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Advancements in the Treatment of Laminitis. University of Rhode Island Lisa Connor. February 24, 2007. Overview. Laminitis Causes Treatment Advancements Heroes Future Outlook/Need for Funding. What is Laminitis?. Pain and inflammation of the sensitive laminae of the foot.

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advancements in the treatment of laminitis

Advancements in the Treatment of Laminitis

University of Rhode Island

Lisa Connor

February 24, 2007

overview
Overview
  • Laminitis
    • Causes
    • Treatment
    • Advancements
    • Heroes
    • Future Outlook/Need for Funding
what is laminitis
What is Laminitis?

Pain and inflammation of the sensitive laminae of the foot

circulatory effects

Normal circulation

laminitis

Dr. Christopher Pollitt

American Farrier's Journal

Circulatory Effects
what causes laminitis
What causes Laminitis?
  • Nutrition (carbohydrate overload)
  • Toxemia
  • Mechanical overload (contralateral effects)
  • Stress
  • Hormonal Imbalance (Cushing’s Disease)
  • Drug Induced (sensitivity to corticosteriods)
applying physics
Applying Physics

40%

60%

  • horse's weight (gold)
  • upward ground force from concussion (red)
  • rear-ward pull of the deep digital flexor tendon (green)
  • The laminae (blue)
  • The forward & upward pull of extensor tendon (purple)
u s statistics
U.S. Statistics
  • 28.5% of polled operations in 28 states confirmed laminitis within their boarding/training population
  • Highest incidence in Spring/Summer

USDA/APHIS Equine 98 Study

goals of treatment
Goals of Treatment

Prevent further development

Reduce the pain or hypertension cycle

Reduce or prevent permanent laminar damage

Improve laminar capillary dynamics

Prevent movement of the distal phalanx

common approaches
Common Approaches
  • Determine cause & correct condition
  • IV fluid therapy
  • Cryotherapy
  • Radiographs
  • NSAIDS (Bute, ketoprofen)
  • Promote vasodilation (Acepromazine, isoxuprine, pentophyline and nitroglycerin)
  • Frog support
mechanical aids
Mechanical Aids

The heart-bar-shoe through its contact with the frog engages weight bearing (*supports bony column*)

  • natural approach in the treatment of several pathologies of the foot (crushed/under-run heels, quarter cracks, and laminitis)
  • helps prevent rotation and or sinking of the coffin bone
more mechanical aids
More Mechanical Aids

Styrofoam padding

Digit Support System

NBHoofcare

NBHoofcare

NBHoofcare.com

alternative practices
Alternative Practices
  • Venograms confirm degree of blood supply
  • Deep digital flexor tenotomy (usually for salvage cases)
    • Restores natural angle with ground surface
      • Study over 10 yr. period
      • n=37
      • 77% survival after 6 mos.
      • 60% survival after 24 mos.
  • Dorsal hoof wall resection
    • Prevent & treat abscesses
  • Prosthetics
  • Barefoot trimming & holistic therapies
the problem with laminitis
The Problem with Laminitis
  • Within the multitude of treatment options

~ NONE are UNIVERSALLY EFFECTIVE

  • Pathogenesis is poorly understood
  • Contradicting theories
    • Heat vs. Cold (Cryotherapy)
    • Use of heartbar shoes vs. styrofoam pads or barefoot trimming
    • Vasodilation vs. Vasoconstriction during onset
advancements in technology
Advancements in Technology

Venogram

A veterinarian can see where blood flow is compromised due to damage, swelling, or poor hoof structure, and thus decide what mechanical support and/or surgery he needs to provide in order to restore blood flow to those areas.

research initiatives
Research/Initiatives
  • Involvement of Circulation (Hood et al, 1993)
    • Vasoconstriction causes decreased perfusion to nutrient laminar capillaries
  • The Glucose Connection (Bailey, 2000)
  • Connective Tissue Connection (Pollitt & Daradka, 1998)
  • National Animal Genome Project
    • (gene map for horses)
steps to conquering laminitis

5 Years

$10M in Research Funds

Foundational Knowledge Today

Collaboration between Veterinarians, Farriers, and Scientists alike

Steps to Conquering Laminitis

Laminitis remains the second largest killer

of horses, behind colic.

beloved heroes

Barbaro, 2006

Secretariat, 1973

Foolish Pleasure, 1975

Beloved Heroes

Patricia McQueen photo