Successful laminitis rehab must involve client - DVM
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Successful laminitis rehab must involve client
Client access to latest research, medical updates cannot replace simple tips needed in the recovery of laminitic cases


DVM360 MAGAZINE



The vast majority of horses will exhibit a solar surface that looks like this. Practitioners sometimes confuse the appearance of the solar lamella tissues with a penetration of the sole by PIII. This horse was packed and wrapped, and eventually regrew a new sole and returned to soundness.
Each case uniqueThere are no specific recommendations for shoeing the foundered horse, because there are too many variables between cases. However, O'Grady sees the basic principles as correcting or realigning the dorsal hoof wall and the dorsal surface of PIII, correcting the solar hoof margins, raising the heels if decreased pressure on the deep digital flexor is needed and removing pressure on the dorsal hoof wall. Many shoes will eventually be used as the foot changes and the laminitis resolves. Dr. Robert Hunt, speaking at the 2003 Equine Laminitis Symposium, says, however, "No single shoe is suitable for all situations."

Occasionally owners and veterinarians will see a horse that starts to slough off its hoof capsule or starts to drain on the sole surface in front of the point of the frog. The sole separates and a section of clear to yellowish tissue can be seen deeper in the sole.

The general comment is that these horses are rotating PIII through the bottom of the foot and that these horses will be lucky to survive. In fact, the majority of these cases are simply inflammations of the solar laminae that are open and draining and many of these laminitic cases show little if any rotation. Packing and wrapping these feet will help resolve drainage and a new sole will re-grow to replace the damaged one. In this stage of rehabilitation owners may need encouragement because this stage lasts for a while and improvements are very hard to notice.

Foundered horses should be kept slightly thinner than usual because additional weight can increase the forces on the deep digital flexor tendon. Conversely, these horses must now regrow new hoof capsules and will need a significant protein source for this task. Quality low protein feed with plenty of hay or pasture is usually sufficient.

Limit medicationPain relief, reduction of inflammation and improved vascular support of the hoof are the main reasons medical therapy is used with foundered horses. Many drugs can be debated as to their exact modes of action and effectiveness in the laminitic horse. General principles are to make the horse comfortable and to use the least amount of medication necessary. Newer drugs are continually being introduced with claims to aid in founder cases. They will have to be tested and evaluated before their use can be encouraged.

Overall, it often seems that once the clinician has applied all the medical information and results of new studies, he or she is still left with a horse with very sore feet. The client quickly becomes the principal caregiver and the veterinarian, once the horse is stabilized enough to return to a semi-normal routine, must be supportive to the caregiver. Attention to small details like skin infections/irritations, diet and general well-being can have a significant effect on the eventual outcome of these cases.

Dr. Marcella, a 1983 graduate of Cornell University's veterinary college, was a professor of comparative medicine at the University of Virginia. His interests include muscle problems in sport horses, rehabilitation and other performance issues.


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