Venograms Can Catch Laminitis Early

Proper blood flow to the laminae of the hoof is critical at all times, but especially when a horse develops laminitis. Diagnostic techniques that can reveal how blood is flowing--or not--can help veterinarians catch laminitis early. Amy Rucker, DVM, of Midwest Equine in Columbia, Mo., discussed the importance of digital venograms in diagnosing and treating laminitis during the Sept. 17-18 Laminitis West Conference, in Monterey, Calif..

When performing a venogram, a veterinarian puts a tourniquet on the fetlock, injects a contrast dye into a vein below the fetlock, then radiographs the foot. The venogram shows how well the blood is flowing, which a normal radiograph (often called an X ray) cannot do, and helps the veterinarian identify any areas with compromised blood flow.

Veterinarians can get similar results with MRIs, but most do not have MRIs in their practice. MRIs also are much more expensive than venograms. Rucker explained that, with practice, any veterinarian with radiograph equipment can perform venograms, which can help them diagnose laminitis early.

To illustrate the importance of venograms, Rucker described a horse that showed no clinical or radiographic signs of laminitis. However, the venogram detailed a severe case that Rucker said would become a "sinker," where the coffin bone sinks down and can penetrate the sole of the foot.

"Venograms really help us follow our cases," Rucker said, adding that the venogram findings guide her choice of treatment for each case. "I also use the venograms to assess if they're responding to treatment."

During the conference Rucker spoke to both clinicians and horse owners. She gave the clinicians tips on how to perform venograms, while she explained to horse owners how venograms can help them, their veterinarians, and their farriers determine the best way to shoe a horse with laminitis.

"The most common error that I see with [veterinarians] that perform venograms is they don't get a tight enough tourniquet," Rucker said. "I apply it at the widest part of the fetlock."

She recommended that veterinarians initially practice on a horse with healthy feet to learn the procedure, recognize the errors that come with inexperience, and learn how to avoid them.

"When you first start to do the venograms, you're going to have a lot of artifacts (misleading findings) that are caused by [improper technique]," Rucker said.

It is also important to remember that the load on the hoof can change the venogram. "You want to have them standing squarely with their cannon bones vertical to the ground," Rucker said, "both front feet on blocks, the head straight forward."

Venograms performed early can save horses' lives. Rucker discussed one case in which an owner observed lameness in her horse at a show. A veterinarian at the show took venograms, found signs of laminitis, and began treatment, including application of special shoes. Rucker followed up after the client returned from the show.

"This horse was seen immediately at the onset of laminitis," Rucker said. "When I did my three-week recheck, we had remarkable improvement with our shoe application."

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About the Author

Tracy Gantz

Tracy Gantz is a freelance writer based in Southern California. She is the Southern California correspondent for The Blood-Horse and a regular contributor to Paint Horse Journal, Paint Racing News, and Appaloosa Journal.

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