I imagine any discussion of Laminitis needs to include a discussion of Onychomycosis. Onychomycosis is not related to Laminitis. However it can leave PIII unsupported and therefore it's treatment shares some of the PIII support methods used in the treatment of Laminitis.

If you are interested in Onychomycosis you should read Tom Stoval's FAQ on "White Line Disease" He can be reached at: tom.stovall@yob.com (I think)

Also check out the article on WLD at the SBS Home Page

Discussions of preventing laminitis

Discussions of fatty crests

Discussions of Nutrition as it relates to laminitis

Discussions of vasoactive substances relative to laminitis

Discussions on Metabolic differences between individual horses

This place is as good as you care to make it. I used to try to impress people with how much I thought I knew about laminitis. Not any more. Now I want you to impress me.

Laminitis is a malady of the hoof usually caused by some sort of systemic upset.

Out of context, "laminitis" doesn't mean much. Many horses will experience mild cases of laminitis without showing overt symptoms. These cases come and go, and we may never be aware of them.

In more severe cases of laminitis it is necessary, imperative, essential, requisite, or, at the very least, worth your while to attempt to identify the causative factor or factors(when possible), and remove or mitigate them(when possible).

Laminitis is not founder. Laminitis is a condition that can lead to founder.

Treatment Protocol

More to follow.

Founder

Founder, or Acute Laminitis, is secondary to laminitis.

Founder starts when P₃ moves within the hoof capsule.

When P₃ sinks or rotates the horse has foundered.

Laminitis is not founder, it allows the horse to founder. Laminitis is an inflammatory condition of the laminae.

Founder describes the movement of P₃ relative to the horny wall made possible by laminitis.

Systemic vs. Mechanical

Though sometimes difficult to separate, systemic and mechanical influences should be understood by those caring for the laminitic horse.

Laminitis is often a metabolic disease, with a host of precipitating causes. Ferreting out the source of the problem or problems can be confounding.

Systemic events can cause laminitis. Mechanical events can sometimes cause, but most often they exacerbate laminitis. The case of laminitis that was precipitated by systemic events may be superseded by mechanical events. This is an important concept, and must be understood to achieve the best therapeutic results.

Mechanical Therapies

The mechanical therapies for laminitis may seem quite tame when compared to challenge of identifying and treating the systemic issues.

The goal of the mechanical therapies is constant. It is to maintain, or reestablish and maintain the position of P₃.

It is my view that any therapy who's goal varies from this will yield less favorable results.

If I'm successful in my goal for this page, the reasons for my previous statement will become clear.

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Mechanical Therapies

Treatment Protocol

This is my weak attempt at describing an emergency treatment protocol for laminitis.

First things to do are: summon a vet; apply any first aid treatments needed.

These might be:

Cold water therapy if there is fever in the foot. (If you're one of my clients I'll insist on it!)

Consider emergency frog support if you know how.

When a vet arrives the horse will be evaluated, certain drugs might be administered. (Some words from a vet here would be nice...hint, hint.)

Radiographs will be made to determine the current state of P₃, for pressure bar location, and for comparison to future radiographs.

Blood will be drawn for a Complete Blood Count, blood chemistry profile, and T-4 thyroid level (TSH stim, when indicated).

P₃ support may be requested.

I'll work on this later.

The savvy horse owner may interview the veterinarian to discover her/his knowledge of laminitis. Is the vet aware of the potentially grave consequences laminitis poses? If your horse is sore, and you think it may be due to laminitis, and your vet says "lets wait and see how he is tomorrow"......Worry!

Chronic Laminitis

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Chronic laminitis refers to the scaring of the hoof that the horse who survives founder must live with.

I don't believe chronic laminitis is always a good descriptive term to use for these horses. In many cases the episodes of pain these horses experience has nothing to do with laminitis. After the original laminitis has run it's course, subsequent episodes of pain are more likely to be caused by mechanical tearing of laminae (rather than inflammation in the laminae), by compression of the solar tissues by P₃, or by abscesses.

This discussion is complicated by the fact that when laminae are stressed they (like most living tissue) produce vasoactive substances, which in turn produce local edema. The process is slightly more complex than stated here, but the point I want to make is that subsequent episodes of pain are frequently the result of mechanical rather than chemical events.

If the pain observed in chronic horses is treated as inflammatory in origin when it is not, the treatment will be insufficient. If mechanical treatment is offered, no other treatment may be necessary, as the mechanically induced release of inflammatories has been averted.

This perspective is pertinent as well to the original laminitis. This brings up one of the most puzzling aspects of laminitis. Why are the mechanical influences on laminitis virtually ignored in the treatment of laminitic horses in the field?

The obvious answer is one I've mentioned somewhere else around here. The heart bar shoe may be it's own worst enemy. Though not that difficult to achieve, P₃ support schemes do require some skill to effectively apply. The apparent ease with which field practitioners abandon P₃ support suggests to me that two things are missing. Understanding that P₃ support can, in all but the most resistant cases, be achieved. And that effective P₃ support is essential to effective treatment of laminitis in horses.

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