Managing complicated laminitis (Dryden)

Question 1

Phases of laminitis

Answer 1

1. Developmental phase-no lameness yet
2. Acute phase-will see CS
3. Chronic phase
   - Compensate (stable)
   - Uncompensated (unstable)

Question 2

Developmental phase multi-systemic

Answer 2

1. Gastrointestinal
2. Respiratory
3. Reproductive
4. Endocrine
5. Musculoskeletal

Question 3

Laminitis critical when

Answer 3

radiographic evidence of coffin bone displacement within capsule

Question 4

Secondary complications laminitis

Answer 4

1. Shear lesions of coronary band
2. Sub-solar seromas
3. Abscesses
4. Pedal osteitis/sepsis

Question 5

Unstable chronic laminitis case characterized by

Answer 5

continual displacement of pedal bone with compression of growth centers

Question 6

Laminitis treatment

Answer 6

1. Treat primary cause

2. Cryotherapy for 72 hours straight

Question 7

Chronic compensated laminitis

Answer 7

• Coffin bone has displaced and then stabilized to some degree
• Hoof growth is often slowed or distorted
• Reduced wall growth at dorsal aspect vs heel
• Reduced wall growth on medial or lateral aspect of sinkers

Question 8

Chronic uncompensated laminitis

Answer 8

• Coffin bone continues to displace
• Usually suffering from severe pain
• Often complete cessation of growth
• Secondary complications
• Coronary band health diminishes
• Lack of perfusion: sepsis/coffin bone penetration through sole

Question 9

Prognosis depends on

Answer 9

1. Amount of lamellar damage (sinkers)
2. Hoof conformation (upright)
3. Duration (bone resorption, infection)
4. Coronary band damage (shear lesions)
5. Vascular damage (venograms)
6. Client goals, economics, nursing care

Question 10

Venogram anatomy

Answer 10

1. Coronary plexus
2. Parietal plexus
3. Circumflex
4. Solar plexus
5. Terminal arch
6. Digital cushion
7. Palmar Digital vein

Question 11

Self ledging

Answer 11

Sinking coffin bone creates ledge at coronary band

Question 12

Hoof wall grooving under coronary band may increase

Answer 12

perfusion

-decreases pressure

Question 13

Deep Digital flexor tenotomy

Answer 13

• CASE SELECTION
• shoe first
• healthy pedal bone
• 8-12 weeks recovery
• Salvage
• Time consuming and $$$$

Question 14

DDF tenotomy complications

Answer 14

1. overloading compromised quarters and heel
   - sinkers
   - foot casts
2. over correction
3. under correction
4. seroma
5. coronary band health
6. infection
7. flexor tendon contractures
8. marginal rim fracture