Laminitis associated with systemic inflammatory response syndrome and sepsis

Laminitis occurs as a consequence of a range of conditions in horses where systemic inflammation is a feature; particularly when this inflammation is driven by bacteria or bacterial products liberated into the bloodstream (sepsis). Gram negative sepsis and endotoxaemia accompany metritis, pneumonia and colitis/enteritis in horses and these conditions are most often complicated by the development of acute laminitis. Experimental alimentary carbohydrate overload models traditionally used to study laminitis feature clinical signs that are characteristic of sepsis and studies have confirmed the presence of endotoxin in the blood and a systemic inflammatory response with these models. It is not surprising that endotoxin, usually of gastrointestinal origin, is an important trigger of sepsis in horses considering their exquisite sensitivity to it, but interestingly investigators have not been able to induce laminitis with experimental infusion of endotoxin alone. Nevertheless, the presence of clinical signs of endotoxaemia/sepsis is an established risk factor for the development of laminitis in hospitalised horses ...