Laminitis: The Vets Perspective

Laminitis remains a crippling disease although increased awareness amongst clients has led to a decrease in the incidence of severe cases. There is still considerable ongoing research work trying to further elucidate the pathogenesis of the condition. The common triggers however remain the same, especially carbohydrate overload. In more idiopathic appearing cases, an underlying pituitary adenoma or Equine Metabolic Syndrome can be the predisposing factors. Severe endotoxaemia such as from colitis or endometritis is also a significant trigger factor. For orthopaedic surgeons, weight bearing laminitis on the contralateral limb to a severe fracture or sepsis remains a frustrating condition to treat.

From a veterinary perspective there have been little changes in the treatments available to us over the last 10-15 years. The mainstay remains the treatment of any predisposing factors. In terms of specific treatment, the horse should be strictly rested and treated with non-steroidal anti- inflammatory drugs, of which phenylbutazone is the most effective unless the horse is showing severe signs of endotoxic shock. Acepromazine is commonly used as a vasodilator. Serial radiography with appropriate coronary band markers is helpful to monitor the progression of any structural changes.

There have been more advances in the farriery aspects than in the veterinary side of laminitis treatment. This will be covered in greater detail by Simon Curtis but the veterinary perspective on corrective farriery is that the advances in the materials available and the understanding of biochemical factors within the feet have given us significant advances in the way we shoe these horses. Styrofoam pads, dental impression material or plaster of Paris casts can be used in acute cases to provide frog support without excessive trauma to the hoof capsule. In subacute cases, frog pads and dental impression material are more sympathetic than heart bar shoes and a smaller percentage of horses react adversely to the pressure being applied in this way. Keeping the break-over point back eases the load upon the supporting structures within the feet.  [...]