Group Title: 2008 Florida Equine Institute Proceedings
Title: Conventional concepts in the treatment of laminitis
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Title: Conventional concepts in the treatment of laminitis
Physical Description: Book
Language: English
Creator: Whitehead, Adam
Publisher: Institute of Food and Agricultural Sciences, University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2008
Copyright Date: 2008
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General Note: 2008 Florida Equine Institute Proceedings
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Bibliographic ID: UF00095041
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.

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Conventional Concepts in the Treatment of Laminitis
Adam Whitehead
Resident Farrier UFVMC

Grossly defined, laminitis is inflammation of the sensitive laminae in the hoof of
the horse, caused by stressful events, trauma, infection, or parturition. This definition
sheds little light on the destructive process that occurs within the hoof or how to treat a
horse suffer from this affliction.
Laminitis is commonly known as a secondary process and is a result of a variety
of primary processes. Some of the primary causes that initiate laminitis are grain
overload, colitis, colic, diarrhea, Cushing's disease, retained placenta, exhaustion, direct
hoof trauma, excessive weight baring on a single limb change in diet or environment and
stressful travel. Once the laminetic process has begun it can be classified into the
developmental, acute, and chronic phases. Treatment plans are based largely upon the
stage of the disease and the amount of damage to the laminae
The developmental phase typically begins with the onset of the primary process
(e.g. hoof trauma or colic). Symptoms such as elevated digital pulse and warmth in the
hooves are typically mild and generally present within 12-24 hours. Treatment for horses
in the developmental stage of laminitis should be proactive, not reactive, and based
largely on the probability of the disease occurring. Most treatment goals are aimed at
eliminating the cause of the episode, preserving circulation, providing axial support and
reducing the bodies biomechanical influence on it self. No one treatment regiment has
proven to be effective and will they vary largely among practioners. Eliminating the
primary process is generally the first step in the treatment process. Consistent quality
Radiographs of the feet are essential at this point. Some practioners have also shown
venograms to be very helpful in providing a prognosis and establishing a treatment plan
at this stage. Modified ultimates, Soft Ride Boots, axial support and ice therapy have
been very useful in this practice.
The acute stage begins with the onset of pain and lameness, typically with in 24-
48 hours, and lasts until the pain and lameness subsides and the horse recovers or
displacement (rotation, sinking or both) of PIII occurs. Horses in the acute phase
generally exhibit common signs such as, elevated digital pulse, warm hooves and painful
response at the toe to palpation and/or hoof testers. Loss of appetite, limited intake of
fluids and the typical laminetic stance (transferring weight off of the front hooves) are
also commonly observed signs. In this phase the inflammatory process is at its climax
and blood supply to the digit may be severely compromised. This hypoperfusion within
the digit may lead to ischemia, necrosis, and edema compromising the integrity of the
laminae. Aggressive treatment during the acute phase generally provides a more
favorable outcome and may preserve the integrity of the laminae. Use of nonsteriodial
anti-inflammatory drugs (NSAID's) such as bute to control pain is common practice. As
previously stated, eliminating the primary process is generally the first step in the
treatment process. Consistent quality Radiographs of the feet and accurate soft tissue
measurement are critical. Treatments will also vary largely among practioners and no
system has been proven to be universally effective. Treatment should also target reducing
the biomechanical forces that further compromise weakened laminae. Preserving the









circulation to the hoof, and reducing the bodies' biomechanical influence on it self are
paramount goals in a treatment plan.
The chronic phase begins when clinical or radiographic signs of displacement are
noted. This rotation and/or sinking of PIII occur as a result of failed laminar bond, which
suspends the bone within the hoof capsule. This displacement compresses the corium at
the coronary band as well as under the tip of PIII, resulting in further compromised
perfusion, abnormal hoof function, and chronic pain. Treatment of chronic laminitis is
primarily based on therapeutic trimming and shoeing, while continuing to control pain
and the initial trigger. Treatment plans will be based largely upon the owner goals,
damage to the feet, type of displacement and practioners experience. Generally goals of
therapeutic shoeing, aided by radiographs, are to restore PIII's orientation to the ground
establishing proper boney alignment and to restore normal function of the hoof.
Dramatically reducing the biomechanical exertion of the deep digital flexor tendon
(DDFT) is paramount to successful treatment as well. These efforts allow new laminae to
generate as the hoof grows, eventually providing stability to PIII. It is important however
to note that the amount of damage incurred during the early stages is directly related to
how well a horse will recover. Therapeutic shoeing may be accompanied by surgical
intervention; performing a deep digital tenotamy allows us to realign the horses' boney
column and generate a new laminar attachment with minimal mechanical influence from
the deep digital flexor tendon. Again treatment plans will vary largely among practioners;
rocker shoes, rail shoes, wood clogs, glue on shoes and foot casts have been useful in this
practice.
Treating laminitis at any stage can be a daunting task. Awareness by owners,
veterinarians and farriers of horses that are high risk as well as early diagnoses and
treatment according to the probability the disease occurring rather than waiting for
laminitis to occur may certainly provide the most favorable outcome. It is also important
to recruit a vet/farrier team that keeps realistic goals in mind such as, maintaining
comfort of the horse, preserving and/or restoring adequate perfusion to the hoof and
reducing the biomechanical influence of the DDFT.




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