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Courtesy of Dr. James Orsini
George D. Widener Hospital
New Bolton Center
Q. What is laminitis?
A. Laminitis is a painful condition in horses with many causes, including excessive weight bearing in one limb, usually as a result of a problem in another limb, most commonly the opposite limb. This causes an inflammatory condition 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.
Q. What are the causes of laminitis?
A. “Target” tissue or end result of many of the following listed causes:
1) Severe colic is a disease/condition of the intestines, in most cases, and is one of the more commonly listed causes for laminitis. Research supports a belief that “laminitis trigger factors” showed the lamellar tissue causing a inflammatory/enzymatic condition and failure of the bond between the hoof wall and pedal bone;
2) Endocrine diseases such as Cushing's Disease and Equine Metabolic Syndrome have been shown to be risk factors for the development of laminitis;
3) Prolonged and excessive weight bearing by one or more limbs is yet another risk factor for the development of laminitis. In a study from the Texas Veterinary Medical Center, horses weighing greater than or equal to 1,200 lbs were approximately twice as likely to develop laminitis than horses weighing less than 1,200 lbs. Also, the duration of lameness is a risk factor for the opposite supporting limb;
4) Retained placenta is another disease condition that has been identified as a risk factor for laminitis;
5) 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; and
6) Repeat trauma/injury to the horse's feet when running on a hard surface with poorly protected feet can end in laminitis. The bottom line is the equine digit is capable of sustaining tremendous loading and weight bearing even at speeds of up to 40 miles per hour, but under certain conditions, weakening of the bond between the hoof wall and pedal bone can cause rapid failure of this magnificent structure.
Q. What is the standard treatment for laminitis?
A. The treatments can be quite varied depending on the underlying cause. The “dictum” that all clinicians live by is to 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, treat the diarrhea; 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. Specifically with laminitis you treat the pain, support the foot, 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!
Q. How can a shoe help in the prevention or treatment of laminitis?
A. The shoe distributes the weight of the limb over a larger surface area, supports the sole of the foot and provides a mechanism for treating the diseased foot with the addition of a special plate on the bottom of the shoe we term a “hospital plate.” With the advent of “glue-on-shoes” we have a uniform adherence of the shoe to the hoof wall and thus reduce stress concentration on any one area of the hoof wall.
Q. What is the difference between acute and chronic laminitis?
A. In acute laminitis, there is no radiographic evidence of 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.
Q. What is the success rate for laminitis treatments?
A. The success rate varies widely and depends on many factors such as the 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.
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