Advancements in the Treatment of

Laminitis

February 24, 2007

University of Rhode Island

Lisa Connor

Overview

• Laminitis

– Causes

– Treatment

– Advancements

– Heroes

– Future Outlook/Need for Funding

What is Laminitis?

Pain and inflammation of the sensitive laminae of the foot

Why is it debilitating?

Sensitivityin Laminae

Separation&

Rotation

TriggeringEvent

Circulatory Effects

Dr. Christopher PollittAmerican Farrier's Journal

Normal circulation laminitis

What causes Laminitis?

• Nutrition (carbohydrate overload) • Toxemia • Mechanical overload (contralateral effects)• Stress• Hormonal Imbalance (Cushing’s Disease)• Drug Induced (sensitivity to corticosteriods)

Applying Physics

horse's weight (gold)

upward ground force from concussion (red)

rear-ward pull of the deep digital flexor tendon (green)

The laminae (blue)

The forward & upward pull of extensor tendon (purple)

40%

60%

U.S. Statistics

USDA/APHIS Equine 98 Study

28.5% of polled operations in 28 states

confirmed laminitis within their

boarding/training population

Highest incidence in Spring/Summer

Goals of Treatment

• Prevent further development• Reduce the pain or hypertension cycle• Reduce or prevent permanent laminar

damage• Improve laminar capillary dynamics• Prevent movement of the distal

phalanx

Common Approaches

• Determine cause & correct condition• IV fluid therapy• Cryotherapy• Radiographs• NSAIDS (Bute, ketoprofen)• Promote vasodilation (Acepromazine,

isoxuprine, pentophyline and nitroglycerin)

• Frog support

Mechanical Aids

The heart-bar-shoe through its contact with the frog engages weight bearing (*supports bony column*)– natural approach in the treatment of

several pathologies of the foot (crushed/under-run heels, quarter cracks, and laminitis)

– helps prevent rotation and or sinking of the coffin bone

More Mechanical Aids

NBHoofcare.com

Styrofoam paddingDigit Support

System

NBHoofcare

NBHoofcare

Alternative Practices

• Venograms confirm degree of blood supply• Deep digital flexor tenotomy (usually for

salvage cases)– Restores natural angle with ground surface

• Study over 10 yr. period• n=37• 77% survival after 6 mos.• 60% survival after 24 mos.

• Dorsal hoof wall resection– Prevent & treat abscesses

• Prosthetics• Barefoot trimming & holistic therapies

The Problem with Laminitis

• Within the multitude of treatment options

~ NONE are UNIVERSALLY EFFECTIVE• Pathogenesis is poorly understood• Contradicting theories

– Heat vs. Cold (Cryotherapy)– Use of heartbar shoes vs. styrofoam pads or

barefoot trimming– Vasodilation vs. Vasoconstriction during onset

Advancements in Technology

A veterinarian can see where blood flow is compromised due to damage, swelling, or poor hoof structure, and thus decide what mechanical support and/or surgery he needs to provide in order to restore blood flow to those areas.

Venogram

Research/Initiatives

• Involvement of Circulation (Hood et al, 1993)– Vasoconstriction causes decreased

perfusion to nutrient laminar capillaries

• The Glucose Connection (Bailey, 2000)• Connective Tissue Connection (Pollitt &

Daradka, 1998)• National Animal Genome Project

– (gene map for horses)

Steps to Conquering Laminitis

Foundational Knowledge Today

$10M in Research Funds

Collaboration between Veterinarians, Farriers, and Scientists alike

5 Years

Laminitis remains the second largest killer of horses, behind colic.

Beloved Heroes

Patricia McQueen photo

Foolish Pleasure, 1975

Barbaro, 2006Secretariat, 1973

The Road to Preservation