laminitis workshop aln veterinary group and northumbria veterinary partnership 26 april 2007

Laminitis WorkshopLaminitis Workshop

Aln Veterinary Group and

Northumbria Veterinary Partnership

26 April 2007

Foot AnatomyFoot Anatomy

What is laminitis?What is laminitis?Inflammation of

the laminae – which act to suspend the pedal bone within the hoof…

…however laminitis is a systemic disease that affects the whole horse

How does laminitis occur?How does laminitis occur?

2 different theories

Vascular theory

Enzymatic theory

Vascular theoryVascular theory

Soluble carbohydrates overload the small intestine Abnormal fermentation occurs in hind-gut Toxins released into blood, which becomes more

acid Blood bypasses laminae causing tissue death Inflammatory fluid builds up between the laminae Pedal bone rotates and drops putting pressure on

sole

Enzymatic theoryEnzymatic theory

New theory – not fully proven and not all questions answered

MMP enzymes normally present to maintain healthy bonds

MMPs become excessive and cause disintegration of the laminar bond

The 3 Stages of LaminitisThe 3 Stages of LaminitisDevelopmental phaseAcute phaseChronic phase

New ideasNew ideas

MMPs

Sulphur

Magnesium

Laminitis affects small fat Laminitis affects small fat ponies…?ponies…?

Retained placenta or any other toxic event

After foaling…After foaling…

Steroid administration…Steroid administration…

Competition horses…Competition horses…

…travelling

…roadwork

…concussion

Acute lameness…Acute lameness…

Cushingoid ponies…Cushingoid ponies…

Equine Metabolic SyndromeEquine Metabolic Syndrome

Related to Cushings diseaseInsulin resistanceRecurrent bouts of laminitisObese, younger horses and poniesBlood test differentiates these conditions

Clinical signs of laminitisClinical signs of laminitis

Altered behaviour e.g. immobility, lying down, depression.

Heat in the feet, esp around the coronary bands.

“Rocking back” stance.Lameness on 1 or more legs.Raised pulse & respiratory rates.

Classic laminitic stanceClassic laminitic stance

Possible other symptomsPossible other symptoms

Bounding digital pulsesA depression at the coronary bandPatchy sweatingNot only the front feet affected

Vets roleVets role

To provide emergency treatment in the form of:

Addressing the cause. Pain relief Preventing further

changes. Monitoring &

prognosis

Types of medicationTypes of medication

Sole and frog supportsSole and frog supports

X raysX rays

FarrieryFarriery

Farrier & Vet liaison is Farrier & Vet liaison is essentialessential

Treatment for your horse or Treatment for your horse or ponypony

Call us straight away- this really helps the outcome!!

Box Rest.A bed to support those feet – shavings,

sand, hemp, sawdust- right up to the door.Minimal forage feed.Cold treatment- from the knee or hock

downwards.

PrognosisPrognosis

Many factors affect this:

acuteness of onset

severity of disease

concurrent factors

previous history

adherence to treatment protocols

radiographic changes

Radiographic changesRadiographic changes

Treatment timesTreatment times

BOX REST – Many people ask why!(weeks to months – not days!)

Can take 6-9 months to achieve final results (may never return to full soundness)

Laminitis is best avoidedLaminitis is best avoided

Condition scoring

Fructan levels in feeding

Avoid grazing fresh cut areas

Thank you Spillers!

Laminitis is best avoidedLaminitis is best avoided

Mixed species grazing

Turnout with a muzzle

Founderguard

Laminitis is best avoidedLaminitis is best avoided

Regular exercise native ponies are capable!

Avoid concussive exercise

SummarySummary

LAMINITIS IS A SEVERE DISEASE THAT CAN

KILL OR RESULT IN PERMANENT DEBILITY

Management is :

Costly

Time consuming

Hard work

Can be an uphill battle

Any questions?Any questions?