Ask the Vet: Laminitis

Question: Can laminitis be reversed with proper treatment and shoeing? Answered by, Karen Blake, DVM, DACVS, Elite Veterinary Services, Park City, UT 

Answer: This is a very good question. Unfortunately, it depends on many variables. It depends on the blood supply to the foot, whether rotation or sinking has occurred and what the quality of the bone present appears like on radiographs. It is also dependent on whether the metabolic status or other diseases of the horse (i.e: Equine Metabolic Syndrome, cushings, severe severe endotoxemia, etc ) is under control or if the horse has an injury and the support limb is under duress. There are also many ways to treat laminitis with various shoes, however in an acute stage Modified Ultimate boots or a wooden shoe are usually recommended.

Question: How much green grass is too much for a weanling miniature horse (approx. 5-months-old)?

Answer: Typically, unless otherwise stated by your own equine veterinarian or nutritionist, it is recommended that any sized horse get 1-2% of its body weight in fiber per day. So, it depends on the size of the horse.

Question: What long term pain and anti-inflammatory medications can be given to a lamintic horse? Is there something easier on the horse than “Bute”?

Answer: There are no great long term pain management strategies in laminitic horses. Bute is actually one of the best pain management drugs out there as far as efficacy seems to go. There is a ‘specific cox-2 anti-inflammatory drug’ – Equioxx. This medication seems to target less of the good ‘housekeeping’ cox-1 pathways, which tends to protect the GI tract and kidneys. However, Equioxx has also been related to acute renal disease, and therefore; is not innocuous.

Additionally, there are additive things which target different pain pathways such as gabapentin. These appear to be horse specific as far as their efficacy for pain control.

Truely, pain control is best achieved by shoeing/therapy to reduce the pull of the deep digital flexor tendon (DDFT), which reduces the strain on the laminae. Also, if the horse has metabolic issues, getting weight management under control is an essential component for halting the inflammatory cascade and resultant laminitis.

Question: When can I take the grazing muzzle off my ex-laminitic horse? It has been three years since her last episode. Now she is back in training and being ridden. Will she always have to wear a grazing muzzle due to her laminitis?

Answer: If your horse is prone to being overweight, has Cushing’s Disease or is an insulin resistant/equine metabolic syndrome horse and has access to grass, then most likely your horse will have to wear a grazing muzzle. Instead of looking at this as punishment (to you or your horse), think about how you are being proactive in preventing further degradation of the laminae or any hyperinsulinemia which has a direct effect on ‘breaking’ the laminar junction.

Question: My horse was recently diagnosed with Insulin Resistance (IR) and is recovering from acute laminitis with coffin bone rotation. This was all diagnosed in July of this year. Should fall core vaccinations be staggered or can they be administered at one time? 

Answer: This question is really for your veterinarian to answer because they have an understanding of your particular horse and the specifics of what has been going on with your horse’s feet. However, If the IR (Insulin Resistance) is under control, meaning your blood insulin level is now normal (checked by your veterinarian) and the feet have stabilized, in theory it would be safe to give vaccinations. That being said, being safe is always better than being sorry, so staggering the vaccines are fine too. Furthermore, if your horse lives by itself, in a northern climate, he/she may not need fall vaccines at all (depending of course on what your veterinarian administered this spring, but again, this would be based on your veterinarian’s recommendations).