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What is laminitis and can it be prevented and treated?

Laminitis is a disease of the hoof and is named after the laminae which are contained within the horse’s foot.  There are sensitive and insensitive laminae which are leaves of interlocking soft tissue which act at as structural support for the pedal bone.  This is the main bone in the horse’s hoof sometimes also called the coffin bone.

Laminitis occurs when the blood flow to the laminae is affected resulting in inflammation and swelling in the soft tissues.  As the laminae are starved of oxygen and nutrients from the blood, the cells become damaged and this can give rise to extreme pain for the horse.  It also causes instability in the coffin joint and can eventually lead onto founder which is another name for laminitis; this is where the pedal bone, lacking support, starts to rotate and sink down and eventually through the sole of the hoof.   Laminitis is most common in the front feet but not exclusively, it can occur in the hinds as well.

Some laminitis is caused by grain overload, essentially a diet which is too rich in starch and sugars but this is not the only trigger.  There are metabolic causes such as PPID – Pars Intermedia Dysfunction also known as Cushing’s Disease and, Equine Metabolic Syndrome or EMS.  These two conditions are distinct but share the common factor that affected horses have abnormal control of their carbohydrate metabolism.  It is thought now that at least 75% of laminitis cases may have a metabolic origin.

Can laminitis be prevented?

The only way to prevent laminitis is to treat potentially vulnerable horses and ponies as laminitics and manage their routine as if they had already had it.  Once a horse or pony has had laminitis then this is what you will be doing anyway  – prevention is always better than cure.

  • Don’t overfeed or rug native ponies – these animals come through the winter carrying far too much weight and arrive on the spring grass already with too much condition – they do not require hard feed
  • If you need to give a small amount of feed then use products especially recommended for laminitics – there should be a naturally occurring sugar level of less than 10% and absolutely no added sugar content like molasses or dried apple
  • Do not feed cereals especially barley
  • Keep grazing spartan –strip graze or graze with other animals or use a grazing muzzle
  • Soak or steam hay to reduce the sugar content
  • Check feet daily for excessive warmth and a digital pulse – this can be easily felt at the back of the fetlock joint. Most horses will have a light pulse after exercise or in the heat but if the pulse is strong and ‘bounding’ then this should be a warning signal that all is not well
  • Know your horse – horses that seem slightly uncomfortable or a bit out of sorts and appear reluctant to move around as easily either in the box or in the field may be giving you an early warning sign that all is not well. This may be a horse that turns around more slowly or doesn’t want to pick up his front feet.  Both of these activities load more weight onto one front foot more than the other
  • Horses which are uncomfortable may shift their weight continuously from one foot to the other
  • Horses in a lot of pain will rock back onto the heels of their front feet in an unmistakeable stance, tucking their hinds legs under their body to relieve the front feet of weight
  • Never turn horses or ponies out onto frosty grazing in the winter as when the grass thaws, it will have a sugar spike
  • Test older horses and susceptible horses for Equine Cushing’s Disease or Equine Metabolic Syndrome as this can have a role to play in the management of Not every Cushing’s diagnosed horse goes on to develop laminitis but it can be a consequence of the condition
  • Keep the horse’s feet in good condition and regularly trimmed
  • Understand which horses are more likely to get laminitis although no owner should ever be complacent. Native ponies seem to be genetically more predisposed to the condition than some other breeds and types

Can laminitis be treated?

The biggest element of treating laminitis is ongoing daily management once the initial acute episode has passed.  Laminitis can be treated but it cannot be cured.  If stable management routines are not altered then laminitis will simply happen again.

In the early stages, laminitis should be treated very seriously and as a situation which requires prompt if not emergency veterinary intervention.  The vet will recommend total box rest and a diet of soaked hay.  NSAID – Non-Steroidal Anti-Inflammatories – like bute will be prescribed to reduce inflammation and ease the pain.  Remedial shoeing or frog supports might be necessary and will be coordinated between the vet and the farrier.

In mild cases of laminitis, once the horse or pony has been removed from the grass and has had a couple of days box rest and pain relief, they can quickly appear sound.  But the recommended period of total rest is usually 4-6 weeks.  Don’t be tempted to turn them out too early.  They are far more likely to just have another episode of laminitis and their feet are also still recovering from the trauma of the initial incident.

It is important to diagnose the cause of the laminitis as this will help hugely in preventing further episodes.  Test for Equine Cushing’s and EMS or could it just have been caused by a starch overload due to too much grass or cereal feeds?

Both EMS and Equine Cushing’s can be treated with medication which will help reduce the risk of laminitis occurring again.  But this alone will not prevent the laminitis from recurring; it is the steps that the owner takes to manage the horse in an appropriate regime which will make the most difference.

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