When Laminitis Strikes, What’s Your First Line Of Defense?

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Barbaro, Edgar Prado, and Dr. Dean Richardson at New Bolton during the Derby winner’s treatment for laminitis

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 the director of the 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.

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Does Your Overweight Horse Have An Insulin Problem?

by Eleanor M. Kellon, VMD

 

Easy keepers and overweight horses and ponies have been around forever. Laminitis has also always been with us, and it’s no secret that overweight animals are at high risk. We now know that the vast majority of laminitis cases are caused by high insulin levels – hyperinsulinemia. Does this mean being overweight/obese causes insulin problems?

 

It might seem that way superficially but the logic is faulty.

 

There is an important principle in science which states, “Correlation (or association) is not causation”. Observing that things occur together does not mean one causes the other. Let’s say that the native horses of the country Muropa are observed to regularly consume the leaves of the Bajunga plant, which only grows in Muropa. It has also been observed that Muropa horses never develop sweet itch. Does this mean Bajunga protects from sweet itch? While there could be a link, this doesn’t prove it. It could be a genetic factor protecting them – or simply that there are no Culicoides midges in Muropa!

 

Many horses that develop laminitis are overweight or obese. We know that the vast majority of laminitis cases are caused by high insulin levels. The correlation has always been obvious and it didn’t take long for an assumption to arise that obesity is a laminitis risk factor and causes elevated insulin. There’s just one thing: It’s not true.

 

A study (Bamford) published in the Equine Veterinary Journal in 2015, fed horses and ponies a control diet or one designed to cause obesity, by feeding either excess fat or excess fat and glucose. The weight gain did not reduce insulin sensitivity in either group. Dr. Bamford has also clearly shown that insulin responses to oral or intravenous glucose have marked variation by breed in horses of normal weight. You can read all of Dr. Bamford’s work in detail in his thesis here: https://minerva-access.unimelb.edu.au/bitstream/handle/11343/148423/Bamford%20PhD%20Thesis.pdf?sequence=1.

 

Selim, et al., 2015, followed two groups of Finnhorse mares on either native pasture or intensively managed improved pasture. At the end of 98 days of grazing, the mares on improved pasture went from a body condition score of 5.5 to 7 and gained 145 pounds; but this was not associated with insulin resistance.

 

If obesity isn’t a cause, why is more insulin resistance seen in obese horses – 25 to 50% IR depending on the study versus 10 to 15% of horses in general? The answer is simple. The IR increases appetite and weight gain. Yes, there is an association between obesity and high insulin but obesity is the result, not the cause.

 

This is more than just splitting hairs. If you think obesity is a cause, then weight control becomes a treatment — even possibly a cure. When you realize it is a consequence, not a cause, expectations for results of weight loss become more realistic. There are many benefits to weight loss and it should be aggressively pursued, but it won’t make insulin resistance go away.  Approximately 50% of IR horses are normal weight.

 

 

About ECIR Group Inc.

Started in 1999, the ECIR Group is the largest field-trial database for PPID and IR in the world and provides the latest research, diagnosis, and treatment information, in addition to dietary recommendations, for horses with these conditions. Even universities do not and cannot compile and follow long term as many in-depth case histories of PPID/IR horses as the ECIR Group.

 

In 2013 the Equine Cushing’s and Insulin Resistance Group Inc., an Arizona nonprofit corporation, was approved as a 501(c)3 public charity. Tax deductible contributions and grants support ongoing research, education, and awareness of Equine Cushing’s Disease/PPID and Insulin Resistance.

 

THE MISSION of the ECIR Group Inc. is to improve the welfare of equines with metabolic disorders via a unique interface between basic research, and real-life clinical experience. Prevention of laminitis is the ultimate goal. The ECIR Group serves the scientific community, practicing clinicians, and owners by focusing on investigations most likely to quickly, immediately, and significantly benefit the welfare of the horse.

 

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