In search of the laminitic pathway - DVM
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In search of the laminitic pathway
The disease holds many mysteries, but treatment options are available to thwart chronic onset


DVM360 MAGAZINE


Redden has been treating the clinical stage for 30 years and says that there has been tremendous progress made in how we can monitor the case, fully assess it and precisely know its status.

"With laminitis, we have a way of evaluating the signs, the symptoms and the clinical workup. If you don't have a way of assessing the amount of damage that has occurred at any particular stage of the syndrome, then your chances of treating the disease are left purely to chance," he says.

Redden developed the clinical protocol for the venogram in 1992; he's done more than 3,000 venograms since then.

The venogram is indicated because it allows you to clearly assess the value of the circulatory system of each foot or each part of the foot at any stage of the syndrome.

"You have to interpret what you see, and that's where the real kicker comes in the interpretation," Redden remarks.

Using the venogram, you can assess how far a horse is from stable. Compared to a normal venogram, the horse can be assessed to be so far from stable, compared to the normal soft-tissue para-meters.

"I don't like to use the word 'stable' in assessing my cases because when a horse appears to be clinically improved, it means nothing unless your venogram shows he's clinically improved and your soft-tissue parameters show he's clinically improved, which means he's growing sole, about 1 to 2mm every three to four days," Redden says. "If he's doing that, his venogram will show you why he's doing that because his fimbriae are becoming functional again."

The future

Practitioners expect the next few years to be very exciting, and the progress will be much faster, Belknap says.

"Our best chance is to find drugs that are going to knock this out in the beginning before you get the secondary breakdown of the laminae, the collagen, the basement membranes, etc."

Hood says he expects the profession to identify the pathway during the next four to five years, ultimately facilitating the work toward a cure.

"Rehabilitation is where we're really making an impact," Hood says.

Currently there is research going on where veterinarians are going to see a major improvement in getting these horses back to function. The prognosis and the long-term outcome of chronically affected horses is where most of the improvements are really going to impact the disease. Usually by the time most of the laminitic horses are brought to the attention of a veterinarian, or maybe before a horse is diagnosed, it is already in the early chronic phase.

But appropriate clinical management of the acutely affected horse has significantly reduced the incidence of progression on to chronic laminitis. Research on the chronic laminitic horse has significantly increased the number of horses with chronic laminitis that can be successfully rehabilitated.


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Source: DVM360 MAGAZINE,
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