Showing posts with label syndrome. Show all posts
Showing posts with label syndrome. Show all posts

Monday, August 27, 2012

Research Update: Hoof Wall Separation Syndrome in Connemara Ponies



A slide show of affected hooves from around the world; these hooves are all on Connemara ponies, although it is not known if this particular type of wall separation is limited to that breed.

Few hoof problems have been as compelling as the relatively-recent one known around the hoof world as "Connemara hoof wall separation syndrome". Owners of the affected horses would prefer that it be called "hoof wall separation syndrome".

Wall separations are commonly seen in the heel area of hooves, but this is different.

At first, it was easy to dismiss the communications as white line disease or just poor hoof maintenance. But they kept coming back. Soon they had amassed evidence of Connemara ponies with this problem from places as far afield as New Zealand, Finland, and Canada.

Robert Eustace of the Laminitis Clinic in England described the problems as "coconut matting hooves". I thought that was an apt description; in some cases, the inner, exposed hoof wall looked like steel wool fibers. Many cases of this type of dorsal hoof wall separation deteriorate to a diagnosis of laminitis.

According to the owners' group, hoof samples of affected Connemara ponies referred to Eustace for treatment were analyzed by the University of Edinburgh, where they found a malfunction of lipid metabolism in the extracellular matrix of the hoof wall between the tubular structures of the hoof wall.

In simple terms: there seems to be a lack of the 'waterproof glue' or 'cement' that holds the hoof wall tubules together, but the findings have not been documented. Nothing about the condition has been documented, other than by horse owners comparing notes.
This image from UC Davis shows a ruler used to measure the extent of a separation lesion on a foot from a cadaver.
Soon, the inevitable Facebook discussion group popped up. It became part of a web of information and communication that included a blog, press releases, and many promises that they would get to the root of the problem.

They may not have reached the root but they are cracking the case. If you have a pet problem in the hoof world and you are sure that there has to be an answer, let this group of dedicated horse owners give you a model to follow.

This hasn't been easy. On  November 11, 2011, I interviewed a regional president and another officer of the American Connemara Pony Society who assured me that they had never heard of the problem and it was surely just a misunderstanding. A veterinarian concurred.

In their defense, this problem is widespread geographically but still relatively uncommon. Since then, owners tell me, the Society has become aware of the problem. It is also possible that owners whose young stock exhibit this problem are not likely to bring them to shows or to comment much about the problem, in the interest of the value of their other horses.

The Connemara owners scattered around the world with lame young horses on their hands eventually found each other, thanks to the Internet. They also found someone who would listen to them. The unraveling of the horse genome has meant that equine disorders that seem to be breed-specific can be examined on the genetic level, so researchers at the Bannasch Laboratory at the University of California at Davis were able to tackle the problem from that angle. (See below for specifics of the genetic assay.)

When a case cropped up near the university and they saw the problem firsthand, they were even more interested.

Is this problem really limited to a single breed? I remember old farrier texts that complained about mice nibbling on the hooves of certain horses at night in the stable--that was a convenient explanation to owners for a problem that looked like the photos you see in the slide show.

A confounding aspect of the problem is that it occurs in radically different environments, without respect to wet or dry, hot or cold, and appears early in the pony's life.

One Connemara owner remarked, "I am seriously starting to think that this issue is probably quite widespread in the general horse population but appears so randomly that it is acknowledged just as 'bad feet with no known cause'. It is only when one has a small inbred population with the over use of certain bloodlines in an already contracted gene pool that the problem becomes more common and obvious.

"Once there is a commercial gene test available, it will be interesting to see whether there is the same or similar problem in other breeds."

Because the cases are farflung, documentation of treatment is sparse. In most cases, some combination or variation of supportive hoof orthotics, foot casts and glue-on shoes along the lines of laminitis treatment are used. Various topical treatments and nutritional supplements have been used. These efforts are under the heading of managing the condition; euthanasia is common.

An example of the type of hoof wall undermining labeled "Hoof Wall Separation Syndrome" by the University of California at Davis, where research is continuing into this problem.

Updated research summary provided by the University of California at Davis School of Veterinary Medicine

Researchers at the Bannasch Laboratory at UC Davis report:

Hoof Wall Separation Syndrome (HWSS) is an inherited condition seen in Connemara ponies and typified by the dorsal hoof wall splitting away from underlying structures.

This hoof defect develops in young foals between one to six months of age. The condition results in afflicted ponies having to support weight on the sole of the hoof instead of the dorsal hoof wall. 

Affected animals can become severely painful despite careful management; their quality of life can diminish and euthanasia may be necessary. Even if the condition is initially controllable, ponies may still develop laminitis over time.

HWSS is particularly troubling for the Connemara community because the parents of affected ponies are themselves completely unaffected. 

Although affected individuals do share common bloodlines, it is problematic to predict whether a particular breeding will produce a foal with unhealthy hooves. Investigation into the underlying genetic cause of HWSS has the potential to inform these breeding decisions, and could also provide insight into the disease pathophysiology.

To investigate the underlying genetic cause of HWSS, a genome-wide association study was performed and a strong association between disease status and polymorphisms in a two-megabase (Mb) region of the genome was observed. Sequencing of candidate genes within this region is currently underway, and any functionally relevant genetic differences identified will be validated using a larger sample set.

Consequently, we are still collecting DNA samples from both affected and unaffected Connemara ponies. If you are interested in submitting a sample, please contact Carly Stevens (cstevens@ucdavis.edu) or Kartika Jayashankar (kjayashankar@ucdavis.edu) for more information.

Funding for this research has been provided by the Morris Animal Foundation, UC Davis Center for Equine Health, and Merial.

Information for this research summary was provided by the Bannasch Laboratory at the University of California at Davis.

Thanks to all the heartbroken Connemara pony owners who faithfully documented their horses' problems and to all the vets and farriers who have tried to help them, even if they couldn't explain the problem. Maybe someday they will.


Click on the ad for more information about this anatomy chart that shows the zones and structures affected by HWSS.

To learn more:
Connemara pony research into hoof wall separation syndrome blog
California case seen by veterinarians at UC Davis 
Functional design of horse hoof keratin by Bertram and Gosline
Isolation, characterization and pressure response of equine hoof keratinocytes by Alanna Chaudhry
Click to download full details and ordering information.



© 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.

Saturday, March 03, 2012

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.  
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 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.

Thursday, November 03, 2011

Prascend® PPID (Equine Cushings Disease) Treatment Approved by FDA for US Horses


Maybe I'm biased, but I thought that the CSI (Cushings Scene Investigation) ad run by Boehringer-Ingelheim Vetmedica in British horse magazines was the most clever horse ad so far this year. It heralded the introduction of Prascend to treat Cushings-suffering horses; Prascend will soon be available in the USA.

The following press release is not an ad, it is published here as a "heads up". Anyone involved in the world of Hoofcare + Lameness is going to hear about this. Farriers and veterinarians will be asked questions by horseowners about this medication, and you need to know about how pergolide has evolved into Prascend®.

Prascend has been available in the United Kingdom for a few months, and Boehringer-Ingelheim Vetmedica has launched an awareness campaign there to urge horse owners to have their horses tested for PPID. I don't know yet what B-I has planned in the USA, but I feel confident in saying that "this is news".

In 2007, this blog reported that a potential crisis loomed for horseowners who were treating the symptoms of their horses' PPID condition with Permax (pergolide). (See links at end of this blog post.) The medication was taken from the market temporarily because of problems with human prescriptions. Before long, it became available again in the compounded form, which many horse owners ordered directly and in different forms.

Compounding pharmacies have been at the center of a controversy in the veterinary industry. At this time, it is too early to give a reliable answer whether compounded (and less expensive) pergolide will remain an option for horseowners as pill-only Prascend enters the marketplace. Ideally, horseowners will have safe and multiple alternatives to keep their horses comfortable.

Much more information will be available at or following the AAEP Convention in San Antonio later this month.
 

Everyone can recognize the advanced PPID (Cushing disease) horse. But laminitis and stretched white lines in younger horses may not seem to be related to PPID until much later, when a definitive diagnosis is made. Only careful testing will discern if horses without obvious signs suffer from PPID. (photo provided by Dr. Christian A. Bingold)

Boehringer Ingelheim’s Prascend® Approved for PPID in Horses
Product is the first and only FDA-approved treatment for the management of PPID.

ST. JOSEPH, Mo. (November 2, 2011) – Boehringer Ingelheim Vetmedica, Inc. (BIVI), has received approval from the Food and Drug Administration (FDA) to market Prascend® (pergolide mesylate), for treatment of clinical signs associated with pituitary pars intermedia dysfunction (PPID), also known as equine Cushing’s disease.

PRASCEND is the first and only FDA-approved product for the management of PPID in horses. (1) Administered in tablet form, treatment with PRASCEND can improve the quality of life for PPID-affected horses by managing clinical signs and decreasing the risk of complications of the disease, including those that have the potential to be life-threatening.

It is estimated that one in seven horses over the age of 15 has PPID (2) and horses as young as seven years of age have been diagnosed with the disease (3). In addition, up to 70 percent of clinical laminitis cases also may be affected with underlying PPID4. The most common clinical signs of advanced-stage PPID that occur in horses are hirsutism (hypertrichosis) or an abnormal amount of hair growth, abnormal sweating, weight loss, muscle wasting, abnormal fat distribution, lethargy, laminitis, polyuria/polydipsia and chronic/recurrent infections.

“Unfortunately, PPID is not a curable disease,” says Dr. John Tuttle, BIVI equine technical services veterinarian. “However, PRASCEND does offer a safe and efficacious treatment option to veterinarians and horse owners that can help reduce the clinical signs of the disease and effectively improve the quality of life of infected horses.”

While PPID is typically considered a late-stage-of-life disease in the horse, Tuttle adds that with horse owner vigilance and regular veterinary care, the disease may be detected earlier.

“Because the early symptoms of PPID may be difficult to recognize, some horses with PPID may go undiagnosed until the disease becomes more advanced,” says Tuttle. “Through regular veterinary wellness exams, oftentimes the disease can be caught earlier. By beginning treatment in the earlier stages of the disease, we are able to reduce the risk of some of the potential complications associated with PPID, such as laminitis, recurring infections, dental disease and other potential issues of uncontrolled PPID.”


Farriers often notice the early signs of PPID in horses' feet while trimming. As Cushings diseases advances, farriers are challenged to keep PPID sufferers comfortable and manage any flare-ups of chronic lamiitis. (Massachusetts farrier Allie Hayes trimming a Cushings-affected pony, photo © Hoofcare Publishing)

Not only can PRASCEND aid in the management of clinical signs of disease, the FDA approval also assures the product has been thoroughly evaluated for safety and efficacy. In addition, PRASCEND has met the standards set forth by the FDA in regard to production to preserve its identity, strength, quality, purity and consistency from batch to batch, and the product has demonstrated stability and effectiveness over time through a variety of environmental conditions.

“We are excited to offer a treatment option for horses suffering from PPID,” says Tuttle. “We encourage horse owners to continue to work with their veterinarians to find the best treatment for their horse and are confident that PRASCEND can help make a difference in the lives of horses suffering from this disease.”

PPID horses may be quite thin under all that hair. Cushings sufferers are also believed to be more highly perceptible to worms than non-sufferers. Many people clip their long-haired horses to be more aware of body condition. (photo © Hoofcare Publishing)
PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Refer to the package insert for complete product information or contact Boehringer Ingelheim Vetmedica at 800-325-9167.

(Hoof Blog note: A web address should be available soon.)

Reference:
  1.  PRASCEND® (pergolide mesylate) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
  2. McGowan TW, Hodgson DR, McGowan CM. The prevalence of equine Cushing’s syndrome in aged horses. In: Proceedings from the 25th American College of Veterinary Internal Medicine Forum; June 6–9, 2007; Seattle, WA. Abstract 603.
  3. Schott HC. Pars pituitary intermedia dysfunction: challenges of diagnosis and treatment. In: Proceedings from the 52nd American Association of Equine Practitioners Annual Convention; December 2–6, 2006; San Antonio, TX.
  4. Donaldson MT. Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis. J Am Vet Med Assoc. 2004;224(7):1123–1127.

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 TO LEARN MORE


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

Pergolide Cleared for Equine Veterinary Use by FDA

Laminitis Research: Australian Breakthrough on Insulin Function in Equine Foot

Too Fat? Too Thin? British Court Faces Conflict Over "Abused" Horse with Cushings Disease

Cornell Laminitis Research Beneficiary of Arabian Horse Foundation Grant to Study Genetic Markers in Equine Metabolic Syndrome and Cushings Disease

Equine Pituitary Dysfunction Test Choices Analyzed by New Bolton Center's Jill Beech VMD

Three Chimneys Farm Works to Help Slew 'o Gold Keep His Cool



© 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.

Wednesday, June 29, 2011

Nicholas Frank, Noted Laminitis Researcher, Will Chair Tufts University's Cummings Vet School Department of Clinical Sciences

(Edited from press release)

Nicholas Frank, DVM, PhD, DACVIM, an equine clinician and researcher with expertise in laminitis, metabolic syndrome and endocrinology, has been named the chair of the Department of Clinical Sciences at Tufts University’s Cummings School of Veterinary Medicine.

As chair of the veterinary school’s largest department, Frank will lead a group of nearly 50 academic and clinical faculty who serve clients in the Cummings School’s hospitals, teach throughout the Doctor of Veterinary Medicine program, and undertake ground-breaking research to improve animal and human health.

Dr. Frank
Dr. Frank comes to Tufts from the veterinary faculty at the University of Tennessee, where, as an equine internist, he was section chief of large animal medicine and led the Center for Equine Veterinary Research. He is an award-winning teacher and also serves as a consulting member of the University of Nottingham faculty in the United Kingdom. Dr. Frank has excelled as a clinician-scholar in the field of equine internal medicine and endocrinology.

“To join Tufts as department chair of such a talented and accomplished faculty represents a wonderful challenge and a true honor,” Frank said. “Several of Tufts’ clinical programs are renowned nationally and worldwide, and I look forward to building upon the clinical, research, and teaching programs already in-place.”

Hoof Blog Note: Dr. Frank is the lead author of this Consensus  Statement on Equine Metabolic Syndrome (EMS) for the American College of Veterinary Internal Medicine (ACVIM), as published in the Journal of Veterinary Internal Medicine.  The paper is available for download at that link.

Tufts University's Cummings School of Veterinary Medicine is located in North Grafton, Massachusetts.
 

 © 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.

Tuesday, October 19, 2010

Hoofcare & Lameness Presents World Horse Welfare's Laminitis Video Conference (Part 4: Measuring Invisble Body Fat Using Ultrasound to Accurately Determine Body Condition)


Welcome to the fourth in a series of feature presentations designed to help horse owners recognize the signs of laminitis in horses and to work toward preventing endocrine-related laminitis. In this video, laminitis researcher Alex Dugdale, currently at the University of Liverpool's Leverhulme Equine Hospital in Great Britain, talks about the subtleties and shortcomings of traditional body condition scoring.

For years, a simple visual evaluation of a horse has been used to determine a horse's relative body score, and this in turn was sufficient for a veterinarian to tell an owner if the horse might be at risk for laminitis and should be put on a weight management program and avoid excess grazing at high risk times.

But Dugdale is muddying that field considerably by suggesting that horses can appear to be slim--thus earning a mid-range or acceptable body score--but have large amounts of interior belly fat that may be making them susceptible to insulin resistance and, by extension, the potential complication of laminitis. Fat tissue can act almost like a gland in the way that it programs the body's reaction to nutritional stimuli, and reacts in particular to fluctuations of sugar-type nutrients in grasses and feed.

Simply put, some horses and ponies are just plain fat, while others show areas of fat in specific areas of their bodies that researchers have come to associate with a suspicion of equine metabolic syndrome. Now Dugdale is taking that regional adiposity a step further to include invisible fat.

Dugdale suggests using an ultrasound probe to scan a horse's belly lining  to see what sort of fat stores are laid down there. Unfortunately, the scan is not recorded on the video because of lighting problems, so this video is a bit incomplete.

To learn more about laminitis prevention: Watch Part 1 of the series, "The Horse's Foot and How It Goes Wrong" and then go on to Part 2, "Recognizing the Early Signs of Laminitis” and Part 3, Hoof Management and Pain Relief. This series was created by World Horse Welfare, a British charity that organized a series of horse owner conferences on laminitis with the support of Dodson and Horrell, a British feed company that is active in laminitis research.

More information about how to access body condition around the horse's girth is available in this article about laminitis prevention for horse owners on The Jurga Report.

© 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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