Laminitis researcher investigates horse owners’ knowledge of disease and how it affects horse care decisions

A new laminitis research study, supported by the equine feed manufacturer SPILLERS®, in collaboration with the Royal Veterinary College (RVC) in England, aims to shed light on British horse owners’ understanding of laminitis and whether or how that knowledge may influence horse management practices in Great Britain.

The Barbaro Effect: How One Horse Changed the Face of Laminitis Awareness--and Google Search Statistics--Forever

A racehorse named Barbaro won the Kentucky Derby in 2006. He fractured his right hind leg in the Preakness, two weeks later, and suffered from laminitis during his complex recovery from surgery to repair the limb that summer. The world watched him struggle to recover. Eight months after his injury, he was euthanized. Laminitis was given as the reason for ending his life. The world--not just the horse world--was stunned that his life couldn't be saved. What was this disease, they wanted to know? Barbaro showed them what it was, in the most tragic possible way. His name became synonymous with laminitis awareness and research. And Google has proof of that.

Barbaro died on January 29, 2007. Where were you, eight years ago today? More importantly, where was your awareness and knowledge of the disease of laminitis? And where are you--and your laminitis awareness and knowledge--now?

Christmas with Laminitis Video: St Nicholas Abbey Five-Month Update from Coolmore in Ireland

St Nicholas Abbey - Five months on from Coolmore Stud on Vimeo.

This video is shown on The Hoof Blog with permission of Coolmore Stud. Click the "play" icon to begin the video.

It's Christmas Eve and you can count your blessings. Count your blessings especially if you are a horse that doesn't have laminitis.

Case Follow-up: How's the Swiss Cheese Hoof Wall?

Do you recognize this foot? Califronia farrier R. T. Goodrich has an update on "the swiss cheese hoof wall" case. The mare continues to improve and the shoeing treatment has been simplified.

On June 7, 2013, California farrier R.T. Goodrich innocently posted a photograph of a hoof on his farrier service's Facebook page. It wasn't a horse that belonged to any of his clients. He shod it for free, just to help the otherwise-helpless owner out. Her horse had received an unorthodox hoof wall dimpling treatment for laminitis.

The Helpful Farrier: Dimpled Laminitis Treatment Stirs Facebook Furor and Charitable Shoeing

This foot was probably the most viewed, shared and commented on hoof in the world in June 2013.  The only problem was that the people doing all the viewing, sharing and commenting didn't bother to read the details of the case posted by farrier RT Goodrich in California, who found the horse with this unusual hoof wall treatment. (RT Goodrich photo)

It appeared on Facebook on June 7 and it went viral: 422 people left comments and 233 shared it all over Facebook. Then others shared it. It took on a life of its own. Who didn't see it?

“It” was a photo posted by California farrier RT Goodrich. "It" was a hoof that had been dimpled all over with holes. It looked for all the world like a hoof made of Swiss cheese.

Laminitis Treatment: UC Davis Experimental Anti-Inflammatory Shows Promise in Test Case

Can an anti-inflammatory medication have curative power over a disease like laminitis? Researchers at the University of California at Davis are beginning clinical testing of a new medication that might be an outside-the-box hope for relieving horses suffering with the disease. Here's a report from UC Davis School of Veterinary Medicine:

Four horses suffering from laminitis have been treated with the investigational anti-inflammatory drug so far. One experienced a complete remission that has lasted for more than a year, and three others have shown some improvement.

A paper on the first laminitis case has been accepted for publication by the peer-reviewed Journal of Veterinary Anaesthesia and Analgesia. The paper is expected to be published in the journal’s February issue, but journal editors authorized the authors to disclose their findings ahead of publication.

Alonso Guedes, an assistant professor of veterinary medicine, treated this four-year-old Thoroughbred mare by administering an experimental anti-inflammatory drug to treat laminitis. (Don Preisler/UC Davis photo)

“This is an unusual step for us to announce this so far in advance, but because euthanasia is often the only way to alleviate pain in severe laminitis, we felt that it was important to let the veterinarians and horse owners know that this compound has shown potential as a treatment,” said Alonso Guedes, an assistant professor in the School of Veterinary Medicine.

The horses were treated under a “compassionate use” protocol approved by the UC Davis Institutional Animal Care and Use Committee. That protocol allows animals to be treated with an experimental drug if no approved alternative treatment exists.

A clinical trial to assess the drug’s safety and establish a tolerable dose for the compound is expected to begin in the spring. Further clinical trials would be needed to establish the drug’s effectiveness as a laminitis treatment.

The experimental compound, known as t-TUCB, belongs to a group of anti-inflammatory compounds called sEH (soluble epoxide hydrolases) inhibitors. It stems from a discovery made more than 40 years ago by UC Davis entomology professor Bruce Hammock while doing basic insect biology research.

The "cure" for laminitis is
the rehabilitation of the
horse's foot and the
elimination of the triggering
cause. (Plastination model
of advanced laminitis by
Christoph von Horst DVM PhD)

 

 

Originally interested in finding biological insect control methods, Hammock has since broadened his research to also search for biomedical applications. He and colleagues have identified a group of anti-inflammatory compounds, including the sEH inhibitors, that have proven to be effective in relieving inflammatory discomfort and pain related to nervous system disorders in mice and rats. Their work has been published in scientific journals including the Proceedings of the National Academy of Sciences and the Journal of Medicinal Chemistry.

Guedes noted that the safe management of laminitis-related pain is one of the biggest challenges for equine veterinarians. Often, euthanasia is the only humane alternative for alleviating pain and suffering in horses afflicted with the condition.

Consequently, according to UC Davis, the survival rate for laminitis is estimated to be only 25 percent. Very few surviving horses return to their previous levels of activity, and laminitis often reappears.

In his upcoming paper, Guedes reports the case of a four-year old Thoroughbred mare named Hulahalla. The horse had been retired from racing following a tendon injury and donated to the UC Davis School of Veterinary Medicine, where it was participating in a study focused on healing tendon injuries using stem cell treatments. She developed laminitis.

Veterinarians from UC Davis’ William R. Pritchard Veterinary Medical Teaching Hospital treated the laminitis with conventional therapies including cold immersion, antibiotics, leg wraps, and two commonly-used nonsteroidal drugs intended to reduce inflammation and relieve pain — but the horse only got worse. At the point that the mare was spending most of the day lying down, Guedes got involved.

Before resorting to euthanasia, Guedes and the veterinary team decided to try one last treatment, t-TUCB.

The veterinarians administered the experimental compound intravenously early on the eighth day of Hulahalla’s illness. After receiving the first dose, the horse remained standing in the stall most of the day, became interested in her surroundings and walked voluntarily.

The mare’s demeanor, posture and mobility continued to improve over four days of treatment, and her high blood pressure gradually returned to normal. No adverse affects from t-TUCB were observed, and Hulahalla has remained laminitis-free for a full year.

The sEH inhibitors, including t-TUCB, are currently available from the Hammock lab, which has provided the experimental compounds to more than 100 academic scientists around the world for basic investigation into their role in treating disease.

Hammock said that work aimed at moving t-TUCB and related compounds toward clinical use is advancing in several areas. He and Guedes are working on compounds with potential for targeting pain and arthritis in companion animals. And they are working with UC Davis to move the intellectual property from this research into a company to develop medications for difficult-to-manage neuropathic pain associated with diabetes and nerve injury.

Funding was provided by the National Institute of Environmental Health Sciences and the UC Davis Center for Equine Health.

The University of California at Davis provided this article.

Click to order this award-winning anatomy reference graphic for the wall of your clinic, forge or office.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Laminitis Research: BEVA's Equine Veterinary Journal Grants Free Public Access to New Findings

Temporary open access to a group of laminitis research papers is available to students, professionals and horse owners.

This doesn't happen every day.

The Equine Veterinary Journal (EVJ) has announced that it is giving the public open (free) access to a collection of important new research papers on equine laminitis.

Normally, non-subscriber access to these articles would be as much as US$40 per view.

The papers include practical advice as well as the latest research. The initiative has been made possible thanks to sponsorship from the British Equine Veterinary Association (BEVA) Trust.

Professor Celia Marr, BVMS, MVM, PhD, DEIM, DipECEIM, MRCVS, and editor of the EVJ explains: “In view of the growing public interest in high quality science, there is increasing demand for easy, open access to journal articles via the internet, particularly on topics such as laminitis.

"In recent years, there has been an explosion of knowledge and new thinking about this devastating condition. We have also recognized that some of the old-fashioned remedies, such as standing in cold water, have sound science behind them. I hope that horse owners who are unfortunate enough to have come across laminitis will find this new online resource valuable.”

Laminitis is an equine health crisis whose time has come. The British Equine Veterinary Association Foundation recognized the need for open access to the latest research, and responded by opening a special edition of its journal to the public. (BEVA image)

The EVJ laminitis virtual issue, comprising 15 original research articles on topics including the role of insulin, the effects of cryotherapy and the regulation of epidermal stem cells in affected horses, is available at http://onlinelibrary.wiley.com/journal/10.1001/%28ISSN%292042-3306/homepage/laminitis__recent_advances_and_future_directions.htm.

In addition, the issue contains several articles from international experts commissioned by the EVJ on important aspects of laminitis including causes, treatment, prevention and future research projects.

Contributors to this special issue include world-leading equine veterinary and research experts on the subject of laminitis: James Belknap, Ray Geor, Samuel Black, James A. Orsini from the USA, Andrew van Eps from Australia and Nicola Menzies-Gow from the UK.

Subjects covered include the present state and future of laminitis research, endocrinological aspects of the pathophysiology of equine laminitis, sepsis-related laminitis, supporting limb laminitis and progress towards effective prevention and therapy for laminitis.

The EVJ has a long history of promoting laminitis research. In 2004, the publication produced a special issue dedicated to laminitis and since that time significant numbers of articles on laminitis have been published every year.

Professor Marr concludes: “We hope that this special laminitis virtual issue will provide the rigor and quality of information that many horse owners are now seeking, to help them to understand and deal with this condition as effectively as possible.”

The landscape of academic publishing is changing as "open access" becomes the zeitgeist.

Open access in scientific publishing is a growing controversy in the academic and professional publishing world. New peer-reviewed journals are appearing that offer the public free viewing and sometimes downloading of new research and educational content, while others continue to restrict access to individuals and libraries that purchase subscriptions. These new journals both challenge the traditional model of restricting access to research while also expanding exposure for researchers.

Logo for the open access system.

Authors and researchers desire more access for their papers, but the traditional model restricts access, and the fees do not go to the authors and researchers. Journal publishers, on the other hand, have the high cost of editing and printing journals and of maintaining web sites.

The debate over open access is a fascinating one. EVJ's opening of this special issue to the public is evidence that the British Equine Veterinary Association recognizes the benefits of at least occasionally opening a few papers to the public, who often donate to the research that is detailed in the papers, but are often asked to pay to read what they have already funded.

To learn more:

Click to purchase and/or review the contents of the 2004 special print edition with Dr. Pollitt's papers

Click to view ordering information for your own copy of Professor Denoix's valuable reference on the horse's foot.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Autumn Laminitis: Prepare to Prevent--Instead of Treat--Seasonal Flair-Ups of Endocrine Conditions in Horses

This is what a foot looks like after laminitis...could this damage and deformation have been prevented? In Great Britain, a study found that 43 percent of horse owners waited more than a week after suspecting laminitis before seeking veterinary intervention. (Boehringer Ingelheim photo)

If Labor Day is over, can autumn laminitis season be far behind?

This summer's drought has been relieved in some states, but many of the horses in the United States are standing in parched pastures, munching on hay, as they have been all summer. The drought put a quick end to the grazing season in many states, and horse owners have been saddled with increased hay bills.

Horse owners who grow their own hay found that they were feeding it as soon as they baled it. Second cuttings were poor in many areas. And a third cutting probably isn't even going to happen.

Fall rains usually send a dark green growth spurt up through brown pastures and with this signal comes the warning to horse owners that the fall can be just as dangerous as spring for horses to develop laminitis as they gorge on the grass.

This video from the British Veterinary Association's Animal Welfare Foundation is a quick primer on the general disease of laminitis and features veterinarian Ben Mayes, president of the British Equine Veterinary Association.

Recent research has shown us that the lush grass does not, by itself, cause laminitis. If two horses had a grazing contest, it's possible neither of them would develop laminitis no matter how much they eat.

But if one or both horses has an endocrine system vulnerable to cycling hormones that may cause laminitis when and if they are pushed, the results can be a stretched white line, hoof rings, a gimpy gait, or full-fledged laminitis.

The time to be vigilant is now, while it is still technically summer and the nights are still pretty warm. But across the country, night-time temperatures are dipping, and snow will soon be showing up on high peaks of the mountains.

Laminitis is a wholly preventable disease, and in the case of endocrine-related laminitis, it is part of a larger syndrome that indicates the horse may have a problem in the way the body processes glucose, in that the condition of insulin resistance prevents normal glucose metabolism or that circulating hormones are elevated by pituitary pars intermedia dysfunction (PPID).

Is this your perception of a horse with Cushings syndrome (PPID)? While there are still plenty of older horses with the problem out there, the obvious change in hair coat is not seen in the early-teens horses whose blood tests yield information about high levels of the pituitary hormone ACTH. (Photo © Dr. Christian Bingold, Pferdeklinik Großostheim, used with permission)

Some of the recommended management suggestions include evaluating a horse's weight and condition and stepping up the exercise for horses kept at pasture during the fall months when risk is increased.

Another simple thing that horseowners can do is get their hay tested. Some hay can have as much or even more sugar than pasture grass. Soaking hay or feeding lower calorie hay to horses with higher laminitis risk quotients may be helpful.

Additionally, horse owners can ask for help from farriers this time of year. Ask to see or photograph the horse's feet after they have been trimmed--is the white line tight or is it stretched? Are there red spots in the line? Ask the farrier if the hoof wall is smooth and healthy or if it is ridged and has "fever rings" that are telltales of some disruption in the horse's diet or metabolism in recent months.

Finally, testing a horse's ACTH levels is now recommended to be done in the fall. Boehringer Ingelheim, manufacturers of the PPID medication Prascend, has recommended that the testing for Cushing's be done in the fall, when differences in test results would be most evident.

Dr. Don Walsh of the Animal Health Foundation explains the basic tenets of laminitis prevention, including insulin resistance and Cushings syndrom (PPID) in this brief video.

Current thinking and evidence suggests that 90 percent of laminitis cases occur as a result of an underlying hormonal condition(1,2) such as Cushing’s disease (PPID) or Equine Metabolic Syndrome. With this in mind, owners - particularly those with a horse over 10 years of age - are being urged to get their horses tested for Cushing’s as soon as possible if they suspect that the horse may be suffering from laminitis, or even if it simply appears a little foot-sore.

Despite the severity of laminitis, only two-thirds of laminitis cases reported by owners in Great Britain were treated by a veterinarian (3) and, in one study, 43 percent of horse owners waited more than a week after suspecting laminitis before seeking veterinary intervention (4).

Boehringer Ingelheim Vetmedica's data shows that one third of laminitic middle aged horses (defined as between the ages of 10 and 15 years) test positive for PPID (Cushing's)(5).

Over 3,100 horses were tested for Cushings as part of the company's Talk about Laminitis campaign in Great Britain during the spring of 2012. The pharmaceutical company is offering free testing for Cushing's in Great Britain again this fall, thanks to the Redwings Horse Sanctuary, which is providing funding.

Horse owners may have to pay for the ACTH and insulin resistance tests in the United States, but there is no price that can be put upon the peace of mind of knowing more about a horse's potential risk for laminitis.

To learn more:
Visit the Animal Health Foundation laminitis web site and watch more videos there.
Boehringer Ingelheim's "Talk About Laminitis" web site is meant for British horse owners, but most of the information is relevant worldwide; Prascend is available in the USA.
Read "Six Steps to Prevent Autumn Laminitis".
Plan to attend the Laminitis West conference in Monterey, California in November 2012.

References from the text:

1. Donaldson, M.T., Jorgensen, A.J.R and Beech, J. (2004) Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis.  Journal of the American Veterinary Medical Association 224, 1123-1127.
2. Karikoski, N.P., Horn. I., McGowan. T.W. and McGowan, C.M. (2011) The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion/referral equine hospital. Domestic Animal Endocrinology 41,111-117.
3. Ireland, J.L., Clegg, P.D., McGowan, C.M., McKane, S.A., Pinchbeck, G.L., 2011.  A cross-sectional study of geriatric horses in the United Kingdom Part 2: health care and disease.  Equine Veterinary Journal 43, 37-44.
4. Knowles, E.J., Withers, J.M. and Mair, T.S. (2012) Increased plasma fructosamine concentrations in laminitic horses. Equine Veterinary Journal 44, 226-229.
5. Boehringer Ingelheim Vetmedica. Resting ACTH results of 724 horses aged 10 to 15 years. 

Do you know your way around the inner hoof wall? This wall chart will remind you of the layers of sensitive and insensitive tissue that make up the hoof capsule. Click this text to go to the ordering page.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Laminitis Trust's Eustace Welcomes Owner-Sourced Research Donation from Feed Company Spillers

Robert Eustace, founder of the Laminitis Trust, receives a cheque from Rachel Austin of SPILLERS®

The British feed company Spillers® has donated GB£12,000 (approximately US$20,000) to the Laminitis Trust, to help fund important research on the devastating condition of laminitis in horses.

The funds were raised as the result of a special campaign run by Spillers®, which involved the feed company donating 20p (about 30 cents in US currency) to the Laminitis Trust from every bag of Spillers Happy Hoof®, sold during the months of April and May 2012.

Happy Hoof is one of two high-fiber products Spillers makes for laminitis-risk horses.

The Laminitis Trust, founded in 1998, is the only registered charity in Great Britain dedicated exclusively to supporting research into equine laminitis.

Clare Barfoot, RNutr, the research and development manager at Spillers®, said: “The Laminitis Trust is at the forefront of essential work to discover the causes of this painful and debilitating condition and we are proud to be able to support their endeavors.”

Robert Eustace, founder of the Laminitis Trust continued: “We are extremely grateful to Spillers® for this generous donation. All the money will be used to help fund our laminitis research projects. Horse owners should select feeds carrying the Laminitis Trust Feed Approval Mark logo to help them keep their animals at the correct body weight and reduce the risk of laminitis.”

Information for this article was received in the form of a press release from Spillers.

Click for more info and easy online ordering via PayPal

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Laminitis: Video Lecture on Metabolic Pathway for Hoof Blog Readers

Please allow sufficient time for this video to load.

Settle down...You needed to get out of the heat anyway. Take an hour to catch up on the latest information about laminitis, with a special emphasis on insulin resistance and Equine Metabolic Syndrome.

What this is: a one-hour video Powerpoint lecture by Dr. Don Walsh on the latest research and horse management information related to laminitis, primarily via the metabolic pathway common in pleasure horses. A preliminary explanation of the septis-related form of laminitis is provided to differentiate between the two main forms of the disease.

Thanks to EquiSearch.com and EQUUS magazine for hosting "Laminitis Lessons: A Webinar for Every Horse Owner" with The Animal Health Foundation's Don Walsh, DVM, and for making this video archive available to readers of The Hoof Blog.

Dr. Walsh

The Foundation is a leading funder of laminitis research and education around the world; it relies solely on donations from individual horse owners and horsecare professionals like you and me to fund research at Dr. Chris Pollitt's Australian Equine Laminitis Research Unit as well as at leading veterinary colleges like Cornell University's equine genetics lab and the labs of private professional researchers like Katy Watts of safergrass.org.

It's not enough just to soak up the information shared in this webinar. It's not enough even to share this video and the information in it with horse owners or horsecare professionals. Please help by sharing information about the Animal Health Foundation, too and by supporting it with your donation--no matter how small--and encouraging others to do the same.

Without a doubt, horses who have laminitis--and horses who might be risk for laminitis--have benefited from the work of the Animal Health Foundation. Directly or indirectly, you have too. Please give back; the Animal Health Foundation will put your donation to work immediately.

Click on the "Donate Online Now" button to go to the Animal Health Foundation PayPal donation page and click on the "donate" button for PayPal. Donations are fully tax-deductible in the United States and may be submitted from any country, in any currency, via a number of credit cards, any time of the day or night. Thank you.

Donation checks may be sent to:

Animal Health Foundation   3615 Bassett Rd.   Pacific, MO 63069

Photo of Dr. Walsh by Julie Plaster. Thanks!

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Equine Laminitis Update: Belknap's Summary of Basic Facts

A laminitis word cloud made from the words in this article. A lot of words and a lot of ideas circulate the world when it comes to preventing, treating and /or understanding laminitis. But what do we really know?

Laminitis: what does that word mean to you? Do you think you know all about it, or does hearing the very word have you shaking your head over all we just don't know.

The recent--and some would say long overdue--expansion in laminitis research has spawned a generation of geeks who can speak the lingo and conject about the future. Their ideas are exciting--but what do we really know about laminitis, and how much more do we know that a year ago, or ten years ago? 

Is it possible to find a cure for something you don't understand?

Dr. James Belknap, a leading laminitis researcher, recently wrote this succinct summary of what laminitis is, based on the few facts he and his researcher allies know to be the foundation of the disease. 


It's not far off to say that what he describes here is the laminitis base camp. Research expeditions head out from here. Sherpas lead the way, but it is one step at a time and sometimes bad weather forces an expedition back to the base just when the summit is in sight. Everyone wants to stand at the summit, on top of the world. Getting there has not been easy, but here's what the tents at base camp are built upon.

Laminitis is not a disease of the foot as much as a disease of the horse--yet the foot has a delicate structure--what Dr. Belknap calls "target tissue"--that is incredibly sensitive to changes from the many triggers. And the target tissue gets bullseyed more often than we'd like.

From Dr. Belknap:

Equine laminitis can be a devastating result of many different disease processes in the horse, including, most commonly, sepsis and endocrinopathies. The two primary types of endocrinopathic laminitis are equine metabolic syndrome (seen most often in the obese horse), and Cushing’s syndrome in older horses (characterized by high levels of circulating steroids produced by a pituitary tumor). Interestingly, the “target” tissue in the horse for sepsis, equine metabolic syndrome, and Cushing’s syndrome is the digital laminae.

Most likely the main reason the digital laminae are the primary target is because no other soft tissue structure in species injury/dysfunction will result in the entire collapse of the musculoskeletal system of the animal. The laminar basal epithelial cells are exposed to incredible forces (supporting the entire weight of the horse).

Dr. James Belknap is a leading researcher in the pathophysiology of laminitis. He is a professor at
 The Ohio State University College of Veterinary Medicine's Galbreath Equine Center.

1. Laminitis related to septic conditions

Septic conditions in the horse that can lead to laminitis include gastrointestinal disease (surgical lesions, diarrhea/enteritis from infectious agents, or carbohydrate overload), retained placenta in the post-foaling broodmare leading to a uterine infection, pleuropneumonia, and any other infection in which enough tissue is compromised to result in systemic effects.

In most of these cases, toxins absorbed from Gram-negative bacteria are thought to be responsible for the systemic problems such as laminitis. However, bacterial infections from other types of organisms can also result in laminitis. Most progress has been made in studying sepsis-related laminitis, as most experimental models for laminitis mimic this condition.

Systemic inflammation leading to inflammatory injury to the laminar tissue has been reported in sepsis-related laminitis in horses. In the laminae, this injury is characterized by adhesion and migration of circulating white blood cells out of the blood vessels into the laminar tissue. This is accompanied by massive increases in expression of inflammatory proteins such as cytokines (a 10-fold to > 2,000 fold increase in expression) and cyclooxygenase-2 (COX -2, the enzyme which is targeted by non-steroidal antiinflammatory drugs such as phenylbutazone or flunixin).

Research attempts to sort out not only what happens, but when it happens,
to cause the horse's hoof to experience the freefall of chronic laminitis,
Plastinated hoof tissue courtesy of HC Biovision/Dr Christoph von Horst

2. Laminitis related to Equine Metabolic Syndrome and Equine Cushing Syndrome

These events most likely cause injury to the laminar basal epithelial cells, leading to disruption of their critical cellular events, including adhesion to the underlying matrix. The matrix itself may also be injured by the release of matrix-degrading enzymes by leukocytes, epithelial cells, and other cell types in the laminae.

Equine metabolic syndrome (EMS), which includes pasture-associated laminitis, is now the most common type of laminitis reported by veterinarians. Although the animals affected are commonly obese, animals in “show shape” that are not overtly obese also succumb to EMS-related laminitis.

A consistent factor in the horse or pony with EMS is insulin resistance, with the animals usually exhibiting increased circulating insulin concentrations. It has been suspected that laminar injury in EMS was from an inflammatory event as discovered in sepsis-related laminitis. However, recently presented data indicate that the high circulating insulin concentration itself can induce laminitis, with limited evidence of inflammation in the laminae.

The other type of endocrinopathic laminitis, Equine Cushing Syndrome (ECS), may have a pathophysiologic mechanism similar to that of EMS, as ECS horses similarly have high levels of circulating insulin. However, it is possible that the glucocorticoids (GCs) may be playing a role in disruption of the cell biology of the laminar keratinocytes in ECS.

3. Laminitis related to weightbearing (“supporting limb laminitis”)

The pathophysiology of supporting limb laminitis, the type suffered by Barbaro, is the type of laminitis about which we presently have the least knowledge. With this type, excessive weight bearing (usually due to a painful injury on the opposite limb) results in laminar failure. The recent interest supporting limb laminitis has resulted in several studies being funded by equine foundations.

Hopefully, these studies will further elucidate the pathologic mechanisms (and thus therapeutic targets) for this equally devastating form of laminitis. Thus, laminitis is likely the end product of a diverse array of disease processes that lead to disruption and failure of a highly evolved cell type that is exquisitely sensitive to injury—the laminar basal epithelial cell.

James Belknap, DVM, PhD, DACVS is Professor of Veterinary Clinical Sciences from The Ohio State University Galbreath Equine Center and a leading researcher in the pathophysiology of laminitis. He shared this succinct summary of the current knowledge based on the types of laminitis via the Equine Disease Quarterly of the University of Kentucky’s Gluck Equine Research Center.

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© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Black Walnut Shavings and Laminitis Subject of Texas Court Case

Owners who bed their horses on shavings or sawdust need to have a trusting relationship with their suppliers. Occasionally, black walnut shavings find their way into the supply line. While this might not bother the guinea pig or the rabbit in their cages, it's a potential crisis at a horse barn. The latest case is in Texas, where a single horse was stricken with laminitis which was believed to have been caused by a small amount of black walnut in the bedding. (Kristen Fulara photo)

The following news item is reprinted for educational purposes.

Toxic black walnut wood shavings sold as bedding caused an Arabian horse to develop laminitis, a Texas ranch claims in court.

An Arabian horse developed laminitis in August of 2011, according to the complaint in Bexar County.

The ranch says it reached out to a veterinarian when the horse exhibited pain and swelling in its legs and sheath area. While examining the stable, the ranch allegedly noticed dark wood shavings with a distinct smell.

The ranch claims it had just switched out the wood shavings the day before, putting in a batch from a livestock product supplier,which obtained the bedding from a hardwoods product manufacturer.

It is possible that as little as 10 percent black walnut shavings can cause laminitis in horses. The entire bedding does not need to be dark-colored. The black walnut can look like threads among the lighter colors. Photo from Purdue Extension special report on black walnut shavings and laminitis.

Once the veterinarian diagnosed the horse as suffering from acute laminitis, he tested a sample of the bedding, according to the complaint.

The ranch says the supplier identified various woods that might explain the dark shavings, first naming elder, then cherry and mesquite.

But the Texas Veterinarian Medical Diagnostic Laboratories Systems at Texas A&M University ran more tests and identified the true source -- black walnut -- a wood known to cause laminitis when used as horse bedding, the ranch says.

The supplier later "admitted that earlier in 2011 another shipment of shavings from (the manufacturer) had contained black walnut and caused a similar incident with another one of (the supplier's) customer's horses," according to the complaint.

The ranch seeks exemplary damages for negligence, deceptive trade practices, breach of warranty and product liability.

It sued the livestock supplier, the hardwood manufacturer, and its owners.

The horse is undergoing medical care, but its owners say they cannot show or breed the horse.


This report was provided to the Hoof Blog by Courthouse News Service.

The complete transcript of the lawsuit can be downloaded as a pdf file: Texas laminitis black walnut shavings lawsuit. Watch the Hoof Blog for the outcome of the suit.

To learn more: Download the Purdue Extension special report on black walnut shavings and laminitis.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines on the Hoofcare + Lameness Facebook Page

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

"Laminitis Lessons": Webinar by Animal Health Foundation's Dr. Don Walsh Will Be a Spring Tuneup on Practical Aspects of Research and Recognizing Laminitis in Horses

Dr. Walsh treating a horse with laminitis at his hospital in Pacific, Missouri

 Mark your calendar and dust off your keyboard: We're saving you a seat at the first AHF laminitis webinar!

The Animal Health Foundation's Dr. Don Walsh will present a one-hour "webinar' (a seminar presented over the web) on Wednesday evening, April 25. The webinar will be hosted by EQUUS Magazine and Equisearch.com (home site of the magazines EQUUS, Practical Horseman, Dressage Today, Trail Rider, etc.) and sponsored by US Rider Equestrian Motor Plan.

Here's a chance to see and hear the newest, most important laminitis research explained in context; over 1400 horse owners have already signed up to watch and it will be fascinating to hear their questions for Dr. Walsh at the end of the video and slide presentation/lecture.

DETAILS

What: "Laminitis Lessons: A Webinar for Every Horse Owner" 

with the Animal Health Foundation's Dr. Donald Walsh

When: Wednesday, April 25, 2012 8:00 PM - 9:00 PM Eastern USA time

Where: On your computer at a special "GoToMeeting" link! (see clickable link below)

Who: Donald Walsh DVM, founder of the Animal Health Foundation, along with an audience of horse owners from all over the world...and you and me!

How: Click on the link and sign up--it will take less than a minute. You'll receive a confirmation email with a link back to the same page to attend the webinar Wednesday evening.

Cost: It's Free!

REGISTRATION LINK FOR WEBINAR:
https://www3.gotomeeting.com/register/960229774

Donald Walsh, DVM, founder of the
Animal Health Foundation;
photo by Julie Plaster

PLEASE FORWARD THIS (you should see a little envelope at the bottom of this post, which will allow you to email it, or you can use the Facebook or Twitter tools to share it) to horse owner friends, veterinarians, farriers, vet techs and anyone else who would benefit from or be interested in information from the Animal Health Foundation's "Laminitis Lessons".

About Dr. Walsh and the AHF: 

Dr Walsh and his wife Diana founded the grassroots, all-volunteer, non-profit organization known as The Animal Health Foundation in the 1990s to fund laminitis research. Dr. Walsh was a full-time equine practitioner in Pacific, Missouri at that time. Since they began, AHF has been able to donate more than $1 million to research, primarily through small donations from horse owners who lost a horse to laminitis.

Early on, the Animal Health Foundation identified Dr. Chris Pollitt and his Australian Equine Laminitis Research Unit at the University of Queensland as a primary beneficiary of support from the AHF. 

After his retirement from active practice last year, Dr. Walsh traveled to Australia to conduct research with Dr. Pollitt and his team and has now returned to the USA to share what he learned there and from other AHF-funded projects around the USA. 

Dr. Walsh recently received the Merial Lifetime Achievement Award at the 6th International Equine Conference on Laminitis and Diseases of the Foot. This year, Dr. Walsh is beginning a national tour of veterinary colleges around the world to educate students about laminitis. He is known for his straightforward, down-to-earth speaking style, has a great skill for explaining complex concepts in a meaningful way, and is a dedicated horseowner himself.

See you there!

Laminitis education links you can use and share:

Please find and "like" the Animal Health Foundation page on Facebook--and share a story from the page on your own timeline so we can build a bigger Facebook presence!

https://www.facebook.com/pages/Animal-Health-Foundation/162860893750859

Follow the Animal Health Foundation on Twitter: http://twitter.com/AHFLaminitis

Watch or send people to watch the Animal Health Foundation's Laminitis Update 2012 videos, currently the #1 most popular post on the Hoof Blog this spring:

http://hoofcare.blogspot.com/2012/03/equine-laminitis-2012-video-education.html

The Animal Health Foundation informational web site and blog: http://www.ahf-lamintiis.org. 

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines on the Hoofcare + Lameness Facebook Page

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.