The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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54 TheHorse.com THE HORSE March 2018 and take steps to relieve the stress and strain on the lamellae interface between the hoof wall and its inner structures. Managing Laminitis Horses with EMS can suffer from either acute laminitis attacks (often when first diagnosed with the disease) or chronic soreness from earlier laminitic damage. "A horse with an acute bout needs to be handled differently than a chronic case, and the chronic horse needs careful management for the rest of his life," says Rucker. "If you think the horse is having an acute episode, whether it's had lami- nitis in the past or not, the main thing is trying to control/halt the laminitis. This might include endocrine management. We may use various medications (such as metformin, pergolide, etc.) to try to get the endocrine disease under control, along with dietary management. We also restrict exercise because we don't want the unstable lamellae falling apart further." It's important to provide affected horses soft footing to help support the foot, so the hoof doesn't meet resistance during movement. "I generally just get the horse into a deeply bedded stall," says Rucker. "This provides cushion and give, and the deep bedding also encourages the horse to lie down and get off his feet." Similarly, van Eps says he keeps acute cases confined during early stages of laminitis, explaining that damaged lamel- lae are weak for a period of time and vulnerable to further damage. "What you do to the bottom of the feet is not as important during that (acute) period as making sure the horse isn't stressing the feet by moving," he says. "We can make the horse more comfortable by providing some sort of cushioning that supports the frog and sole and takes some of the weight off the hoof wall, but the best support is sand because it conforms to the bottom of the foot. It supports the foot because it packs in and evenly distributes under the foot, and when the horse turns it allows the inside foot to pivot easily, without gripping the ground." This give and easy movement put less stress on those inner attachments. "The other thing that sand does is ease breakover," says van Eps. "When the foot breaks over, the toe can dig in; the foot can pivot with less stress on the lamellae." With this level of comfort and easy break- over, there's less need for a special shoe. Your farrier can provide your horse with similar support using dental/silicone impression or other hoof cushioning materials, van Eps adds. He also suggests using ice boots to cool the feet continu- ously for the first couple of days of an acute bout of laminitis to help reduce pain and inflammation. If your horse seems more comfortable after a few days of confinement, however, don't relax. "The old rule of thumb was to confine them a week for every day that they are lame," says van Eps. "If the horse is lame for five days, he needs to be confined for five weeks. This seems like a long time, but it guarantees that this episode will be over and the tissue will have some integrity and strength again before the horse stresses it." Then the compromised lamellae, which stabilize and repair to an extent (though never to normal) over time, will be more likely to withstand the pressure of weight-bearing. After the first month or so, once the acute phase has passed and the horse enters a chronic phase, he might benefit from a more permanent hoof attachment. "Some type of easy-breakover shoe, with support material for the frog and rear portion of the sole can be very helpful," says van Eps. "There are a lot of options," he contin- ues. "What's best will depend on the foot. This is why it's important to work with a farrier and (be sure he or she has) access STEP BY STEP The industry's first 5-year DR Flat Panel Warranty NOW! The new exclusive Portable X-ray Unit VIP LIFETIME WARRANTY Lifetime Repair • Hot Swap Replacement vetxray.com/service/warranty 90KvP/30mA 15 pounds Ultra 9030Hf 120KvP/40mA 25 pounds Ultra 12040Hf QUALITY | INTEGRITY | VALUE since 1983 • Fast and Durable • Superior Software • CsI Pixel Pitch – 76 μm • Lightweight Wireless 10" x 12" • 5 yr hardware & software warranty Ask about our Price Match Guarantee 1-866-820-1694 Hoof cushioning or impression material can help support a laminitic horse's sole. COURTESY DR. AMY RUCKER