Laminitis has long been among the most dreaded diagnoses in the horse world, and understandably so. The destruction of the connective tissues within the foot (laminae), combined with the muscle forces that pull on the coffin bone, can separate the bone from the hoof wall. This can cause excruciating pain and often leads to permanent unsoundness. Cases may be severe enough that euthanasia is warranted to relieve suffering.
There are many treatment options proposed for laminitis. Unfortunately, most have not been tested, and many are often ineffective. The sad reality is that by the time a horse is showing the first outward signs of lameness and pain, the damage within the foot is already underway.
It’s not fully understood exactly how and why a case of laminitis develops. However, in recent years, state-of-the-art biotechnology has yielded sometimes surprising insights into the bio-molecular changes within the tissues of the foot that lead to laminitis. For example, it is now known that not all cases of laminitis begin the same way. Sometimes, laminitis is the result of inflammation that develops within the connective tissues of the foot. But in the majority of cases—about 70 percent—inflammation is not the triggering event, but the result of external forces.
With this growing knowledge, veterinarians have been able to identify with increasing precision which horses are more at risk for pasture-associated or endocrinopathic laminitis. This allows owners to target their preventive measures toward the horses who are most vulnerable to different forms of the disease.
Here are three major risk factors—along with specific steps you can take to minimize them and reduce your horse’s chances of developing laminitis.
Cause: Metabolic disorders
Many cases of pasture-associated or endocrinopathic laminitis stem from equine metabolic syndrome (EMS), a disorder that is characterized by insulin resistance, a condition in which a horse’s cells do not respond appropriately to the hormone insulin. These horses have high concentrations of insulin in the bloodstream (hyperinsulinemia), similar to type-2 diabetes in people. Exactly how hyperinsulinemia leads to laminitis isn’t known. In fact, the insulin resistance itself is likely not the cause of the condition. Researchers have shown that injecting horses and ponies with high doses of insulin can induce laminitis without insulin resistance.
Often, endocrinopathic laminitis is a low-grade chronic form of laminitis without severe rotation of the coffin bone. It tends to come on slowly, causing soreness in the feet but not necessarily extreme pain. Separation and displacement of the coffin bone may not occur, but if it does, the process is fairly gradual, not a single catastrophic event.
Fortunately, metabolic disorders in horses can be controlled, reducing the risk of laminitis, with these basic steps:
1. Identify at-risk horses. EMS is a complex disorder that is not yet fully understood. But horses prone to EMS do have several distinct characteristics. Often, they are “easy keepers,” who gain weight even with little or no grain in their diets. Many are obese or exhibit “regional adiposity”—the development of fat deposits in distinct areas—even if they are not overweight. They may be “cresty,” with fat accumulating along the crest of the neck, and may also have unusual pads of fat over the tailhead, behind the shoulders or near the sheath or mammary glands. Another sign may be distinct growth rings on the hoof walls that show previous episodes of mild laminitis. Talk to your veterinarian if your horse fits this profile; blood tests can determine if he is insulin resistant.
2. Treat PPID. Pituitary pars intermedia dysfunction (PPID, also commonly called Cushing’s disease) is a malfunction of the pituitary gland that results in excess production of the hormone cortisol. This leads to hormone imbalances throughout the body. Unlike EMS, which tends to develop while a horse is younger, PPID is more common in those over 16 years of age. However, a horse with EMS may be more likely to develop PPID at a younger age, and both conditions may occur together in some animals.
Increased susceptibility to laminitis is one of the primary concerns with PPID, which is also characterized by a heavy coat that is slow to shed out (hirsutism), increased thirst and urination (from renal hormone problems), excessive sweating, loss of muscle mass, lethargy and an increased susceptibility to infections. Exactly how PPID causes laminitis isn’t certain. Hyperinsulinemia may play a role, or it may result from high levels of a different hormone.
Consult your veterinarian if you notice any signs of PPID in your aging horse. PPID can be controlled with the drug Prascend. The active ingredient in Prascend is pergolide and is formulated for consistent absorption in horses.
3. Minimize sugars and starches in the diet. Even small or “normal” portions of grains, molasses, sweet feeds and other sources of sugars and simple starches, also called nonstructural carbohydrates (NSCs), may trigger laminitis in horses with metabolic disorders. You’ll want to limit or eliminate concentrates, especially if your horse is overweight.
If your horse is not overweight and needs extra calories to maintain his condition, look for a feed that derives calories from fat, not NSCs. A number of low-sugar feeds are available that are formulated for horses at risk of laminitis. Breaking up the ration into multiple small meals served throughout the day can help avoid wide fluctuations of glucose and insulin in the blood. Also be careful of treats—a number of seemingly “healthy” treats for horses can be high in sugar.
4. Limit access to lush pasture. Grazing lush pasture grasses, which are rich in a sugar called fructan, is a well-established cause of laminitis in at-risk horses. Fructan levels tend to peak in spring and fall but can fluctuate throughout the year. Sending a grass sample to a laboratory for analysis is the surest way to be certain of it sugar content. Your veterinarian or a local extension agent can help you locate a suitable facility and understand the results. Testing your grass periodically throughout the year, in different seasons and climatic conditions, can help you identify patterns in the fructan levels in your pasture.
How much grazing is “too much” depends on the individual horse. Knowing what your pasture fructan levels are, and how and when they vary, your veterinarian can help you develop a turnout schedule that suits your horse’s needs. You may need to use a grazing muzzle to limit his intake during peak periods of grass growth or, if your horse is especially vulnerable, the only safe form of turnout may be in a year-round dry lot.
The stance of a horse with acute laminitis, trying to get weight off the front feet
Typical stance of a horse with laminitis, trying to get off his front feet
The old adage that an ounce of prevention is worth a pound of cure is especially true of laminitis. Since it’s a given that many horses that develop the condition will be permanently affected – and some will not recover at all – it makes a lot of sense to do whatever you can to keep your horse from developing the problem in the first place.
What is laminitis? It’s a condition affecting the connections of the hoof wall – which is the equine equivalent of your fingernail – to the live tissue underneath. Think of it this way. The hoof is connected to the live tissue underneath in very much the same configuration as is the paper on everybody’s favorite peanut butter and chocolate cup. As far as the horse’s hoof goes, the crinkled edges are layers of tissue; the Latin word for “thin sheet of material” is lamina. And laminitis is a still poorly-defined problem that affects that thin layers of tissue that form these connections.
It’s an awfully big problem because when the connections of the hoof get in trouble, horses have difficulty walking. Their feet hurt. But it get’s worse. If the connections get in so much trouble that they start to let go, the bone in the hoof can separate from the hoof itself. Laminitis is a big deal for affected horses.
Since it’s such a bad problem for horses, it makes a lot of sense to try to prevent laminitis. Of course, there is one big, fundamental, gigantic problem with the absolutely well-intentioned notion that laminitis can be prevented. That big problem is that preventing laminitis is not always possible. I mean, if I were to try to come up with a short list of what should be done to prevent laminitis in every horse, it would look something like this.
- Don’t ever let them get fat
- Don’t ever let them get old
- Don’t ever let them get sick
- Always take good care of their feet
- Make sure they never inadvertently get into the feedroom
- Don’t let them gorge themselves on lush grass pasture
So you can see the problems here. Sometimes, there are things you just can’t do anything about.
ASIDE: I’ve had people ask me – usually at the scene of some accident caused by something like a horse being scared to death by a particularly threatening shadow – if it might not be better to try to keep horses in a padded stall so as to prevent any sort of injury. And I, having at this point seen just all sorts of idiotic things that horses can do to themselves – often with human help – will usually reply something along the lines of, “No, that would be a terrible idea. They’d just eat the padding and colic.”
Anyway, back to preventing laminitis. Another big problem with laminitis is that it’s not a single problem. In fact, it’s not even a disease. Laminitis is not a disease, it’s a clinical sign of a disease. Laminitis can occur because of overeating, uterine infections, being too fat, diarrhea, poor hoof care, pneumonia, endocrine problems, etc., etc. I mean, what other single disease can claim all that physiologic mayhem? It’s not possible to prevent all cases of laminitis any more than it is possible to prevent all causes of pain. Sometimes stuff just happens. That doesn’t mean you shouldn’t try the best that you can, but it also means that you shouldn’t beat yourself up if something goes wrong.
Seriously, though – which, admittedly, can be a hard place for me to stay in for long – although preventing laminitis is not always possible, there are some important considerations to keep in mind in managing your horse so as to at least increase the likelihood that your horse (and you) will never have to deal with laminitis. In fact, there are quite a few of them. And rather than ask you to read through all of them, I’ve put them into separate documents so that you can print them off and read them at your leisure.
Click on the documents below to get information about various aspects of laminitis prevention.
Not all cases of laminitis can be prevented. Not all cases of pain can be prevented, in your horse, or in you, for that matter. Sometimes your horse is going to step on something. Or twist something. Or bump into something. Pain sometimes happens, no matter how careful you try to be. Laminitis, too.
Here’s an example, No matter how well you take care of a horse with “Cushing’s Disease,” sometimes his hooves are going to get in trouble (laminitis) because of uncontrolled problems with his endocrine system (that is, problems with one or more glands that secrete various regulatory substances known as hormones into the blood). You can’t fix the primary problem with Cushing’s horses – which is associated with aging, which, by the way, is another thing that can’t be fixed – and you can’t prevent the primary problem, either. Nobody know why horses get “Cushing’s,” either. If you can’t fix or prevent a primary problem in medicine, things are ultimately not going to work out very well.
You’ve got your best chance at keeping your horse from getting laminitis if you take good care of him. Laminitis prevention is not to be found in any particular product. And since an episode of laminitis can affect your horse for the rest of its life (assuming he recovers), it’s well worth trying to prevent it. A good prevention program should be a lifelong task. It’s just that it’s not always going to work.
Control your horse’s weight. Don’t think of any particular type of food as bad, but rather consider your horse’s calorie intake overall. As a rough guide, fat and oil are the highest in calories, followed by starch, grass, hay and straw, so obviously you can feed more of the low calorie feeds. Be vigilant all year round and remember that horses are the original yo-yo dieters. They should be thin-ish coming out of winter as they’ve evolved to put weight on in spring.
Weightape him regularly to monitor his condition, and aim for a condition score of 2.5-3 on a scale of 1-5 (0 being emaciated and 5 obese). As a guide, a score of 2 is the thin side of acceptable – and 3 is the plump side of acceptance, so you can feel the ribs but not see them.
Exercise your horse regularly. Turn put doesn’t count as adequate exercise – there needs to be a commitment to active exercise – that means riding, driving, lungeing or long-reining.
According to nutritionists, 24-hour turnout on a paddock with little access to grass is best. Grass may well be full of calories, but if you keep your horses in, he won’t be moving around as much and his metabolism will slow, so use a grazing muzzle or get your lawn mower out, cut the grass – then make sure you rake it up.
Consider the conformation of your horse’s feet and work with a good farrier to keep his hooves in the best possible shape to maintain the pedal bone’s correct position within the hoof capsule.
- Laminitis prevention
- Trigger factors
- Risk reduction
- Support Group
It’s one of the leading causes of lameness in the UK, but thanks to all the research that’s being done, our horses now stand a better chance of surviving a laminitis attack – and avoiding this deadly condition in the first place. Here, we bring you the latest information, research and advice so you can help keep your horse laminitis free.
Know Your Enemy
If you imagine the horse’s pedal bone as a trapeze artist and the 600 or so laminae as the ropes supporting him within the hoof capsule, laminitis attacks these ‘ropes’ causing them to weaken, fray and even snap in extreme cases. Because of this, the pedal bone can drop (known as ‘founder’) and rotate.
The result? Chronic pain and an animal who’s in a great deal of trouble unless swift first aid is applied to support the frog – and, by association, the pedal bone directly above it – and take the pressure off the delicate laminae to let them repair.
A horse who’s suffered an attack in the past is more prone to one in the future, and should the pedal bone drop, or one too many attacks leave the laminae damaged beyond repair, it’s serious news. So serious that experts from the veterinary, farriery, and equine nutritional worlds have invested huge amounts of time and effort trying to pinpoint what puts a horse at risk – and how an attack can be avoided in the first place.
The Biggest Culprit
Rising out from the mountains of laminitis-related research is one simple three -letter word that’s to blame for the vast majority of cases: fat.
For years it was thought to be an inert, ‘cuddly’ tissue, most often wrapped around native ponies’ waists, but research has shown the opposite to be true.
The experts now realise that fat is a toxic, inflammatory protein-producing reservoir, and these toxins circulate in the body, wreaking havoc. In men, the most dangerous type of fat is around the midriff as the proteins produced here damage the heart and blood vessels. But in horses, it’s the fat around the crest of the neck that’s the most dangerous, as the inflammatory proteins produced here prime the animal to develop laminitis.
However, any fat is capable of this. Put simply, a fat horse is predisposed to the condition and less of a trigger factor will be required to tip him into a laminitic state be that an excessive amount of simple sugars in the form of lush or frost-covered grass, the psychological stress of a yard move, excessive concussion to the foot, or some sort of hormonal disease usually Equine Metabolic Syndrome (EMS) or Cushing’s.
It can be useful to explain laminitis in terms of a mountain peak – if your horse is already at the peak of the mountain because he’s fat, then if anything goes wrong he’s tipped over the edge into potential laminitis territory.
A buffer is needed, so if something goes wrong if he breaks out into a field of rich grass for example he only moves up the mountain towards the peak, rather than tipping straight over the edge.
You can prevent laminitis by avoiding high risk situations. The following is a list of “causes” or circumstances which we know commonly precede the onset of laminitis.
- Overeating on foods rich in carbohydrate or rapidly fermentable fibre i.e. cereals, coarse mixes, rapidly growing or fertilised grass
- Any illness which involves a toxaemia. This may be a bacterial infection or following the ingestion of plant or chemical toxins.
- Cushing’s Disease. This is a condition which follows an abnormality affecting the pituitary gland in the horse’s head. It results in the horse failing to shed its winter coat. The coat becomes long and matted and eventually curly. The horse drinks and eats increased amounts of food while sweating excessively and losing weight. All Cushing’s cases suffer laminitis.
- Weight-bearing laminitis. When the horse is severely lame on one leg and has to put all his weight on the contra-lateral limb they often suffer from founder in the weightbearing limb. This is particularly common in hind feet.
- Concussive laminitis (road founder). When horses are subjected to fast or prolonged work on hard surfaces they may develop laminitis as a result of trauma to the laminae, particularly if their horn quality is poor.
- Hormonal problems. Animals which are “good doers” may be hypothyroid or have an abnormal peripheral cortisol enzyme system. The latter condition, recently described has been called obesity related laminitis or peripheral Cushing’s disease. Others develop laminitis when they are in season.
- Cold weather. A few horses show laminitis during cold weather, fitting warm leg wraps during cold snaps prevents the problem in most cases.
- Stress. Worming, vaccination, traveling or separation from a “friend” can trigger an attack of laminitis.
- Drug induced laminitis. Although some wormers can precipitate laminitis, the most common group of drugs which cause laminitis are the corticosteroids. Even injecting short acting corticosteroids into joints can cause severe laminitis.
Overeating / Obesity are the most common high risk situations which lead to laminitis. The secret to avoiding laminitis in this situation is not to turn the horse out whilst he is fatter than condition score 3. This means he should not have a fat depot along his crest or at the tail head, around the sheath or udder or over the loins. You should be able to feel his ribs easily by running your hand along his side yet you should not be able to see his ribs.
Limiting the grass intake can be accomplished by using a grazing mask or muzzle or by restricting the area available for grazing.
To prevent laminitis, you need to avoid potential causes of laminitis.
Inflammatory and Overload Laminitis
For most cases of inflammatory laminitis, there is little you can do except perhaps make sure that horses cannot have feeding accidents by keeping the feed room door secured, making sure prompt veterinary attention for any mare who has foaled and retained her afterbirth, or any horse showing signs of severe illness and following general good husbandry guidelines in terms of feeding your horse an appropriate diet, making changes slowing, regularly getting your horse’s teeth checked and deworming your horse according to an appropriate plan. (See also our Colic page)
In some cases your vet might ice the feet while they are in hospital at risk for inflammatory laminitis (Figure 1) as this has been shown to reduce the likelihood of laminitis occurring and also reduce clinical signs in cases where it has already occurred. The ice needs to be changed approximately every 2 hours to keep the feet cool enough, so is reserved for horses in intensive care.
For overload laminitis prevention is aimed at supporting the limb that is bearing more weight as shown in Figure 6. Sadly, most causes of non-weight bearing lameness are accidents and we cannot prevent these.
Preventing Metabolic Laminitis (EMS and PPID)
PPID is a degenerative disorder of old age, much like Parkinson’s disease in humans. It is common, affecting around 1 in 5 horses aged 15 years and older, and also increases in prevalence for every year of age over 15 – so your 30 year olds are much more likely to have PPID than the 15 year olds.
However, it is inevitable that we all age and horses do too, so sadly PPID is no preventable. It is, however, treatable as described above ‘Treatment of PPID’ and on the TAL website.
Preventing Laminitis in Horses and Ponies with EMS
Of course, knowing if your horse has EMS or not is the most accurate way to determine its risk. If your horse is of a native breed or a ‘natural good doer’ (prone to gaining excessive weight) it might be genetically predisposed to EMS. More serious alarm bells should ring if your horse or pony develops bulging areas above his eyes (instead of the hollow that normal horses and ponies have) or develops the hoof changes described above like laminitic rings, dropped soles or separation at the white line (see Signs of Laminitis and What Causes Laminitis?).
If you suspect EMS in your horse, your vet can perform an in-feed or intravenous glucose test (Figure 2) to determine if your horse can tolerate carbohydrates without produce excessively high insulin concentrations that will cause laminitis (see What Causes Laminitis?).
If your horse does have EMS and does not yet have laminitis, then your main laminitis prevent strategy is to keep your horse fit and healthy without allowing it to accumulate too much bodyweight.
How do I keep my horse fit and in ‘good’ condition
Before you start working on keeping your horse trim, it is best to double check you are able to assess your horse’s fat properly. Dr Alex Dugdale from the University of Liverpool has produced Body Condition Scoring in Horses and Ponies that gives details on body condition scoring in horses and ponies which has arisen from her extensive research in this area.
Dr Alex Dugdale from the University of Liverpool has also provided Managing Weight Loss detailing weight loss strategies that you can employ to keep your horse the right BCS to prevent laminitis.
Of course exercise is also important and we must remember, many of our obesity prone horses were selectively bred to be able to exercise for many hours each day for transport, farming or war – so it is little wonder that if we exchange this for a sedentary lifestyle when we are busy at work or doing other important things, that the fat accumulates!
Advice on turn out
If your horse has a metabolic disease, it does not necessarily mean that pasture turnout is never going to be an option for your horse or pony in future. In fact, if your horse has PPID there is often no problem with maintaining a horse at pasture once medical treatment (Pergolide, licensed in the UK as Prascend) has been initiated, but your vet can test for this by measuring his hormone responses to injected or fed sugar. The results of this test will help your vet formulate recommendations about grazing. If your horse shows an abnormal insulin response, the vet may advise that grazing is restricted during higher risk periods like the late summer-Autumn when the pituitary gland is most active.
If your horse has EMS, then depending on how bad your horse’s hormone responses to injected or fed sugar are will determine if it is safe to be managed on pasture. In a research project carried out by the University of Liverpool in collaboration with Edinburgh University all EMS horses were able to be returned to some form of turnout once we had their hormones under control (but not before). The trick is testing the hormones to find out when it is safe to do so.
Most grass pasture in the UK has a high sugar content so turn out on grass can be very dangerous if this is unlimited and when the hormones are out of control. You may need to fence off a small area so you can manage the grazing and create your own ‘bare’ paddock or try the muzzle again. Muzzles should not be able to be removed if fitted properly so perhaps you should seek advice e.g. from your local tack store on how to fit it properly. Just check your horse can drink through it and the fencing is good enough to avoid your horse getting its muzzle caught.
The other thing to remember regarding 100% pastured horses is to use the natural seasons to keep your horse as safe as possible – allowing your EMS horse to lose weight over the winter months is vitally important to ensure the weight gain over spring and summer does not cause laminitis. Think of native ponies – that is how EMS horses/ponies evolved as ‘natural yo-yo dieters’ and to disrupt their winter weight loss by excessive supplementary feeding, rugging and housing is a key factor in causing problems with their hormones.
Figure 1 – I cing the feet of a horse in intensive care for a systemic inflammatory condition can help reduce the likelihood of laminitis occurring and also reduce the clinical signs in cases where laminitis has already occurred
Figure 2 – P reparing an in feed sugar test – glucose powder is mixed with a small quantity of chaff and feed to your horse. Blood samples are taken just before feeding and 2 hours later to check for insulin concentrations
Laminitis in Horses, the Causes and What You Can Do About It
Laminitis is one of the most serious and crippling diseases horses can have. Sadly, severe and recurring cases of laminitis can cause your horse to suffer a lot and limit his ability. Treatment for laminitis can be extremely time consuming and expensive, requiring a lot of persistence from the carer for an extended period. I have written this article to raise awareness of horse health and how they develop laminitis. Hopefully it will help educate horse owners on the condition so that people know how to prevent and treat it.
What is Laminitis in Horses?
Before I go any further, it is worth explaining what exactly laminitis is and how it affects horses. Laminitis is a painful inflammatory condition of the tissues that can affect horses of any age or gender, at any time of the year. Laminitis is caused by a weakening of the supporting lamina within the hoof. This causes painful tearing of the support structure that suspends the pedal bone within the hoof. If the condition is not treated properly, the condition can worsen and cause considerable damage.
Causes of Laminitis in Horses
The true cause of laminitis in horses is still unclear. However, there are a number of factors that may lead to the condition or cause it to worsen. There are also numerous factors that can make a horse predisposed to getting the painful condition. Please add to this list by posting a comment. we know our readers always benefit from the experiences of others. And if we can save one horse from suffering unnecessarily, then it will all be worthwhile. Set out below are some of the main causes of laminitis in horses:
Overweight horses are significantly more prone to laminitis than healthy, fit horses. Feed overload, either through overfeeding or from when a horse breaks into a feed bin, can cause a horse to eat far too much. Encourage your horse to stay a healthy body weight by feeding him appropriately sized meals and providing him with regular exercise. An overweight horse is likely to take the following path to laminitis:
- Too much food in the stomach.
- Soluble carbohydrate that should be digested in the small intestine overflows into the hind gut.The bacterial balance in the hind gut is upset and bacteria that prefer soluble carbohydrate proliferate and take over from fibre-digesting bacteria.
- Death and rupture of the fibre-digesting bacteria due to acid conditions leads to endotoxins (poisons) being released. The acid environment also makes the gut wall more permeable (leaky) and toxins enter the blood stream.
- Blood circulation and pressure is affected and laminitis will follow.
Stress is bad for horses in many ways. However, a horse that is continually stressed may be more prone to laminitis. For example, when stressed from a long journey a horse will release higher levels of corticosteroid hormones. These have a similar effect to administered steroids and can make a horse more susceptible to laminitis.
This is a term that can be confusing for some, but it basically means that a horse has numerous toxins circulating in its blood stream. This can be caused by a number of things, such as diarrhoea or from a retained placenta after foaling. If you suspect your horse has Toxemia, book a check-up with a trusted vet.
Horses can experience all kinds of traumas. If a horse suffers a concussion (to which driving horses are particularly prone), he may be more susceptible to laminitis. Futhermore, a horse with uneven weight bearing, where one limb is immobilised due to an injury, can also be more prone to laminitis.
There are particular drugs that horses react badly too or that have risky side-effects. Corticosteroids can result in an increased constriction in the arteries of the foot. This can restrict blood flow, causing a horse to fall ill with laminitis.
Common Symptoms of Laminitis
The symptoms of laminitis differ with each horse. Some horse’s clearly show extreme pain reactions to the condition, while others show very few symptoms.
For horses suffering from acute laminitis, symptoms can come on very quickly and severely – causing extreme pain to horses. A horse suffering from acute laminitis will show a reluctance or complete inability to walk or move, in case he causes further pain. With acute laminitis, your horse will be visibly lame when moving and, when standing, may well support his weight on his hind legs to relieve the pressure on his front feet.
Horses with chronic laminitis will show signs of laminitis and ongoing symptoms that generally result from a previous attack. The horse’s hoof will have what appears to be growth rings around the hoof wall, which generally indicates that it has suffered from laminitis in the past. In cases of chronic laminitis, the heel will often grow faster than the toe and the white line in the hoof will have widened.
Emergency Treatment of Laminitis
- Call the vet
- Remove the horse from the grass and confine on deep, supportive bedding (sand, sawdust or pea gravel)
- Apply cold therapy to the feet to reduce inflammation and pain
Correct treatments need to be administered by your vet as soon as possible to prevent any lasting damage to the feet and provide effective pain relief.
Is There a Cure for Laminitis in Horses?
Most horses will recover from laminitis, given the appropriate treatment. However, their recovery will depend upon many factors, including when the problem was first spotted, how severe the problem was and how soon treatment was started. The mildest forms of laminitis can often be cured quickly by making simple changes in management, notably feeding. Following the recommendations and treatments suggested by your vet and nutritionist will lay the foundation for the most successful recovery.
Check Your Horse Daily for Laminitis
To keep on top of your horse’s health and ensure he isn’t developing any clinical signs or symptoms of laminitis, carry out daily checks:
- Walk your horse on hard ground to see if he shortens his stride or seems at all unwilling.
- Turn your horse in a tight circle to see if he is reluctant to complete the task or extremely stiff.
- Check your horse’s digital pulses are normal.
- Check for areas of fat build up that are unusual (neck, above the tail, or bulges above the eyes).
How to Prevent Horse Laminitis
There are numerous steps you can take, in caring for your horse, that help prevent laminitis from developing. Most cases of laminitis are predominantly triggered by an excessive intake of sugar and starches. This can be effectively management through dietary changes to improve the health of your horse. You can also take further steps to prevent laminitis by ensuring your horse not overweight, is regularly exercised, and has a healthy diet.
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Recognizing Laminitis in Horses and How to Prevent it
Laminitis is a debilitating condition in horses involving inflammation of the laminae in the hoof, with numerous causes. Find out how to prevent it.
By: Ali Miletic | April 26, 2019
Laminitis is inflammation of the laminae in the horse’s foot (most often one or both front feet, but it can affect the hind feet as well) caused by a disruption of blood flow that can be intermittent, chronic, or temporary. The hoof is connected to the body via finger-like projections that grow inwardly from hoof wall to coffin bone (non-sensitive laminae) and outwardly from coffin bone to hoof wall (sensitive laminae) creating a zipper-like ‘Velcro’ structure that holds the coffin bone in place. If the laminae become inflamed, the structure loosens, which allows for movement of the coffin bone within the hoof capsule. This is very painful for the horse; think of what happens when you slam your finger in a car door. Your nail bed becomes black and very painful. Now imagine the pain of bearing 60 per cent of your weight on that finger!
Laminitis affects many horses and can be one of the most difficult diseases to treat as a veterinarian, because we still don’t have all the answers as to the exact mechanism for how or why disruptions in blood flow cause inflammation of the laminae. Research is ongoing to figure out the missing pieces of the laminitis puzzle.
Causes of Laminitis in Horses
There are a number of causes of laminitis, some of which veterinarians and horse owners can prevent, and some we can’t, such as a natural predisposition for the condition in some draft breeds, Morgans, ponies and donkeys.
Laminitis-causing situations that horse owners can watch out for or try to avoid include:
- bedding on shavings made with black walnut
- a retained placenta after foaling
- severe colic
- high fever
- illnesses such as Potomac Horse Fever
- blood poisoning from infections or toxins released into the bloodstream from plants or chemicals
- excessive weight-bearing on one leg due to severe lameness in the other
- overweight animals and older horses with equine metabolic syndrome (EMS) or pituitary pars intermedia dysfunction (PPID or Cushing’s disease)
- hoof trauma caused by riding on hard surfaces
- diet-based causes such as grass founder or grain overload
Grass founder, triggered by sudden access to lush pasture, can cause a disruption of blood flow to the feet. The mechanism behind this is due to the increased sugar in the grass. When the horse digests the grass, the increased sugar content causes an overgrowth of bacteria in the gut. These bacteria release endotoxins that travel to the bloodstream and damage the small blood vessels in the feet, leading to a disruption in blood flow and subsequently laminitis.
To reduce the negative effects of spring grass, there are a number of ways to limit how much your horse is eating. Grazing muzzles, allowing them to fill up on hay before limited turnout, and keeping overweight, older, or cresty-necked horses on sparse pasture or in a dry lot until the grass growth has slowed are some ways to reduce exposure. Similarly, if your horse or pony happens to be an escape artist, gets out of his stall overnight and helps himself to the grain supply, the sudden increase in sugars from the grain will have the same effect as the lush pasture to his digestive system. Ensuring that stall doors are secured with horse-proof bolts, having doors on the grain room or lockable lids on grain bins can save your horse or pony from a very upset GI system and very sore feet – or worse.
Signs and Symptoms of Laminitis in Horses
Clinical signs of laminitis can range from mild to severe and acute to chronic. Signs of acute or sudden-onset laminitis include warmth in the feet, increased digital pulse, a horse that appears to be walking on eggshells, lameness especially when turning, shifting weight while the horse is standing still and a “sawhorse” stance where the horse shifts his weight onto his hind feet with front feet stretched out in front. This stance helps alleviate pressure on the front feet by bearing more weight on the hind.
Visual signs of chronic laminitis can be observed in the hoof as rings in the hoof wall, bruised soles, and a widened white line.
Treatment and Prevention of Laminitis in Horses
Treatment for laminitis is mostly symptomatic once the primary problem is identified and removed. Depending on the cause of the laminitis, treatment options can include IV fluids, antibiotics, anti-endotoxic medications, pain medication in the form of NSAIDs such as phenylbutazone (Bute) or flunixin meglumine (Banamine), vasodilators and bedding your horse on deep shavings or even sand to provide sole support. In severe cases, lidocaine patches applied to the horse’s pastern and fetlock can provide some relief, as does lidocaine infused into the digital nerves via a perineural catheter.
Changing the shoeing of the patient can make a huge difference in comfort level of the horse. There are many different ways to shoe laminitic horses, from a simple shoe with a rolled toe to a wooden clog to cushioning pads. Working closely with an experienced farrier can be infinitely beneficial to the horse’s comfort.
A newer treatment option for horses that are known to be high risk (such as a mare with a retained placenta or a pony that you know has eaten a large amount of grain) is cryotherapy. Standing the horse in ice boots for the first 72 hours after insult has been shown to reduce the risk of laminitis. Although this is a huge undertaking for caretakers, it often pays off in reducing the severity of the condition.
Laminitis can be a horse owner’s (and veterinarian’s) worst nightmare, and a lot of the time the treatments are just playing catch-up to the condition. Frequently, treatments allow the patient to become more comfortable and even return to previous work; however, there are many occasions where no progress is made despite giving gold standard care and in severe cases euthanasia may be necessary. Speak to your veterinarian if you think your horse or pony may be at risk for laminitis, or if you want to learn more about prevention.
Feeding the Laminitic Horse
A horse’s dream residence would consist of rolling, lush pastureland stretching for miles, allowing the horse to graze peacefully and uninterrupted. There would be a sunset on the horizon, a light breeze ruffling the horse’s mane, and warm sun fading on its back. Despite how much horse owners would love to provide this beautiful setting for their horse, for many, it is an unattainable dream. Many horses are prone to or have laminitis, an inflammatory disease of the hoof laminae. Thick, green pastureland is typically high in sugar, which, when too much is eaten, heightens the severity of laminitis the inflammation of the hoof laminae. In the most severe laminitis cases, the hoof laminae can separate from the hoof wall, causing the toe-shaped coffin bone to rotate inside the hoof or sink deeper towards the sensitive sole. A sunken coffin bone causes painful pressure buildup on the bottom of the soles. This causes the recognizable “standing back” position a horse does when suffering from sunken, pressured coffin bones. So, if forage that is high in sugar is so bad for a laminitic horse, then how is an owner supposed to feed for optimal nutrition?
To begin, certain horses are more prone to developing laminitis than others. For instance, laminitis is quickly developed in shorter animals with large necks that become rotund easily. Sadly, this classification fits most of the pony category – that is why ponies wearing muzzles in the pasture are such a common sight! Horses with a high body condition score (BCS) of a 7 or higher are also more likely to develop laminitis, as their metabolism and the ability to break down sugars is weakened. There is a high correlation between horses that are both obese and have insulin resistance with the onset of laminitis, meaning that horses with either of these conditions are far more likely to develop the disease. Horses who are stressed, such as those with recent diet or stabling changes, are at a higher risk along with those that already have endocrine diseases, such as Cushing’s disease (PPID) or equine metabolic syndrome (EMS).
The first and foremost rule to preventing the onset of laminitis is to limit a horse’s exposure to lush, green pastureland that is high in sugar. When feed/pasture that is high in NSCs, like sugar and starch, are consumed by these higher-risk horses, the end products of digestion can cause toxic components to be created, leading to inflammation in the hoof laminae. It is best to avoid feeds that are high in soluble carbohydrates, as some horses are at a higher risk of developing laminitis. Excel Equine’s Carbolyte ® is a great choice for horses needing to limit starch and sugar intake, as it is low in nonstructural carbohydrates (NSCs) such as glucose, fructose, sucrose, lactose, and starch.
A balanced diet and adequate exercise have proven to be the best preventative measures for laminitis. If a horse has not yet developed laminitis, then routine exercise is crucial for those who are prone, such as ponies and overweight horses. These horses are more likely to overgorge themselves on lush green grass. However, if a horse has already developed laminitis and is unable to continue work, a structured diet plan is crucial for the horse’s health and longevity. It is important to only feed a horse according to its energy requirements so that overfeeding is avoided. Therefore, a horse who is retired in pasture may not require as much feed as a horse in work. For many, a forage diet is adequate. While soaking hay used to be recommended to reduce the hay’s sugar content, it is now encouraged against due to the nutrients and dry matter that is lost in the soaking process. For horses trying to lose weight, this is especially important, as they must receive their daily intake of nutrients. Veterinarians recommend conducting hay analyses to determine the level of NSCs so that the least number of soluble carbohydrates is given. If this approach is taken, a ration balancer should be given to the horse to provide nutrients. Excel Equine produces Enrichment ® , a ration balancer that can be fed as a top dress on grain or by itself. Enrichment ® is designed to deliver essential vitamins, minerals, and high-quality protein. Lastly, as always, it is best to avoid feeds that are high in NSCs when feeding a laminitic horse. Another supplement that may be beneficial to the laminitic horse is the use of a hoof supplement. Excel Equine Hoof Pro Plus ® provides optimal levels of protein, amino acids, vitamins, and minerals to promote quality hoof growth and maintenance.
It is important to maintain a regular turn-out schedule and perform pasture maintenance to prevent the laminitic horse from developing further symptoms. The NSC content in green grass develops symptoms of laminitis faster in horses prone to the disease than others. Considering such, it is best to limit free-choice grazing on lush pasturelands to laminitis prone-horses. It is best to turn out horses when the sugars in the grass are not at their highest, such as in the early morning. The NSC content in grass is at its lowest between a couple of hours before sunrise to a couple of hours after. Spring is the time of year known for its high-sugar grass, yet late summer and early fall are also high-risk periods. If a horse must be restricted from grazing all day, do not keep in a stall, as it will cause the horse unnecessary stress and raise its insulin concentrations. Rather, turn the horse out in a dry lot, if you have one, with another horse for company. If there are no available dry lots, it is best to turn out a horse with a grazing muzzle in its normal pasture. If using this method, remember to check the horse’s body condition score regularly to monitor weight gain when given a grazing option.
While laminitis can be a frightening condition, as it can be life-threatening, the effects can be minimized in conjunction with a proper diet plan. Feeding a horse a quality feed at recommended amounts ensures that the horse does not have to worry about laminitis developments.