The latest on laminitis: What veterinarians have learned and what lies ahead - DVM
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The latest on laminitis: What veterinarians have learned and what lies ahead
Prevention and treatment strategies were highlighted at the recent International Conference on Laminitis and Diseases of the Foot.


Presentation highlights

Figure 2: Chronic phase of laminitis with rotation of the third phalanx away from the hoof wall. Lamellar wedge or "scar horn" development in chronic laminitis has a negative effect on the horse’s prognosis.
The conference was divided into several different sections—scientific, practical and owner-based focus programs and workshops—each building on the science of laminitis research. The scientific program began with a focus on the epidemiology of the disease, since that plays such an important role in identifying at-risk horses and the factors that may put horses in jeopardy of getting laminitis.

"We have a better understanding of laminitis knowing this type of information, which then allows early intervention for prevention rather than treatment strategies in managing these horses," stated Orsini. "Our goal is to be able to intervene before clinical signs are evident in the at-risk horse."

The other components of the scientific program included endocrinopathic laminitis, anatomy and physiology, and equine metabolic syndrome and inflammation.

Contributing factors for laminitis

Orsini explained that some of the reported contributing factors for laminitis are body weight, body condition score (BCS), occupation (i.e., racing, trail riding, Western competition, dressage and so on), age and the type of pain medication being used to manage the disease.

"Horses with supporting limb laminitis are generally a younger group—a racing or competing athlete that sustained a severe orthopedic injury," explained Orsini. "Horses used more for pleasure had a tendency to have a higher body weight and BCS and were not being exercised on a regular basis, which is another significant finding contributing to the development of laminitis."

Additionally, horses receiving "stronger" pain medications, in addition to NSAIDs, were more likely to have advanced disease and greater rotation.

Pathology of laminitis

Inflammation is the primary pathology occurring in horses with laminitis mediated by cytokines. This was discussed in a presentation by Patty Weber, DVM, assistant professor in the Large Animal Clinical Sciences Department at Michigan State University's College of Veterinary Medicine, who looked at the various chemokines and cytokines expressed in damaged tissue in both lean and overweight ponies.

Overweight ponies demonstrate some cytokines that are proinflammatory and contribute to the systemic inflammatory response state. These glycoproteins are very important in the disease process, and enzymes such as COX-2 are known to be detrimental to the laminar tissue. That is why COX-2-specific NSAIDs, such as firocoxib, are a better choice to manage the inflammation associated with laminitis.

Treatment for laminitis

Also discussed was the importance of cryotherapy to manage laminitis, especially in reducing inflammation. An abstract by Susan Holcolme, VMD, MS, PhD, DACVS, DACVECC, professor of large animal surgery and emergency medicine at Michigan State University's College of Veterinary Medicine, looked at 130 horses where prophylactic cryotherapy (encasing the foot and distal limb in a 5 L bag of crushed ice for 48 hours) decreased the incidence of laminitis associated with colitis.

Those horses treated with cryotherapy were 10 times less likely to develop laminitis compared with those that did not have cryotherapy. Digital ice therapy was an effective prophylaxis in horses admitted with colitis and at risk for systemic inflammatory response syndrome (SIRS).


Source: DVM360 MAGAZINE,
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