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Advancements in the Treatment of Laminitis

Advancements in the Treatment of Laminitis. University of Rhode Island Lisa Connor. February 24, 2007. Overview. Laminitis Causes Treatment Advancements Heroes Future Outlook/Need for Funding. What is Laminitis?. Pain and inflammation of the sensitive laminae of the foot.

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Advancements in the Treatment of Laminitis

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  1. Advancements in the Treatment of Laminitis University of Rhode Island Lisa Connor February 24, 2007

  2. Overview • Laminitis • Causes • Treatment • Advancements • Heroes • Future Outlook/Need for Funding

  3. What is Laminitis? Pain and inflammation of the sensitive laminae of the foot

  4. Why is it debilitating?

  5. Normal circulation laminitis Dr. Christopher Pollitt American Farrier's Journal Circulatory Effects

  6. What causes Laminitis? • Nutrition (carbohydrate overload) • Toxemia • Mechanical overload (contralateral effects) • Stress • Hormonal Imbalance (Cushing’s Disease) • Drug Induced (sensitivity to corticosteriods)

  7. Applying Physics 40% 60% • horse's weight (gold) • upward ground force from concussion (red) • rear-ward pull of the deep digital flexor tendon (green) • The laminae (blue) • The forward & upward pull of extensor tendon (purple)

  8. U.S. Statistics • 28.5% of polled operations in 28 states confirmed laminitis within their boarding/training population • Highest incidence in Spring/Summer USDA/APHIS Equine 98 Study

  9. Goals of Treatment Prevent further development Reduce the pain or hypertension cycle Reduce or prevent permanent laminar damage Improve laminar capillary dynamics Prevent movement of the distal phalanx

  10. Common Approaches • Determine cause & correct condition • IV fluid therapy • Cryotherapy • Radiographs • NSAIDS (Bute, ketoprofen) • Promote vasodilation (Acepromazine, isoxuprine, pentophyline and nitroglycerin) • Frog support

  11. Mechanical Aids The heart-bar-shoe through its contact with the frog engages weight bearing (*supports bony column*) • natural approach in the treatment of several pathologies of the foot (crushed/under-run heels, quarter cracks, and laminitis) • helps prevent rotation and or sinking of the coffin bone

  12. More Mechanical Aids Styrofoam padding Digit Support System NBHoofcare NBHoofcare NBHoofcare.com

  13. Alternative Practices • Venograms confirm degree of blood supply • Deep digital flexor tenotomy (usually for salvage cases) • Restores natural angle with ground surface • Study over 10 yr. period • n=37 • 77% survival after 6 mos. • 60% survival after 24 mos. • Dorsal hoof wall resection • Prevent & treat abscesses • Prosthetics • Barefoot trimming & holistic therapies

  14. The Problem with Laminitis • Within the multitude of treatment options ~ NONE are UNIVERSALLY EFFECTIVE • Pathogenesis is poorly understood • Contradicting theories • Heat vs. Cold (Cryotherapy) • Use of heartbar shoes vs. styrofoam pads or barefoot trimming • Vasodilation vs. Vasoconstriction during onset

  15. Advancements in Technology Venogram A veterinarian can see where blood flow is compromised due to damage, swelling, or poor hoof structure, and thus decide what mechanical support and/or surgery he needs to provide in order to restore blood flow to those areas.

  16. Research/Initiatives • Involvement of Circulation (Hood et al, 1993) • Vasoconstriction causes decreased perfusion to nutrient laminar capillaries • The Glucose Connection (Bailey, 2000) • Connective Tissue Connection (Pollitt & Daradka, 1998) • National Animal Genome Project • (gene map for horses)

  17. 5 Years $10M in Research Funds Foundational Knowledge Today Collaboration between Veterinarians, Farriers, and Scientists alike Steps to Conquering Laminitis Laminitis remains the second largest killer of horses, behind colic.

  18. Barbaro, 2006 Secretariat, 1973 Foolish Pleasure, 1975 Beloved Heroes Patricia McQueen photo

  19. The Road to Preservation

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