Acute and Chronic Laminitis: An Equine Podiatrist’s Perspective

Acute and chronic laminitis is a frustrating and often disheartening condition to manage. Having had the opportunity to observe, treat and shoe laminitic horses for over 30 years, I have a unique prospective into this disease.

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Acute and chronic laminitis is a frustrating and often disheartening condition to manage. Having had the opportunity to observe, treat and shoe laminitic horses for over 30 years, I have a unique prospective into this disease.

The biggest challenge to the veterinarian and the farrier is improving function in a foot that might have potential, substantial, and possibly permanent structural changes. It should be remembered from the onset that it is the extent of the lamellar damage that will influence our ability to treat a given case, not the treatment regimen that is used. If this was not a fact, we would not read about some horse that was lost to laminitis on a weekly basis in equine journals or magazines. Another problem we need to overcome is that treatment regimens for both acute and chronic laminitis generally remain empiric and are based on the past experience of the attending clinician/farrier.

Each case of laminitis should be approached on an individual basis.

Acute Laminitis

When we approach a case of acute laminitis, we encounter two problems.

Again, when the animal first shows signs of acute laminitis we have no way of knowing the extent of the laminar damage present and if this damage will be permanent. The number of horses that have suffered a severe laminitic episode that we are able to treat successfully is small and the window for treatment once signs are observed is also relatively small.

Secondly, we have no practical means to counteract the vertical load of the horse’s weight that is placed on its feet. In other words, we have no method that allows us to take weight off the inflamed lamellae.

Frog pressure has become ingrained in the veterinary and farrier literature as a method to support the weight of the horse. If we consider the anatomy of the bottom of the horses’ foot, the horny frog (which varies in thickness) and the digital cushion above it are both readily compressible structures under pressure. When pressure is placed over the frog, it quickly deforms, compresses, and the interface between the outer surface of the frog and distal phalanx (P3) is diminished. These structures are generally irreversibly damaged by frog pressure and the animal often feels more discomfort. Therefore, I do not recommend this practice.







Figure 1


Radiograph before wooden shoe.


Figure 2


Wooden Shoe. Note the new hoof wall growth

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Stephen E. O’Grady, DVM, MRCVS, was a professional farrier for 10 years prior to obtaining his degree in veterinary medicine. He learned farriery through a formal apprenticeship under Hall of Fame farrier Joseph M. Pierce of West Chester, Penn. After graduating from veterinary school, O’Grady did an internship in Capetown, South Africa. Then he joined Dan Flynn, VMD, at Georgetown Equine Hospital in Charlottesville, Va., as an associate for five years. Since that time, he has operated a private practice in Virginia and South Africa, with a large portion of the practice devoted to equine podiatry. He has published numerous articles and lectured extensively on equine foot problems. His web site is www.equipodiatry.com.””tephen E. O’Grady

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