New Statistics: Lameness Most Critical Health Problem for British Horses; Laminitis Increased in 2014

A new study published today in Great Britain sorts out what is likely to send horses to vets and farriers for treatment there, and you have to look pretty far down to find hoof-related problems (other than laminitis) on the list. 

Great Britain's National Equine Health Survey (NEHS), held annually every May, has confirmed for the second year that lameness is the most common syndrome affecting the UK’s horses and ponies. This year’s top results, compiled in this report, have also revealed an apparent increase in laminitis compared with previous years.

Run annually by the Blue Cross charity in partnership with the British Equine Veterinary Association (BEVA), NEHS is sponsored by SPILLERS and Zoetis and supported by the UK’s leading equestrian organizations and charities.

This year’s results revealed that almost one in five (18.5%) horses were suffering with lameness due to joint disease or other non-foot related problems. The results are consistent with last year’s non-foot related lameness figure of 18.6%.

NEHS 2014 has also highlighted that laminitis had a much higher prevalence than in previous years (7.1%) with 43% of these recorded as first episodes. 

Past NEHS results showed a lower number of horses affected by laminitis (4.4% overall prevalence of laminitis, with 25% first episodes, in 2013) but further work is needed to confirm if this increase is representative of the total horse population in the UK.

Gemma Taylor, Education Officer at Blue Cross explains: “The increase in laminitis may be linked to the mild winter, extensive rainfall and consistently warm spring. These conditions were ideal for flushes of grass growth, known to be a trigger for the disease.”

The top five findings from the 2014 healthy survey of British horses are:

1. Lameness affected almost one in five horses (18.5% of returns 2014, 18.6% 2013; 13.8% 2010-2012). Most lameness was due to joint disease and other non-foot causes of lameness with foot lameness (not including laminitis) accounting for only a quarter of all lameness*.
2. Laminitis had a higher prevalence than in previous years (7.1%) with 43% of these recorded as first episodes and 67% as recurrent episodes. This contrasts with the 2013 NEHS data of 4.4% (25% first occurrences and 75% recurrent episodes).
3. Skin disease was recorded in 18.3% of cases (14.6% 2013,15.2% 2010-2012). Sarcoids were again a prevalent tumor (5.6% 2014; 2.8% 2013; 3.25% in NEHS 2010-12), reinforcing previous NEHS surveys and the published data.
4. Overweight horses or ponies were recorded in 16.9% of cases (7.8% 2013, 7.5% 2010 – 2012) with most horses (79%) being recorded as ideal/normal weight and 4% recorded as being underweight. New data was obtained on weight monitoring. Some 59% of respondents said that they assess weight regularly, with 85% using weigh tapes. 
5. Respiratory disease was reported by 7.1% of respondents (5% 2013; 5% 2010-2012). The majority of these horses (96%) were affected by allergic respiratory disease (6.9%; 4.2% 2103; 3.6% 2010-12), which was more frequently recorded than infectious respiratory disease at 0.3 (0.3% 2013, 0.5% 2010-12).

In response to an increase in reports of Atypical Myopathy in the UK, a question on this frequently fatal disease was included in this year’s survey. Reports showed 13 veterinary-confirmed cases. Professor Josh Slater from the Royal Veterinary College, who is member of BEVA’s Health & Medicines Committee and analyzed the data, explained: “We are keen to continue to collect information on the prevalence of Atypical Myopathy through the survey. The number of cases of this disease that occur each year are not known and although NEHS has provided a snapshot we need to capture data from a much larger number of horses to know how common this disease truly is across the UK as whole."

Participation in NEHS has increased significantly this year. Data was collected from 11,002 horses, ponies, donkeys and mules across the UK, representing an increase of more than double last year’s figure of 4,730. The majority of horses reported (88%) were kept either in livery yards or private yards, with only 0.7% kept by equine welfare charities.

Josh Slater commented: “The annual surveys have shown consistent trends and already challenged some established dogma on disease prevalence--for example, laminitis--and validated much of the accepted veterinary opinion, for example on lameness and colic.”

A copy of the results, will be available for downloading at www.bluecross.org.uk; British horseowners may register for next year’s survey at www.bluecross.org.uk/nehs

*Rough math: One-quarter of all lameness would be 25 percent of 18.5 percent, or 4.6 percent of British horses affected by non-laminitis foot lameness. 

(end of official document)

Reliable and recent statistics about lameness in populations of horses are difficult to find when you are looking for some to reference. The undocumented statement that "90 percent of lameness in horses is in the foot" continues to be used as a stigma on the state of hoofcare and instills a defeatist attitude in many people about the inevitability of foot problems. 

Even in this age of "evidence-based medicine", that statistic is still quoted, without a source and without statistics to back it up. 

Other countries are not lucky enough to have surveys like the one summarized here; it would certainly be interesting to compare statistics, especially on foot-related lameness, between countries. Could the difference really be from less 25 percent of all lameness cases in the UK to 90 percent in the US?

The number of cases of laminitis is also open for interpretation. A nationwide public education project called "Talk About Laminitis" was launched in the UK last year. Free blood tests were offered to horse owners to evaluate blood levels of insulin and ACTH for equine metabolic syndrome and Cushing's disease, respectively, and the public was invited to webinars and exposed to laminitis awareness campaigns via social media. 

It's possible that, as a result of the program, many more people were actually having their horses medically treated for laminitis related to EMS or Cushing's, and that these horses' seasonal or occasional foot soreness and minor lameness had never before been actually diagnosed as laminitis. 

Or, as the press releases suggests, winter conditions could have simply made preventing grass-related laminitis this year a more daunting challenge for owners. The "Talk About Laminitis" program might also explain the increase in the number of obese horses; there may be simply be a new awareness that the horses are obese because of the education efforts.

To learn more:

Compare 2014 statistics with 2011 NEHS study and interpretation, particularly for laminitis

Statistics of Equine Foot Lameness: New Diagnostics Document More Precise Damage to the Feet of Sport Horses

Statistically Speaking: What Was the #1 Keyword on the Hoof Blog in 2011?

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