Predicting Laminitis and Survival in Horses with Research

"You've never seen it miss this house, and miss that house, and come after you!"--Jo, from the movie Twister.

Laminitis is like a tornado--you can't predict when or where it will strike and who will survive. 

"Laminitis is a very frustrating disease from a number of standpoints, including management," explained James Orsini, DVM, Dipl. ACVS, director of the Laminitis Institute at the University of Pennsylvania. "The pain and debility are often so severe that euthanasia is often considered, but this decision is not easy because of our lack of data and uncertainties about which horses are more or less likely to recover."

To try to take the guesswork out of predicting which horses are less likely to recover from laminitis, Orsini and colleagues reviewed the medical records from 247 horses treated for laminitis that were euthanized or died. These records were compared to the records of 344 horses treated for laminitis that survived and were discharged from the University of Pennsylvania's George D. Widener Hospital for Large Animals between 1986 and 2003.

"One of the most important findings of this study was that as the grade of lameness increased (using the Obel grading scheme from I-IV, where IV is extremely lame and reluctant to walk), the chance of a poor outcome also increased," relayed Orsini.

Horses with an Obel grade II lameness were three times more likely to die or be euthanized than horses with grade I lameness. Horses with grade III and IV were 9.6 and 20 times more likely to have a poor outcome than the odds of a similar horse deemed grade I.

This study also found that horses with laminitis were more likely to die or be euthanized if they were:

  • Thoroughbreds;
  • Racehorses;
  • Treated with the non-steroidal anti-inflammatory drug flunixin meglumine (Banamine);
  • Diagnosed with an infection of a blood vessel secondary to the use of intravenous catheters for administering drugs and fluids (i.e., vascular pathology);
  • Diagnosed with "sinking" of the pedal bone (third phalanx/coffin bone); or
  • Treated for pneumonia while hospitalized.

The use of glue-on shoes significantly reduced the risk of death in horses with laminitis.

The study, "Prognostic indicators of poor outcome in horses with laminitis at a tertiary care hospital," was published in the June 2010 edition of the Canadian Veterinary Journal. The full-length article is available for free through PubMed Central.

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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