Laminitis—the inflammation of the sensitive laminae inside the hoof wall—is a frightening disorder. Excruciatingly painful, laminitis can weaken the laminae and allow the coffin bone inside the hoof to sink and/or rotate downward, causing permanent deformity. In severe cases, euthanasia may be the only humane option, and survivors may never be sound again.
Any horse can develop acute laminitis, caused by an overload of carbohydrates, severe gastrointestinal illness or mechanical stresses. More common, however, is the chronic form, a milder condition triggered by hormonal imbalances associated with equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID, also called Cushing’s disease) or other disorders.
The earliest signs of laminitis may be alarmingly obvious or they may be subtle—but once you spot them, you need to act immediately.
When you suspect laminitis
If you see these signs:
• shifting of weight back and forth between the front feet or adopting the “founder position”—leaning back on the haunches with the forefeet stretched forward;
• recumbency and reluctance to rise;
• sweating, fever and shallow breathing or other signs of pain;
• hooves that are warm to the touch;
• a “bounding” (rapid and strong) pulse on the back of the pastern, either just above or just below the ankle;
Three key steps
Here’s what to do:
FIRST:
Call the veterinarian; say you have an emergency and explain the situation.
SECOND:
Put the horse’s feet in ice. Icing the feet is the one treatment that has been proven to halt the progress of laminitis under laboratory conditions. The earlier, the better. When researchers in Australia starting icing a horse’s feet immediately after administering oligofructose to induce the disease, they were able to prevent laminitis from developing.
Icing may be useful if a horse has broken into a grain bin and you strongly suspect laminitis may follow. And this therapy can also greatly reduce the severity of the disease, even if the treatment does not start until after signs of foot pain appear.
Stand the horse in a tub with cold water and ice deep enough to submerge the leg up to the middle of the cannon bone, and replenish the ice as needed until the veterinarian arrives.
THIRD:
Take the horse’s temperature. Laminitis may accompany other illnesses. Of course, you’d probably already know if your horse were seriously ill, but an elevated temperature might indicate underlying problems you hadn’t noticed. Report your findings to your veterinarian. When she arrives, the veterinarian will offer guidance based on your horse’s condition and circumstances.
As you wait, you may want to enlist a friend who can lend a hand and help gather any supplies your veterinarian might need.
What NOT to do
Do not walk a horse you suspect has laminitis. Each step he takes increases the stresses on the laminae. Instead, keep him as still as possible. Ideally, you’d leave the horse exactly where you found him until the veterinarian arrives.
If he must be moved, choose the shortest route available, preferably over soft ground. To move him over a longer distance, try bringing a trailer out to where he is and letting him ride into the barn. If he wants to lie down, let him.
In the meantime
Locate an area with soft footing. As your horse begins recovery from laminitis, you will want to provide him with a stall with very deep bedding (at least eight inches) or a small pen with deep, soft footing, such as sand.
The soft material will pack up inside the hoof, supporting the coffin bone, which may prevent or reduce rotation while also easing the horse’s pain.
Why PPID increases laminitis risk
One important step in preventing laminitis is to control another condition: Pituitary pars intermedia dysfunction (PPID). Also known as Cushing’s disease, PPID occurs when an overactive pituitary gland produces excessive levels of adrenocorticotropic hormone (ACTH). These excess hormones cause a slew of systemic signs including a long hair coat that is slow to shed, muscle wasting, lowered immune function and susceptibility to infection.
Perhaps most alarmingly, some horses with PPID are prone to slow-onset chronic laminitis that can go undetected until hoof structures have been irreversibly damaged. PPID is most common in older horses but can affect horses as young as 15.
To protect your horse from this insidious form of laminitis, consult with your veterinarian if you have any suspicion your horse has PPID. If testing confirms the condition, your horse can be given the drug pergolide (brand name Prascend), which binds to the receptors in the brain that normally respond to dopamine, reducing the blood levels of ACTH. Given daily, pergolide is considered extremely effective at controlling the signs of PPID and lowering laminitis risk. You’ll also want to have your horse tested periodically to ensure the dose he is receiving is still appropriate.
