The War on Laminitis: Reports from the Front Line
Across the country, horse owners are digging in. Battle lines are being drawn. Horses are no longer just helpless victims of laminitis; horse owners are fighting back. The Jurga Report checked in on several developing battlefronts to share with you how the face of laminitis awareness and prevention may be changing this year, and how your horsecare could be adapted to make sure your horse is a card-carrying laminitis freedom fighter.
Laminitis comes in many forms. A horse recovering from colic surgery may develop laminitis. A mare may develop it after giving birth. A horse with a limb injury can sometimes develop it in the opposite foot. A horse that breaks into the grain room could get laminitis. But the most common form of laminitis is “endocrinopathic”, or related to the endocrine system. One type is Equine Metabolic Syndrome, characterized by an inefficient metabolism of insulin (“insulin-resistance”); the second type is Equine Cushing’s Disease, which affects levels of the hormone ACTH.
And just like the forms of the disease, freedom-fighting takes many forms. You might be fighting it with your own horse, or fighting it as an educator or breed specialist. Others fight it with their hands and minds each day as farriers and veterinarians and technicians. You might be a researcher or a product developer. We can all be involved in the freedom fight, and the fight would be a lot easier if each of us found a way to do our share.
We are hearing a lot about autumn laminitis this year, but perhaps the packaging is a little inaccurate. It’s true that we need to stop thinking of laminitis as a spring problem, but one thing you can be sure of is the laminitis is truly seasonal…as in any season. And if you’re around a lot of horses, make that every season.
The autumn months, however, can be trouble for horses, especially when weather conditions are right (or wrong, depending on how you think of it) and depending on how horses with insulin-resistance problems are faring. If you’re not expecting it, it can come as a shock.
Trouble seems to come when wet autumn weather wakes up the dormant grass and sends a flush of green spreading across our pastures as the chilly nights arrive. Sometimes, pastures can change from brown to green almost overnight. But what if the autumn is exceptionally dry? Is anyone keeping weather records and comparing them with laminitis statistics?
Laminitis risk lies within our horses more than it lies in the color of the grass or how frosty the nights are. There are many kinds of laminitis, and autumn grass is associated with one type: the “Equine Metabolic Syndrome” (EMS) horse, or a horse that has developed insulin resistance.
Grazing lush October grass can be a problem for some of those horses. But still others of those horses might have problems with rich hay in the middle of winter, or first-cut hay in June, or almost any switch in the metabolic balance between energy “in” and energy “expended”.
The newest prescription for the EMS horse is one of the simplest ever: if the horse is not lame from laminitis, exercise it! The therapeutic effects of exercise are well-documented in humans and translate to horses, as well. Even a small increase in exercise can make a difference in helping a horse utilize its energy more efficiently and stabilizing some of the hormonal imbalance question marks that could be a prelude to a sore feet episode.
In general: Be careful this fall, this winter and every season, but be active. The new laminitis awareness means being aware of how changes in your horse’s environment can translate to changes in hormone levels.
Who’ll open the first store just for laminitis prevention and treatment? No doubt, there probably already is one. Supplements are the first thing that come to mind, but horses need equipment, too. Horses with endocrine-related laminitis sensitivity–equine metabolic syndrome and equine Cushing’s disease–need management tools, and many are now being mass-produced.
First we had grazing muzzles, then hay soakers. Now the trend is to hay feeders that provide small openings so that horses have to work to get their hay in smaller mouthfuls, but as a result are able to make their hay last longer and slow down the gulping.
Many of the products can be made as DIY projects, or ordered from any number of creative entrepreneurs. You can order a large community feeder for a field use or hanging nets for stalls and almost everything in between. The ultimate “gearing up” is a pasture-track overhaul that encourage horses to keep moving, and even mechanized feeders that open and shut so that a horse has to walk around when one side’s timer tell it to close, as documented in research from Australia.
Pass the test
Horse owners are learning that there are numbers involved in laminitis prevention, at least when it comes to the endocrine-related types. Numbers begin with knowing what a horse’s baseline insulin, glucose and ACTH levels are, as well as the horse’s general health and weight.
When a horse is experiencing laminitis, the levels of either hormone may fluctuate. They may also rise and fall with the seasons. Has your horse ever been tested? The first set of test results might not mean much to you, but they will be kept in your horse’s medical records for reference. You might see a change in a different season or if a change in environment or hay or weight loss affects your horse.
A major initiative in Great Britain in the past two years gave horse owners free access to hormonal tests for their horses. As a result, researchers had a great database–8500 horses–to analyze. One of the most critical findings was that 46 percent of horses tested showed some level of abnormal hormone levels suggestive of Equine Cushing’s Disease, and that this evidence was being seen in younger horses than typically expected, and in horses that did not show overt signs of the disease.
Ask your veterinarian when the best time for testing would be, and get some numbers on file for your horse, especially if you have reasons to suspect that your horse might be at risk for laminitis or is showing symptoms of Equine Metabolic Syndrome or Equine Cushing’s Disease.
Karo Syrup? Really?
The Animal Health Foundation recently funded a validation study at Cummings School of Veterinary Medicine at Tufts University. Professor Nick Franks wanted to test the repeatability of a simplified way to test a horse’s insulin and glucose levels, with horse owner participation. To perform this test, the owner gives the horse a dose of Karo syrup, that clear sugary liquid used to make candy and cocktails.
Donald Walsh, DVM, of the Animal Health Foundation explained, “The traditional single fasting insulin test can miss some horses that look normal when fasting but actually do have insulin resistance. Dr. Frank had proven this simple new test where the horse gets a dose of light Karo syrup based on their weight; a single blood sample is taken 60-90 minutes later and the insulin and glucose are measured. He had already submitted a paper showing the test works, but what needed to be done was to test and re-test a large number of horses and ponies two times each to validate that the results were consistent and repeatable.”
Dr. Frank has completed that work now, and you shouldn’t be surprised if you start seeing bottles of Karo syrup in horse barns!
Here’s a video about the Karo syrup test, produced by Holistic Horse magazine editor Karen Tappenden with Dr. Frank Reilly, a veterinarian with a keen interest in endocrinopathic laminitis at Equine Medical and Surgical Associates in Pennsylvania. Please understand that the method used by your veterinarian may vary slightly, but this video has the main ideas of the test as Dr Reilly performs it.
Vets and farriers
Some interesting results emerged in a survey done of farriers by Professor James Belknap of The Ohio State University College of Veterinary Medicine. He asked farriers for their input on the way they work on laminitis cases, and reported the results last month at the British Equine Veterinary Association Congress.
More than 800 farriers responded, and overwhelmingly said that they would like to see improvements in the way that the horse’s status and treatment are presented to the horse owner, especially when laminitis is the problem. They also want to know sooner that the horse has developed laminitis.
Owners can help make sure that this happens by clearly posting preferred emergency contact information for vets and farriers on a horse’s stall, with caregivers and on show entry records. Horses are often seen by different veterinarians at different times of the year so make sure that your horse’s medical records are up to date and readily available, especially if there is a history of laminitis.
Even sound horses can show evidence of wall and sole bruising, flattening soles and white line hemorrhaging that might indicate a low level of laminitis has been affecting the horse. These signs are so common that many farriers don’t mention them, but if you are concerned about your horse, make sure that your farrier knows you want to be notified of any changes in foot condition.
Laminitis researchers are hard at work, as always. Part of their hard work is always finding funding for their studies. Much of the research is highly sophisticated science that most people can’t grasp, and that causes a level of disconnect that is dangerous, since so much support for laminitis research comes from the grassroots network of horse owners and organizations.
While most horses are affected by the endocrine type of laminitis, where energy invested in prevention really pays off, the general mechanism of laminitis is still not understood, and more basic research is sorely needed before a cure or even effective prevention can be guaranteed. Laminitis is always handicapped by how much is not known about the disease.
No doubt there are many more, but (at last count) 24 new papers chronicling laminitis research accomplishments have been published so far this year in peer-reviewed veterinary journals. Budding areas include the study of incretins in insulin regulation, microscopic analysis of hoof tissue samples from horses with different types of laminitis, and some experimental effects of substances that might have some roles to play in prevention and treatment, such as milk thistle and hops.
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The freedom fighters have a noble cause and deserve all our support. We may never end laminitis but we can stop it from affecting so many of our horses, so much of the time, and ending too many lives far too soon.
Thanks to the Animal Health Foundation, Holistic Horse and everyone who is in some small way a laminitis freedom fighter on the side of healthy, sound horses. And thanks to Jazz Napravnik for sharing her donkey!
To learn more:
Open/shut feeder system: Hampson, B.A., de Laat, M.A., Monot, J., Bailliu, D. and Pollitt, C.C. (2012). Adaption of horses to a novel dynamic feeding system: Movement and behavioural responses. Equine Veterinary Journal, Published online October, 2012. Full article available at: http://onlinelibrary.wiley.com/doi/10.1111/evj.12002/abstract;jsessionid=BC66FE0801C8421D32E3E51F37E
Animal Health Foundation 5-part video summary of current laminitis prevention and owner education
“Talk About Laminitis” awareness education program in Great Britain