The most important time to take action against laminitis is when a horse shows early signs or a high-risk event occurs that might trigger laminitis. Triggers for laminitis range from exposure to black walnuts to injury to physiological disruption from colic, high fever, retained placenta, or carbohydrate overload. In essence, anything that causes a horse significant trauma might set in motion a cascade that ends in laminitis.
Laminitis is regarded by many in the veterinary field as the most horrific disease to attack horses because in severe cases, it literally causes the hoof capsule to slough off when the laminae that make up the connective tissue between the interior structure of the hoof and the hoof wall die. Theories about what actually happens to the horse physiologically to cause laminitis are numerous, and researchers still seek answers to many questions about the disease.
Dr. Hannah Galantino-Homer is a senior research investigator and the founder of the Galantino-Homer Laminitis Laboratory at the University of Pennsylvania's New Bolton Center. The laboratory is part of the Laminitis Institute founded by the university after the tragic death of 2006 Kentucky Derby winner Barbaro. The colt was euthanized after an eight-month battle against laminitis at New Bolton Center after fracturing his right hind leg at the beginning of the Preakness Stakes.
If you think laminitis is a threat, call your veterinarian immediately. Time is of the essence.
Galantino-Homer said several things can be done while waiting for the veterinarian to arrive. First, move the horse to a confined area with soft footing. This can be a round pen with a deep sand base or a stall with at least six inches of bedding, either shavings or several bales of scattered straw.
“This allows them to distribute the weight more, and it encourages them to lie down if their feet are really sore,” she said.
Next, ice the horse's feet. Studies show that cryotherapy reduces pain and inflammation. This can be done by standing a horse in ice and water, using ice boots, packing crushed ice in a bag and securing it to the horse's foot with bandage, or pulling pantyhose over the horse's lower limb and filling it with ice. If you are fortunate to have a Game Ready system, this is an ideal use for it.
More importantly, icing can slow down the cascade of events.
“Any kind of damaged tissue tends to compound the damage by releasing more things that cause more damage, more inflammation,” Galantino-Homer said. “You're slowing all that down. You're slowing the metabolism of the white blood cells that have been activated by tissue damage going on. So you're trying to slow all that down.”
Administering a nonsteroidal anti-inflammatory drug is the next measure but be sure to get your veterinarian's approval first. The horse's history, current medical condition, and potential cause of laminitis must all be factored into what the horse should receive.
“Veterinarians have preferences for what they use,” Galantino-Homer said. “For a horse owner in a first-aid situation, it would be whatever you have on hand—Bute, Banamine. It's medical management for painkilling and inflammation, and it is going to depend on other clinical aspects. Such as a horse with colitis, you have to worry more about kidney damage. So they may manage pain differently.”
When your veterinarian arrives, he or she will examine the horse to determine the best course of treatment. This commonly includes tubing the horse with mineral oil and activated charcoal to protect the intestinal mucosa, particularly in the case of carbohydrate overload. When colitis is a threat, your veterinarian may recommend Bio-Sponge to combat bacterial overgrowth, Galantino-Homer said. Developed by the late Dr. Doug Herthel's Platinum Performance laboratory, Bio-Sponge oral paste is an intestinal adsorbent that grabs onto damaging agents and carries them out of the horse's body when it defecates.
Because laminitis is a complex disease and every horse is an individual, no set plan of treatment can be applied to every horse. Long term, expect the horse to require the care of a farrier knowledgeable about laminitis and therapeutic shoeing. Your veterinarian also may recommend management changes for the horse, including a nutritionist to modify the horse's diet.
Note: An earlier version of this article misidentified Dr. Galantino-Homer's job title as Director of the Laminitis Laboratory at New Bolton Center. She is a senior research investigator and the founder of the Galantino-Homer Laminitis Laboratory at New Bolton Center
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