Equine Hoof Lameness, Laminitis Survey Results from British Study; Statistics Announced at National Equine Forum

Great Britain's Princess Royal addressed the National Equine Forum, where new statistics on horse health were presented.

The 19^th National Equine Forum (NEF), held in Great Britain on March 8, 2011, was the launch pad for the results of the United Kingdom’s first public National Equine Health Survey. The event was attended by over 200 of the country’s most influential members of the equestrian industry, including NEF President HRH The Princess Royal, leading equine vets, international riders and trainers, equestrian society figureheads, business leaders and numerous members of the equestrian trade industry.  

Josh Slater, Professor of Equine Clinical Studies at the Royal Veterinary College and immediate past president of the British Equine Veterinary Association (BEVA), announced the results of the survey, which was pioneered by The Blue Cross animal charity and is supported by BEVA. The survey was conducted in November 2010.

The survey, which was pioneered by The Blue Cross animal charity and is supported by The British Equine Veterinary Association (BEVA), was carried out last November following two years of pilot schemes. The intention was to find out more about endemic non-notifiable equine diseases that have never before been recorded, such as coughs, skin diseases and lameness.

The results were announced at the Forum by Professor Josh Slater, Professor of Equine Clinical Studies at The Royal Veterinary College, who has been working with The Blue Cross on the survey.

Analyzed data from the study will be used to pinpoint current, non-notifiable healthcare issues affecting horses, ponies, donkeys and mules in the UK and is expected to break new ground for all of Europe as well.

Professor Slater explained that the survey should provide a future benchmarking facility for equine disease, welfare, standards of care and codes of practice and it has also confirmed the workability of an important template to monitor the serious threat of infectious and exotic disease in the future.

Laminitis cases still abound in Great Britain; this dramatic photo of a medial sinker from the case files of farrier Jim Ferrie FWCF is evidence of that. Jim provides consulting services at the University of Glasgow's Wieper Equine Hospital. (Jim Ferrie photo)

A total of 306 sets of records were submitted from 3120 horses in mainly private ownership, with a balance of representation from competition yards, riding schools, welfare charities and studs. A broad range of syndromes and diseases were assessed including colic, sarcoids, laminitis, wounds, dental issues, eye disease, lameness and weight issues.

Equine lameness statistics also figure prominently in the survey and show some variation from oft-quoted statistics about soundness problems in horses.

The results showed that lameness was the most common problem affecting horses (11% of horses surveyed) but that, unexpectedly, the foot was not the most common cause of lameness and that laminitis (3%) was less common than the 7-8% total that previous surveys had suggested.

Weight management was the next most common issue for horse owners, with 9% of horses recorded as overweight and 8% as underweight.

The new statistics are not far from those compiled in the study Equine laminitis in the new millennium: frequency, risk factors and assessing a potential new therapy by Claire E. Wylie et al, presented at the 2009 meeting of the Society for Veterinary Epidemiology and Preventive Medicine. Wylie found that  laminitis cases contributes to between 0.11‐28.57% of all equine visits analyzed by veterinarians who participated in her study, with a mean of 5.03% and a median of 3%.

The most often quoted statistics from Britain are from Hinckley and Henderson's 1996 paper presented at the 35th Congress of the British Equine Veterinary Association. (See Hinckley, K.A. and Henderson, I.W. 1996. The epidemiology of equine laminitis in the UK in the 35th BEVA Annual Congress Proceedings) That paper stated: From a study involving 113,000 horses in the UK it was estimated that the total prevalence of acute laminitis in the UK was over 8,000 cases annually, giving a prevalence of 7.1%.

Anyone who reads this blog knows enough to see little red flags popping up right away: there is a big difference in a study like Hinckley's that tracks cases of acute laminitis with a study of all cases of laminitis, like the National Equine Health Survey's, as reported by horse owners.

Many horses who suffer from mild chronic laminitis never get treated and may never even have an official diagnosis. (VetMoves photo)

Another study that is often quoted found a much higher prevalence of laminitis in Great Britain around the same time. Katz surveyed the health of horses at a large charity farm with a population of 1140 horses and ponies, and found an average of 148 episodes of laminitis (prevalence of 13%) occurring each year (between 1997 and 1999), involving 113 animals. (See Katz L, DeBrauwere N, Elliott J, Marr C, Pfeiffer D. The prevalence of laminitis in one region of the UK in Proceedings of the 40th British Equine Veterinary Association Congress.)

None of these statistics really add up. I have often heard Katz's 13% quoted as the nationwide prevalence of laminitis in the UK, when he was actually studying a population of horses that might rightfully be expected to have some sort of laminitis, related to age or neglect circumstances that required their removal to a charity farm. Were those horses a suitable population to use as a sample of the entire national population of horses?

Hinckley's statistics have always been shocking, considering that she was documenting strictly acute cases. Wylie's study, presented as a poster at the conference, does not specify how laminitis was defined. Having her statistic closely matched by the much larger population sampled by the National Equine Health Survey's is encouraging, if their parameters were similar.

That said, a lot depends on when a survey is conducted. Some years have much higher numbers of cases because of weather conditions that encourage grass-related laminitis. The problem with this study's result is that it is tempting to say that education, medication and horse-owner awareness are kicking in and more horses are avoiding laminitis than in the past. But then we immediately see that 9% of the horse population is overweight, and can only wonder if that figure is up or down from previous periods. If that number is down as well, then all the hard work of vets, farriers, feed companies and charities is having an effect and horses in Great Britain are in a lot less pain now than they were 15 years ago. Maybe.

Here's a brief slide show summarizing the National Equine Health Survey in Great Britain (click on right to advance slides):

An interesting extrapolation from the study is that 18 percent of the horses had a problem with weight management (either under- or overweight) vs 11 percent who had suffered from lameness. It's possible that the actual weight problem is much higher, since the statistic allowed the owner to judge his or her own horses' weight suitability.

To clarify the location of lameness: it may sound like news that lameness in the foot was lower than expected, but it should be made clear that lameness location was divided into three groups: foot (3.7%), non-foot (4.5%), and laminitis (3%). If you consider laminitis a lameness of the foot, the combined total would be quite a bit higher than non-foot sources of lameness. However, for the purposes of the study, the statisticians were probably trying to keep their categories separate.

Meanwhile, the British Horse Society reports that its 2011 Laminitis Conference, planned for the end of this month in conjunction with Dodson and Horrells, has been sold out and no more registrations can be accepted.

It's so difficult to compare statistics from different studies or to say that one is the definitive measurement of the most pressing equine health issues. It sounds like the new National Equine Health Survey could be on its way to being the one-stop source for horse health statistics in Great Britain. While it's easy to wonder about the validity of horse owners' judgments about things like their horses' conditions, it's more productive to congratulate the Blue Cross and BEVA for undertaking such a massive effort, and for getting it done. And, most of all, for making the results available to the public. Thank you!

About the Forum: The National Equine Forum is chaired by Professor Sir Colin Spedding and is convened by Miles Williamson-Noble. It is usually attended by HRH The Princess Royal, its President, and is supported by the Association of British Riding Schools, Bedmax, The Blue Cross, British Equestrian Federation, British Equestrian Trade Association, British Equestrian Veterinary Association, British Horse Society, British Horseracing Authority, Bulley Davey, Darby’s Solicitors, Dodson and Horrell, Donkey Sanctuary, Equine Products UK,  Horse Trust, Jeffress Scholarship Trust, NFU Mutual Insurance, South Essex Insurance Brokers, Weatherbys and World Horse Welfare.

Photos of The Princess Royal and Professor Slater courtesy of the National Equine Forum/Craig Payne Photography.

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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.

Arkansas Veterinary Practice Act Definitions Sought for Guiding Exclusion of Farriers, Tooth Floaters, Other Professions

This video requires Silverlight, a Microsoft video interface. 

Before you click "play" on the video, please take a minute to read this text so you will know what you are watching.

It's time for the politics of horsecare again. Or is it the politics of veterinary care?

We're back in Little Rock, Arkansas, and here are the gentlemen of the House Agriculture, Forestry & Natural Resources Permanent Subcommittee of Agriculture. They need to review all bills under their jurisdiction before they are presented to the legislature. We met them before, in late January, when they heard testimony on House Bill 1099 (video of that hearing is also posted). H.B. 1099 would have exempted a long list of animal care professionals from the all-encompassing but loosely defined description of veterinary medicine in the Arkansas Veterinary Practice Act. That bill was not voted forward by the committee.

So Representative Gary Smith came back again on March 9, with House Bill 1712. This bill was much more specific and only dealt with horsecare. In particular, 1712 would have exempted massage therapy, tooth floating, and farriery and hoofcare, although it would have created a state certification program for equine dental technicians.

The video you'll see in this video begins as the hearing for House Bill 1712. It, however, morphed into a presentation of a second bill; likewise, farriery and hoofcare morphed into "the lawful practice of horseshoeing". There is considerable discussion of what the lawful (or unlawful) practice of horseshoeing might be.

This is a very long discussion, but probably worth your time to have a listen. The second bill, known as House Bill 1763, was received more favorably and seems to be a compromise favored by the state veterinary board. Please note, however, that HB1763 is marked by the state government as "re-referred to committee" on the official state web site rather than approved. Reports in the press indicate that the bill was approved. This is a discrepancy.

For those who don't want to go through the video, the second bill went through an amendment process, in part to clarify the description of horseshoeing. The bill was amended to read: Arkansas Code § 17-101-307(b), concerning the practices that are excluded from the practice of veterinary medicine, is amended to read as follows: (b) This chapter shall not be construed to prohibit: (8) Any person: (A) Engaging in the art or profession of horseshoeing.

The meeting to amend HB 1763 was not videotaped, or the video is not available to the public.

If HB 1763 passes the legislature, it does not exempt massage therapy and tooth floating indefinitely; it only gives them a two-year moratorium from cease-and-desist orders from the veterinary board. After two years, some other bill should be waiting in the wings to take over, or these horse professionals may not be able to work in Arkansas.

Hopefully other states can learn from what is going on in these midwest states (Oklahoma and Texas are two other states with recent legislation) as they struggle with the interpretation of what veterinary medicine is, and isn't. According to the existing law in many states, veterinary medicine pretty much encompasses all care of animals. The time to have exempted professions was back when the draft veterinary practice act was introduced, but no one's ears were up then, or else no one ever thought that cease-and-desist letters would be sent out.

It seems pretty obvious that efforts to combine large and small animals or even cattle and horses, or to combine different professions makes it difficult for legislators and for people from agencies and businesses who would testify. It may be that it's every profession for itself. Arkansas has proven that quite clearly.

Another thing that seems obvious is that the legislators are looking for highly credible testimonies on these subjects. There's no question that they don't know much about the flow of services, or what happens when a horseowner needs some work done on a horse.  Before this legislation came up, they probably never gave it a thought beyond the fact that they knew that veterinarians make barn calls. They're getting an education and they're learning that the horse industry in their state employs a lot of people on a lot of levels. And it takes a support crew of professionals of many descriptions to keep a stable of horses adequately prepared for showing, racing or even just recreational riding.

No one who is elected by public votes wants to put people out of work, yet the state government is in the business of enforcing the laws and legislation it has on its books. These legislators have to stand behind their government's previous actions. Change may be necessary, but it may also be incremental...and painstakingly slow.

If I lived in Arkansas and was working in any of these professions, I think I would slow the process down even further and ask for more amendment to HB 1763 by defining each of the professions the way that tooth floating is defined. If someone has a natural hoofcare practice and does not engage in horseshoeing per se, is he or she not exempt? Must a shoe be on the horse for this law to stick? Now's the time to find that out, not when a cease-and-desist letter arrives in the mail. And to get it printed in the bill, not in a verbal assurance.

Maybe you're one of the people affected by legislative rumblings in Arkansas or other states. Maybe you're hoping this will just go away. Be careful what your wish is: it will be back, if people care about preserving your profession. If no one cares, your profession may be lost in a legislative or legal shuffle one day, and your livelihood along with it.

 © 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 Prevention Research: Ponies Adapt to Grazing Time Reduction by Eating More in Less Time

Recent laminitis prevention research soon to be presented at a biannual nutrition meeting in the United States suggests that ponies given reduced access to pasture are capable of ingesting considerable amounts of herbage during the time they are turned out and may indeed increase their intake during this time as they become accustomed to the routine.

Intake of large amounts of fructan and other rapidly fermentable carbohydrates by grazing ponies has been linked to the development of laminitis. As a result, it has become common practice for horse owners to follow advice from researchers, farriers, veterinarians and nutrition experts to restrict their ponies’ access to pasture, especially at key times of the day/year in order to reduce the risk.

The study, which was conducted at the Institute of Biological, Environmental and Rural Sciences (IBERS) at Aberystwyth University in Wales, in collaboration with the WALTHAM Equine Studies Group, aimed to investigate the effect of grazing restriction on herbage intake and grazing behavior in ponies.

The grazing behaviour of eight ponies was measured daily over a six-week period to assess their voluntary intake of herbage and to monitor the effects of restricting their access to pasture. Two groups of four pony mares were used. Group A had 24-hour access to pasture while the ponies in group B had three hours of pasture access per day and were stabled for the remaining 21 hours, with ad libitum access to haylage and water.

Herbage intake was estimated during the three hours when all the ponies were at pasture by monitoring the change in weight of each individual over the period. Grazing behaviour was analysed from video footage of the two groups using interval sampling. The ponies in group B had higher estimated grazed herbage intakes than those in group A during the three hours studied and this difference was significant during the final week, when they consumed 40% of their total daily dry matter intake as grass in the three hours at pasture. This compared with an intake of grass of around 25% of their daily dry matter ingested during the first week.

Clare Barfoot RNutr is the research and development manager at SPILLERS®, the British feed company. On learning of this research, she said: “This suggests that ponies with reduced access to pasture are capable of ingesting considerable amounts of grass during the time they are turned out and may indeed progressively increase their intake during this time, indicating that the behavior could be learned. The implication is that reducing ponies’ time out on normally managed pastures with the view to limiting the intake of rapidly fermentable carbohydrates may not be as effective as first thought.”

Reference: J. Ince, Institute of Biological, Environmental and Rural Sciences (IBERS). Aberystwyth University; A. Longland, ELNS, Pantafallen Fach, Tregaron, SY25 6NG C. J. Newbold, Institute of Biological, Environmental and Rural Sciences (IBERS). Aberystwyth University; ;& P. Harris, WALTHAM Centre For Pet Nutrition. (2011) Changes in proportions of dry matter intakes by ponies with access to pasture and haylage for 3 and 20 hours per day respectively for six weeks. Journal of Equine Veterinary Science (in press)

© 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.

Theo Jansen's Anatomical Inspirations: Abstract Musing Can Help You Understand and Appreciate Hoof Design

Spring is in the air and a hoof blog editor's fancy turns to...kinetic sculpture. 

But you'll soon understand why.

To anyone who says we can't improve on the way that horses are trimmed or shod, or the way that lame and sick horses' legs are treated or cared for, I'd have to say we're just not trying hard enough. And the answer is not likely to come from tinkering with the designs and devices we already have in our hands.

Kinetic sculptor Theo Jansen builds 'strandbeests' out of PVC pipe and turns them out on the wild ranges of the sand on Dutch beaches. The goal is for his perpetual motion creations to become permanent, independent citizens of the sands.

Jansen's kite-like sculptures will trot along the beach on PVC legs and coffin joints.

That's right. He wants to turn them loose. It sounds like he's been watching some fantasy beer commercial where the wild horses run free forever.

You can't help but notice that his sculptures' legs and feet mimic the design of horse' limbs, right down to the single digit and breakover action of forward motion via a rotating distal joint.

I

Maybe Jansen's been reading the Hoof Blog and saw this extreme rocker rehab on a foundered foot from Loic Entwistle's photo files in Germany. I'm sorry I don't have more information about this photo. I don't even know if this is Loic's work. But the image has always intrigued me. It's a thought-provoker.

Think backwards for a minute. What if you could be Jensen and design a new hoof for the horse, one that would be easier to work on, to keep sound, to serve the horse on multiple surfaces, in multiple environments, under a rider's weights, in different sports?

What would your design parameters be for the lower limb and hoof? Where would you start--at the bottom? in the middle? Would you specify a model with replaceable (transplantable or implantable) parts?

There's no doubt that Nature designed an amazing structure that functions organically with perfection when everything's right. Humans just seem to muck it up, in one way or another. Bioengineering is on its way to being able to identify weak tissue structures; perhaps digital cushion implants will be possible soon, or coronary band grafting will allow rehab to be completed in six weeks instead of six months.

I suspect most of us would be happy to tinker with the parts to improve them, but we like the design just the way nature has given it to the horse, and to us to work on, to ponder, to study, to capitalize upon, or to admire.

Maybe we should invite Theo Jansen to watch our horses run on the racetrack. What we'd end up with in return might be a little different than what you''d see him sketch on a drawing board. Imagine a silky, kite-like kinetic sculpture floating around the infield of a dark racetrack at night, under its own perptual power, making eerie music like a chorus of call-to-the-post buglers playing a duet with every foghorn on the coast of Maine.

People would pay to see (and hear) something like that. I think they'd pay to see lots of things he does. Keep an eye on him, and his beests. I think he's trying to tell us something

© 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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Racetrack Horseshoer's Survey Launched by Grayson Jockey Club's Welfare and Safety of the Racehorse Summit

The Shoeing and Hoof Care Committee of the Grayson Jockey Club Foundation's Welfare and Safety of the Racehorse Summit has compiled an online survey to collect data from horseshoers at US racetracks. Information from the survey will be used to assist the committee's efforts to study how horseshoers are licensed by states or racing jurisdictions, and what changes horseshoers feel may be warranted in the system to improve the education of horseshoers and the welfare of the horses in their care.

A sub-committee of the Welfare and Safety of the Racehorse Summit's Shoeing and Hoof Care committee will use the results of this survey to gain information on topics, ideas and structure for a uniform national racetrack horseshoer test for state licensure. The committee feels that this step, which is similar to the Jockey Club's efforts in unifying Thoroughbred racetrack trainers' tests, will raise the bar of horseshoer qualifications and thereby boost the overall safety of the racehorse.

Hoofcare Publishing and The Hoof Blog have been asked to help disseminate news of the survey into the Thoroughbred racing shoeing community.

The survey is primarily an online questionnaire, and should only take a few minutes to complete.

To preserve the integrity of the survey, only those directly involved with racetrack horseshoeing should fill out the survey. This means: professional horseshoers who earn part or all of their living at the racetrack and are affected by state or track licensing.

An alternative path through the survey is available for trainers, owners, stable employees, racing officials, veterinarians, non-track horseshoers or others who are interested in expressing opinions about the practice of racetrack horseshoeing, but only racetrack shoers should answer the shoeing questions to preserve the survey's validity.

The committee has been collecting information for the past few years on state licensing and tests administered, and has sought the input of racetrack shoers in improving the process of testing new farriers. It is hoped that this survey will be able to reach many more horseshoers at tracks across the country.

A word about the survey: it is an automated program. Once you start to take the survey, you should finish it; you cannot go back and finish it later. The program will also prevent you from answering the survey more than once.

While the survey is anonymous, the Committee would like to hear more opinions from racetrack shoers, and has provided a comment section at the end of the survey for general feedback. Horseshoers are also invited to contact the committee directly to become involved in the efforts of the Welfare and Safety of the Racehorse Summit and the Shoeing and Hoof Care Committee.

Please click on the red survey badge to open the survey:

If viewing on a text-only or mobile device, the direct address of the survey is http://www.surveymonkey.com/s/farriersurvey

If you have any questions before you attempt to complete this survey, please contact Cathy O'Meara at comeara@jockeyclub.com. If you know someone who does not have Internet access but who should take the survey, Cathy will be able to help.

The Foundation has not provided a deadline date for completing the survey, but you should not delay in submitting your answers if you want to have an impact on the decision-making process.

Notification of this survey is provided as a public service by Hoofcare Publishing. Comments left on this blog post, by clicking on "comment" at the bottom of this article, once published, will be visible to anyone visiting this blog but will not go directly to the Grayson Jockey Club Foundation, so please make comments on their survey feedback area as well.

 © 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.

Umbilical Stem Cells Show Promise in Pilot Study at Rood and Riddle Equine Hospital Podiatry Center

What's underneath that hoof cast? The latest laminitis therapy is virtually invisible to the observer, and may often covered with a foot cast.

The following article is provided by the Rood and Riddle Equine Hospital Podiatry Clinic in Lexington, Kentucky.

Background

Laminitis can be a devastating and expensive disease to treat. Today there is no true cure for the disease. However cases can often be rehabilitated back to varying degrees with the aid of therapeutic shoeing, foot management, and medical therapies. Although special foot management can in some cases return horses back to previous athletic use, others remain severely compromised and lame. Once the lamina detaches and the pedal bone displaces, each case heals back with varying degrees of stability. The tissue that heals the separated lamina is a combination of scar tissue, dysfunctional disorganized horn tissue (epithelial cells) and healthy lamina.

Additionally, these cases can suffer permanent damage to the growth centers of the foot such as the coronary band and the sensitive sole, further limiting their ability to heal. The degree of future stability most likely is dependent upon the type of tissue that heals the diseased region.

What are stem cells? What is regenerative medicine?

Stem cells are cells that have the ability to replicate themselves and regenerate tissue. They play an important role in embryonic and fetal development as well as repairing damaged tissue. Isolating these cells and using them for a targeted treatment with the intention to heal a specific area is the principle behind their potential use.

Stem cell therapy or regenerative medicine is an exciting, but relatively new area which has sparked great interest. Its potential use to influence the type of tissue that heals a diseased or damaged area is a great interest to the veterinary community.

How is Rood and Riddle approaching stem cell therapy for laminitis patients?

Rood and Riddle Equine Hospital is currently working on clinical-based research using stem cells on severe laminitic patients which have proven unresponsive to other treatments. The clinical use of stem cells is still in its early stages, but results appear promising and worth further investigation.

Since many laminitis cases can be rehabilitated with other modalities, it was determined to limit our clinical study to those cases which have been unresponsive to all other treatments. These cases failed to show sole or wall growth after shoeing, foot casting, slinging and, in many cases, after deep digital flexor tenotomy.

Stem cell therapy is an adjunctive therapy, used in conjunction with extensive medical and mechanical treatments. To date, Rood and Riddle's laminitis-specialist veterinarians selected cases based on poor response to the disease's normal treatment protocols at the clinic. (Fran Jurga photo)

To date we have used stem cell therapy on twelve cases as an adjunctive treatment. All but one case has responded with significant sole and wall growth in the affected feet. Typically signs of growth were evident within two weeks.

The one case that did not respond was a severe acute “sinker” (lamellar failure or detachment occurs around the entire hoof capsule causing the coffin bone to “sink”) ; the horse was sloughing the hoof and had severe soft tissue necrosis before treatment.

It is important to note that stem cell therapy alone will most likely offer little benefit in the unstable cases. As with all therapies these feet will require special management (shoeing, casting, sling, and DDF tenotomy) to help stabilize and support the foot while it is healing.

The stem cells used in Rood and Riddle's clinical laminitis research are harvested and cultured from the blood in umbilical cords of foals. (Joanna8555 photo)

Umbilical stem cells from newborn foals

Rood and Riddle's Stem Cell Lab is currently harvesting cells from the umbilical cord blood of newborn foals. Umbilical cord blood is collected at the time of birth, which provides a pool of stem cell which can be cultured and expanded for clinical use.

When these cells are used as a treatment on another horse, they are considered allogenic (from a donor) with the possible risk of rejection. However, no reactions in our cases have been noticed.

Stem cells can also be collected from fat or bone marrow and used specifically for that horse if needed. The best source of cells, timing, dose, administration, and route still need to be determined.

Case Study from Rood and Riddle Equine Hospital's Podiatry Clinic

The following case is a severe bilateral front foot sinker. This case had a deep digital flexor tenotomy, foot cast, and partial hoof wall resection. She failed to show any signs of wall or sole growth over a two-month period of time.

Stem cell therapy and foot casts were applied on both front feet as a last effort to save her. Within two weeks she showed signs of healthy wall and sole growth and improving her comfort level. Currently this mare is doing well; it has now been six months since treatment and she is turned out in a small paddock.

Left and right foot radiographs before treatment. Stem cell therapy was begun at this time along with foot casts and antibiotics.  Two weeks later the coronary band and sole began to show healthy growth.(Scott Morrison images)

These are radiographic images of a 10 year old thoroughbred mare with severe sinking of both front feet before and after stem cell therapy. The mare was treated with deep digital flexor tenotomy, foot casts and partial wall resections. The foot did not show any signs of improvement for over 2 months.

 This photo was taken at six weeks post stem cell treatment. Note the new, healthy wall growing from the coronary band. (Scott Morrison image)

Left and right feet six months after therapy with umbilical stem cells. (Scott Morrison images)

Watch for more news about the use of umbilical and other stem cells in horse foot problems.

Rood and Riddle Podiatry Clinic veterinarians working on the stem cell treatment cases mentioned in this article are (from left to right) clinic director Dr Scott Morrison, Dr Vern Dryden and Dr Raul Bras.

TO LEARN MORE: The Second Annual North American Veterinary Regenerative Medicine Conference (NAVRMC) is scheduled for June 2-4, 2011, at the Marriott Griffin Gate Resort in Lexington, Kentucky.  Held in collaboration with the University of California at Davis Center for Equine Health, Alamo Pintado Equine Medical Center and Rood & Riddle Equine Hospital, the NAVRMC is a three-day working meeting consisting of scientific presentations and discussion sessions on all aspects of stem cell therapy and regenerative medicine in horses and small animals.

The conference will bring together researchers and practitioners to discuss and apply this promising area of veterinary medicine. Topics will be a blend of research and practical application discussions.

New to the NAVRMC in 2011 is a special session for horsemen. The half-day forum, set for June 4, is open to all horse owners, trainers, and equine professionals who are interested in learning more about this rapidly growing area of veterinary science.

For complete NAVRMA sponsorship information, membership fees, and conference registration please visit www.navrma.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.
 

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