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Laminitis: A year round concern
Despite a long-standing belief that laminitis is a spring-time disease, a recent study identified that there is no ‘safe’ season, and laminitis remains a threat regardless of the time of year. The same study also revealed that 1 in 10 horses/ponies develop laminitis every year.
When to worry?
This shows as horse owners we must remain cautious and not reduce preventive measures when the perceived spring ‘high-risk’ period is over. Furthermore, the study highlights the importance of recognizing subtle signs of potentially life-threatening episodes.
This was supported by another study which revealed 45% of owners did not suspect laminitis was the problem prior to veterinary diagnosis so learning to recognize laminitis including the more subtle signs is very important for all horse owners.
In addition, research by Rossdales Veterinary hospital and the Animal Health trust in Newmarket warned that commonly cited clinical signs such as the classic ‘laminitis stance’ and divergent growth rings, were found in less than half of the active laminitis cases in their study.
What to look for?
Evidence suggests there is a period where laminitis is present and causing changes to the hooves, but lameness is not yet apparent. Picking up these early signs of laminitis before there is any pain associated with the condition would allow horse owners to adjust their management strategies and their veterinarian to treat the underlying disease to help prevent a painful episode of laminitis.
The signs of laminitis can be broadly grouped into two groups: signs associated with hoof changes, and signs associated with hoof pain.
Signs associated with hoof changes:
Hoof rings which are wider at the heel than the toe (divergent hoof rings)
Cracks in the wall of the hooves
Changes in the angle of the hoof walls
Increased amount of horn at the toe of the hooves
Changes in the angle of the hoof walls
Changes in the angle of the hoof walls
Bruising in the wall or the white line
Sensitive to pressure on the soles of his feet?
Signs associated with hoof pain:
Spending more time lying down than normal
Rocked back or rocked forward stance
Unwilling to move/ Unable or unwilling to stand
Constantly shift weight from leg to leg
Foot-sore after a farrier visit
Resistance to you picking up one or more of his/her feet
An unusually strong pulse in one or more of his/her digital arteries. (This pulse can be felt if you place your fingers below the back of the horse's fetlock) Or feet feel hotter than usual
If you think your horse or pony has laminitis…
First and foremost, call your veterinarian!
While you wait for the veterinarian remove your horse from pasture, provide soft footing for them to stand on and make sure they have water and hay within reach.
Prevention is better than cure…especially when there is no cure!
Feeding remains key to reduce the risk of laminitis. Modern grass varieties are generally productive grasses, too rich for horses especially those susceptible to laminitis which is closely linked to obesity.
Access to grass should be restricted but it’s important not to starve them as they still need plenty of fiber to avoid other problems such as gastric ulcers and colic. Whilst most cases of laminitis have an underlying hormonal cause their diet certainly contributes, usually by excess sugar (water soluble carbohydrates (WSC)) and starch, the main sources of which are grass and cereals. If too much sugar and starch is consumed at one time, it overloads the small intestine and accumulates in the hind gut instead.
The digestion of the sugar and starch by the hind gut bacteria produces stronger acids than would be produced by fiber digestion (the hind guts usual job). This results in acidosis causing bacteria to die and release toxins which can enter the bloodstream via the leaky gut wall caused by the acidity. This is thought to trigger a series of reactions that result in damaging enzymes. These enzymes destroy the bond between the pedal bone and the hoof capsule which ultimately can result in pedal bone rotation and euthanasia is then about the only option.
Alternatives to grass
Consider supplementing at least part pasture with hay, this can be fed outside on a dirt area so the horse still gets to spend time outside as well as in the stable.The recommended sugar level of hay for those at risk of laminitis is 10% sugar so it’s best to choose a lower grade hay and get it tested. It’s not always possible to find a suitable hay and you can’t tell just by looking at it so get your hay tested. Most feed companies offer this service as well as independent nutritionists such as Briony Witherow who gives more details of how and what to test in this article here.
It is common practice to soak hay for horses with laminitis and while this is effective for reducing the nutritional value of the hay it does have a number of drawbacks. Soaking increases the bacterial content, reducing the hygienic quality, it produces an environmental pollutant (the brown yucky water left in the bucket) and results in an unpalatable soggy hay that can sour in summer temperatures and freeze in the winter.
High temperature hay steaming is also an option. Haygain’s patented method improves the hygienic quality of hay by killing bacteria, mold and fungal spores as well as reducing airborne respirable dust by up to 99%. Another benefit of steaming over soaking is that it retains the nutritional goodness of the hay, OTHER THAN a variable loss in water soluble carbohydrate!
Once you’ve had your hay tested and you know the starting content you may find you only need to reduce the sugar (WSC) a bit and then a single steam cycle will be enough. The benefit of this is it will retain most of the nutritional goodness including protein and minerals while reducing the WSC fraction.
However,if your hay has a high sugar content then you will need to leach more WSC and its best to use a combination of soaking and steaming. This means you will have the benefit of the clean steamed hay but with the nutritional value leached out more by the soaking phase. Research has labelled the gold standard treatment as a 9 hour soak followed by a 50 minute steam cycle. In the study soaking plus steaming reduced the WSC contents of all hays down to the recommended level of 100g WSC/kg DM (Harris et al., 2017) for fat horses and those pre-disposed to laminitis. The steaming after soaking not only further reduced the WSC content but also killed any bacteria that had multiplied during the soaking process so improved the hygienic quality of the hay.
Take home message - Never let your guard down!
Be aware of the risks of laminitis to horses and ponies at all times, manage their weight and diet with it in mind. Be vigilant of any signs of hoof changes and hoof pain no matter how subtle and seek veterinary advise as soon as you suspect laminitis.
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DVM, Dipl. ACVIM, CHT Director of the McGee Critical Care and Medical Center Hagyard Equine Medical Institute, Lexington, Kentucky
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See the Steamer range
Harris, P.A., Ellis, A.D., Fradinho, M.J., Jansson, A.,Julliand, V., Luthersson, N., Santos, S., and Vervuert, I., 2017. Review:Feeding conserved forage to horses: recent advances and Recommendations Animal.11:6, 958–967
Moore-Colyer, M.J.S., Lumbis, K., Longland, A.C. and Harris,P.A. (2014) The effect of five different wetting treatments on the nutrientcontent and microbial concentration in hay for horses PLOS One
Pollard, D. , Wylie, C. E., Verheyen, K. L. and Newton, J.R. (2017), Assessment of horse owners’ ability to recognise equine laminitis: Across‐sectional study of 93 veterinary diagnosed cases in Great Britain. EquineVet J, 49: 759-766. doi:10.1111/evj.12704
Pollard, D. , Wylie, C. E., Newton, J. R. and Verheyen, K.L. (2019), Incidence and clinical signs of owner‐reported equine laminitis in acohort of horses and ponies in Great Britain. Equine Vet J, 51: 587-594. doi:10.1111/evj.13059
Wylie, C.E., Shaw, D.J., Verheyen,K.L.and Newton, J.R. (2016) Decision‐tree analysis of clinicaldata to aid diagnostic reasoning for equine laminitis: a cross‐sectionalstudy. Vet. Rec. 178, 420.