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.

Grass Laminitis: What You Don’t Know Can Hurt You (and Your Horse) and Surprise the Researchers

New ad promo and publicity from Boehringer-Ingelheim Vetmedica perhaps oversimplifies grass laminitis. But it might get the attention of horse owners.

When it comes to laminitis, I feel like a whirling dervish: what’s going on in Australia, what’s going on in Europe? what’s going on here in the USA? (whirl)

Equine Laminitis: 2012 Video Education Update from the Animal Health Foundation

The Animal Health Foundation, a non-profit organization that funds laminitis research at Dr Chris Pollitt's Australian Equine Laminitis Research Unit and at universities in the United States, has assembled a quick course update for horse owners and horse professionals on preventing, managing and treating the disease of equine laminitis.

While there is still much that we don't know about laminitis, Donald Walsh, DVM has prepared a primer that should make clear the current state of practical information.

Please watch all five videos in the Animal Health Foundation's EQUINE LAMINITIS 2012 UPDATE and share these videos with everyone in the horse world. This is important information.

1 INTRODUCTION TO LAMINITIS
Does your horse have laminitis or founder? Would you like to prevent the disease? Are you concerned about the dangers of insulin resistance, obesity, over-grazing and hoof condition changes? Have you been told your horse is at risk for laminitis? If you answered yes to any of those questions, this educational video series could save your horse's life. Five concise, free, non-commercial videos from the non-profit Animal Health Foundation offer the latest practical and scientific information to help you help your horse avoid or overcome laminitis in its many forms. Your host: Donald Walsh, DVM, founder of the Foundation and a practicing veterinarian who specializes in laminitis and founder.

2 UNDERSTANDING EQUINE LAMINITIS: HOW DOES LAMINITIS OR FOUNDER AFFECT YOUR HORSE?
What happens in horses' feet during laminitis? What's the difference between laminitis and founder? You will learn three different ways that a horse gets laminitis and the many causes, including Equine Metabolic Syndrome and Cushing's Disease, or "PPID", and support-limb laminitis. The non-profit Animal Health Foundation and Dr. Donald Walsh offer the latest practical and scientific information to help you and your horse avoid or overcome laminitis in its many forms.

3 WHAT CAN YOU DO IF YOUR HORSE HAS "ACUTE" LAMINITIS?
Can you recognize "acute" (sudden onset) laminitis symptoms? How can you help your horse during this medical emergency? Dr. Walsh encourages horse owners to employ the only scientifically-proven method to prevent laminitis: "icing the feet" , or "cryotherapy". Does your horse need blood insulin tests to find the cause of the laminitis? The non-profit Animal Health Foundation and Dr. Donald Walsh offer the latest practical and scientific information to help you help your horse avoid or overcome acute laminitis.

4 CHRONIC LAMINITIS AND FOUNDER
Chronic laminitis means a life of ongoing, crippling pain for horses. What can a horse owner do? Dr. Walsh explains long-term ("chronic") laminitis and current methods of hoof mechanics to support damaged feet. He explains abnormal hormones and that Cushing's disease ("PPID") or Equine Metabolic Syndrome may be the underlying cause. You'll learn about hay testing and benefits of soaking hay in water. Finally, Dr. Walsh speaks frankly about putting some horses to sleep because of advanced laminitis.

5 PREVENT LAMINITIS IN YOUR HORSE
What are the best horsecare practices to protect your horse from laminitis? What are the risk factors? Can icing the feet help? What might a cresty neck or hoof rings mean? You'll learn to recognize early changes in your horse's feet before laminitis occurs and how to correct hormone levels before horses go lame. Dr Walsh suggests ways to prevent supporting limb laminitis in horses with leg injuries.

LAMINITIS RESEARCH. This video, made in 2011, explains the priorities of laminitis research in Dr. Pollitt's Australian Equine Laminitis Research Unit, which is funded in many of its projects by the Animal Health Foundation. It contains the core principles of the AHF concern to make laminitis research relevant and helpful to real people and real horses. Other studies funded by AHF have included genetic studies at Cornell University, endocrine studies at the University of Missouri and Cornell, and Katy Watts' innovative "Safer Grass" studies to analyze how grass founder might be prevented.

The Animal Health Foundation depends on large and small donations to fund research projects. All donated funds go directly to research; the foundation is run by volunteers including Dr. Walsh, whom you met in the video.

Further Animal Health Foundation research will enable us to prevent laminitis and "Free the Horse of this Disease".

Learn more about the Foundation and how you can donate or become involved in the fundraising process.

Thank you.

© 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 that I serve on the Board of Directors of the Animal Health Foundation, which is a volunteer position. 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.

Insulin Resistance and Equine Laminitis Research: Australia's Melody De Laat's Academic Elevator Video

Imagine the challenge laid down by the University of Queensland to its graduate researchers: give a three-minute presentation encapsulating your doctoral work. Tell an audience of everyday people from all walks of life why it matters, what it's all about. But keep it short. Can an Australian laminitis researcher describe equine metabolic syndrome in that short amount of time--using only one slide? 3-2-1...talk!

What's your elevator speech?

You have to have one.

If you're an entrepreneur, a job seeker, self-employed or just someone who doesn't want to be left in the dust of this ever-changing world, you have to have to an elevator speech. Once all you needed was a firm handshake, and a spare business card in your wallet for when you met someone. Now you need to be able to tell him or her what you do with your life and why you do it in just a few words.

You need to be able to get the message across that you're special and you're interesting and you're worth knowing/hiring/considering, and you need to say exactly why--all in the time it would take to ride a couple of floors on the elevator of a hotel or office building.

When that elevator door opens, your speech is over.

Yes, you're saying...But then there are academics. And forget engineers. Have you ever asked a researcher or engineer what he or she actually does? I know what you're thinking: Maybe there are some elevators in some coal mines in some Third World countries that would take long enough for a researcher's speech to get to the point--if there is one, that is.

But things are changing. We live in an age of pecha-kucha, the PowerPoint challenge to present your idea in 20 slides that change every 20 seconds, whether you're ready or not. It's the age of the "unconference". And the two-minute video rules, thanks to the way that YouTube has reset our attention spans.

So imagine the challenge laid down by the University of Queensland to its graduate research community: give a three-minute presentation encapsulating your doctoral work. Tell an audience of everyday people from all walks of life why it matters, what it's all about. But keep it short.

And if you get your message across? You could be the winner.

Last year, Melody De Laat answered the UQ Three Minute Thesis competition challenge with a topic related to her thesis: The Investigation of Insulin-Induced Laminitis in Horses. Her research at the Australian Equine Laminitis Research Unit (AELRU) focused on how elevated insulin levels, which occur as a result of insulin resistance, damage the sensitive lamellar (laminar) structures of the horse's foot.

And she had to do it on a huge stage, in an even bigger theater, in front of people who knew nothing about horses' feet, let alone about laminitis or insulin resistance.

“Insulin resistance is an increasingly common problem in horses. The lamellar failure, which is known as laminitis, that results as a consequence of the elevated insulin levels in the body is a painful and debilitating condition,” Melody said confidently.

“By uncovering the mechanisms involved in insulin-induced laminitis it is hoped that we will be able to reduce the morbidity and mortality rates associated with this disease.”
 
The Queensland competition was so well-received that it has been extended to other national and international universities in Australia and beyond. Master of Ceremonies for the event is the award-winning science writer and broadcaster with ABC Science Online, and regular judge on Australian ABC TV's The New Inventors, Bernie Hobbs.

I hope you enjoyed Melody's equivalent of her elevator speech. She advanced to the finals, and there are a lot more people in Australia who know a little bit about laminitis thanks to this competition and Melody's PhD.

And--Oh! Is this your floor?

One of Melody De Laat's research breakthroughs on metabolic laminitis was featured on The Hoof Blog on July 1, 2011. If you'd like to learn more, Melody De Laat will be one of four doctoral and post-doctoral researchers from the Australian Equine Laminitis Research Unit (Simon Collins, Melody De Laat, Brian Hampson and Andrew Van Eps are the team) who will accompany AELRU director Chris Pollitt to speak at the 6th International Equine Conference on Laminitis and Diseases of the Foot in West Palm Beach, Florida October 29-31. 

© 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: Equine Insulin Resistance Does Not Respond to Metformin Medication; Diet and Exercise Remain Key to Laminitis Prevention

Researchers in Australia tested the effects of a human medication, metformin, on ponies with insulin resistance, a condition that puts horses at risk for developing the endocrine or metabolic form of laminitis. The medication had no effect. (J.A. Holland image)

New research on the pharmacological management of the condition of insulin-resistance in horses and ponies has suggested that diet and exercise are still key in any management plan.

Insulin resistance (IR) is defined as the diminished ability of a given concentration of insulin to exert its normal effect on glucose dynamics in particular. This causes the body to keep releasing more and more insulin in order to elicit an effect. This may be one of the most predictable factors that determines whether a horse or pony could be more susceptible to what is commonly known as the "endocrine" or "metabolic" form of laminitis.

The University of Minnesota College of Veterinary Medicine's Equine Genetics and Genomics Laboratory explains insulin resistance this way:

Insulin  is a hormone involved in the regulation of glucose (sugar) levels in  the blood and tissues of the body.  In response to feeding, insulin is  secreted by the pancreas into the blood stream. Insulin in the blood  stream directs the glucose (sugar) absorbed from the food into the  body’s tissues including liver, fat and muscle.  Insulin resistance  occurs when insulin no longer has a normal effect on the tissues. In the  insulin resistant horse, the pancreas releases insulin into the blood  stream, and the insulin arrives at the tissues and binds the cells,  however the glucose enters the tissue cells at a much lower rate than  normal. This lower rate of glucose uptake into tissues results in higher  levels of blood glucose.

Horses and ponies compensate for  insulin resistance by secreting even more insulin into the bloodstream  in order to keep the blood glucose concentration within the normal  range.  Therefore, horses and ponies with EMS (Equine Metabolic Syndrome) have a higher  concentration of insulin within the blood, which can be measured to  determine if insulin resistance is present.

An important goal for owners and vets should be to prevent IR from developing, or to manage it before it contributes to the development/progression of other potentially life-threatening conditions. While the correct management of energy intake and exercise levels is thought to be essential, in some cases medication is also considered, especially when increased exercise is not possible. With no licensed drugs currently available for the treatment of IR in horses and ponies, off-label medications used for IR in humans are sometimes prescribed.

A trial was conducted by the School of Animal and Veterinary Sciences at Charles Sturt University in New South Wales, Australia and the Department of Clinical Studies at the University of Pennsylvania's New Bolton Center, in collaboration with the Waltham Equine Studies Group in Great Britain.

The study's intention was to confirm the positive effect of the human medication metformin on insulin and glucose dynamics in insulin-resistant ponies so that this treatment could be used as a positive control in other studies.

Glenys Noble BAppSc(Equine Studies) PhD, along with PhD candidate Kellie Tinworth BSc(hons) MSc, carried out the clinical trial in Australia. Six insulin resistant, non-obese ponies were repeatedly monitored by means of a frequently-sampled intravenous glucose tolerance test (FSIGT). Metformin ia a drug reported to enhance insulin sensitivity of peripheral tissues in humans without stimulating insulin secretion. It was administered twice-daily (15mg/kg BW BID) to three of the ponies for 21 days.

Meanwhile, the three remaining ponies formed a control group, and each received a placebo. After a wash-out period, the treatments were crossed over.  A Frequently Sampled Intravenous Glucose Tolerance Test (FSIGT) was conducted to evaluate the level of insulin resistance before and after each treatment.  The ponies' body weight, body condition score and cresty neck score were also assessed. They did not change during this study.

Ray Boston MSc PhD is Professor of Applied Biomathematics in Clinical Studies at the University of Pennsylvania's New Bolton Center. He analyzed the data using MinMod, a computer program to calculate glucose effectiveness and insulin sensitivity from the frequently sampled intravenous glucose tolerance test, and Stata 10.1 statistics analysis software. No change in insulin sensitivity or glucose dynamics was seen under the control conditions or in response to the dose of metformin given in this study to these ponies.  

What does this study mean to horse owners? Clare Barfoot RNutr is the research and development manager at the British feed company Spillers®; she reviewed the research and said: “Although clinical trials with metformin are ongoing, this trial was consistent with our previous work showing that the bioavailability of metformin in horses is poor, and chronic dosing at these levels may not achieve therapeutic blood concentrations.”

She continued: “On this basis it would seem that a fiber-based diet that is low in starch (found in cereals) as well as  (being low in) sugar and fructans (found in grass), in conjunction with regular exercise if possible, is still the safest and most effective way to manage insulin-resistant ponies. It is important to recognize that, even if other doses of metformin are shown to be beneficial in the future for certain sub-groups of animals, full consideration to diet and management should remain a key tactic.”

The Waltham® Equine Studies Group, headed up by Dr Pat Harris MA PhD, VetMB DipECVCN MRCVS, provides the scientific support for the Spillers® and Winergy® brands sold in Great Britain.

To learn more: K. D. Tinworth, R. C. Boston, P. A. Harris, M. N. Sillence, S. L. Raidal, G. K. Noble (In press). The effect of oral metformin on insulin sensitivity in insulin-resistant ponies The Veterinary Journal; Available online 23 February 2011, doi:10.1016/j.tvjl.2011.01.015.

Thanks to Spillers for sharing this information with Hoofcare and Lameness.

© 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 the Hoof Blog 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.

Hoofcare & Lameness Presents World Horse Welfare's Laminitis Video Conference (Part 1)

Welcome to an amazing educational opportunity. World Horse Welfare and feed company Dodson and Horrell have created a series of videos from their recent "laminitis roadshow" conference in Great Britain and the Hoof Blog will be posting the videos here for you to watch at your leisure. This first brief video is the introduction and summary, featuring equine nutrition researcher Teresa Hollands of Dodson and Horrell.

In this first "feature-length" 24-minute video, you will meet Professor Derek Knottenbelt, who is no stranger to readers of Hoofcare and Lameness Journal. His article on pemphigus (sometimes called coronary band dystrophy and the subject of more articles to come) is one of the most popular articles ever published by Hoofcare and his work on hoof diseases is extraordinary in the way he integrates research and treatment with other areas of medicine.

Professor Knottenbelt was recently a guest speaker at Tufts University's Cummings School of Veterinary Medicine and I highly recommend him as a speaker. You'll see why when you watch this video, which includes one of his clever improvisational dramatizations--he becomes the hoof's laminar bond!  His simple explanation takes the mystery out of insulin resistance and how it is involved in the mechanical collapse of the foot in laminitis; this video also helps with explaining many other key concepts of laminitis and its prevention for horse owners.

More videos from the road show conference will be added to the blog in the next few days. Please watch them all, share them all, and refer back to them.

Many thanks to World Horse Welfare and Dodson and Horrell for their leadership in laminitis education for horse owners. This is critical information that needs to circle the world, wherever horses can be cared for in a way that helps prevent laminitis. It is, after all, a preventable condition in most cases and so much pain and suffering could be spared if horse owners can be educated about management practices.

© 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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Laminitis Research from the Field to the Feed Room

Research by Bridgett Byrd (M.S., PhD candidate) at Virginia Tech, was used to create this graph. It shows that pastures at certain times of year have specific times of the day when plants contain high levels of non-structural carbohydrates (NSC). This is effectively mirrored by the insulin concentrations of the horses grazing on such pastures, in a similar way to the feeding of high starch and sugar diets. While this research has been available for the past few years, many horses owners have not been informed of the cumulative effects of long-term high-sugar diets on horses, particularly on sedentary recreational horses. (Graph and caption credit Virginia Tech.)

Remember the image in that graph. We have just turned the calendars to March, so spring will soon be here and the time is here to start planning how horses will be managed on spring grass.

This year, thanks to increased educational efforts, many horse owners are seeking advice on how to avoid laminitis caused by spring grazing. Many horses suffer annual bouts of laminitis that can adversely affect the horse’s soundness for months, or may develop into serious chronic laminitis with its many problems.

Nutritional experts, however, caution that laminitis and insulin resistance are year-round problems and that a horse's entire feeding program should be scrutinized, not just the turnout on pasture.

The Waltham® Equine Studies Group, led by Dr Pat Harris MA PhD, VetMB DipECVCN MRCVS, offers this summarized explanation: “Turning certain ponies out onto lush pasture in the spring and autumn is a common triggering factor for the development of laminitis. It is currently thought that high levels of water soluble carbohydrates, (which include simple sugars as well as Fructan – the more complex storage carbohydrate) – and/or starch may be involved in this process.

"Previous research carried out in collaboration with Virginia Tech by the Waltham® Equine Studies Group in 2004 confirmed a link between insulin resistance and laminitis. This work demonstrated that a high starch and sugar diet, that causes corresponding peaks and troughs in glucose and insulin, increases the degree of insulin resistance.

Dr Harris continues: “The new revelations linking pasture directly to the potential risk of insulin resistance have important consequences for certain horses and ponies prone to laminitis and tying up, as well as obese animals that will already have a greater degree of insulin resistance. For these animals it is likely to be safer to feed alternative sources of forage at key times of year.”

Last month, Florida-based Seminole Feeds announced that it would no longer be the US distributor for Spillers brand feed products, which are developed with Waltham research principles. “Happy Hoof”, a high-fiber alternative to high-sugar hay, was one of the products sold by Seminole in the USA. Seminole has launched a new line of low-starch feeds under its “Wellness” label.

Hoofcare and Lameness does not have much information at present for horse owners "orphaned" by the dearth of Spillers products in the USA.

Maine-based Lucerne Farms, makers of the Dengie product lines of alfalfa-based chopped hay in the USA, is now offering high-fiber, low-sugar products for horses at risk for laminitis. The company also offers excellent customer support.

AAEP Statement on FDA Withdrawal of Pergolide for Human Use: Will It Still Be Available for Horses?

The American Association of Equine Practitioners (AAEP) has issued this statement to its members about the potential crisis of pergolide's removal from the drug market.

"As you may be aware, the FDA has withdrawn the drug pergolide from the market for use in humans. In order for the drug to continue to be available for use in veterinary medicine, the FDA must approve an exception for pergolide to be used by veterinarians and to be compounded in bulk quantities.

"The AAEP, through its Drug Compounding Task Force, has been in contact with the FDA, and they are aware of the significant impact of pergolide’s withdrawal from the market on equine medicine. The FDA Center for Veterinary Medicine is working with its counterpart for human medicine, the Center for Drug Evaluation and Research, to allow importation of pergolide for use by compounding pharmacies. The FDA expects to have an official announcement by the end of this week.

"The AAEP will continue to communicate with the FDA on this issue."

Note to blog readers: Pergolide is a drug that has been found to have some problems in human use; it is often prescribed for Parkinson's disease. Pergolide has been very helpful to some older horses suffering from problems like Cushings disease or insulin resistance that may have laminitis as a side effect. Many horse owners are concerned about a shortage of the medication for their horses.

Please read my original post from March 30 for more information.