Laminitis

Question 1

What is laminitis?

Answer 1

failure of the distal phalanx to maintain its attachment to the lamellae of the inner hoof wall

Question 2

Signs

Answer 2

weight shifting
widened white line
pain in toe
hot hooves
increased digital pulse
lameness
bruised sole
leaning back
abnormal hoof growth

Question 3

what are the two categories?

Answer 3

acute- systemic illness with lameness

chronic- definable episode of acute illness, inconsistent lameness, occurring secondary to other diseases

Question 4

Pathophysiological theories

Answer 4

vascular 
inflammatory
metabolic
enzymatic
biomechanical

Question 5

Common Causes of laminitis

Answer 5

Overload
systemic inflammatory response syndrome
metabolic
steroid administration- limited literature

Question 6

How does overload affect laminitis?

Answer 6

DDFT pulls on the distal phalanx when the limb is loaded and perfusion to hoof wall is reduced

pain and stress could increase release of cortisol

cortisol has an antagonistic effect on insulin, leading to hyperglycaemia or laminitis

Question 7

What is the non-structural carbohydrate risk?

Answer 7

The amount of fructans in the pasture can lead to pasture associated laminitis
mainly at autumn- sugar storage time

NS carbs are poorly digested in the small intestine and there is rapid fermentation in the hindgut
->
production of lactic acid- hindgut acidosis
->
death of healthy bacteria
->
increased gut permeability due to acidity
->
peripheral vasoconstriction leading to lamellar separation due to reduced nutrients

Question 8

What does equine metabolic syndrome do?

Answer 8

diet and exercise can effect this

insulin- major regulatory hormone in fat metabolism, vascular function, inflammation
insulin resistance alters it by- decreasing insulin action in resistance pathways
- increasing insulin signalling in unaffected pathways

Question 9

Management of laminitis

Answer 9

box rest
deep bedding
grazing management
increase exercise
pain relief
remedial farriery
dietary management

Question 10

EMS management

Answer 10

test for ems or cushings
encourage weight loss
diet and exercise

Question 11

how do we diagnose laminitis?

Answer 11

clinical signs
nerve blocking rarely
x-rays 48-72hrs post sign onset to identify changes
x-rays to monitor progress

Question 12

How does polytherapy aid treatment?

Answer 12

stem cell therapy and medication enhances tissue regeneration and target initiation factors