2. Laminitis Workshop Aln Veterinary Group and Northumbria Veterinary Partnership 26 April 2007

3. Foot Anatomy

4. What is laminitis? Inflammation of the laminae – which act to suspend the pedal bone within the hoof… …however laminitis is a systemic disease that affects the whole horse

5. How does laminitis occur? 2 different theories Vascular theory Enzymatic theory

6. Vascular theory Soluble carbohydrates overload the small intestine Abnormal fermentation occurs in hind-gut Toxins released into blood, which becomes more acid Blood bypasses laminae causing tissue death Inflammatory fluid builds up between the laminae Pedal bone rotates and drops putting pressure on sole

7. Enzymatic theory New theory – not fully proven and not all questions answered MMP enzymes normally present to maintain healthy bonds MMPs become excessive and cause disintegration of the laminar bond

8. The 3 Stages of Laminitis Developmental phase Acute phase Chronic phase

9. New ideas MMPs Sulphur Magnesium

10. Laminitis affects small fat ponies … ?

11. Retained placenta or any other toxic event After foaling …

12. Steroid administration …

13. Competition horses … …travelling …roadwork …concussion

14. Acute lameness …

15. Cushingoid ponies …

16. Equine Metabolic Syndrome Related to Cushings disease Insulin resistance Recurrent bouts of laminitis Obese, younger horses and ponies Blood test differentiates these conditions

17. Clinical signs of laminitis Altered behaviour e.g. immobility, lying down, depression. Heat in the feet, esp around the coronary bands. “Rocking back” stance. Lameness on 1 or more legs. Raised pulse & respiratory rates.

18. Classic laminitic stance

19. Possible other symptoms Bounding digital pulses A depression at the coronary band Patchy sweating Not only the front feet affected

20. Vets role To provide emergency treatment in the form of: Addressing the cause. Pain relief Preventing further changes. Monitoring & prognosis

21. Types of medication

22. Sole and frog supports

23. X rays

24. Farriery

26. Farrier & Vet liaison is essential

27. Treatment for your horse or pony Call us straight away- this really helps the outcome!! Box Rest. A bed to support those feet – shavings, sand, hemp, sawdust- right up to the door. Minimal forage feed. Cold treatment- from the knee or hock downwards.

28. Prognosis Many factors affect this: acuteness of onset severity of disease concurrent factors previous history adherence to treatment protocols radiographic changes

29. Radiographic changes

30. Treatment times BOX REST – Many people ask why! (weeks to months – not days!) Can take 6-9 months to achieve final results (may never return to full soundness)

31. Laminitis is best avoided Condition scoring Fructan levels in feeding Avoid grazing fresh cut areas Thank you Spillers!

32. Laminitis is best avoided Mixed species grazing Turnout with a muzzle Founderguard

33. Laminitis is best avoided Regular exercise native ponies are capable! Avoid concussive exercise

34. Summary LAMINITIS IS A SEVERE DISEASE THAT CAN KILL OR RESULT IN PERMANENT DEBILITY Management is : Costly Time consuming Hard work Can be an uphill battle

35. Any questions?