Figure 1. A - Rotation B - Mediolateral rotation C - Symmetrical distal displacement or "Sinking"

Figure 1. A - Rotation B - Mediolateral rotation C - Symmetrical distal displacement or "Sinking"

Equine Laminitis is a disease characterized by failure of the soft tissues that suspend the distal phalanx (coffin bone) within the hoof wall. This failure can lead to:

 

‐ Symmetrical distal displacement of the phalanx (sinking)

‐ Assymetrical distal displacement of the phalanx (medial/lateral/rotation) 

 

 Figur 2. Inside of the hoof of a horse, showing the laminae

Figur 2. Inside of the hoof of a horse, showing the laminae

An individual horse may suffer from both distal displacement and rotation of the phalanx. Laminitis usually occurs as a consequence of the following:

  1. Diseases associated with sepsis/endotoxemia
  2. Excessive weight placed on a limb(often due to injury of the opposite limb)
  3. Equine Cushing’s Disease or Pituitary Pars Intermedia Dysfunction (PPID)
  4. Equine metabolic syndrome (EMS) (pasture associated laminitis)
  5. Carbohydrate overload (Grain overload)
  6. (Black Walnut shavings consumption) 

One can try to classify laminitis in 3 different stages:

- PRODROMAL – A horse fits this classification if it is suffering from a disease that increases the risk of laminitis
- ACUTE – A horse fits this description if it shows signs of laminitis but there is no radiographic evidence of displacement of the distal phalanx.

- CHRONIC – a horse enters the chronic phase once there is displacement of the third phalanx.


Clinical Signs

Lameness associated with laminitis varies in severity but often includes one or more of the following symptoms:

 Image of unknown origin

Image of unknown origin

  • Reluctancy to walk / lying down for extended periods of time

  • Lack of appetite

  • Mild fever

  • High Respiratory and Heart rate

  • Increase in digital pulses

  • Increased temperature of the hoof wall and coronary band

  • Alternatively picking up front feet

  • Painful response to hooftesters

  • Camped out position (hindlegs under body and front feet placed forward

  • Deformation of hoof wall and/or sole 


Diagnosis

  • Clinical signs

  • Radiography 


Treatment

Treatment and management of laminitis depends on the stage of the disease process and also on the type of displacement present.

- PRODROMAL – During this phase, Cold therapy and the use of NSAID (Non Steroid Anti Inflammatory Drugs ) may be beneficial.

- ACUTE – The aim of treatment is to stabilize the digit (regardless of degree of displacement).

  • There are several methods ways to provide sole support to the laminitic horse. Some of them include: 
    • Appropriate bedding ( fine sand, extra bedding, rubber mat)
    • "Gel pads", "styrofoam", "frogpads", "cushion support
  • esponsible use of NSAIDS (such as meloxicam and flunixin meglumine)
  • Possible use of drugs that influence bloodflow to the laminae (such as pentoxyfilline, acepromazine)
  • Hoof care. The main objective of hoof care should be to redirect pressure from the wall and to ease breakover. For this purpose different shoes can be used such as wooden shoe, bar shoe, gel pads, leather pads, among others.

- CHRONIC – The main objectives are to maintain the stability of the disease process, while trying to reestablish the normal relationship between the hoof capsule and distal phalanx.

Hoof care of horses with ”rotation” – Vet and Farrier should aim to realign the phalangeal axis by trimming, preserve thickness of the sole, recruit weight bearing of the sole, ease the breakover and reduce tension in the DDFT (Deep Digital Flexor Tendon). Some horses benefit from elevating the heels. It is important to bear in mind that trimming and shoeing should be planned based on radiographic analysis and patient consideration.

Hoof care of horses with distal displacement or ”sinking” – These horses do not usually benefit from elevating the heels. Ease of break over and sole support are very important aspects of hoof care in these horses.

Hoof care of horses with unilateral distal displacement ”medial/lateral rotation” – The objectives of hoof care in such horses should include the redirection of load away from the most damaged area of the laminae.

It is also important to understand that the process of rehabilitation of a horse with chronic laminitis , often takes a long time. Owner, vet and farrier should be aware of this and must be prepared for ”the long road that lies ahead”.

Laminitis is a very serious disease. As with most other health problems in the horse, ongoing communication and cooperation with your veterinarian is very important. With laminitis, the farrier also plays a very important role and as such should be recruited into this 3 person team.