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Laminitis Institute

Laminitis is a painful inflammation of the lamellar tissue, the strong connecting tissue that attaches or bonds the pedal bone and the inner hoof wall together.

Laminitis is very serious and can be life threatening due to the chronic and unrelenting pain associated with the loss of support and tearing of the tissue in the hoof. The front hooves are most commonly affected, although the hind feet are sometimes affected.

The faculty and clinicians at Penn Vet's New Bolton Center are well-known leaders in the field of laminitis and serve as a resource for current information on the state-of-the-art treatment of horses with the disease.

The composition of this group of experts is the "best of the best" with a wealth of information to answer your questions and advise you on practical ways to help your horse suffering from laminitis.Laminitis Institute, New Bolton Center

Here are some frequently asked questions and answers to help you better understand laminitis, its causes, and current prognosis of treatment protocols:

 

What is laminitis?

  • Laminitis is a painful inflammation of the lamellar tissue, the strong connecting tissue that attaches or bonds the pedal bone and the inner hoof wall together. Laminitis is very serious and can be life threatening due to the chronic and unrelenting pain associated with the loss of support and tearing of the tissue in the hoof. The front hooves are most commonly affected, although the hind feet are sometimes affected.

What are the symptoms of laminitis?

  • Symptoms of laminitis include:
    • Increased temperature of the wall, sole, and/or coronary band of the foot;
    • A pounding pulse in the digital palmar artery (The pulse is very faint or undetectable in a cold horse, readily evident after hard exercise.);
    • Walking very tenderly, as if walking on egg shells;
    • The horse standing in a "founder stance" (the horse will attempt to decrease the load on the affected feet. If it has laminitis in the front hooves, it will bring its hind legs underneath its body and put its forelegs out in front.)

What is the standard treatment for laminitis?

  • The treatments can be quite varied depending on the underlying cause. Generally clinicians treat the primary disease that led to laminitis, which in many cases will minimize progression of the disease.
  • For example, if the primary cause is diarrhea the diarrhea is treated and if it is due to excessive weight bearing on one limb, the goal is to improve the weight distribution as soon as possible in the other leg.
  • With laminitis, treat the pain, support the foot and reduce the inflammation using anti-inflammatory drugs. In many cases, cold therapy (also called cryotherapy) or ice therapy has been effective. The study for new and better treatments is ongoing.

What are the causes of laminitis?

    • Severe colic, a disease/condition of the intestines, is one of the more common causes for laminitis. Research supports a belief that ‘laminitis trigger factors’ shower the lamellar tissue, causing an inflammatory/enzymatic condition and failure of the bond between the hoof wall and pedal bone
    • Endocrine diseases such as Cushing's Disease and Equine Metabolic Syndrome
    • Prolonged and excessive weight bearing by one or more limbs;
    • Retained placenta
    • Systemic diseases such as pneumonia and diarrhea result in a showering of the body with bacteria and can lead to a toxin release termed endotoxemia and end with laminitis
    • Repeat trauma/injury to the horse's feet when running on a hard surface with poorly protected feet
    • Carbohydrate overload: if a horse eats too much grain or grass, resulting digestion problems can lead to restricted circulation that ultimately results in laminitis

What is the difference between acute and chronic laminitis?

    • In acute laminitis, no radiographic evidence shows separation of the hoof wall and pedal bone.
    • In chronic laminitis, radiographs or x-rays reveal a change in the position of the pedal bone and hoof wall which equals separation or loss of the bond between the hoof wall and pedal bone.

What is the success rate for laminitis treatments?

  • The success rate varies widely and depends on many factors, such as rapidity of onset and degree of separation of the hoof wall and pedal bone, weight of the horse (many ponies can have repeat episodes of laminitis and live a good quality of life just because they are lighter weight), control and treatment of the underlying cause for the laminitis in the first place and overall general health of the individual horse.
  • The good news is that our success rate in treating laminitis continues to improve every year because veterinarians, farriers, horse owners, trainers and other health care providers better understand the disease and how to treat it.

How can a shoe help in the prevention or treatment of laminitis?

  • The shoe distributes the weight of the limb over a larger surface area and moves the breakover point further back on the foot, thus reducing the stress on the lamellar tissue along the front of the foot while consistently supporting the sole of the foot.
  • With the advent of glue-on-shoes, we have a uniform adherence of the shoe to the hoof wall, and therefore can reduce stress concentration on any one part of the hoof wall.

Project: Establish and Maintain Laminitis Discovery Database

Dr. Galantino-Homer received a three-year grant from the Bernice Barbour Foundation to establish and maintain a Laminitis Discovery Database, including a tissue bank of clinical and experimental samples, as well as information on data obtained from these samples and a database of information on antibodies for equine disease research.

Dr. Julie Engiles, a veterinary pathologist at Penn Vet, is documenting the disease status of banked tissues as well as conducting her own studies on the pathology of chronic laminitis.

Project: Investigating the gene and protein expression profiles of two models of laminitis

Dr. Galantino-Homer's collaborative Grayson-Jockey Club Research Foundation project with Drs. Orsini, Pollitt, Dr. Rebecca Carter (post doctoral fellow) and Dr. Neal Rubinstien of Penn Medical Center is ongoing.

An expert in equine genomics, Dr. Bhanu Chowdhary of Texas A&M University, has joined this project.

Study: Equine basa epithelial cells

Dr. Galantino-Homer's Laminitis Laboratory continues to study equine basal epithelial cells from the lamellae and to develop an in vitro culture system for the study of equine laminitis in collaboration with Dr. Makoto Senoo, an epithelial stem cell biologist at Penn Vet.