Looking for a cut-and-dried formula for bringing all laminitic horses back to health? Good luck! Laminitis treatment is an ever-evolving art, the success of which depends on disease cause, type, severity, and many other factors.
Debra Taylor, DVM, of Auburn University's College of Veterinary Sciences, recently studied one small subset of these horses to try to determine an accurate rehabilitation strategy. She evaluated obesity-associated laminitis cases subjected to identical rehabilitation protocols to determine if their recovery was successful; she presented her findings at the 2013 International Equine Conference on Laminitis and Diseases of the Foot, held Nov. 1-3 in West Palm Beach, Fla.
In the retrospective study, Taylor and colleagues looked back at Auburn University Veterinary Teaching Hospital’s clinical data from 14 obese horses (defined as having a body condition score [BCS] of 7 or higher on the 1-9 Henneke scale) suffering from laminitis but with no history of pituitary pars intermedia dysfunction (or equine Cushing's disease) or systemic inflammatory disease—two conditions associated with laminitis development. Six horses presented with acute laminitis and eight with chronic, but all underwent the same rehabilitation process.
"The rehabilitation method emphasized a mineral-balanced, low-nonstructural carbohydrate diet; controlled grazing; daily exercise; hoof trimming that minimized hoof wall loading; and sole protection in the form of rubber hoof boots and/or hoof casts," Taylor said.
She said veterinarians chose to place a horse in a cast for six to eight weeks only if his soles were cracked or had a thickness less than 7 mm around the coffin bone. Daily exercise objectives were to decrease horses' BCS and improve their insulin sensitivity. Taylor said they did restrict exercise in horses that showed signs of discomfort (e.g., toe-first landing).
During the recovery period the team evaluated each horse's BCS, Obel grade (from I-IV, used to classify laminitis-related pain), and five radiographic parameters: coffin bone rotation, palmar angle (the angle the wings of the coffin bone make with the ground), sole depth, horn-laminar zone thickness (the distance between the dorsal, or front, face of the coffin bone and the outer edge of the hoof wall), and the vertical distance from the coronary band to the extensor process (the tip of the coffin bone).
Following five to 12 months of therapy, the team determined that:
- Coffin bone alignment within the hoof capsule improved significantly;
- Hoof wall thickness decreased significantly, indicating a more appropriate horn-laminar zone thickness;
- Sole depth increased significantly;
- Palmar angle measurements decreased. "This treatment effect was statistically greater for horses with chronic laminitis than for horses with acute laminitis," Taylor said; and
- Horses were 5.5 times more likely to be sound post-treatment than pre-treatment.
Taylor and her team then conducted a follow-up owner survey 23-73 months after 10 of the 14 horses' first presentation at the clinic and learned that:
- 8/10 horses did not relapse or develop hoof abscesses, a common long-term complication of laminitis;
- 8/10 horses were rideable after therapy; and
- 2/10 horses had been euthanized for other reasons.
Taylor concluded, "The hoof care and husbandry (daily exercise, dietary modification, and removing ground reaction force from the hoof wall) applied to these horses may be an effective method of rehabilitation for horses with obesity-associated laminitis."
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.