Very few equine conditions can be as debilitating as laminitis, which can be triggered by a variety of events or occur on its own. Laminitis occurs when the laminae, a set of finger-like structures which support the coffin bone and hold it in place in the hoof capsule, become inflamed. This inflammation is incredibly painful and can be catastrophic for the horse's athletic career.
Many horses that develop laminitis are not euthanized because of the changes to the laminae, but because of the uncontrollable pain the condition brings on. A virtual session of the 2020 American Association of Equine Practitioners annual convention summarized the current research on the best way to manage pain in different types of laminitis cases.
The pain a laminitic horse feels is multidimensional. It can be brought on by pressure within the hoof capsule, inflammation of the laminae, tearing of soft tissues, a reduction of blood supply to the hoof, contact between the coffin bone and the sole of the hoof, and neuropathic pain.
Dr. Katherine Ellis of Gail Holmes Equine Orthopaedic Research Center at Colorado State University, explained several different strategies for different causes of laminitis. Phenylbutazone (bute) is commonly given to treat laminitis, but that other drugs, including as flunixin, ketoprofen or firocoxib, may be better at controlling laminitic pain.
Ellis stressed that if an NSAID doesn't seem to be providing pain relief to a laminitic horse, another should be considered. A horse that has developed laminitis from overindulging in grain would benefit from having his hooves submerged ice water. This will be helpful for controlling pain and limiting injury. Ideally, the hooves would be submerged constantly for 48 to 72 hours, though this is a labor-intense endeavor.
Metabolic issues like equine metabolic syndrome (EMS) and Cushing's disease can put a horse at risk for chronic laminitis. Gabapentin has been shown to be an effective pain medication for horses with chronic laminitis, but higher doses of pain medications may be necessary to provide relief.
Ellis noted that acupuncture and use of a TENS unit may offer some additional pain relief. Chiropractic work and massage may offer respite from body pain brought on by the laminitic stance.
A horse that has an injury to a leg may develop supporting limb laminitis. Ellis suggests using morphine and butorphanol blocks and fentanyl patches to help control pain in these cases. A tramadol and ketamine infusion can also be used. Ellis notes that biologics like stem cells and platelet-rich plasma can be used for the anti-inflammatory properties.
Read more at EquiManagement.
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