Diagnosis and Treatment of Equine Laminitis

Clinical Signs

The clinical signs include lameness affecting two or more limbs, characteristic stance of leaning back on the heels, bounding digital pulses, increased hoof wall temperature, pain on hoof tester pressure near the point of the frog and a palpable depression at the coronary band. The lameness varies in severity from only perceptible at the trot to spending prolonged periods recumbent.

Diagnosis

The diagnosis is based on the clinical signs. Further tests are performed when an underlying endocrinological abnormality is suspected and radiographs are warranted if movement of the pedal bone is suspected.

Endocrine Tests

Endocrine tests are performed when pituitary pars intermedia dysfunction (PPID) is suspected. Single blood insulin and/or cortisol measurements are unreliable. Basal ACTH concentration and dexamethasone suppression test results can be suggestive of PPID. However, there is no reliable single diagnostic test.

Radiography

Lateromedial radiographs are taken to assess pedal bone position. Both the degree of rotation and the founder distance (D) are useful in predicting outcome. If the angle of rotation is >11.50, the chance of returning to the former performance level is significantly reduced. If D is >15mm, the horse has 40% chance of returning to soundness.

Medical Treatment

Once the clinical signs become apparent, the lamellar tissues have already been subjected to activation of metabolic and degenerative changes. Thus, therapy should be aimed at providing analgesia and foot support. Non steroidal anti-inflammatory drugs (NSAIDs), are the first choice for analgesia as they also inhibit part of the inflammatory cascade that may be involved in the pathogenesis of laminitis. If the pain relief is insufficient, opiates alone or in combination with other drugs such as ketamine, detomidine and/or lignocaine can additionally be used. [...]