Managing chronic laminitis in horses calls for a proactive approach

Orion went straight from the sale barn to the hospital. FarmHouse Fresh Sanctuary, in McKinney, Texas, agreed to pick up, foster, and stabilize the horse on behalf of another rescue organization, says Elise Khan, sanctuary manager. Orion, she says, was a mess.

His soles were thin, and he appeared to have laminitis, a condition when lamellae, or the tissues that anchor the coffin bone within the hoof, become inflamed and painful. His lamellae were compromised, and the coffin bone had sunk. Orion had a body condition score of less than 1, and he also had pneumonia.

While hospitalized for his other issues, Orion wore boots with an orthotic gel insert to support his feet. He continued wearing them after he went home to the sanctuary.

But then Orion ended up with fluid around his heart and lungs, and his feet started abscessing.

Kendell Metcalf, DVM, CED, AVCA, an equine podiatrist at Three Oaks Equine Clinic, in Whitesboro, Texas, who treats Orion, opted to switch out the gel orthotics for custom sole support made with dental impression putty. For a time Orion wore wooden shoes and improved but then became uncomfortable again.

Orion’s saga could be termed chronic laminitis; his coffin bone and laminae were compromised from previous episodes. Getting him comfortable was a long process.

“The way we think about laminitis changed a bit over the past 20 years,” explains Benjamin Flakoll, DVM, a podiatry and ambulatory associate at Rood & Riddle Equine Hospital in Saratoga, New York. “We thought of laminitis as a discrete disease with a common pathophysiology, regardless of what caused laminitis.”

Now, laminitis is thought of more as a syndrome, he explains. Historically, veterinarians described the pathophysiology of laminitis in terms of four phases: developmental, acute, subacute, and chronic