Laminitis

Question 1

what is another word for laminitis?

Answer 1

founder

Question 2

does a horse stand on the ground?

Answer 2

no it is suspended by laminae inside a hoof capsule attached to P3

Question 3

what happens with laminae is weakened by injury?

Answer 3

normal forces acting on digit cause shearing/tearing of laminae

Question 4

how does the digit slip inside the hoof capsule downwards during laminitis?

Answer 4

weight of horse and rotation from pull of deep digital flexor

Question 5

what are clinical signs of laminitis?

Answer 5

Question 6

what is wrong?

Answer 6

widened white line - stretched laminae

Question 7

Describe laminitis grade 1-4

Answer 7

Question 8

what are the causes of laminitis?

Answer 8

endolrcrinopathic laminitis
enzymatic associated laminitis
support limb overload laminitis
black walnut toxicity
steroid induced laminitis
heat induced laminitis

Question 9

what are the two examples of endocrinopathic laminitis?

Answer 9

equine metabolic syndrom/insulin dysfunction
pituitary pars intermedia dysfunction

Question 10

what model is use to study endocrinopathic laminitis?

Answer 10

hyperinsulinemic model

Question 11

what model is use to study enzymatic associated laminitis?

Answer 11

SIRS/endotoxemia

Question 12

What is the pathophysiology of enzymatic model of laminitis?

Answer 12

-accumulates leukocytes in lamellar tissue
-metric metalloproteinases up regulated and cause basement membrane damage

Question 13

what is the pathophysiology of endocrinopathic laminitis?

Answer 13

lamellar epithelial cell stretching
not induced by inflammation

Question 14

what is the pathophysiology of support limb laminitis?

Answer 14

loading cycle (offloading and loading the feet) through walking, or shifting weight when standing still, helps to maintain BF to lamellar tissue
stop moving so BF reduced

Question 15

what does the clinical damage in laminitis?

Answer 15

forces acting on digit (weight of horse)

Question 16

How is laminitis diagnosed?

Answer 16

radiographs - stand horse evenly on blocks and take both later and dorsal palmar (DP) views

Question 17

what are the abnormal signs seen in an acute laminitis radiograph?

Answer 17

jet line - edema of laminae
possibly no overt changes

Question 18

what are the abnormal signs seen in an chronic laminitis radiograph?

Answer 18

ski tipping of P3
loss of parallel between dorsal hoof wall and dorsal P3
medial to lateral asymmetry
sinking

Question 19

what is the normal found distance?

Answer 19

2-15mm
sinking determined by extensor process to coronet length

Question 20

what should the cobb angle be? what does it determine?

Answer 20

0 - determines rotation
hoof wall and dorsal P3 should be parallel

Question 21

what should palmer angle be?

Answer 21

3-10 degrees but bony alignment is key

Question 22

what is the normal sole depth?

Answer 22

15-20mm

Question 23

what is the dorsal hoof wall thickness?

Answer 23

<18-20mm

Question 24

what is the black line?

Answer 24

bony alignment

Question 25

Label

Answer 25

Question 26

Label

Answer 26

Question 27

what areas are evaluated in a venogram of a hoof?

Answer 27

terminal arch coronary papillae (makes up coronary plexus) sublamellar vascular bed circumflex vessels lamellar-circumflex junction with terminal papillae

Question 28

what are venograms useful for?

Answer 28

determine progress of deterioration

Question 29

what is wrong?

Answer 29

falling caudally, backward ledge

Question 30

what does a return to normal venogram for laminitis within first 4 weeks indicates?

Answer 30

an excellent chance for return to use

Question 31

What drugs would you use for acute laminitis?

Answer 31

phenylbutazone - NSAID to dec inflammatory cytokines and pain DMSO - reduce edema and reduce ischemia reperfusion injury Pentoxyphylline - alter RBC membrane to make more deformable and improve BF Acepromazine - tranquilizer, inc digital BF Opioids - butorphanol, fentanyl patches Anticoagulant thearpy - reduce micro thrombi that can compromise vasculature in foot

Question 32

what has been shown to be slightly protective during colic/colitis?

Answer 32

anticoagulant thearpy

Question 33

what is the goal of acute laminitis?

Answer 33

decrease pull of DDF

Question 34

How can you decrease tension on DDF?

Answer 34

farrier care - elevate heels with wedge or Redden shoe, trim shoes DDT tenotomy - for rotating not sinking, salvage

Question 35

How long do you do cryotherapy for acute laminitis?

Answer 35

48 hours continuous cryotherapy to distal limbs 5L bag with hoof, ice, and water taped into place

Question 36

when is sole/frog support used in acute laminitis?

Answer 36

thin soles/sinking

Question 37

How can the tension of the suspensory apparatus of distal phalanx be reduced?

Answer 37

strict stall rest encourage to lie down with very deep bedding or sand

Question 38

what is the prognosis for acute alminitis?

Answer 38

wait and see - depends on each horse and how they respond to therapy if lots of $$$ use venogram to get idea

Question 39

How is chronic laminitis treated?

Answer 39

farrier care and control of underlying disease absolutely critical

Question 40

what are most chronic laminitis?

Answer 40

endocrinopathic laminitis - must manage primary disease

Question 41

what is the farrier concept for laminitis?

Answer 41

realign the bony column - remove toe and heel aggressively

Question 42

How is PPID caused laminitis treated?

Answer 42

prascend

Question 43

How is insulin dysregulation laminitis treated?

Answer 43

metformin, levothyroxine

Question 44

How is chronic laminitis nutritionally managed?

Answer 44

low starch < 10% NSC

Question 45

How is chronic laminitis footing treated?

Answer 45

deep, soft, supportive

Question 46

How is chronic laminitis pharmacologically treated?

Answer 46

NSAIDS Phenylbutazone firocoxib

Question 47

what does the prognosis for chronic laminitis depend on?

Answer 47

farrier, veterinarian working together stoicism of horse how primary disease responds to treatment