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Wednesday, March 27, 2019

Laminitis Prevention: Along with weight gain, shoeing and trimming still factor in risk


Although excess weight has long been considered a primary risk factor for laminitis, new research continues to sort through the many risk factors and look for patterns of horsecare or links between the factors themselves, as well as that weight gain is most likely to be associated with laminitis.

A relatively large study, by equine science standards, was conducted in the United Kingdom and gave researchers access to data on more than 1000 horses in "real time" by receiving monthly reports for more than two years from owners about the same horses. The sole purpose of the study was to gather data on laminitis and the horsecare factors that may contribute to it.

Out of 1,070 horses followed in the study, 97 experienced 123 episodes of laminitis over the 29 months the data was collected.

The bottom line conclusion was that weight gain more than doubled the risk of developing laminitis, but other horsecare practices, including hoofcare, should not be ignored.



While the emphasis of the study report is designed to continue to hammer home the message that excess weight puts a horse at high risk for laminitis, the study also looked at other factors worthy of mention, such as laminitis in horses with lameness caused by soft tissue injury, the possible influence of anti-inflammatory medication, and the negative consequences of infrequent trimming and shoeing. The length of time required for a horse to recover from a previous laminitis episode was also a factor.

The inclusion of hoofcare practices outlined in this study keeps the health of the hoof in the laminitis risk equation. While the need for attention to weight control is of critical importance, a bigger picture of overall horsecare practices is in sharp focus, thanks to the study results.

(Please read the full paper to gain an understanding of the impact of this major study; it is published in an Open Access journal and free for all to read.)

The bottom-line, "take home" message of this new research reinforces previous warnings from research that horses and ponies allowed to gain weight are more than twice as likely to develop laminitis than if they lose or maintain their weight.

Laminitis developed significantly more often after horses and ponies gained weight, compared to when they lost or maintained weight.  Weight gain was often occurring unintentionally, even when owners said they were aiming for weight maintenance or loss.

Status of study horses for equine metabolic syndrome (EMS), insulin dysregulation, and/or pituitary pars intermedia dysfunction (PPID) was not consistent; not all horses had been evaluated so the role of underlying metabolic disease in risk was not completely reported. "The limitations of owner-reported data in the present study and of animals not clinically examined, nor blood sampled, are acknowledged," the authors wrote.

However, the study results also add an important PS: Other possible risk factors should not be ignored.

Native pony breeds and their crosses, horses and ponies with a history of laminitis, and those with lameness or soreness after routine hoof care are also at risk. In particular the study selectively collected data not just on "ponies" but ponies of particular breeds and sizes to look for laminitis risk in that light.

The records of the horse owners related to how often they had horses trimmed or shod, whether using the services of a farrier, and whether or not episodes of foot soreness preceded laminitis episodes are valuable.



A summary item advises owners, "Regular foot care, diagnostic testing for underlying metabolic disorders and their management, and involving your vet during an active episode should reduce the risk of future episodes."

The authors state, "There is now evidence that discomfort following routine hoof care preceded laminitis development. This may be reflective of animals with existing sub-clinical lamellar alterations, which then develop into acute-phase episodes following altered foot load bearing.

"However, the effect of poor trimming or inadequate shoeing techniques on laminitis development cannot currently be discounted," they continued.

"Trimming or shoeing intervals greater than eight weeks were additionally associated with higher rates of laminitis...The majority of the animals in the current study were trimmed by farriers and there is scope to involve farriers to a greater extent in laminitis research.

"Active involvement of farriers in future epidemiological studies would further quantify the relationship between hoof care and laminitis, as well as contribute to knowledge of foot characteristics associated with previous laminitis episodes," they explained.

Another interesting finding was that moving a horse to a new yard (stable or farm) could affect the horse's risk for laminitis. Animals that moved yards within the previous year had higher rates of laminitis development compared to animals transported for other reasons or not at all.

Along those lines, the type of worming products used was also studied, "The association between worming practices and laminitis should form the basis of future targeted research," the authors wrote.
Grazing time and environmental factors are mentioned in the study results and will surely be studied more. Subjects for future investigation will include, for example, investigating how short-term access to grass in the morning and part-time use of grazing muzzles may contribute to laminitis development. The authors describe the concept of "compensatory eating" in ponies who anticipate being deprived of grazing.

Study author Dee Pollard

In addition to keeping records, submitting surveys, and observing their horses, owners were encouraged to use a custom weight tracking tool designed by the study/research team to help regularly track changes in their animal’s weight and body condition. The uptake of this tool was high, with over half of participating owners using it. It is freely available at: www.aht.org.uk/research/lameness/laminitis.

Dee Pollard, BSc, BSc Honours, MSc, PhD of the Animal Health Trust, one of the study’s chief authors, commented on the research: "We now have good evidence to develop laminitis prevention guidelines, and a number of different avenues to explore in the future. We cannot emphasize enough how important systematic and regular weight and body condition monitoring are."

The research was carried out by representatives of the Royal Veterinary College (RVC), the Animal Health Trust (AHT) and Rossdales Equine Hospital. The results of the study are published in the Open Acccess Biomed Central journal, BMC Veterinary Research.

This research was funded by the British-based international charity, World Horse Welfare.

Supplemental information provided by the Royal Veterinary College in support of this study is included in this article.

Citation for this study; click the title link to open the full Open Access article, which includes access to supplemental data from the study:

Pollard, D., Wylie, C. E., Verheyen, K. L. P., & Newton, J. R. (2019). Identification of modifiable factors associated with owner-reported equine laminitis in Britain using a web-based cohort study approach. BMC veterinary research, 15(1), 59.

Credits: Top photo by Michael Frank (preserved specimen "chronic laminitis with pedal bone rotation") courtesy of Wellcome Collection and Royal Veterinary College pathology museum; photo of Dee Pollard courtesy of the author; infographic provided by Royal Veterinary College.

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