Laminits Scenario

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Scenario

14 yr old Shetland pony gelding

Lives with 1 other pony, 3 sheep ,2 alpacas

Not much grass in field = owner gives ab lib

1) Clinical signs

Holding legs forward to remove weight from foot

lying down a lot?

Reluctance/inability to walk

Inc HR and RR

Bounding digital pulses

Feet hot to the touch

arched mane crest? hardened

retrobulbus? fat pad fat behind shoulder, lions and tail head hardened

sweating

Pottery - lameness

Pained expression

Heel first - pressure off toe

2) Grade 3

3) BCS = 3 as 200kg is within normal limits. Soak hay ,

4)

PAIN RELIEF

Morphine 0.1mg/kg =20mg 4x day

Bute - non selective NSAID 2 weeks

Once given horse MUST NOT enter human food chain

Shoe off

Foots supports

Stop rotation ad pressure on back of insertion of deep digital flexor

Vasodilator 0.1mg/kg = 20mg 3x a day

Anticoagulants 1.1mg/kg = 220mg

Antioxidants 100mg/kg = 20kg

5) cause? Isolate, trim foot Box rest for 14 days, Do realigning trim, soft deep (1ft +half) bedding all the way up to door-shavings /sand ideal (though owners don't like sand), diet- , no fatty treats, low carbs low sugar -- laminitis feed, or plain chaff or soaked hay (8hrs) remember to rinse after. Same amount as before use soaked.

NB each hour takes 10% sugar out

6) Hoof re-angled? Do angles , founder distance

NB pin - in front of frog , metal over central dorsal hoof wall, level with cor? band at top

7)Cushings = don't produce enough dopamine .overpotoduction of ACTH? Exaggerated immune response in response to high levels of glucose. High levels of insulin cause laminitis

Clinical signs - curly coat (pathognomonic), drink a lot, PUPD, fat redistribution, lethargy, muscle atrophy

Drug - dopamine agonist , purgalide?

Diagnosis via blood sample

EMS = high insulin levels in blood stream, have been associated with blood vessels narrowing and a heightened inflammatory state, native ponies predisposed Often struggle to loose weight

Treatment - no one treatment , drug met-4-min increase tissue sensitivity to insulin, exercise lung 10 mins 4 times a week ,

Clinical signs - obesity, 30% of horses with bushings have EMS, cresty neck,

90% of laminitis cases have underlying endocrinitis problem

10% all other causes - weight bearing laminitis, overweight, injuries, endotoxaemia

8)Cheap, improves quality of life, quick, minor surgery. Farrier shoes needed after - expensive

9) Seasonality

Lush grass contains readily digestible sugars

Bacteria in intestines release toxins

Toxins enter blood stream causing laminitis

Laminitis

Laminae break down

Pedal bone no longer suspended in foot

Deep digital flexor inserts on back of pedal bone dragging it backwards

Pedal bone sinks and/or rotates

Sinking can occur due to major break down of laminae

Hoof can also come off

NB pedal bone rotation can be saved with good farriery

Sinnking has v poor prognosis

more likely to get laminitis in front feet as they bear more weight

Lateral views show us rotation and sinking

Dorsopalmar shows rotated sinking (usually occurs in V large horses

Re-visit

Stop bute / take it down

No bute for 7 days until sure theres improvement

DMSO

Increases membrane transport

Makes skin v thin

Not-lisenced

No longer in practise