peripheral Insulin Resistance These are two medical conditions, the former primarily affecting older horses, the latter younger horses, that can result in laminitis. Signs of Cushing's disease include an excessively hairy coat, failure to shed coat normally, lethargy, drinking/urination excessively and recurrent infections. Metabolic syndrome often has similar signs but is usually associated with obesity in younger horses. Your vet will be able to advise further should you have any concerns. Drug Induced There is a purported link between some drugs, most notably a type of anti-inflammatory called corticosteroids, and laminitis. However this is a rare occurrence and should your horse require corticosteroids for another condition then that will often outweigh the small risk of inducing laminitis. Your vet will be able to provide more detailed explanation of the risks of using any such drug should the need arise. Severe lameness of another limb If a horse remains severely lame on one limb for an extended period of time this causes overloading of the opposite leg. This can result in laminitis. This is more a concern for your vet however as any severely lame horse will undoubtedly be under veterinary care. Road founder An excessive amount of hard work of an unforgiving surface such a road can result in laminitis. This is commonly known as "road founder". Colic/diarrhoea Certain types of severe colic and rarely diarrhoea can precipitate an attack of laminitis. However as all types of colic that do not resolve rapidly should receive veterinary attention then this is more a concern for your vet. SIGNS OF LAMINITIS Due to the speed with which laminitis can progress and the severe sequelae that can result many regard laminitis as a medical emergency, as important as colic or a bleeding wound. As an owner the ability to recognise the signs of laminitis will enable earlier intervention and often greatly improve the eventual outcome should your horse or pony be unfortunate enough to be struck by laminitis Mild laminitis Short stilted gait with a "heel first" footfall Shifting of weight from one leg to another Repeated lifting of alternate feet Gait worse on hard ground/reluctance to stand on hard surface Often worse when turned sharply Heat in feet Increased digital pulses . Severe laminitis Acute onset lameness affecting one or more feet, usually both front feet Reluctance to move May be impossible to lift feet Recumbency Increased digital pulses Heat in feet. Moderate laminitis lies somewhere in between with varying degrees of the above signs / symptoms Treatment for Laminitis If you have any suspicion of laminitis then the horse or pony should be ideally be placed on a deep shavings bed and given only hay and water whilst you seek veterinary attention. However if the horse/pony is severely affected whilst out at grass it may be better to leave the horse where it is until your vet arrives but prevent it from grazing. Spreading a bale of shavings around the horse and getting the horse to stand oin them may also offer some relief. A full discussion of the treatment of laminitis is out with the scope of this piece, suffice to say the mainstays involve the removal of any inciting cause, prescription of various drugs to arrest the process of laminitis and relieve the discomfort and lastly varying degrees of frog support. Once the laminitis is under control involvement of the farrier is extremely helpful as at worst remedial farriery will be required and at best a preventative shoeing / trimming strategy will need to be agreed upon to minimise the risk of further attacks. CONCLUSION Whilst laminitis remains a common and devastating condition the old adage that prevention is better than cure is one that holds especially true for laminitis. Hence a good knowledge of the commoner triggering factors is essential. If laminitis does strike the earlier appropriate treatment is received the better the eventual outcome is likely to be. Knowledge of the signs of laminitis will greatly facilitate this.


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