Coping with acute laminitis

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$Przewalski\'s Horse$

Karen Coumbe MRCVS

14 May, 2008

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Laminitis is a potentially agonising condition and the spring grass can increase the likelihood of an attack. Every case should be dealt with promptly and the condition should never be underestimated — in a recent study, one in five horses with laminitis were destroyed.

Laminitis can occur in two forms:

Acute laminitis is the early stage of the disease when the animal is uncomfortable and showing signs of lameness, but major damage has not yet happened within the hoof. The chances of recovery are maximised if treatment is started early.

Chronic laminitis is when the pedal bone sinks or rotates within the hoof, leading to permanent damage. These cases are not necessarily such an emergency as the acute attacks, as damage to the foot has already occurred, but a vet should be contacted if the horse or pony is in pain.

Recognising the signs

In severe cases, animals will be unable to move. They may be panting, sweating and leaning back on their heels, trying to take their weight off their feet. In the worst cases, they will lie down and be unable to stand – this condition can be confused with colic.

This is obviously urgent and you should contact your vet immediately. In milder cases the signs are more subtle, but they include:

Hooves that feel hot and feet that are painful with pressure to the sole
A tendency for the horse to stand with its legs stretched forward, while leaning backward, to ease his weight off his feet
Mild cases will constantly shift their weight from foot to foot as they try to find the least painful way of weight-bearing
The pain of laminitis means that the horse's pulse and respiratory rate rise

Frequently, a prominent pulse is obvious where the horse's digital artery runs over the fetlock. In a severe case, this digital pulse (which is where the blood flows into the foot) will be pounding on all four feet.

Mild, chronic laminitis can be confused with other sorts of lameness. Look out for the following:

A pony that 'feels his feet' and so may be intermittently lame, especially on rough ground
Foot soreness or lameness after shoeing
Odd shaped feet – indicated by rings in the hoof wall that are wider at the heel than at the toe. Dropped soles, with wider than normal white lines, and flat feet are also common
Pus, which is often present in the horse's foot, due to the weak horn growth in the diseased hoof
Visible red bruising within the hoof, particularly obvious when the farrier trims the horse's feet

What should you do

First, contact the vet. Severe cases will need painkillers and other treatment urgently – this may include frog supports, medication to control blood pressure, and treating any underlying illness that may be causing the laminitis – while mild, chronic cases will require planned action involving both vet and farrier. If laminitis is suspected, never force the horse to walk or exercise.

Current thinking is that warm water hosing or applying warm compresses around the lower limbs – for example, heat pads that can be microwaved – is far better than standing in cold water or hosing. Cold provides some relief, but this is only a temporary help, as while it numbs the pain, it also reduces the damaged foot's blood supply – this causes damage within the laminae, increasing the risk of pedal bone rotation.

It is possible to tape frog supports onto the feet to help relieve pressure on the laminae. There are now several types of tape-on support available, from purpose-designed pads or rubber wedges to homemade bandage supports. Purpose-designed frog supports can be obtained from the Laminitis Clinic – visit: www.laminitisclinic.org. If you are unsure how to apply frog supports, consult your vet.

If your horse or pony appears to be reluctant to move due to laminitis while out at grass, it may help to fit frog supports before slowly bringing them in or travelling them home, ideally in a low-loading trailer.

All laminitis cases should be box-rested, ideally on non-edible bedding. A very deep bed (40-50cm) of dust-free shavings is best. This can act as support for the feet nearly as effectively as – and more simply than – frog supports. Allow affected horses to lie down and rest their feet.

Total box rest is important. This should continue for at least 30 days, during which the diet needs to be adjusted to ensure that the horse's weight is controlled. It is crucial that any overweight laminitic loses weight, but this must be a gradual process. Consult your vet or equine nutritionist for advice.

This veterinary feature first appeared in the September 2004 issue of HORSE magazine.