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LAM 1 > Laminitis > Flashcards

Laminitis Flashcards

1
Q

What are 3 causes of laminitis?

A
  • Systemic inflammatory disease
  • Endocrine disease
  • Trauma
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2
Q

The typical clinical syndrome of laminitis is not observed in what age group of horses?
Why?

A
  • Less than 1 year of age

- Lighter in weight

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3
Q

Is laminitis considered a primary or secondary disease?

A

Secondary disease

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4
Q

Laminitis is often highly associated what condition?

A

SIRS

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5
Q

In practice, what is the most commonly reported association?

A

Endocrinopathies

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6
Q

What are 4 possible endocrine-related causes of laminitis?

A
  • PIPD
  • IR (insulin resistance)
  • EMS (equine metabolic syndrome)
  • Steroid administration
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7
Q

What are 4 laminitis-predisposing phenotypes?

A
  • Obesity
  • Insulin resistance
  • Hyperinsulinemia
  • Mild hypertriglyceridemia
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8
Q

What is a kind of tree that should not be used as bedding for horses?

A

Black Walnut

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9
Q

What starts the inflammatory process associated with sepsis?

A

The infiltration and migration of leukocytes (neutrophils).

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10
Q

What are 5 examples of inflammatory mediators?

A
  • IL-1
  • IL-6
  • CXCL1
  • MMP-2
  • MMP-9
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11
Q

What does MMP stand for?

A

Matrix metalloproteinases

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12
Q

What is released from basal membrane cells and becomes active in response to acute disease?
What else can activate them?

A
  • Metalloproteinases

- Bacterial proteases

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13
Q

What is the initial change seen with the vascular theory of laminitis?
What does this lead to?

A
  • Initial vasoconstriction

- Hypoxia/ischemia

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14
Q

Components of what 3 conditions can contribute to the development of cell damage/destruction?

A
  • Reperfusion
  • Compartmental syndrome
  • Localized DIC
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15
Q

What, in the face of normal glucose levels, can lead to laminitis?

A

Insulin Resistance or High Insulin

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16
Q

What does insulin resistance or high insulin do to glucose locally?

A

Disrupts glucose metabolism locally.

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17
Q

Exacerbation of what may precede the onset of clinical laminitis in susceptible animals?

A

Insulin resistance and hyperinsulinemia

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18
Q

How does excessive insulin affect the hooves?

A

Glucose dysregulation at lamellar epithelial cell level.

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19
Q

What does disturbances in vascular function cause in the hoof?

A

Makes them more susceptible to other vascular events.

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20
Q

What are 2 other conditions insulin resistance tends to be related to?

A
  • Obesity

- Chronic inflammatory state

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21
Q

What does lamellar hypoxia lead to?

A

Up-regulation of MMPs.

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22
Q

What are the 3 major forces involved with laminitis?

A
  • Shear forces
  • Vertical forces
  • Tensile forces
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23
Q

What is playing a critical role, contributing to amount of other forces repercussed on foot?

A

Vertical load

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24
Q

What are 2 factors contributing to the vertical load placed on a hoof?

A
  • Weight of horse

- Size of hoof

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25
Q

Rotational displacement is attributed to what type of forces?

A

Tensile forces

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26
Q

Where do the tensile forces originate from?

A

Deep digital flexor

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27
Q

Where do the shearing forces originate from?

A

Leverage of dorsal hoof wall

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28
Q

Vertical displacement is attributed to what type of forces?

A

Shear forces

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29
Q

The shear forces causing vertical displacement result in what 2 types of movement?

A
  • Hoof wall up the limb

- Sole into the ground

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30
Q

It is important to make sure the toes don’t get too what with laminitis?

A

Too long

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31
Q

What needs to be done first with a suspected case of laminitis?

A

Complete physical exam with specific evaluation of the hooves.

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32
Q

What are 5 aspects of evaluating the hooves for laminitis?

A
  • Stance, gait
  • Heat, swelling, digital pulses in multiple feet
  • Palpation of coronary band
  • Hoof tester response to DDF
  • External hoof exam
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33
Q

Where in the hoof will you see a response from a hoof tester if laminitis is present?

A

Responsive in the toe

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34
Q

What is the most subtle/sensitive clinical sign for laminitis?

A

Weight shifting

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35
Q

What can be used to show increased weight shifting?

A

Pedometer

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36
Q

Pedometers can pick up weight shifting an average of how much earlier before other clinical signs of laminitis?

A

2-4 hours

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37
Q

Horses with laminitis will sometimes take up what type of stance?

A

Tripod stance

38
Q

What type of a gait might horses with laminitis have?

A

Walking on eggshells

39
Q

What arteries are used for digital pulse evaluation?

A
  • Posterior palmar digital artery

- Posterior plantar digital artery

40
Q

Where are 2 locations digital pulses are felt for?

A
  • Abaxial sesamoid area

- Mid-low pastern

41
Q

An obvious indentation at the level of the coronary band and indicate what?

A

Sinking

42
Q

With severe laminitis, detachment can be seen in what part of the hoof?

A

White line

43
Q

What is one diagnostic technique that can be used for rotational evaluation of laminitis?

A

X-ray

44
Q

The distance between the outside hoof wall and the dorsal surface of P3 should be less than what in a normal horse?

A

18 mm

45
Q

Increasing distance between the outside hoof wall and the dorsal surface of P3 indicates what?

A

Rotation

46
Q

What are 3 possible causes of a radioluscent density on a radiograph looking for laminitis?

A
  • Air
  • Serum
  • Hemorrhage
47
Q

A radioluscent density on a radiograph between the outer hoof wall and P3 shows what?

A

Detachment

48
Q

What are the 4 stages of laminitis?

A
  • Developmental
  • Acute
  • Sub-acute
  • Chronic
49
Q

Which stage of laminitis has no clinical signs?

A

Developmental

50
Q

Which stage of laminitis has clinical signs but no mechanical disruption?
What is the time frame for this stage?

A
  • Acute

- 72 hours or less

51
Q

What is the third stage of laminitis?

How long might it take?

A
  • Sub-acute

- Weeks to months

52
Q

Which stage of laminitis has clinical signs with mechanical disruption?
This can take place as soon as when?

A
  • Chronic

- Within 24 hours

53
Q

What are 3 exam findings that can indicate laminitis?

A
  • History
  • Signalment
  • Clinical signs
54
Q

What are 3 types of clinical signs that can indicate laminitis?

A
  • Stance
  • Gait
  • Foot
55
Q

What are 2 diagnostic procedures that can be used to diagnose laminitis?

A
  • Hoof tester evaluation

- Radiography

56
Q

Where are 3 locations to place marker for a laminitis radiograph?

A
  • Dorsal hoof wall
  • Tip of frog
  • Coronary band
57
Q

Which radiographic hoof marker us used in the determination of rotation of P3?

A

Dorsal hoof wall

58
Q

A thumb tack at the tip of the frog can be used to determine what?

A

Specific location of P3 with respect to external landmark in hoof.

59
Q

What type of a shoe is used for laminitis?

A

Heart bar shoes

60
Q

What is a marker at the coronary band used to evaluate?

A

Distal displacement in the hoof.

61
Q

What are 2 types of scoring systems used to evaluate lameness associated with laminitis?

A
  • Obel scoring system

- Clinical scoring system

62
Q

What are 2 things that have been used to identify perfusion deficits?
If perfusion deficits are present, this usually indicates what?

A
  • Digital venogram and vascular perfusion casts

- Indicates poor prognosis

63
Q

What are 2 treatment generalities to consider with laminitis?

A
  • Address systemic nature of the disease

- Specifically treat the feet

64
Q

What are 2 aspects to treating the inciting disease?

A
  • Address the localized problem

- Systemic disease treatment

65
Q

What is a way to specifically address the feet?

A

Cryotherapy

66
Q

When should cryotherapy be applied?

A

Throughout the developmental period.

67
Q

What is the best choice of cryotherapy to apply?

A

Ice and water immersion

68
Q

What are 3 drugs that can be used to promote digital perfusion through vasodilation?

A
  • Acepromazine
  • Isoxuprine
  • Nitroglycerin
69
Q

What are 2 general ways to limit the damage of laminitis?

A
  • Systemic pharmacotherapy

- Local support therapy

70
Q

What are 3 categories of drugs that can be used systemically for laminitis?

A
  • Anti-inflammatories
  • Analgesics
  • MMP inhibitors
71
Q

What is a drug that can be given CRI to help limit the damage of laminitis?

A

Lidocaine

72
Q

Lidocaine decreases the production of what two things?

A
  • Chemokines

- Inflammatory mediators

73
Q

What are 2 forms of local support that may help limit the damage of laminitis?

A
  • Bedding

- External application of support to hoof

74
Q

Will laminae reattach once they have been separated?

A

No

75
Q

What are 3 ways to provide local foot therapy to treat laminitis?

A
  • Support
  • Reduce stresses
  • Return normal relationship between P3 and hoof
76
Q

What is a type of pad that can be used for hoof support with laminitis?
What else can be used that might be handy?

A
  • Lilly pad

- Gauze roll

77
Q

What color Styrofoam has the right consistency to be used as a hoof support for laminitis?

A

Pink

78
Q

What does EDSS stand for?

A

Equine digital support system

79
Q

What are 3 things an EDSS incorporates?

A
  • Frog support
  • Wedge
  • Easier break over
80
Q

What is a Redden Ultimate?

A

Support option for laminitis.

81
Q

What can be done with the toes of a laminitic horse?

A

Trim and roll the toe.

82
Q

What are 2 things to be avoided with a laminitic horse?

A
  • Avoid shoes and nails

- Avoid moving the horse if they don’t want to move

83
Q

What are 2 ways to achieve a “roller toe” in a laminitic horse?

A
  • Trimming and shaping hoof directly

- Applying shoe

84
Q

What is an alternative to nails?

A

Toe clips

85
Q

What is an option reserved for more severe cases of laminitis?

A

Deep digital flexor tenotomy

86
Q

What are 4 indications for a DDF tenotomy?

A
  • Rotated more than 12 degrees in first 30 days
  • Extensor process distal 1 cm in first week
  • Unresponsive
  • Chronic where other methods unsuccessful
87
Q

What is a specific type of shoe used for laminitis?

A

Heart bar shoe

88
Q

How does the functional outcome of laminitis correlate to the degree of rotation or distal displacement of P3?

A

It does not correlate.

89
Q

What does functional outcome correlate to?

A

Clinical grade

90
Q

Laminitic horses with what are more likely to die?

A

Distal displacement

LAM 1 (8 decks)

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