Laminitis

Our team at Towcester Equine Vets understand how devastating a diagnosis of laminitis can be.

Read on to find out how our vets treat laminitis and what you can do to help prevent this debilatating disease. If you are at all concerned, call us today on 01327 811007.

What is laminitis?

Laminitis is a condition that affects the laminae in your horse’s feet. All horses are susceptible to the condition but certain breeds (such as native breeds) can be predisposed. Different factors can cause swelling of the laminae – the soft tissue structures that attach the pedal bone to the hoof wall. When the laminae swell, it causes the pedal bone to become unstable within the hoof capsule, causing in some instances, rotation or sinking of the pedal bone, coupled with extreme pain.

Signs to look for are:

• Is your horse/pony displaying a rocked back stance, weight shifting, or lying down more? These are signs that their feet are causing them discomfort and are commonly observed in laminitic ponies.
• Increased heat and digital pulses in the hoof and coronet band, as well as pain over the frog. This part of the frog will be directly below the pedal bone so sensitivity here can indicate that there is pain in the hoof. Heat can often be palpated by holding your hand over the hoof and comparing to the other hooves. Bounding digital pulses either side of the pastern just above the coronet band are also a sign that your horse may be affected by laminitis as this indicates increased blood flow to the area.
• Your horse may have an elevated respiratory rate (or heart rate as evaluated by your vet)
• Your horse may find it difficult to lift their leg or weight bear on one leg when picking out their feet
• A reluctance to turn or a change in the horse’s gait/stride
• A change in behaviour or temperament

Horse’s suffering with hormone disorders may also be predisposed to laminitis. Common examples include horses affected by Cushing’s disease or Pituitary Pars Intermedia Dysfunction (PPID) and EMS (Equine Metabolic Syndrome). If you know that your horse suffers from either of these conditions, please follow management advice prescribed by our vets to reduce the risk of laminitis.

PPID can present in your horse exhibiting abnormal hair shedding patterns or excessive curly coats (known as hirsutism), patchy sweating, increased drinking and urination, fat pads above the eyes, a lack of energy, dullness and lethargy, a lower body condition score compared to their ‘normal’ and an increased susceptibility to infections and laminitis.

EMS most often presents in overweight horses that may have abnormal fat distribution over the crest and rump and will often have recurring bouts of laminitis.

Both conditions can be managed with medication so please call our vets to discuss this further.

How do our vets diagnose laminitis?

In order to successfully diagnose laminitis our vets will take a detailed history of your horse coupled with a full clinical picture. This will include information on diet and exercise regimes, recent management changes and previous medical problems they may have experienced. Following this the vet will undertake a detailed fully body examination noting the horse’s body condition score, fat distribution, their stance at rest and how they move in a straight line or on a circle. The vet will also examine hoof conformation, feel for digital pulses and use hoof testers to see how reactive the horse is over their sole. In extreme cases where this examination proves too painful, pain relief is administered.

Digital radiographs of the feet are taken to ascertain the position of the pedal bone and whether there is any gas shadowing present from laminar damage. The vets will measure angles of the pedal bone from the x-ray images in order to diagnose severity of the laminitis.

PPID can be diagnosed by measuring for the ACTH hormone levels in your horse’s blood. These samples will need to be returned to the clinic within 2 hours so that our nurses can spin the blood and pull off the plasma component which is sent to the external lab for testing.

Risks that contribute to laminitis

Your horse may develop laminitis for a number of different reasons:

• Pasture quality: grass that has been heavily fertilised, affected by frost or that has been overgrazed will contain high levels of fructan, a sugar linked closely to laminitis. If you know that your horse suffers from laminitis or is predisposed due to a hormone condition, heavily monitor their grazing and restrict access to fresh grass.
• Grain: high volumes of grain and cereals in your horse’s diet may cause a non-grass, carbohydrate overload, increasing the risk of laminitis. Introducing new feed should be undertaken gradually.
• Hormonal disorders: Cushing’s disease (PPID) and EMS (Equine Metabolic Syndrome) cause changes in the hormones which will increase the risk of your horse developing laminitis.
• Underlying toxic disease: Less commonly associated with laminitic risk. If your horse is already suffering from another infection (such as a uterine infection), the toxins circulating in the body can cause a cascade of reactions resulting in laminitis.
• Dependent limb laminitis: Also a less commonly associated laminitic risk is the scenario where there is a fracture,/foot abscess/injury in one leg, and the ensuing additional pressure put on the opposite leg may cause them to develop laminitis in that limb.
• Medication: Keep in mind that there is a very minor risk of laminitis developing following steroidal use which is discussed on a case-by-case basis. Our team always adhere to the correct dosage levels, however if your horse is prone to laminitis please inform the vet before any steroid use or joint injections are carried out.

How do we treat laminitis?

Laminitis is considered an EMERGENCY as the condition can quickly deteriortae and affect the welfare of your horse. There are a number of first aid treatments available for affected horses but the best way to treat laminitis is early diagnosis combined with correct management.

Firstly, ensure your horse is confined to their stable in order to restrict movement and keep them on a deep bed of shavings to improve comfort levels. Shavings are the best bedding because of the way in which they pack the foot and provide extra support. Remove all treats, hard feed and any excess sugar from the diet as these are detrimental. Hay should be soaked to remove excess sugar and fed only in small nets with small holes. You should be feeding your horse 1.5-2% of their bodyweight in kilograms of hay per day. Your vet will be able to advise on the use of anti-inflammatories and mild sedatives to keep your horse calm and comfortable. Following digital x-rays, the vets will be able to make a plan with your farrier on how best to support your horse’s foot/feet going forward.

If your horse’s laminitis is linked to an underlying hormone disorder, it is more difficult to get their management under control. Cushing’s disease is treated using medication that helps to control the hormone imbalance in the body. EMS cases may also benefit from oral medication but both require regular blood tests and health checks.

If underlying toxic conditions are the reason your horse has been affected by laminitis, then aggressive management early on will help to control the condition. Removal of the toxins and anti-endotoxic drugs, combined with anti-inflammatories and antibiotics will help to fight the cause of infection. If your horse is suffering from a fracture or prolonged foot abscess, it may be appropriate to consider  fitting foot supports to the opposite limb. This will help prevent dependent/contralateral limb laminitis.

Ongoing management of a laminitic horses

Regular checkups are a necessary part of a laminitic horse’s management. Moving forward our vets will be working closely with your farrier and any grooms who may be looking after your horse to ensure that appropriate management reduces the risk of any further laminitic episodes. Daily monitoring of comfort levels is required and careful grassland management is a necessity.

Our team are happy to meet your farrier at the yard to take further x-rays, helping to determine the best plan of action for trimming and remedial shoeing. Also, keep in mind that the less your horse weighs the better their comfort levels. Make sure that you regularly weigh them using a weight tape or our weigh-bridge at our Towcester clinic.