Laminitis is an emergency , so call your vet the moment you suspect an attack, but be wary of moving your horse if he’s in acute pain. Those delicate structures within the hoof that have been weakened may be damaged further if you force your horse to walk, so wait for your vet – and his army of painkillers – to arrive.
In extreme cases he may be able to perform a foot nerve block, but in the meantime he may advise you to apply emergency first-aid in the form of a soft pad or cotton wool under the frog, held in place with a bandage, until he arrives.
Once your vet arrives, he’ll administer anti-inflammatories for pain relief, and take X-rays to identify the extent of the damage if he suspects founder. He may suggest additional measures to support the foot while it heals, for instance glue-on supportive shoes.
Lengthy box rest for at least four weeks or more is the next step, ideally on a shavings bed or a mix of shavings and sand that’s several centimetres deep.
Depending on the possible cause of the attack, your vet will advise you on the best way to aid healing, but as the vast majority of cases are caused by the horse being overweight, he may well ask you to implement a low-calorie, high-forage weight loss plan.
If your horse or pony is at grass, bring him into a stable as soon as you realise he has laminitis. If his field is a long way from his stable, bring him home in a trailer or horsebox rather than making him walk. Treat this as an emergency and call your vet straight away.
Do not give him any medication yourself as this will prevent an accurate assessment of the condition. The vet will provide appropriate pain killing and vasodilating drugs (these dilute the walls of the blood vessels).
Make sure the whole stable floor is bedded with clean, dry white wood shavings to a depth of atleast 45cm. If you know how to fit bandage frog supports, then fit them.
Try to keep your horse’s environment as quiet as possible and encourage him to lay down and take the weight off his painful feet. If he is wearing shoes, do not remove them unless his feet are overdue for trimming and have become overgrown. Your vet should remove the shoes or attend with your farrier to supervise his foot trimming.
Your aim is to improve your horse’s comfort, so it is important not to allow his feet to be trimmed in such a way as to force him to stand on his soles. This will simply cause him to become much more uncomfortable.
Medical measures
Laminitis often originates from an organ system remote from the foot, such as the gastrointestinal, respiratory, reproductive or edocrine systems. Therefore, treatment during the acute stage needs to aggressively address the initiating cause of laminitis.
The principal medications used to treat the inflammatory response in early laminitis are nonsteroidal anti-inflammatory drugs (NSAIDs), such as phenylbutazone and founixin. The analgesic effects of NSAIDs are important from a humane perspective, but should be used judiciously so that your vet is able to accurately monitor the clinical signs in the feet.
Horses who have developed laminitis associated with insulin resistance, such as in equine metabolic disease, may benefit from early intervention to increase insulin sensitivity.
Measures should be taken immediately to reduce the weight of oebse horses. Ice or cold water therapy should also be applied to the lower limb and hoof as soon as laminitis is suspected.
Farriery work
In the acute phase of laminitis, the farrier can redistribute weight to the back of the foot by applying deformable material to the solar surface so that the bars, frog and sole become load-sharing with the hoof wall. Thick styrofoam, deformable impression material and pads or boots are available for this purpose. Placing the horse in sand can also help redistribute the weight.
Trimming and shoeing have always been the mainstay of treating chronic laminitis, and the main aim is to reduce or remove the adverse forces on the compromised laminae. Realignment of the pedal bone to create a better relationship of its solar surface with the ground is used as the basis of farriery in laminitis. This should promote and produce hoof wall growth at the coronet and sole growth beneath the pedal bone. X-rays taken by your vet are crucial in aiding the farrier to accurately and appropriately trim a laminitis horse’s feet.
Surgery options
In horses with chronic and severe laminitis, deep digital flexor (DDF) tenotomy – cutting of the tendon – can be a useful procedure for treating chronic laminitis in severely-affected cases. However, knowing when to use it poses a dilemma. After a DDF tenotomy, the pastern bone will move lower and backwards relative to the pedal bone. This concentrates the load on the palmar soft-tissue structures of the foot, rather than redistributing the load on the solar surface of the pedal bone. It should not be done without other options being explored and only used as a last resort in severe cases.
