WHAT IS LAMINITIS?

Laminitis is a painful condition of horses’ feet. The actual word laminitis means ‘inflammation (itis) of the sensitive laminae (lamin)’. These laminae are the membranes that hold the bone of the foot (pedal bone) in place inside the foot. So in Laminitis when they get inflamed it is as if your horse has to stand on a very badly bruised fingernail.


 

CAUSES

The main cause of almost all laminitis is poor digestion and the biggest problem in this regard comes from rich grass.  Fertilised grass is particularly dangerous and fat ponies are even more prone to problems for reasons described at the end of this section.  Some types of rich grass are more dangerous than others especially those which contain high levels of sugars called ‘fructans’.  Fructans are not so easy for a horse to digest and break down and when food is not broken down properly, acids and toxins are produced which leak into the body and damage blood vessels.  When blood vessels that feed the feet are affected in this way the amount of blood flowing down to the sensitive laminae is reduced and they become swollen, inflamed and very painful. (Some alternative theories also suggest that toxins more importantly affect horn growth and that these are the cause of most laminitis).  Damage to the laminae means that they cannot do their job of holding the pedal bone in place properly and this results in all the pain. As the situation gets worse and if the flow of toxins is not reduced then the laminae can be so damaged that the foot bone sinks right through the sole of the foot and the horse will have to be euthanased. When the foot bone changes position a little the pedal bone is said to have ‘rotated’.  In the US this is called ‘Founder’. Very rarely grass is not the cause of the problem. Probably the most common ‘non-grass’ causes of laminitis is a disease caused ‘Cushings Disease’.  Many of the rare cases of laminitis that do not respond to normal treatment do so because they are caused by this problem.  Cushings disease is caused by a growth on the part of the brain, which controls the body’s normal production of steroids.  This condition is mostly seen in older individuals and the high levels of steroids in the body directly cause laminitis.  Cushings disease can be treated effectively. In recent times other explanations have been put forward that explain the cause of laminitis in more detail.  In fat ponies the fat that is laid down disturbs the body’s metabolism and releases chemicals similar to steroid hormones.  These steroids make the horse or pony even more prone to getting laminitis and the condition is often called ‘metabolic syndrome’. In addition, changes to the horse’s metabolism often mean that a hormone called insulin does not work properly.  Lack of good insulin causes diabetes but in horses with laminitis insulin does not work properly meaning that blood sugar levels get too high.  In this situation horses are said to be ‘insulin resistant’.  High levels of blood sugars damage cells in the laminae region and make horses more prone to getting laminitis. Other rare causes of laminitis include: overeating grain, concussion from excessive work on hard surfaces,  womb infections from retained placentae immediately after foaling and stress.  Stress results in the body releasing large amounts of steroids.


 

THE STAGES OF LAMINITIS

Laminitis can start quickly or slowly. Owners may be distressed to suddenly find their horse lying on the ground unable to rise because of laminitis pain or their horse may just be a little lame with slight warmth in one or more feet.


Acute laminitis

Generally, however, laminitis will start as an acute event. This means that it starts quite quickly and causes quite a lot of pain. If such a condition is treated quickly it can stop quite quickly and be over in 10-14 days but if not treated quickly and effectively and if preventative measures are not used it can progress to become a chronic (long term) case.


Chronic Laminitis

Chronic laminitis is that type of disease problem which drags on and on and never really goes away. The horse in question has repeated mild attacks of the disease and the feet are so changed that any little change in diet brings on the problem again. A horse may be a chronic laminitic case but still get one or two acute attacks each year. Of course one acute attack always makes it more likely that your horse will become chronic and prevention is very important from that time on.


 

LAMINITIS TREATMENT - WHAT YOUR VET CAN DO

Treatment of laminitis by your vet most commonly involves the use of anti-inflammatories (non steroidal anti-inflammatories NSAIDs) which also have some pain relieving effect and diet adjustment. NSAIDs such as ‘bute’ or flunixine are commonly used for around 2 weeks in acute laminitis cases and sometimes indefinitely in chronic laminitis cases. They effectively combat inflammation in the laminitis treatment.

OTHER LAMINITIS TREATMENTS INCLUDE

1. Extra pain relief with narcotic analgesics e.g. fentanyl patches in America. Not used much in the UK.
2. Antibiotics like virginiamycin. Laminitis treatment aims to reduce the number of harmful bacteria in the gut causing release of toxins.
3. Drugs to improve circulation e.g. ACP the sedative (also reduces stress). Practically most such drugs have not been shown to help a lot in laminitis treatment. Isoxuprine has also been used.
4. Cold therapy. Can help in initial stages of laminitis treatment but the benefits have not been accurately assessed.
5. Heat therapy. Aims to improve circulation to laminitic feet but there is no evidence that it works.
6. Antihistamines. Once used for the treatment of laminitis but a role for their use has not been found.
7. Nerve Blocks to desensitise the feet in laminitis treatment may seem sensible but it may mean that laminitis cases put too much weight on sensitive feet and do more damage.
8. Uses of drugs to combat Cushings disease.
9. Use of drugs to combat insulin resistance.


 

LAMINITIS MANAGEMENT & PREVENTION

At the start of treatment for laminitis horses are better stabled on a deep clean bed (shavings may be best which gives support and comfort). As you see improvement the horse can be let out onto an even concrete yard or small starvation paddock with no grass. Do not feed any concentrates or allow grazing and just feed hay or other pure roughage material. The horse should not be overstarved and supplements in the feed will help proper recovery of the foot and rest of the body. Simple hoof growth formulae may be useful, MSM and minerals and vitamins as well as Laminitis Prone Supplement. Immune support may also help with healing of the damaged tissues within the foot. Walking too early on may make laminitis worse. Forcing exercise may encourage separation of the sensitive laminae but when things are more stable walking on soft ground may encourage circulation.

HOOF CARE:

Foot care is very important in confirmed cases of laminitis. Quick removal of the shoes may further traumatise the feet and if the sole has already dropped, then shoes will make the feet more comfortable by raising the sole off the ground. Frog support is often important in laminitis cases and temporary padding placed over the frog may provide useful support until Xrays can be done or the farrier used.

Once the laminitis has settled down, corrective shoeing aims to restore the natural shape and conformation of the foot. Vet and farrier should work together and trimming is carried out once a month. Using Xrays as a guide, farriers will aim to shorten long toes, rasp back the front hoof wall to make it parallel with the pedal bone, remove excessive heel length and fit corrective shoes as required. In special cases heart bar shoes provide support to the pedal bone through the frog. Glue on shoes or plastic strap on shoes may help to eliminate trauma.

MANAGEMENT PREVENTION:

1. Diet: Restrict intake of food that may be causing the problem e.g. grass. This is particularly important for fat ponies which have more pressure on the feet and in all horses prone to the problem. Diet should also contain supplements and nutrients that are known to help limit laminitis damage and improve digestion of food thus helping prevent the problem. Most ponies are safe if they are only allowed to graze for an hour in the morning or an hour in the evening.

2. Make use of starvation paddocks to restrict intake of grass and think about using muzzles to prevent ponies and horses that are prone to laminitis eating too much.

3. Avoid using your horse on the road and on hard surfaces as this traumatises the feet and may cause laminitis to come back.

4. Make sure that medical conditions such as colic and infections are treated quickly as these can result in release of toxins which can bring on laminitis.

5. Ensure that rich food is locked away safely.


 

LAMINITIS RESEARCH LINKS

An Overview of the last 20 years of Laminitis Research Funding
by Fran Jurga

A Review of “Equine Laminitis” – a new book by Dr C. Pollitt, a world expert in Laminitis Research

Laminitis Terminology – a review by Christy West of Horse Interactive

Sponsors of Laminitis Advice, Global Herbs

THE LAMINITIS ADVICE SUPPORT NETWORK

Any organisation involved in Laminitis Research, Bibliography, provision of best-practice veterinary services or publication of Laminitis News may apply for a link on this page provided they have placed a link, in the first place, to LAMINITIS ADVICE. Please activate your link to this site ie. visit this site via your link so it shows up in our Weblog Stats. Thank you.
E-mail: John@ laminitis-advice.co.uk

Stephen Ashdown’s Free Vet Advice Helpline: 01243 773363


 

SUPPLEMENTS

When you use dietary control to help with laminitis treatment remember that a lack of proper nutrients may make it more difficult and slow healing. This is why supplements are very important not only for ensuring that your horse recovers but also to make sure that he or she does not become nutritional deficient whilst undergoing treatment.

Because Laminitis is really a nutritional problem it is possible to help horses a lot by using nutritional supplements. These are not used as medicines but as aids to the work of your vet. Aloe vera, probiotics and antioxidants can help a lot but we find liver tonic to be the most effective supplement we have found yet.

A liver tonic supports the way the body deals with toxins that are circulating around the body and at the same time tones up the digestive process. It has the added benefit that most other parts of the body work a lot better once the liver is toned up.