Laminitis

Question 1

What is Laminitis

Answer 1

Inflammation/ odema of sensitive/ insensitive laminae of the hoof (Kahn 10)

Question 2

What can cause laminitis? (including predisposing and other factors)

Answer 2

• Grain feed overload, specially if exercise is not increased.
• Decreased digital perfusion & ischemic necrosis
• Insulin resistance
• Direct damage to epithelia cells due to cytokines
• Dietary change
• Ingestion of toxins (Kenalog, need to exercise horse when taking this otherwise get laminitis)
• Septic metritis
• Shock
• Trauma (of limb via concussion)
• Cushings

Question 3

What are the clinical signs of laminitis?

Answer 3

• Rotation of P3
• Inc. digital pulse
• Stance
• Lame
• Poor body conditioning
• Increased temp
• Recumbency
• Postural changes (stand with head up, and lean back to reduce weight)

Question 4

Structural changes generally occur before any signs are apparent. What structural changes can occur with laminitis?

Answer 4

• Laminar destruction & dysfunciton
• P3 detachment from hoof wall—> deformation
• Distal phalanx rotation & sinking
• Seperation of sensitive & insensitive laminae
• Complete separation from of the hoof from the capsule

Question 5

How is laminitis measured? And what does this include?

Answer 5

On a scale of 1-4.
1- alternatlvely and incessantly lifts the feet.
2- moves willingly at walk but gait stilted, lifts foot of floor w/o difficulty
3- moves v.reluctantly and resists foot being lifted from floor
4- refuses to move and has to be forced to do so

Question 6

What therapy is used for laminitis?

Answer 6

Medical- drugs

Mechanical- support

Question 7

What medical therapy is used in laminitis?

Answer 7

• Vasodilators to increase blood/ oxygen flow to foot
• Ice baths- To reduce inflammation
• Antithrombotics- To thin the blood
• NASID’s (not strong as need to ensure the horse will lie down to rest the feet)

Question 8

What mechanical therapy is used in laminitis?

Answer 8

• From support- guaze, laminitis clinic frog support (beadle pad)
• Sand bedding (solid but movable)
• Deep shavings with straw on top
• Damp wood pellets to ensure dont get stuck in feet

Question 9

What chronic management maybe used in laminitis?

Answer 9

• Derotation of P3 to restore P3 angle.
• Good foot care (balanced shoeing, clean environment, sole pads
• Appropiate nutrition

Question 10

What is involved in derotation therapy?

Answer 10

Shoeing every 4 weeks and the use of glue instead of nails.

• Roll toe
• Trim heel (every 7-8wks as each 5mm removal improved angle by 1 degree)
• Frog support
• Decrease pull of flexor tendons byt putting wedges on heels/toes

Question 11

What will you generally see with laminitis?

Answer 11

• Laminar oedema
• Epithelia cell necrosis
• Laminar degeneration
• Sensitive and insensitive laminar seperation

Question 12

What is the prognosis of laminitis?

Answer 12

W rotation = poor
W sinking = v.poor
w/o sinking and rotation = Ok as can manage this
Complete hoof- capsule sep = euthanasia required