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How to Support Horses With Acute or Chronic Laminitis

How to Support Horses With Acute or Chronic Laminitis
By Stephanie L. Church
 
“My horse has laminitis. What do I do?” Even though we might know the fundamentals—cool the feet, provide support, address pain—it can be helpful to ask veterinarians researching the painful hoof disease for updated advice on how to manage cases. Recommendations do change as researchers learn more about laminitis.
 
Andrew van Eps, BVSc, PhD, MACVSc, Dipl. ACVIM, is associate professor of equine musculoskeletal research at the University of Pennsylvania School of Veterinary Medicine’s (Penn Vet) New Bolton Center, in Kennett Square. He and his colleagues focus on laminitis in the van Eps Laboratory at Penn Vet, working to understand why it occurs in different clinical situations. Along the way they’ve found or confirmed the efficacy of mechanical methods to help both acutely and chronically laminitic horses.
 
Van Eps reviewed these approaches for veterinarians and farriers during the 11th annual Northeast Association of Equine Practitioners (NEAEP) symposium, held Sept. 25-28, 2019, in Saratoga Springs, New York.
 
Laminitis Defined
 
Laminitis occurs when the interlocking laminae, which suspend the coffin bone within the hoof capsule, are damaged or inflamed. In severe cases the laminae pull apart, and the coffin bone rotates downward or sinks. A variety of scenarios, from sepsis (infection of the blood) and endocrine problems to excessive weight-bearing on a limb can cause laminitis. (Learn more about why and how it happens here.) Many horses with the acute or chronic forms of the condition suffer tremendous pain, enough so that veterinarians elect to euthanize them.
 
Managing Acute and Chronic Cases Mechanically
 
With laminar inflammation and failure comes a need to unload the hoof wall and reduce the lever arm of the foot. Think of the bones in the limb and hoof as levers; if the toe is quite long, then the load on it is increased as the foot breaks over during movement, which is painful for the animal with laminar inflammation. Van Eps has several ways he supports the horse and attempts to reduce that lever arm.
  • He uses solar impression material as a first line to unload the hoof wall: “There are some fantastic boots out there that you can build custom impression material inserts into,” he said.
  • He recommends standing horses with acute severe laminitis on sand. “It conforms to the frog and sole,” he said. “It transfers load from the hoof wall to the frog and sole, it allows ease of pivoting so it will give underfoot and reduces that torsional stress on the wall, and it enables the foot to find its own comfort zone a bit. It reduces that moment arm lever on the toe during breakover.”
He acknowledged sand is difficult to manage in the barn; it’s heavy and is difficult to keep dry, and it must stay dry to be useful for these cases (it gets hard if it’s allowed to get wet/soiled). Some horses do not like to lie down in sand, so he recommends putting it where the horse is most likely to stand and then bedding the rest of the stall. Despite the inconvenience, “I don’t think you can beat it for an acute case.”
 
In fact, he said, standing on sand and soaking in ice water are the two things that help severe acute laminitis the most.
 
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