advancements in the treatment of laminitis february 24, 2007 university of rhode island lisa connor
TRANSCRIPT
Advancements in the Treatment of
Laminitis
February 24, 2007
University of Rhode Island
Lisa Connor
Overview
• Laminitis
– Causes
– Treatment
– Advancements
– Heroes
– Future Outlook/Need for Funding
What is Laminitis?
Pain and inflammation of the sensitive laminae of the foot
Why is it debilitating?
Sensitivityin Laminae
Separation&
Rotation
TriggeringEvent
Circulatory Effects
Dr. Christopher PollittAmerican Farrier's Journal
Normal circulation laminitis
What causes Laminitis?
• Nutrition (carbohydrate overload) • Toxemia • Mechanical overload (contralateral effects)• Stress• Hormonal Imbalance (Cushing’s Disease)• Drug Induced (sensitivity to corticosteriods)
Applying Physics
horse's weight (gold)
upward ground force from concussion (red)
rear-ward pull of the deep digital flexor tendon (green)
The laminae (blue)
The forward & upward pull of extensor tendon (purple)
40%
60%
U.S. Statistics
USDA/APHIS Equine 98 Study
28.5% of polled operations in 28 states
confirmed laminitis within their
boarding/training population
Highest incidence in Spring/Summer
Goals of Treatment
• Prevent further development• Reduce the pain or hypertension cycle• Reduce or prevent permanent laminar
damage• Improve laminar capillary dynamics• Prevent movement of the distal
phalanx
Common Approaches
• Determine cause & correct condition• IV fluid therapy• Cryotherapy• Radiographs• NSAIDS (Bute, ketoprofen)• Promote vasodilation (Acepromazine,
isoxuprine, pentophyline and nitroglycerin)
• Frog support
Mechanical Aids
The heart-bar-shoe through its contact with the frog engages weight bearing (*supports bony column*)– natural approach in the treatment of
several pathologies of the foot (crushed/under-run heels, quarter cracks, and laminitis)
– helps prevent rotation and or sinking of the coffin bone
More Mechanical Aids
NBHoofcare.com
Styrofoam paddingDigit Support
System
NBHoofcare
NBHoofcare
Alternative Practices
• Venograms confirm degree of blood supply• Deep digital flexor tenotomy (usually for
salvage cases)– Restores natural angle with ground surface
• Study over 10 yr. period• n=37• 77% survival after 6 mos.• 60% survival after 24 mos.
• Dorsal hoof wall resection– Prevent & treat abscesses
• Prosthetics• Barefoot trimming & holistic therapies
The Problem with Laminitis
• Within the multitude of treatment options
~ NONE are UNIVERSALLY EFFECTIVE• Pathogenesis is poorly understood• Contradicting theories
– Heat vs. Cold (Cryotherapy)– Use of heartbar shoes vs. styrofoam pads or
barefoot trimming– Vasodilation vs. Vasoconstriction during onset
Advancements in Technology
A veterinarian can see where blood flow is compromised due to damage, swelling, or poor hoof structure, and thus decide what mechanical support and/or surgery he needs to provide in order to restore blood flow to those areas.
Venogram
Research/Initiatives
• Involvement of Circulation (Hood et al, 1993)– Vasoconstriction causes decreased
perfusion to nutrient laminar capillaries
• The Glucose Connection (Bailey, 2000)• Connective Tissue Connection (Pollitt &
Daradka, 1998)• National Animal Genome Project
– (gene map for horses)
Steps to Conquering Laminitis
Foundational Knowledge Today
$10M in Research Funds
Collaboration between Veterinarians, Farriers, and Scientists alike
5 Years
Laminitis remains the second largest killer of horses, behind colic.
Beloved Heroes
Patricia McQueen photo
Foolish Pleasure, 1975
Barbaro, 2006Secretariat, 1973
The Road to Preservation