Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Large Animal Medicine > Laminitis > Flashcards

Laminitis Flashcards

1
Q

What 3 things do you often see laminitis with?

A

SID (Systemic inflammatory disease)
Endocrine dz
Steroid administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which feet do you expect to see laminitis in first?

A

Front feet b/c bear more weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If only one foot is involved, is it likely laminitis?

A

Not usually.

Exception is if horse is non-weight bearing on the other foot (eg. really bad musculoskeletal injury), so the sore foot has had extra weight for a long period of time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the typical signalment of laminitis?

A

Older horses (not less than 1 yoa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why don’t young horses seem to get laminitis (3 things)?

A

They’re lighter
Don’t usually get significant displacement
Respond quickly to therapy so no long term consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What must you consider laminitis as?

A

A syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: Laminitis is a secondary dz/complication of a primary dx.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does laminitis have a high association with?

A

SIRS (systemic inflammatory response syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What 4 risk factors pre-dispose a horse to laminitis?

A

Obesity
Insulin Resistance (IR)
Hyperinsulinemia
Mild hypertriglyceridemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common laminitis research model?

A

Sepsis laminitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 3 causes for potential laminitis?

A 
CHO overload (grain or oligofructose/fructans from luch green pastures)
Black walnut extract (NEVER bed down on black walnut shavings)
Intravascular insulin clamp (hyperinsulinemia with euglycemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 broad etiology categories for laminitis?

A

Sepsis model
Endocrinopathies
Trauma/Excessive weight bearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 2 possible divisions in the sepsis model?

A

Inflammatory

Vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the current thought on the sepsis model?

A

Sepsis associated mostly inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is important to remember about the inflammatory branch of the sepsis model?

A

Will have vascular implications.

Changes to matrix metaloproteinases are responsibe for the controlled letting go of epithelium so hoof can grow. Excessive activation = detachment of lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may cause matrix metalloproteins to become active?

A

Acute disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the more heavily weighted theory of the sepsis model?

A

Vascular theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the components of the vascular theory?

A

Vasoconstriction -> ischemia -> reperfusion -> compatmental syndrome -> localized DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What role might insulin have in laminitis?

A

Insulin resistance or high insulin disrupts glucose metabolism locally at lamellar epithelial cell and may precede the onset of clinical laminitis in susceptible animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does lamellar hypoxia cause an upregulation of?

A

MMPs (matrix metaloproteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do MMPs (matrix metaloproteins) do?

A

Control letting go of epithelium so hoof can grow. Excessive activation = detachment of lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 3 forces are involved in the mechanical disruption?

A 
Shear forces (tissue sliding against each other)
Vertical forces (weight through bony column of the foot)
Tensile forces (pull from DDF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of horse do you need to watch for major vertical forces?

A

QH (muscular horse on little tiny feet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What two things affect the amount of vertical load?

A

Weight of animal

Size of foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does “rotation” refer to?

A

Aignment between dorsal wall of hoof and dorsum of P3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the prognosis for a horse with 0-5% rotation?

A

Can return to normal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the prognosis for a horse with 5-10% rotation?

A

Can be managed and be comfortable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the prognosis for a horse with 10-12% rotation?

A

Not good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where is the disconnect with rotational displacement?

A

Dorsal lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What 2 forces can the rotational displacement be attributed to?

A

Tensile force from the DDF
Shear from the dorsal hoof wall

Can cut the DDF, but athletic career will be over (horse probably still rideable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does “vertical displacement” refer to?

A

“Sinking” of P3 without rotating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where is the disconnect with vertical displacement?

A

Circumferential release of the lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What 2 forces can the vertical displacement be attributed to?

A

Shear from the hoof wall

Vertical from weight of animal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens over time in the case of rotational displacement?

A

DDF pulls P3 away from the wall more and more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What 5 things do you look at on a foot exam?

A 
Stance and gait
Heat, swelling and pulses in multiple feet
Feel coronary band (heat and swelling)
Hoof tester response
External hoof exam
36
Q

What do you expect to see with hoof testers on a laminitic horse?

A

Painful at toe

Can also be sore throughout sole, but that doesn’t confirm laminitis, can be sole sore without being laminitic

37
Q

What is the most subtle clinical sign you will see with laminitis?

A

Weight shifting

If you use pedometers, can see 2-4 hours before you can visually note shifting

38
Q

What stance do you see in a horse with laminitis in front feet?

A

Front limbs extended, resting on heel

39
Q

What stance do you see in a horse with laminitis in all 4 feet?

A

Inverted tripod to get equal weight distribution

NOTE: These horses tend to “plant themselves” and not move

40
Q

What gait do you see with a laminitic horse?

A

“Walking on eggshells”

41
Q

How can you evaluate a horse for sinking or vertical displacement?

A

Run thumb down dorsum of pastern and try to get thumbnail under coronary band.

Should NOT be able to do this.

42
Q

What is white line detachment?

A

A breakdown between the laminar interdigitations

43
Q

If one foot is more affected that the other, what 2 things will you see in bahviour and stance?

A

More affected foot will be ore forward

Difficulty picking up the LESS affected foot

44
Q

How do you determine the agree of rotation?

A

Measuring the degree of the angle formed on xray between the dorsum of the hoof wall and the dorsum of P3

45
Q

What is the normal distance between the dorsum of the hoof wall and the dorsum of P3?

A

less than 18mm

46
Q

Can you evaluate “sinking” on n xray?

A

Can look at distance between coronary band (marker) to top of P3, but there is a lot of range for “normal”

47
Q

What 3 radiolucent densities might you see in a laminitic foot on RADs?

A

Air (could be just air from an opening OR gas from bacteria)
Serum (seroma)
Hemorrhage (won’t be as dark because has more density than serum or air)

48
Q

What will happen if you have complete detachment of the lamina?

A

Horse will walk out of hoof. Can grow new hoof, but takes close to a year so difficult to manage.

49
Q

What are the 4 stages of laminitis?

A

Developmental
Acute
Sub-acute
Chronic

50
Q

Describe the developmental stage of laminitis.

A

No clinical signs

51
Q

Describe the acute stage of laminitis.

A

Clinical signs present, NO mechanical disruption, short time (~72 hours)

52
Q

Describe the sub-acute stage of laminitis.

A

Clinical signs present, NO mechanical disruption, longer time

53
Q

Describe the chronic stage of laminitis.

A

Clinical signs WITH mechanical disruption

NOTE: Time can be within 24 hrs

54
Q

What are the 3 radiographic markers to check for laminitis?

A

Dorsal hoof wall (rotation)
Coronary marker (distal displacement)
Tip of frog (used to determine specific location of P3)

55
Q

What can you use on the hoof to help counter the pull from the DDF?

A

Heart bar shoe

56
Q

What is the scoring system that grades lameness associated with laminitis?

A

Obel Scoring System

57
Q

What are the 4 Obel grades of lameness associated with laminitis?

A

I - Constantly lifts feet, no lameness walking, short gait trotting
II - Will walk, but gait is laminitis
III - Reluctant movement, resists lifting forefoot
IV - Must be forced to move

58
Q

What are the 5 clinical scoring grades of lameness associated with laminitis?

A

CS-1 - Return to full athletic fxn
CS-2 - minimum pleasure riding
CS-3 - Cannot be ridden, can be bred or left on pasture with minimal analgesics
CS-4 - Needs systemic analgesics
CS-5 - Euthanasia d/t severe unresponsive pain

59
Q

What can be used to identify perfusion deficits?

A

Digital venogram

60
Q

What prognosis does a perfusion deficit indicate?

A

Poor

61
Q

What are the 2 treatment generalities for laminitis?

A

Address systemic nature of dz

Specifically treat the feet

62
Q

What is treatment of laminitis related to?

A

Treatment of endotoxemia

63
Q

What is the number 1 therapy for laminitis?

A

Cryotherapy

64
Q

How do you specifically address and treat the feet?

A

Cryotherapy

65
Q

What is the best therapy in the developmental stage?

A

Cryotherapy

66
Q

What is the mechanism of action for cryotherapy?

A

Helps slow down metabolism in the epithelial cells to match the decreased perfusion and minimize the glucose dysregulation

67
Q

What do you want to promote in laminitis?

A

Digital perfusion

68
Q

What are 3 drugs you can use to promote digital perfusion?

A

Acepromazine
Isoxuprine
Nitroglycerine

NOTE: Very small dose of ace.
NOTE: Isoxusprine usually used for navicular dz
NOTE: Nitro may not be all that helpful

69
Q

What should you do with an endotoxemic horse that you wan tto use Ace on?

A

Stabilize cardiovascular

70
Q

Why should you not give steroids to a laminitis horse?

A

Because steroids can e a cause of laminitis/make it worse.

71
Q

What is a very important component in treatment of laminitis?

A

Analgesics because pain is associated with spasms of the DDF.

72
Q

If you use Flunixin and Pheylbutazone together, what must you do with the doses?

A

Considder them as one drug and be careful not to overdose.

73
Q

What would you worry about with using Flunixin and Phenylbutazone together for a long time?

A

GI Ulcers

74
Q

How does a CRI of lidocane help treat laminitis?

A

It helps limit damage by decreasing production of chemokines and inflammatory mediators

75
Q

What are two types of local therapy to help treat laminitis?

A

Bedding (bed them deeply)

External support to the hoof

76
Q

Will the laminae reattach once they’ve separated?

A

Nope!

77
Q

What does a “lily pad” do in a case of laminitis?

A

Supports the heel and frog

78
Q

What is the purpose of taping a gauze roll to the foot?

A

Support

79
Q

What type of construction styrofoam is the best for support?

A

Pink stuff because it has the best density without causing pain

80
Q

What is another benefit to using styrofoam on horses with laminitis?

A

If they also have a subsolar abscess, you can dig out the parts where you don’t want them to bear weight

81
Q

When placing styrofoam for support, you expect the horse to walk off funny, but when do you decide to try a different support option?

A

If animal is still really uncomfortable after a few hours

82
Q

What is an EDSS?

A

Equine Digital Support System

83
Q

What 3 things does an EDSS incorporate?

A

Frog support
Wedge (to relieve tension fro the DDF)
Easier breakover

84
Q

When is a DDF tenotomy indicated?

A

Rotated more than 12 degrees in first 30 days
Extensor process distal 1cm in first week
Unresposive
Chronic where other methods unsuccessful

85
Q

What does the functional outcome correlate to?

A

Clinical grade

86
Q

What does the functinoal outcome NOT correlate to?

A

Degree of rotation and distal displacement

87
Q

Which horses have a worse prognosis?

A

Those with distal displacement

Large Animal Medicine (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions