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There are many causative agents which can be broadly classified into one of two groups
- Systemic poisoning (the feet are affected indirectly by pathology in the body)
- Overload of sugar in the digestive tract
- Grain overload
- Infection (especially pregnancy related)
- Colic
- Snake bite
- It can even be something as simple as a long drink of cold water immediately after hard work
Mechanical distress (laminitis originating in the feet)
- poor hoofcare
- neglect
- too much concussion
- over exuberant hot shoeing
Laminitis can be acute (sudden onset) or chronic (long term), or even a combination of both (ie: pre-existing low level chronic laminitis with an acute attack!).
Whatever the cause, laminitis is a serious condition. If you suspect laminitis, it is necessary to seek veterinary advice.
Traditional treatment
Corrective shoeing is based on devices that either transfer weight onto the frog to relieve pressure from the laminae and/or raise the heel height to relieve pressure from the flexor muscles. Over the years there have been many different engineering devices developed - but all have had only limited success. There is a basic and underlying flaw with corrective shoeing for laminitis and that is the foot is being asked to carry weight on the laminae which is the very thing that is being torn apart by the inflammatory processes. It is a contradiction in terms and is why the prognosis for laminitis has traditionally always been guarded.
Barefoot rehabilitation
Since the principles of barefoot rehabilitation have been developed, laminitis is no longer a death sentence for horses. Serious cases that were once considered hopeless and euthanased without delay or question are now being routinely salvaged.
Why is barefoot rehab so successful?
It takes the pressure off the laminar attachment (both vertical "sinking" and rotation) and allows healing to proceed.
Barefoot rehab involves three steps
(remembering we are only acting after the fact; after veterinary diagnosis and treatment)
- Identify and remove the cause (whether it is systemic or in the feet).
- Provide comfort with padded boots or rubber laneways or even both, along with drugs (veterinary prescribed) and/or herbal support.
- Facilitate the growth of a new attachment by keeping all the weight off the laminae (removing any mechanical forces that perpetually tear apart damaged laminae).
Specific treatment depends on the originating source of the laminitis.
Mechanical laminitis
Laminitis that is coming from incorrect mechanics in the foot. The foot is the problem. Soreness is mostly only coming from stressed laminae and comfort is restored with correct trimming.
Systemic laminitis
Laminitis that is not originating in the feet. The sore feet are just the outcome of a problem elsewhere in the body that needs to be addressed. If the underlying poisoning is not resolved, then the feet and the lameness cannot be fixed.
With systemic laminitis, there is often inflammation beneath the sole and sometimes even beneath the frog as well. Treatment needs to consider this.
It should be noted that every case of laminitis is unique and needs to be treated individually. What works for one horse may not work for another.
How long until recovery?
This depends on each individual case.
With mechanical laminitis, recovery is often swift. Horses that may have even been sore for many months, may occasionally begin walking soundly after just one trim!
With systemic laminitis, recovery begins immediately following the removal of the causative agent, but soundness does not return immediately. It usually takes about four months for the newly attached laminae to grow from the hairline to the ground surface at the heels. This seems to coincide with a return to comfortable movement. Most cases are fully sound after six months.
What about the success rate?
With acute laminitis the story is black and white. If the underlying cause is removed, soundness will return. The severity of the attack (the degree of rotation, sinking or even penetration) seems to have little bearing on the eventual outcome.
Chronic laminitis, however, is a grey one. The longer a horse has been suffering the condition, it seems the less likely is a full recovery. There may always be some residual lameness. This is linked with the progressive damage to both the pedal bone and - more importantly - the corium beneath it. There may also be metabolic issues at play (such as Cushing's disease or insulin resistance) which may affect the outcome.