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( ADVICE FROM THE VET )

Laminitis – A year round problem

By James Evans BVetMed, BAEDT, MRCVS

aminitis is an extremely painful inflammatory condition of the feet in which DIAGNOSIS Lthere is weakening of the sensitive tissues (laminae) that bond the wall to the pedal Diagnosis can frequently be made by clinical signs bone within the ’s hoof. It can affect any alone. X-rays are often required to determine horse, or donkey of any age or sex, at any whether there has been any rotation or dropping of time of the year. results in weakening of the pedal bone. It is essential to involve your the supporting lamina within the hoof, leading to farrier in discussions with your vet, working as a rotation and/or sinking of the pedal bone. In team, and sharing the X-rays to help determine severe cases, it can lead to penetration of the future trimming and/or shoeing plans for your pedal bone through the sole of the foot. horse.

WHAT CAUSES LAMINITIS? When trying to evaluate whether there is concurrent hormonal disease, blood testing for PPID or EMS There are many different reasons for the onset of may need to be delayed until the horse/pony is laminitis and these can be broadly categorised as comfortable again, as severe pain and inflammation follows: during an acute laminitic episode could cause false positives to be seen on blood tests. For this 1. Hormonal: Recent research has shown that A pony with laminitis shifting weight from reason it is often necessary to re-test bloods once Equine Cushing’s disease (Pars Pituitary Intermedia one foot to the other. Image courtesy of the laminitic episode has resolved. Dysfunction (PPID)), and Equine Metabolic Syndrome Dr D Pollard, AHT (EMS) cause most cases of laminitis in the UK and around the world. 2. : Too much and starch (e.g. feet. In most instances the affected animal will spring grass, excessive concentrates). shift its weight from one limb to another, will be 3. Toxic: infections and severe inflammatory reluctant to move, may lie down and there is often issues, such as a retained placenta after foaling, excessive heat in the with a strong ‘digital endotoxaemia, some types of colic or severe pulse’ felt at the of the fetlock (the palmar or pneumonia can induce a bout of laminitis; plantar digital arteries). Ask your vet to demonstrate 4. Mechanical: Too much length of toe, how to feel for pulses if you are unsure. over-zealous foot trimming or improper shoeing, will be exaggerated when turning on a hard surface. fast or prolonged work on hard surfaces; supporting In cases of chronic laminitis, there will be changes limb laminitis due to foot abscess, fracture, joint to the hoof. Signs include horizontal ridges around infection, or soft tissue damage in the opposite the hoof, which are wider at the heels, and an limb. overly flat or convex sole. An abscess can present An x-ray showing a horse with a rotated 5. Stress: Any stress, such as overworking unfit similar clinical signs to laminitis, such as lameness, pedal bone , a dramatic change in environment and/or excessive heat in the foot and a bounding digital frequent travelling, particularly for overweight pulse, but usually only affects a single foot. animals, can trigger laminitis. However, recurrent abscesses are more likely to TREATMENT occur in feet compromised by chronic laminitis. A recent study by the Animal Health Trust, in In milder cases, there may be only a slight change Laminitis is an emergency: your veterinary surgeon collaboration with the Royal Veterinary College in the animal’s gait, with the horse moving in a should be contacted as soon as a case of laminitis and Rossdales Equine Hospital, funded by World ‘pottery’, short-striding or ‘stiff’ fashion. These is suspected. Pain relief is a key part of treatment Horse Welfare, showed that: animals will go on to deteriorate further, unless they and usually involves the use of non-steroidal anti- are rested and treated promptly. inflammatories (NSAIDs) such as • laminitis was more than twice as likely to (bute) or . A recent study also described develop in horses/ that had recently paracetamol as a useful short-term adjunctive gained weight; is a risk factor for when treating laminitis alongside laminitis. NSAIDs. Acepromazine (Sedalin)is also sometimes • horses/ponies that had a history of laminitis prescribed to reduce the blood pressure in the were more at risk at developing the disease laminar vessels. again; • horses/ponies with lengthy recovery The horse should be stabled immediately and foot periods after the previous bout of laminitis support is a vital part of the treatment to limit were more at risk; movement of the pedal bone and to reduce pain. • horses/ponies who were lame or foot-sore A deep bed that extends all the way to the door after routine shoeing were at increased risk should be provided to relieve pressure on the feet. • there was a higher incidence of laminitis in Twice daily monitoring of the feet and digital horses/ponies who had longer than 8 week pulses is essential. cycles between routine trimming/shoeing; • native breeds to the UK and Ireland Discuss with your farrier therapeutic trimming showed an increased risk of laminitis. and/or shoeing to relieve pressure on the toe and to prevent further damage to the feet. The use of SIGNS OF LAMINITIS frog supports, such as Lilypads or TLC Frog Supports, or frog and sole combined supports, Laminitis usually affects both front feet but can Recurrent abscesses are more likely to occur in such as dental impression material or styrofoam sometimes affect one foot, and occasionally hind feet compromised by chronic laminitis. pads, may be helpful. Imprint shoes are also Image courtesy of Dr D Pollard, AHT

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( ADVICE FROM THE VET )

Consistent weight and body condition recording is important to identify any weight gain before it negatively impacts the health of Infographic from CARE Study - courtesy of Dr D Pollard, AHT your horse.

commonly used by farriers for laminitic cases. carbohydrates. There are other ‘laminitis-friendly’ management and specialist farriery, horses can These are based on a heart-bar design and feeds available, but seek advice from a vet or make a good recovery. However, if hoof damage described as nail-less shoes which mould qualified nutritionist. occurs, this can be irreversible and lead to perfectly with the individual shape and contours ongoing problems. Previously affected horses of a horse’s hoof, providing maximum support. If the laminitis is the result of an underlying must be monitored closely and managed condition, such as an endocrine disorder, that vigilantly to prevent recurrence of the disease. Box rest along with dietary changes are very disease should be treated accordingly, as advised important to aid recovery. Grass should be by your vet. The results of the AHT study emphasise the avoided and instead low-nutritional hay should be importance of consistent weight and body fed in small amounts several times a day to If there is damage to the hoof caused by an condition recording, so that undesirable weight provide the required roughage. Hay should be abscess, this must be drained and treated with gain can be recognised before it negatively soaked for 4 hours out of sunlight to remove as topical dressings, again as advised by your vet. impacts health. Owners need to review their animal’s much of the soluble as possible, without current diet, exercise and health management risking growth of and fungus which routines as soon as undesirable weight gain is increase if you soak for longer or in sunlight. Hard CONCLUSION detected and take action. feed should be limited to a low-calorie balancer only. This ensures the essential vitamins and If you suspect a case of laminitis, contact your vet minerals are being provided without any excessive immediately. With early diagnosis, appropriate

About The Author: James Evans BVetMed, working with a wide variety of horses and BAEDT, MRCVS ponies across all disciplines.

James joined Rossdales Although James has experience in all Hertfordshire as an aspects of equine veterinary work, he has a ambulatory vet in 2017. He particular interest in equine dentistry and graduated from the Royal orthopaedics. Veterinary College in 2011, where he then became part He is a qualified dental technician, of the Equine Referral having gained membership of the British Hospital team as one of the Association of Equine Dental Technicians Junior Clinical Training Scholars. (BAEDT) by examination in 2019. He is also an FEI Permitted Treating . He subsequently worked in a number of equine and mixed practices in the Home Counties, www.rossdales.com

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