Podiatry Table Topic: A Focus on Laminitis (AAEP 2012)

Podiatry Table Topic: A Focus on Laminitis (AAEP 2012)

Laminitis is a devastating disease that does not discriminate based on a horse's age, breed, or discipline.

Photo: Nora Grenager, VMD, Dipl. ACVIM

Laminitis is a devastating disease that does not discriminate based on a horse's age, breed, or discipline. For that reason, at the 2012 American Association of Equine Practitioners (AAEP) Convention, held Dec. 1-5 in Anaheim, Calif., it became a focus of discussion during the podiatry table topic led by Andy Parks, VetMB, MRCVS, Dipl. ACVS, professor of large animal surgery at the University of Georgia, and Steve O'Grady, DVM, MRCVS, APF, of Northern Virginia Equine.

Laminitis remains a challenging disease to manage and often poses more questions than answers. According to one study (Equine Veterinary Journal), 4-5% of all horses will suffer from laminitis during their lifetimes. One participant in the podiatry discussion commented that laminitis is a "forever disease."

The table topic opened with case study of a 23-year-old Warmblood mare with active laminitis for more than a year that began experiencing bone loss at the tip of the coffin bone. This often results from reduced blood flow along with initial weight-bearing overload of the foot. If allowed to progress too far, bone loss can lead to fracture.

Is Tildren an Option for Laminitis Treatment?

Veterinarians in attendance reported some success using the drug tiludronate (Tildren) to treat navicular horses due to its effect on reducing bone resorption. Because bone resorption also occurs in the coffin bone of laminitic horses, some clinicians have wondered whether tiludronate might be useful for treating laminitis.

Currently, the moderators said, there is insufficient evidence for veterinarians to recommend its use due to a lack of investigation into potential side effects and no confirmation of any beneficial effects based on literature review.

Regardless, practitioners in the room stressed that any medication approach must always be combined with good farriery that shifts the load in the foot toward the heels; this also vastly increases a laminitic horse's comfort.

Supporting the Hoof

Parks noted that laminitic insult to hoof tissues probably occurs over a very short time, and the extent is impossible to predict. "We try to hold them steady to let them heal," he said.

Most importantly, he urged, "We need more preventive and supportive strategies because once damage is present it becomes an uphill climb to restore a laminitic foot toward normal."

O'Grady stressed that a proper trim is essential for laminitic horses and must be based on radiographic images. He said it's important to recognize that "the ability to rehabilitate laminitis cases is directly proportional to the amount of damage."

He professed getting excellent results when using a wooden shoe in laminitis cases. This solid wooden "clog" helps move hoof breakover toward the front of the margin of the coffin bone.

O'Grady promotes using wood, which he said is more forgiving than steel when concussion shock waves are set off in the feet at the beginning of each stride from the impact of the hoof with the ground. And, he said, it is also more easily shaped and customized than steel. In addition, wood allows a horse to find a comfort point by scraping away wood as he moves. O'Grady did caution that "the wooden shoe won't work on sinkers."

Equine Metabolic Syndrome and Laminitis

The veterinarians also discussed another high-risk factor for laminitis--the development of metabolic syndrome secondary to obesity. This is at least in part due to modern husbandry, they agreed. On the wild range, horses tend to fatten in the warm months and lose weight in the winter so their body condition varies throughout the year. However, in domesticated living, they retain a robust body condition all year long while not exercising much, which increases the risk of development of laminitis and other endocrinological abnormalities.

As Parks observed, "Horses have become apartment dwellers." Horse owners must manage their horses' diets appropriately relative to the animals' actual dietary needs. Regular exercise is essential to maintaining healthy feet and warding off obesity that increases horses' risk of developing laminitis.

About the Author

Nancy S. Loving, DVM

Nancy S. Loving, DVM, owns Loving Equine Clinic in Boulder, Colorado, and has a special interest in managing the care of sport horses. Her book, All Horse Systems Go, is a comprehensive veterinary care and conditioning resource in full color that covers all facets of horse care. She has also authored the books Go the Distance as a resource for endurance horse owners, Conformation and Performance, and First Aid for Horse and Rider in addition to many veterinary articles for both horse owner and professional audiences.

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