Laminitis – failure of attachment between the distal phalanx and lamellae of the inner hoof wall.

Stay Connected:

Veterinary Institute if Integrative Medicine

Laminitis is the failure of the attachment between the distal phalanx and the lamellae of the inner hoof wall. When the distal phalanx is no longer properly attached to the inside of the hoof the distal phalanx can descend down through the foot and even penetrate the sole. Many factors can trigger an episode, from overeating pasture or grain to metabolic disorders, or as a sequela to other diseases. Chronic laminitis usually has a metabolic component that needs to be addressed. Natural compounds can assist in insulin resistance and reduce inflammation.

A typical x-ray or radiograph of a laminitic foot in a horse. The annotation P2 stands for the middle phalanx (pastern bone) and P3 denotes the distal phalanx (coffin bone). The white line marks the boundary of the outer hoof wall and the yellow lines show the distance between the top and bottom part of the coffin bone with the outer hoof wall. In this example the distal (bottom) part of the coffin bone is rotated away (greater distance) from the hoof wall, an indication of laminitis. Date 1999 Source Radiograph created by Malcolm Morley , annotated by Froggerlaura
A typical x-ray or radiograph of a laminitic foot in a horse. The annotation P2 stands for the middle phalanx (pastern bone) and P3 denotes the distal phalanx (coffin bone). The white line marks the boundary of the outer hoof wall and the yellow lines show the distance between the top and bottom part of the coffin bone with the outer hoof wall. In this example the distal (bottom) part of the coffin bone is rotated away (greater distance) from the hoof wall, an indication of laminitis.
Date 1999
Source Radiograph created by Malcolm Morley , annotated by Froggerlaura

If laminitis is suspected, all feed should be immediately removed from the stall.  If the equine is in a pasture, move it to a stall.  The primary goal is to reduce the severity of the attack and prevent the rotation of the coffin bone – the main bone in the hoof.  The horse will most likely not suffer permanent lameness if the disease is minimized as soon as possible. Placing a 2-inch thick builder Styrofoam (from the local home improvement store) under the soles of the feet will help provide support and relief from pain. This will also help decrease the amount of damage to the horse’s foot. Horse-specific pads are also available.

Prevention of laminitis is always preferable; here are a few easy ways to help prevent the formation of laminitis:

Keep the equine’s weight in check;

» Keep him off hard surfaces for prolonged periods of time;

» Cut off any access to the feed bin;

» Carefully monitor the starches and sugars in the horse’s food; high concentrations of starch and sugar (including grains, molasses-based foods and even artificial sweeteners!) can lead to:

 

1.An increase in bad bacteria (Streptococcus);

2.Digestive upset;

3.The destruction of good gut bacteria/flora; and

4.Eventual insulin resistance issues.

 

Read more

» Be knowledgeable about the different types of hay (some hays can have a higher sugar content depending on the type and growing conditions);

1.These types of hay include Timothy, Orchard and Brome (cool season crops).

» Stick with hays that are low in sugars and native prairie grasses, these vary depending on the specific area; and

Always maintain consistent and proper hoof-trimming and shoeing (if cracks or any separation of the hoof and sole wall occur, this will predispose the horse to further infection and challenges).

Horses with laminitis need a month or more of stall rest after they are sound and without painkillers. Horses that have progressed to founder need to regrow the foot before they are sound, but can start exercising gradually as they heal. The acute symptoms of laminitis should be resolved within the first 10 days of treatment, but the total healing time depends on the severity of the disease.

If the equine is diagnosed with grain laminitis, treatment will begin with passing a stomach tube to coat the horse’s intestinal tract with a large amount of mineral oil (3 to 4 quarts per 1,000 pounds of equine body weight). Doing this will help eliminate the grain from the horse’s intestinal tract quickly and before it reaches the colon and begins fermenting which releases the dangerous toxins and bacteria.  Mineral oil acts as a laxative and can also help prevent the absorption of toxins.  The dosage of mineral oil may need to be repeated every 6 hours until all the grain has safely passed through the equine intestines.

Once the symptoms of laminitis appear, provide soft footing on the stall floor that includes at least 6 inches of sand or 18 inches of deep shavings, so the horse can stand more comfortably as the tension is reduced on the deep digital flexor tendons.  Another way to reduce the pull of the tendon is to apply wedge pads beneath the heels.  Wrapping a roll of elastic gauze will also work well if you do not have access to the wedge pads.  Avoid exercising the horse as this can make the coffin bone rotate (or founder) making the hoof not only more painful, but risk further damage (sinking). The hoof can be further stabilized with a frog support. If this support is placed correctly, the horse will immediately feel relief and be more comfortable. If not, remove and place the support differently.

Once the laminitis has been properly diagnosed, treatment should include Flunixin Meglumine for its anti-endotoxic (anti-toxin) properties and Butazolidin (a non-steriodal anti-inflammatory drug (NSAID) commonly referred to as Bute). When given in combination with Acepromazine (a tranquilizer), it has been shown to reduce both capillary constriction and hypertension in horses.  For best results, both should be given as an IV. After 24 hours have passed, Butazolidin can be given by orally or by the mouth.   X-rays should be taken over the next two weeks to monitor the position of the coffin bone. Horses being treated by a holistic veterinarian may not need anti-inflammatories and may actually do better than horses treated with Bute or Banamine.

For the recovering horse – or to prevent laminitis — careful attention should be exercised in adapting the equine to a healthier diet and feeding schedule.  Eliminate grain from the horse’s diet and replace it with good-quality grass hay.  Do not give unlimited access to lush green pastures. Offer a few pounds of hay 2-3 times per day, but vigilantly watch for signs of relapse. Encourage mineral intake by feeding minerals and salt separately. Grain can be introduced later if needed, in small amounts of a cup or so, if the horse is overweight.  Make sure a fresh, clean and abundant water source is available at all times (this will also help ease the symptoms of laminitis). If the horse is overweight, a proper diet plan should put into place to safely reduce their weight which will also help decrease the chances of laminitis reoccurring. If a horse has foundered once, chances are it can happen again.

Integrative Medicine

Laminitis is more than just a ‘hoof’ problem. The whole (or holistic) health of the horse must be considered and addressed. With quick and proper treatment and more healthful changes, most equines can return to a normal life.

In addition to the recommendations made above, the consistent use of supplements can help strengthen the afflicted horse’s hoof and decrease the chance of developing laminitis or reducing the damaging effects of the disease.

Read the complete article here

 

 

 

 

 

GEM