Management of the acute laminitis case

An animal presenting with acute laminitis is usually easy to diagnose; the combination of hoof pain, increased temperature of the hoof and coronary band, and digital pulses that are easier to palpate, form the classic scenario. The challenges in these cases are providing sufficient analgesia, preventing further damage to the affected tissues and identifying and removing any underlying causes of the condition. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat laminitis. As well as analgesia their anti-inflammatory effects may be of some benefit. In severe cases however, NSAIDs alone may not be sufficient. Opioids can be used but concerns relating to ileus and the restrictions on controlled drug use exist. Tramadol may prove useful [1]; the combination of a subanaesthetic dose of ketamine with tramadol resulted in superior analgesia than tramadol alone in one study of chronic laminitics [2]. Gabapentin has been used for the treatment of neuropathic pain in the horse [3,4] and may be helpful in the management of laminitis. An experimental epoxide hydrolase inhibitor improved analgesia in one refractory case [5]. A licensed product should always be used at first, additional drugs may be prescribed following the cascade ...