Thursday, November 28, 2013

St Nicholas Abbey Update: Champion "Struggling to Overcome Laminitis", Maggot Therapy in Use

Laminitis may be manifest in many ways. It can be a simple detachment of a portion of the "laminae", which are linking fibers that attach the main bone of the foot to the hoof capsule. It can also be a complex combination of mechanical failures that includes a complete detachment of the bone, resulting in a collapse known as "sinking". In this sample tissue plastination prepared by Dr. Christoph von Horst, you see a detached, sinking bony column that has descended from its normal position inside the hoof capsule. This is a sample image, and is not meant to accurately represent St Nicholas Abbey's current condition

Coolmore Stud issued the following update on champion Irish racehorse St Nicholas Abbey. The 2012 Breeders Cup Turf winner suffered a pastern fracture during training on July 23 and later developed what is probably a form of support limb laminitis in his "good" foot. The colt has been hospitalized at Fethard Equine Hospital in Tipperary, Ireland since the initial fracture.

The announcement reads:

"St Nicholas Abbey is struggling to overcome the laminitis in his left front foot, this is indeed life threatening and is the single biggest complication he has faced since his initial lifesaving surgery.

"The worry is that if the condition progresses and further sinking of the pedal bone takes place it may prolapse through the sole of his foot.

"In spite of this St Nicholas Abbey is very comfortable, being just a little ouchy when walking in his first steps and better thereafter, his appetite and demeanour remain incredibly good.

"His intensive veterinary treatment continues and includes maggot therapy for the slight discharge at the toe of the laminitic foot and a daily session on a vibrating plate.

"The next few weeks are critical for St Nicholas Abbey – we are just hoping that he can turn the corner."

Maggot under microscope
A microscopic view of a sterile bottle fly maggot of the type used in biotherapy for distal limb infections in horses. ( image shared from Ackbar91)
The mention of maggots in St Nicholas Abbey's foot is not a cause for alarm. They are sterile maggots bred in a laboratory for medical therapy. Their use for distal limb infections in horses was popularized by Scott Morrison DVM of Rood and Riddle Equine Hospital in Lexington, Kentucky, who was previously mentioned as a consultant on St Nicholas Abbey's laminitis treatment.

The maggots gorge themselves on dead tissue at the infection site and are replaced periodically to introduce hungry new maggots to the task at hand. They also excrete an anti-bacterial saliva. Maggots are especially effective when wounds and infections are located in areas where the blood supply is compromised or disrupted, as may happen when laminitis changes the foot's ability to bear weight or walk normally.

Vibration therapy is used both in recovery and maintenance of horses with hoof problems. The horse may stand on a vibrating plate for a period of time each day, or the entire floor of a stall may vibrate. Race and sport horses may have vibration therapy as part of their daily routines to encourage hoof wall or sole growth or stimulate blood flow.

The announcement from Coolmore is the first since October 23, when it was revealed that the colt had developed laminitis while recovering from a broken pastern.

To learn more:

French Sterile Maggot Debridement Study Finds 93% Efficacy for Equine Wounds from The Hoof Blog

Maggots Approved by FDA for Human Use from The Hoof Blog

Whole Body Therapy for Horses from the HBPA Journal

From the archives: free download: Hoofcare + Lameness: Maggot Debridement Therapy Alternative for Foot Infection with Dr. Scott Morrison by Hoofcare Publishing

Click to download anatomy specimen brochure; laminitis specimen and tools available. 

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