LAMINITIS POST PART 2 - Diagnosis, Management and Prevention
Diagnosis
Clinical examination:
During our general health examination we look for indicators suggestive of previous or current laminitis. These could include changes to the appearance of the hoof, increased blood flow to the hooves (increased digital pulses), shifting of weight between legs or changes in stance, and as the pain worsens, we can see elevations in heart rate, more time spent lying down, and anorexia.
As mentioned in our post last week, there are multiple factors that can contribute to a clinical laminitic episode, (please read our previous post). Blood analysis could be used to help differentiate some of these causes.
Examination of the hoof itself, can show changes to the appearance of the hoof wall growth rings, the sole, or the white line. Hoof testing is an additional diagnostic tool which can indicate focal solar pain, for example when a pedal bone has rotated. The temperature of the hoof capsule can be an indicator of inflammation, however can also be very inaccurate.
Radiographs:
The damaging effects of laminitis can be assessed with radiography: Radiographs can indicate the angle of the pedal bone, changes in shape of the pedal bone itself, allow measurement of the thickness of the laminae, and the degree of separation at the dorsal hoof wall surface. This information can give indications of previous laminitic episodes, in addition to the current one.
Management
Immediate management in acutely painful horses, aims at managing the pain, and reducing the horses movement to prevent the deleterious effects of laminitis.
Various types of pain relief can be used, which include anti-inflammatories, centrally acting pain relief, and opioids. Support of the frog assists in reducing the laminar pain, as can wedge applications to the sole surface; this can help to relieve the stretching caused by the deep digital flexor tendon pulling on the pedal bone.
In more severe cases, hoof abscesses can form from bleeding laminae. The abscess can be addressed to relieve the pressure inside the hoof capsule.
Depending on the primary cause of laminitis, we may address dietary management and prescribe additional medication.
Furthermore, it is vital to confine your horse to minimise movement whilst the laminae are weak. Soft supportive bedding can assist in pedal bone support.
Lastly, continuous icing of the affected legs has shown to decrease inflammation in the hoof and can speed up the healing process. Unfortunately, this is not always practical as it requires 24/7 care.
Prevention
Weight management of your horse is the best method of preventing laminitis, as it reduces the forces upon the feet as well as decreasing the risk of the development of metabolic related laminitis. Ideally, you want your horse to be at a body condition score of 5/9; this means that you are easily able to feel the ribs when applying light pressure to the chest wall.
Blood testing can assist in detecting conditions which put your horse at risk from laminitis.
Please feel free to get in touch for further dietary advice. We understand the importance of a well balanced diet and have a passion for correct nutritional education.
If your horse has been diagnosed with a metabolic disorder such as Cushing’s or EMS, we are also happy to discuss management options that suit your horse.
We hope you have enjoyed our posts and please do not hesitate to get in touch if you have any further questions. We are happy to help!
Your Central Lakes Equine Team