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Laminitis

I've personally experienced two first-hand cases of full-onset laminitis with our own horses. The first was with our daughter's first pony, the adorable Molly, a hardy native type who we bought from a gypsy horse trader.

For those of you who know me, you'll know that with me it only takes one look and that's it - I'm hooked. Well, it only took one look to realise that when we went to see Molly she was in the throes of full blown laminitis, and to be honest I think that was the reason I took her there and then and didn't even quibble the price. Apart from the fact that I instantly fell for her, I also knew there was no way I was going to let her stay with her current owner, so Molly came to live with us there and then.

The second time was with daughter's second pony, Dinky. He literally crashed overnight, after we'd only owned him for 6 weeks, and whose management had been entirely lami-preventive. However, by this time we'd moved to an extremely toxic enviroment caused by localised agri crop spraying, and I firmly believe that this was a contributory factor as to why Dinks, as well as our other horses, became extremely sick as a result of their environment. For the full story, read our About chapter.

I learnt so much from Molly and Dinks. When you see how brave and stoic these little ponies are while enduring crippling pain, it’s a humbling experience. Since then, and wearing my EquiNatural hat, I’ve heard many sad stories from our clients and their laminitic horses and ponies. On the positive side, the good news is that laminitis is one of the most researched and studied equine conditions, which is now shouting out two very clear messages :

  • Laminitis can affect any horse, any pony, any breed – including TB’s.
  • Laminitis is preventable.

So, what is Laminitis?

Laminitis is a serious inflammation of the sensitive laminae, or layers of tissue, inside the hoof. It is utterly debilitating, and can afflict any horse, young or old, and any breed.

The laminae have just one item in their Job Description – to secure the pedal bone (the wedge-shaped bone within the foot), also known a the coffin bone or P3, to the hoof wall.

There are two types of laminae in the hoof - the ‘sensitive’ which supports the pedal bone, and the ‘insensitive’ which is attached to the inner hoof wall – and they bind to each other to protect the pedal bone. However, when a ‘trigger’ happens further up in the system which causes the laminae to inflame (known as ‘acute’ laminitis), the function and form of the hoof as a whole can potentially be compromised. If not caught in time, the progression of laminitis from ‘acute’ to ‘chronic’ can be swift, and severe.

Until 2012, laminitis was only ever thought of as a hoof disease, then in 2012 that all changed with research showing that chronic laminitis was not just limited to the foot, specifically that the digestive and immunity systems were also affected, and that it should now be considered a 'multi-system' disease. This is all the more important, considering that the usual conventional vet/farrier route was simply to focus on making sure the hooves were comfortable, without considering preventative measures for the gut and immune systems.

Chronic cases are termed as such due to the displacement, or sinking, of the pedal bone, also known as ‘rotation’, although in reality it doesn't actually rotate. The bond between the sensitive and insensitive laminae separates, which means the outer hoof wall can no longer support the leg bone structure and weight of the body within the hoof which is seriously major. The pedal bone then becomes loose in the hoof structure, and the hoof structure itself becomes ‘mobile’. The horse’s bodyweight, together with added pressure from movement, can then cause the pedal bone to displace downwards, tearing through the weakened laminae.

The veins, arteries and the sole corium (a blood filled gel pad which aids in shock absorption and produces the sole horn) surrounding the hoof wall and sole are destroyed as the pedal bone, followed by the leg bone column, sinks (founders) through the hoof and penetrates the sole, devastating the entire hoof. NB – the more the hoof wall is raised with no sole support, i.e. remedial heart-bar shoes, the further the bone column can sink, which is why shoeing a laminitic hoof for 'protection' is not appropriate.

If the laminitis gets to this stage, the horse's life could now be seriously at risk, although remarkably it is still survivable. A vet may recommend euthanasia, however, due to the extreme degree of suffering and the risk of infection.

It's all about healthy blood flow

Whether the laminitic trigger is feed-induced or brought on by a metabolic syndrome, the laminae in the hoof are affected by the disruption of a healthy blood flow to and from the hoof. It’s all about healthy blood flow, and the only way to achieve this is to have a healthy system, which means a healthy gut, with what I call the 3-amigos, the body's natural detox system, namely the liver, kidneys and lymphatics, all working in harmony with each other. A depressed immunity, a poor/inappropriate diet, a sluggish digestive system, leads to overburdened (toxic) blood, which does not a healthy horse make.

Cut to 2013/2014, researchers at the University of Queensland studied blood flow to the hoof, in horses in temperate conditions. In normal healthy horses, it was noted that there were periods of normal blood flow interrupted with long periods of very low flow. The same studies were carried out on horses in the initial (low-grade) and ‘acute’ stage of laminitis, which showed that blood flow increased prior to the development of pain.

Those with heat in the hooves which indicated vasodilation - where the nervous system (CNS) automatically recognises that it must provide more nutrients to metabolically active tissue, and so widens the blood vessels and releases excess heat - developed onset laminitis. The studies then showed that if vasoconstriction occurred - where the blood vessels constrict and essentially decrease the blood flow - laminitis did not transpire.

Recognising the early signs of laminitis is crucial, so first up, cool those legs and hooves - cold hosing, ice buckets, whatever you can lay your hands on to reduce the heat and inflammation. Reduce the inflammation and heat, and you could well be on your way to preventing onset laminitis. However, if left untreated, the horse’s life can potentially be put at risk if the bone structure and the hoof wall separates.

How to recognise the symptoms

The early 'acute' state can show early warning signs - uncoordinated movement, anxiety, increased heart rate, immobility, a reluctance to turn. Later signs, but still in the acute stage, may be a rocked-back stance, lameness, reluctance to move forward, and signs of pain such as heavy breathing, flared nostrils, and patches of sweat.

For the record, Molly, Dinky and Mac all presented with different symptoms - with Molly we had uncoordinated movement and awkward stiff walking; with Dinks we had seriously heavy breathing with significant sweating, enough to make me first think that he was having an extreme respiratory pollen reaction. With Mac in March 2020, he was basically stuck, immobile, at the top of the field. None of them had the rocked-back stance.

Whether you see the obvious signs or not, one of the easiest ways to monitor is to check for digital pulses. If your horse or pony is out on grass, check the hooves every day. If you feel the pulse bounding, and/or any unusual warmth in the hooves, or you see the formation of event lines appearing below the coronary band, usually curling down towards the heels, these could be the first signs of the early stages, also known as low-grade laminitis (LGL), and your signal to take preventative action.

2020 - Our Mac gets laminitis - our own experience

Mac went down with what I'd term low-grade lami. Heat for sure in his hooves but no sign of event lines, yet he couldn't walk. His pulses, to me, weren't throbbing, just seemed slightly raised, but a 2nd opinion thought different and considered them pounding.

Mac very stoically shuffled into a small corrall we rigged up next to our field shed (we couldn't get him down to the yard and a stable) and we got him on our TriBute straight away with a pile of hay. He wasn't really interested in eating, just stood still a lot or laid down. Three days later he was shuffling, Day 4 he seemed keen to be back with his buddies on the other side of his corrall so he went out with a muzzle, which came off overnight - I couldn't get it back on him. He shuffled within his comfort levels while staying on the TriBute for a week in total, then we switched him down to our DuoBute for the summer, although I've since kept him on it permanently.

How did he get it? My fault entirely. We moved yards as Covid hit, literally on the Saturday before the Monday of the first major Lockdown. He'd spent the previous 6-months on a family-run barefoot no-grass yard and a hay-only diet, because I'd badly broken my leg the previous August and needed livery services through winter 2019. Cue Covid in Spring 2020 and we had to move them, so we were back on grass on our former yard.

It took just a week for him to crash. Of course I beat myself up - so stupid of me not to see it coming, especially considering he's high up on the metabolic spectrum, full onset IR, very cresty/fat-pads. He's also impossible to walk out for exercise as he's an unrideable thug and tanks off - his full story's in our Case Studies, plus having myself not long recovered from the leg break I couldn't walk him out even if he wasn't a thug!

At the ripe age of 20, this is the first lami bout he's had with us in 4-yrs, but there's no doubt I had my head in the sand as being our previous yard I simply assumed that their tums knew the grass to be 'safe'. Truthfully, I didn't even consider it ...

The others were all absolutely fine, although thanks to Mac they all went onto lami-watch and I immediately got a track system up. 2021 is already very different - we've now got a smaller summer field with a rigid track system, hay stations set up and two field shelters with a lovely loafing area for them.

Early intervention is critical

Get your horse off the grass immediately if you can - we couldn't with Mac so I rigged up a corrall in the field with his buddies - and treat with cold therapy, i.e. cold hosing or cold-water bucket soaking, with ice-cubes in the water if you can get them (never use ice directly on the skin as it can destroy skin tissue) to help reduce the inflammation.

Apply for 15-30 minutes every few hours for a few days until you notice a significant difference. If your horse develops laminitis, your horse is now experiencing severe pain and inflammation which need immediate addressing - I immediately got Mac onto our TriBute. Continue to apply cold therapy for a couple more days which will help reduce the inflammation and potentially reduce any damage.

If your horse can move, get him onto a conformable surface with as little pressure on the sole as possible. Bring a field buddy in with him so he has company, to help reduce any stress he may be feeling. If he can’t move, don’t force him as this can cause physical damage to the hoof structure – far better that the vet sees the horse where he is comfortable.

What can we do?

We know the first trigger in developing laminitis is from a toxin-burden in the blood-circulation, so preventing laminitis is making sure those toxins don't leak from the gut into the bloodstream in the first place.

  • Everything starts with the gut - keep the gut system, microbiome and immunity strong and healthy. See our Gut System section, and specifically the chapters on Leaky Gut and The Microbiome.
  • Diet, Diet, Diet - Fibre, Fibre, Fibre. No sugar, no molasses, check ingredients and analysis on processed feed bags. Feed your horse like a horse with clean, healthy forage and fibre – it really is all they need. All covered in our Feeding our Horses section, and specifically the page Why what we feed has to be right.
  • Become Grass-Aware! All covered in our I'ts hay, hay, more hay and only hay page.
  • Spring/Summer. Look at setting up a track system which is incredibly easy to implement with electric fence posts and tape. Position hay stations so as to allow plenty of movement between them while keeping grass consumption down.
  • Winter. Don’t think you're out of the woods once summer is over - as autumnal nights cool down, the dangerous grass carbs once again increase. Frozen frosty grass is akin to a sugary grass-lolly so beware those glorious ice-blue, sunny frosty days. Sugar levels rise in that intense winter sunlight, triggering fructan formation which head straight to the hindgut for the lactic-acid bacteria to gorge on, releasing lactic acid and turning the hindgut acidic.
  • Avoid obesity. If you can’t exercise, restrict. But – do NOT starve your horse - see our Metabolic Horse page for more info. Feed a managed diet with plenty of high fibre forage and appropriate vitamins/minerals to support and nourish the system.
  • Balance the nutrient profile in your forage. Balanced minerals in your horse’s diet = healthier horse = significantly less risk of laminitis. See our Mineral Solutions page. They need a clean, nutrient-rich, balanced diet with vitamins and minerals to help support the healing process during recovery.

The symptoms of laminitis are awful to witness, with the obvious pain and distress being enough to make us want to do all we can to prevent it ever happening again. Good supportive care such as proper nutrition and restricting grass intake can really help to keep a laminitic-prone horse healthy.