Monday 13 April 2015

Laminitis



Laminitis is a terrible and crippling condition of the feet.  However, it is also one that is understood more and more each year.  This can only be a good thing as treatments are developed and better understanding helps us to avoid the condition affecting our horses or ponies.

The key thing to remember is that Laminitis can affect any type of horse or pony.

What is Laminitis?

To understand laminitis you need to understand a little about the structure of a horse's hoof.  The hoof wall consists of an outer layer of horn (which is insensitive) under this there is an inner layer which is sensitive - the laminae!  The laminae support the pedal bone which in turn supports the horse's weight. 



In laminitis the blood flow to the laminae is affected and this causes the tissues in the hoof to swell and become inflamed.  The lack of blood flow to the laminae mean the area is starved of oxygen and other nutrients and the cells become damaged and can die.  This can then mean that the pedal bone sinks and rotates, in some cases it can push through the sole of the foot.

What causes Laminitis?

This is an area that has gained increased understanding in the last few years.  It is now thought that up to 90% of laminitis cases have an underlying hormonal disease which is the root of the problem.  These hormonal diseases have been found to be either PPID (Pituitary Pars Intermedia Dysfunction) also called Cushing's Disease or EMS (Equine Metabolic Disorder).

PPID is an abnormality in the pituitary gland.  Clinical signs include:
  • laminitis 
  • hirsutism - long hair and/or abnormal shedding of winter coat 
  • muscle wastage 
  • lethargy

However, we must not discount the factors that we can have a direct affect on and always remember that horses (and ponies) that are overweight are particularly susceptible!

  1. High intake of sugars and starch - an excessive amount of these can cause an overload in the digestive system.  Any undigested sugar and starch are pushed through to the hindgut.  As the bacteria in the hindgut break down the sugar and starch the acidity in the gut increases - this kills off the bacteria that digest the fibre in the horse's diet.  As these bacteria die they release toxins into the gut which are passed into the bloodstream causing a response which appears to disrupt the blood flow.  In the feet this can cause laminitis as explained above. 
  2. Stress - dramatic changes in environment have been seen to trigger laminitis, especially in overweight horses or ponies.  Mares also seem to be at risk shortly after foaling. 
  3.  Obesity - (see last week's blog) excess weight increases the strain on a horse's vital organs and limbs.  
  4.  Concussion - if a horse has been worked fast on a hard surface eg: trotting on the road the laminae can be affected.  This trauma to the laminae can cause laminitis.

Symptoms of Laminitis



Typical laminitis stance


There are 2 types of the disease; acute and chronic.

Acute Laminitis: the symptoms appear suddenly and are severe.
  • Inability or reluctance to walk or move 
  • May lie down and be unwilling to get up 
  • Horse will be visibly lame, especially on a circle or hard surface 
  • Digital pulse in the foot will have increased 
  • When standing the horse may lean back on to its hind feet 
  • When walking the horse may place his heels down first to avoid placing extra weight on the painful area in front of the point of the frog.

Chronic Laminitis: the symptoms are ongoing usually from a relapse of a previous acute attack.
  • Horse's hoof will have the appearance of growth rings around the wall (easily confused with rings as a result of changes in nutrition) 
  • The heel often grows more quickly than the toe 
  • The white line may have widened in the hoof wall 
  • The horse or pony may have a large crest.


Laminitis rings

Treating Laminitis
  • Call the vet immediately if you spot any of these symptoms to avoid worsening of the signs and so that they can reduce the horse or ponies pain and give advice 
  • Put the horse in a stable with a deep bed 
  • Remove any feed but provide clean fresh water 
  • Roughage should still be provided - follow the vet's advice

What can the vet do?
  • Give extra pain relief 
  • Give anti-biotics to reduce the number of bacteria in the gut which are causing the toxin release

Prevention
  • Ensure your horse or pony maintains a healthy weight (see my obesity blog) 
  • Feed high fibre feed, low in carbohydrate and sugar.  Avoid cereal mixes and molassed products 
  • Restrict grass intake - especially in spring and autumn when the grass is high in soluble carbohydrates (fructans) 
  • Turn out at night when there are less fructans in the grass, keep them in the stable in the day 
  • Do not turn out on lush or grass covered with frost - high fructans 
  • Reduce any stress by keeping the horse with a friend on the same routine

Always monitor your horse or pony's weight and be vigilant for any signs or symptoms.  Once a horse has suffered they are more susceptible in the future.  Since Fidget had laminitis a few years ago I have managed to prevent a recurrence by following the advice above!

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Until next time!
Jo

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