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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33 February 2016 THE HORSE TheHorse.com a treatment team that includes the horse's owner/manager, veterinarian, and farrier. The veterinarian should make sure the owner understands the risks associated with severe acute laminitis, he said. Hors- es with this disease generally don't have a good prognosis. Therapy can be time- consuming, prolonged, and expensive, and the disease's course is unpredictable. There's a substantial amount of infor- mation a veterinarian must ascertain with these cases. "We know there's pathology present, but what's the extent of this damage?" he said. "Have we missed the window for resolution?" Further, a thorough history can help him or her determine whether the lami- nitis likely developed due to systemic dis- ease, carbohydrate overload, medications (e.g. corticosteroids), or whether it's an idiopathic (has no apparent cause) case. A detailed exam is mandatory in acute laminitis cases, O'Grady said. He encour- aged attendees to pay attention to the horse's stance, the degree of lameness, the intensity of the digital pulse, whether there's heat in the hooves, the coronary bands (checking for depressions, which could indicate the coffin bone is already displaced to some degree), and hoof size and conformation. The veterinarian should always use hoof testers to find tender areas. After a complete exam, it's time to develop a treatment plan. He discussed several medical options: ■ Non-steroidal anti-inflammatory drugs Veterinarians can use these medica- tions to help keep the horse comfort- able because they have both analgesic (pain-killing) and anti-inflammatory properties. He advised using NSAIDs at their label doses and avoiding adminis- tering more than one at a time. O'Grady stressed that veterinarians should use NSAIDs judiciously to help the horse "respect" his feet—if you provide too much, the horse might move around enough to cause additional damage. ■ Vasodilators Theoretically, vasodila- tors (medications designed to increase blood flow, in this case to the hoof) could help ensure continued perfu- sion of the foot. However, O'Grady cautioned that most vasodilators have not been studied in laminitic horses. ■ Dimethyl sulfoxide (DMSO) An anti- inflammatory, diuretic, and oxygen radical (a byproduct of inflammation) scavenger, DMSO could also aid in vasodilation, making it seem like a logi- cal treatment option. But again, there's currently no proof of its efficacy in treating laminitis-related pain, he said. ■ Cryotherapy Submerging horses' lower limbs and feet in an ice water slurry can help prevent further damage to the lamellae, O'Grady said. He encouraged attendees to use a tub filled with ice and water and to submerge horses' limbs up to their knees or hocks for best results. O'Grady also described imaging op- tions useful for gaining information about what's going on inside the horse's hooves. Taking baseline radiographs (a minimum of two views for each hoof—from the side and front to assess structural damage in the hoof capsule) is beneficial, along with subsequent serial X rays to monitor treatment progress. TH 2015-08 Tired of guessing what supplement your horse needs? Ask your vet. Available only through your veterinarian. Developed by: No more guesswork. No more worries. KPPvet.com, 859-873-2974 Elevate ® Research-proven to have superior bioavailability, Elevate supplies the essential natural vitamin E often missing from the diet. Elevate supports healthy muscle and nerve functions.