Dealing with Laminitis
Why is it important to act immediately when a horse suffers from an acute attack of laminitis? ANDREW POYNTON, of the Poynton Farriery Clinic has studied the problem in depth.
MANY cases referred to Andrew are frequently in a far advanced state of deterioration, often as the last hope before euthanasia.
By outlining the sequence of events within the foot during an acute attack, and the potential mechanical after effects, he explains his treatment methodology, why he developed the Imprint Shoe and how it can benefit the horse.
Laminitis is a major vascular crisis that results in inflammation and weakening of the laminal structures and bonds within the hoof. The damage to the hoof tissue can be severe and may cause rotation and sinking of the pedal bone (P3).
Possible symptoms include:
- Difficulty in walking and turning
- Standing awkwardly with more weight on hind legs, while shifting weight from one foot to another
- Hooves which feel warm to touch with increased digital artery pulse rate
- A depression felt at the coronary border
Internally the blood supply to the hoof has been disturbed through a laminitic trigger factor that affects the horse’s metabolism. This may be caused by diet, toxaemia, stress, hoof concussion or, another condition for example Equine Cushing’s Disease. As a result of metabolic disturbance, blood vessels become constricted, reducing oxygen and other nutrients to the hoof and laminal tissues.
The laminal bond becomes damaged and weakened and pulls away from the hoof wall.
P3 is no longer supported by laminal structure and begins to rotate and descend towards the sole. The tissue in the sole of the foot becomes compressed, more blood vessels collapse leading to further crushing and subsequent infection.
Once laminal breakdown has occurred, these lamellae will not reattach nor will P3 be pushed back into position. If the foot is to recover, the detached horn must grow out and be trimmed away.
As long as P3 is supported from below, and there is no permanent vascular damage, new horn derived from the papillae at the coronary border will grow down in alignment, and new lamellar attachment will be established as the new horn surrounds P3 to the ground border.
Immediate action is vital to recovery and pain management.
Ideally we apply the Imprint First support shoe to alleviate further damage from nailing before, there is any visible displacement of P3. Whether the horse’s feet make a full recovery or are permanently damaged or lost may depend on how soon supportive treatment is initiated. Laminitis is a complex multi-factorial disease – even when all the boxes have been ticked some cases frustratingly and sadly do not respond – some ponies with Cushing’s disease inexplicably suffer recurring acute attacks with no apparent dietary or management changes.
These are systemically sick animals, and although diet, drug, exercise and farriery management are just as important and will help, this does not guarantee recovery. Experience has shown that the degree of severity of the case determines the time of recovery, which is logical.
This equates with effort and cost of recovery in time and money. Once aware that laminitis is a possibility it is wise to stable the horse on a clean, deep, shavings bed and take veterinary advice regarding medication and diet.
The vet will organise radiographs of the feet. When treating laminitis it is essential to ensure optimum balance and correct proportions of the hoof in relation to the pedal bone, to neutralise unequal forces within the hoof. Then, guided by the radiographs, we are able to accurately apply Imprint First support shoes. When fitted the support is there until the shoe is removed.
Depending upon severity, box rest continues under veterinary supervision, for at least 30 days. A deep, supportive bed of clean, dry wood shavings or another material that moulds to the underside of the foot is used.
The horse’s diet is reviewed with the vet. The hooves are picked out and thoroughly disinfected twice a day to avoid build up of foreign matter, and allow air to the soles which helps keep them dry. Imprint shoes are reapplied approximately every five weeks to ensure ‘ideal’ pedal bone/hoof capsule alignment and further radiographs taken as required.
As recovery progresses, when the horse is being given gentle exercise, Imprint Plus or Imprint Sport shoes are applied. The picture shows a normal healthy foot. The noteworthy features are, a parallel hoof wall with P3 face, close lamellar attachment, P3 high in the hoof and a vaulted sole.
The Imprint First shoe fitted illustrates the unique frog cradle providing central support to P3 via the frog and digital cushion. Notice that the front of the frog cradle is forward of the articulation above.
There is visible clearance between the sole and shoe forward of the frog. The toe of the shoe has a shortened point of breakover. (photo above)
This article by Andrew Poynton first appeared in Horse Health Magazine.