b'YOUR GUIDE TO THE 2017 AAEP CONVENTIONFinally, he said, improved regional painand sole, such as coffin bone penetrationinside the hoof. Nerve blocks can help medications, allowing delivery straightand subsolar abscesses. the veterinarian localize pain to the hoof to the area of concern, could help reduceJames Belknap, DVM, PhD, Dipl.(and numb the hoof for later treatment); affected horses pain. ACVS, a professor of equine surgery athowever, Belknap said they wont neces-The research into SLL is ongoing, andThe Ohio State University College ofsarily help differentiate solar from lamel-van Eps and colleagues are working toVeterinary Medicine, in Columbus, gavelar pain, because the same nerve block find new ways to combat and prevent it.veterinarians tips on how to evaluate andanesthetizes both structures.We are evaluating new means ofmanage these scenarios. After thoroughly evaluating complica-improving foot perfusion using devicesHorses that develop complicationstions, veterinarians can develop treatment designed to dynamically manipulate thetypically exhibit more severe lamenessplans.load on the supporting limb, he said.(usually in one limb) and, possibly,Subsolar abscessesThese painful We are also utilizing the robotic imagingan increased heart rate and increasedinfections can be bad news for laminitic facilities at New Bolton Center to betterrecumbency, he said. The question ishorses. Belknap said one major concern understand blood perfusion to the footwhether the pain is coming from the soleis exacerbating laminar injury in the under load. or the lamellae. opposite foot if the horse offloads weight To find out, he said veterinarians mustfrom the abscessed hoof (whats seen with Managing Two Common Laminitisexamine the hoof, sole, and frog andSLL).Complications determine whether the horse is painful inHe said it is much more common for Two of the most common laminitisresponse to solar pressure (indicative oflaminitis-related subsolar abscesses to be complications veterinarians face are inju- sole pain). Radiographsdorsal-palmarunderrun abscesses (involving a large ries to the subsolar tissues (the soft tissue(front to back), lateral, and solar marginportion of the sole). Therefore, its impor-located between the coffin bone and theviews, specificallycan also reveal valu- tant for the veterinarian to determine the hard/keratinized sole, in front of the frog)able information about whats happeningextent of the sole involved and establishEvaluatingstructures for signs of laminitis,dysfunction) is the key concern,until the nerve blocks wear off.such as coronary band separa- the veterinarian might have theBelknap said to avoid holding Extremely Painfultion from the hoof wall or solarhorse jog on a soft surface. one hoof in the air for prolonged Horses With surface abnormalities. Regardless of the type ofperiods, as this could lead to Laminitis The heart rate is extremelylaminitis, the veterinarian mustfurther lamellar damage in the important to obtain initially,determine how much, if any, coffinopposite limb. He also advised Laminitis is a debilitatingBelknap said. In my view, thebone displacement has occurred.practitioners to, in most cases, disease. Affected horses that areheart rate (if not increased dueFor this reason hoof radiographsremove the horses shoes during under particular duress must beto sepsis) is the most valuable(X rays) are critical. the exam and supply adequate evaluated carefully to avoid fur- physical parameter regardingBelknap said administeringhoof support and padding.ther pain and lamellar damage.assessment of the horses duress.short-lasting nerve blocks in theBelknap said it can be difficult James Belknap, DVM, PhD, Dipl.Whereas heart rates in the rangefront feet can help rapidly reduceto determine if and how much the ACVS, a professor of equine sur- of 45 to 55 beats per minute arethe horses pain and allow veteri- coffin bone has moved if baseline gery at The Ohio State Universitycommon with moderate pain innarians to get better radiographs;radiographs arent available. College of Veterinary Medicine, inlaminitis cases, heart rates in thetheyre able to manipulate theTherefore, he recommended tak-Columbus, reviewed how to evalu- 60sand especially those in thehorses feet better without makinging serial radiographs to measureate these patients.70s and 80sare of great con- him more painful, which canongoing displacement.As with any veterinary exam, acern not only regarding humanelead to improved image quality.In most cases, he said, thorough history is important. Keygrounds but also prognosis. Blocking the front feet also allowsveterinarians wont need to collect factors include when the episodeIf the horse can walk, theveterinarians to assess any hind- additional types of imaging. The began (specifically regarding sea- veterinarian might perform alimb involvement. He cautionedexception might be if a horse is son and forage availability), anylameness exam that includesthat if horses cant feel theirextremely painful but has no evi-dietary changes, previous lame- walking in a straight line andhooves, they could move arounddence of laminitis on radiographs. ness issues, and recent infectionsturning figure-eights on hard andtoo much and cause additionalIn these cases veterinarians might that could lead to sepsis (infec- soft surfaces. If endocrinopathiclamellar damage. As such, hehave a better chance of seeing tion of an organ that results in alaminitis (the most commonrecommended protecting thelamellar separation on MRI.systemic inflammatory response).form thats often associatedhooves (e.g., with padded boots)From there, the practitioner can The veterinarian should also ex- with equine metabolic syndrometo reduce the likelihood of furtherformulate a treatment plan, as amine the hoof and surroundingand pituitary pars intermediadamage and restraining horseswell as a prognosis.Erica LarsonA24 TheHorse.com/AAEP2017 AAEP Wrap-Up THE HORSEMarch 2018'