Laminitis is one of the most painful diseases in horses. In the acute stage, it is always an absolute emergency. If left untreated, it can lead to a horse's limited or permanent uselessness, permanent suffering and even the loss of any quality of life.
What is laminitis in horses?
Laminitis develops as an inflammation of the hoof corium. As a result of the disease, the hoof corium swells so that the blood circulation in the hoof is disturbed. The swelling cannot expand in the hoof capsule, resulting in severe pressure pain.
In the further course of the disease, the hoof corium becomes very painful and partially or completely detached from the horn capsule. In very extreme cases, the horn capsule detaches completely (shoeing out).
Mild and insidious laminitis
Mild, insidious laminitis symptoms are often overlooked. Temporary lack of diligence on the part of the horse may be interpreted as laziness. With a bit of luck, everything will appear normal again after a few days. Only the attentive hoof trimmer may point out a slightly widened white line with signs of bleeding or non-parallel hoof rings on the hoof wall a few months later.
Here too, there may already have been a slight change in the hoof bone position with a deviation of the hoof shape from the normal state. Where a first hoof relapse occurs without optimization of the posture and conditions of use, further, more severe relapses usually follow.
Acute laminitis
In the case of a moderate, acute bout of laminitis, the signs are more obvious and should definitely be noticed by the attentive horse owner. The gait is reluctant, sluggish, clumsy.
In the acute phase of severe deer thrush, the horse can hardly move due to the pain and can only stand in pain. The more severe the laminitis, the more severe the inflammation and the resulting damaging effects on the structures in the hoof.
All laminitis episodes are absolute emergencies for the vet and cannot be postponed!
Chronic laminitis
In the chronic phase, the acute hoof dermatitis has subsided. The painful changes to the structures in the hoof have largely come to a standstill. The horse must now somehow cope with the damage inside the hoof capsule and all the resulting consequential damage.
Healing, i.e. restoring the original shape and functionality of the hoof, is sometimes possible over a long period of time, depending on the severity of the damage.
Recognize laminitis
Symptoms of acute laminitis
One of the first (often overlooked) recognizable symptoms of acute laminitis is a slight warming in the area of the heels and the overlying suspensory ligament. As the disease progresses, the entire hoof may become warm to the touch. A strong pulsation may be felt on the inside of the fetlock joint. The horse is reluctant to move, with short, hesitant steps and noticeable pain when turning. When standing, it often lifts the affected legs alternately due to the pain.
This can lead to the typical "deer posture". The horse shifts its center of gravity to the heels in order to relieve the toe area. The front and hind legs are pushed forward. Picking up a leg can become difficult or even impossible. If the horse is given the opportunity, it usually wants to lie down to take pressure and tension off the hoof structures.
The acute phase usually lasts 2 to 3 days. Due to the severe inflammation and swelling of the hoof corium, the blood supply to the hoof corium is significantly reduced. After this, the horn capsule is no longer warm, but cold.
Symptoms of chronic laminitis
Due to the severe inflammation in the acute phase, the connection between the coffin bone and the toe wall was destroyed. The coffin bone is pulled backwards and downwards by the pulling effect of the deep flexor tendon (coffin bone rotation). As a result, the tip of the coffin bone can even penetrate the sole of the hoof (sole breakthrough).
In most cases, the coffin bone also sinks downwards (coffin bone subsidence) due to the defective suspension apparatus in the horn capsule. The chronic stage begins with these changes in the position of the coffin bone. The painful inflammation usually subsides over the next few weeks, but the change in the horn capsule remains. As the condition progresses, the shape of the hoof gradually changes noticeably.
Typical symptoms of chronic laminitis are
- Increased heel foothold
- Widening of the white line in the toe area.
- Development of the beak hoof (toe wall moves away from the front)
- Trachte gets higher
- Formation of a bulbous hoof
- Little to no or even convex curvature of the hoof sole.
- Pressure-sensitive hoof sole
- Rings of the hoof wall that are not parallel but diverge towards the heels
Even after the acute inflammation has subsided, the horse usually remains sensitive on the sole of the hoof, walks with feeling and is bound. It avoids hard ground. It often puts more weight on the heels when walking and especially when standing in order to relieve the hoof toe area. The horse's conformation and posture change for the worse. This favors wearer exhaustion.
What are the causes of laminitis in horses?
The causes of laminitis are varied and complex, and new findings and correlations are constantly being added. It is often a combination of several causes. Overweight plays a decisive role in most horses.
Fodder deer
The best known and probably most common cause is incorrect feeding. A sudden change in the intestinal environment due to an individual or sudden excess of starch, sugar or fructans causes crude fiber-digesting bacteria to die off and release massive amounts of toxins. This can then lead to inflammatory reactions in the hoof corium.
A typical example is the start of the grazing period without the horse having been gradually acclimatized to the grass. Grazing at times when the fructose content of the grass is particularly high or a sudden, significant change in feed quantity, e.g. from hay to haylage or concentrated feed, can also be causes of laminitis.
Overweight
The ticking time bomb. Often already unrecognized, associated with metabolic diseases such as EMS. These horses have often already had minor bouts of laminitis without being recognized until the famous straw breaks the camel's back and triggers really bad laminitis.
Exertional laminitis (mechanical laminitis)
Overloading of the hoof sole due to mechanical impact, e.g. uneven hard ground (unpaved runs during long periods of frost), high speed on hard ground (endurance rides), barehoof rides on hard uneven ground.
Chronic diseases such as Equine Cushing's Syndrome (ECS) and Equine Metabolic Syndrome (EMS)
Horses with EMS or ECS are more likely to suffer from laminitis due to the disturbed insulin or hormone balance.
Medication
Some horses, especially if they already have a metabolic problem, react to cortisone treatment, for example with laminitis.
Poisoned laminitis
Triggers can be contamination of the feed (e.g. borreliosis bacteria), but also poisonous plants, moldy bread and insecticides in the feed.
Postpartum laminitis
Poisoning can for example, can also be caused by only partial shedding of the egg membrane/afterbirth after the foal has been born.
Irritation of the coronet band
Harsh rubs can lead to irritation of the coronet band.
How can laminitis be treated in horses?
What can the owner do in case of acute laminitis?
The vet should be contacted immediately when the first symptoms of laminitis are recognized, as this is an emergency! Rapid treatment of laminitis within the first 48 hours can avert or reduce the chronic stage.
5 tips for acute laminitis treatment
- Movement is harmful: every step leads to further tearing of the connection between the horn capsule and the coffin bone. It is therefore important to provide the horse with deep (at least 30 cm), soft, yielding bedding (shavings, peat, sand or similar). Straw is unsuitable. The horse should be able to stick its toe down into the bedding without much effort and lie down. (Practical test to see if the amount of bedding is sufficient: From a standing position, let yourself fall onto your knees with a swing. Is the landing soft and comfortable?) Lying down reduces the pull of the deep flexor tendon on the coffin bone. This reduces the risk of rotation of the coffin bone. The vet will probably prescribe anti-inflammatories. These also have a pain-relieving effect. However, this must not lead to the horse moving more again.
- Permanent cooling of the hooves: It is often recommended to keep cooling the hoof to reduce inflammation. This does not work with laminitis! After each cooling, the part of the body reacts with increased blood circulation, which means that the inflammation is stimulated again. Cooling only works for acute laminitis if the cold stimulus (ice water) remains on the hoof for at least 72 hours. This means constantly monitoring and renewing the compresses over this period. Alternatively, the horse can be placed in flowing water (paddock in a stream) for this period. This is only possible if the horse can still stand well.
- Naturopathy: Naturopathic methods (e.g. homeopathy or leeches) can provide support.
- Diet for overweight horses: If the horse is overweight, you should use the period of rest in the stable to carefully put the horse on a diet. However, you should seek professional advice here. Simply reducing the amount of roughage too much can be dangerous.
- Care products: The white line should be treated with a suitable care product, e.g. the Keralit hoof strengthenermeticulously. The condition for this is that the horse can hoof without pain.
What can the owner do during the transition to the chronic phase?
After a few weeks of rest in the box, the horse should be able to stand on its four legs and move freely in a suitable exercise area without painkillers.
Any forced movement (including driving by other horses) should be avoided. The hoof trimmer can then try to gradually restore the position of the coffin bone parallel to the hoof wall. An informative x-ray image of the position of the coffin bone is helpful.
Restoring the original, functional hoof shape is a long process and takes at least as long as it takes for the hoof horn to grow completely downwards from the upper hoof edge (at least twelve months). Only when this is successful is the connection between the hoof capsule and the coffin bone stable again. Only then can the horse be carefully loaded again. If the load is applied too early or too heavily (rider's weight, surface, speed), new tears will occur again, leading to further inflammation of the hoof corium.
Professional correction of the hoof must continue to be carried out meticulously. It can take several months to years until the original, functional hoof shape is restored. Permanent sensitivity often remains on the sole of the hoof. A complete restoration of the horse's performance is usually questionable. Depending on the severity of the change, it may already be a success if the horse can live pain-free without weight bearing.
How can horse owners support their horses with permanent chronic laminitis?
It is not always possible to completely restore the hoof shape and coffin bone position.
Hooves damaged by laminitis have a widened white line. Their structure is softer and provides an open attack surface for bacteria and fungi. Small stones are easily pushed in. All this further damages the white line. This often leads to an increase in hoof ulcers.
A clean, dry stable and paddock in combination with care helps the sensitive hoof horn. The daily, dry cleaning of the white line and a care product to protect against horn decomposition, such as the Keralit hoof strengthener is very useful. As a result of the altered horn capsule, small cracks and fissures appear in the hoof wall. These are also entry points and a stomping ground for fungi and bacteria, which damage the hoof wall even more. The Keralit hoof bath counteracts the horn decomposition processes.
Hooves damaged by laminitis are sensitive on the sole. Hard ground, gravel and hard unevenness (stones on the ground) cause pain and can trigger a new inflammation of the hoof corium. Barehoofed horses with laminitis therefore need soft, yielding ground without stones, whether in the paddock or on excursions.
A suitable hoof boot can be helpful for short distances. Alternatively, a permanent hoof protection (deer shoe) should be fitted, preferably with a plate and pad (e.g. Luvex laminitis pad) to protect the sensitive hoof sole.
A suitable product should be placed between the hoof sole and pad to protect against white line disease, e.g. Keralit Undercovershould be applied. In the case of horseshoes, more severe burning can already trigger a new problem on the hoof hide.
The weight of the horseshoe or shoe should be kept as low as possible. Plastic hoof protection, either nailed or glued, can be a good alternative.
Rider weight and speed increase the strain on the hoof. It is essential to pay attention to signs of pain during movement.
What can the owner do to prevent a new bout of deer?
Preventing another relapse: A horse that has already had a relapse is predestined for further relapses. Possible causes must be meticulously eliminated. If the horse is overweight, attention should be paid to the following:
- Adjust the amount of feed (weigh the hay!)
- Low-fructan and low-energy hay, straw (be careful not to use too much, as there is a risk of blockages!)
- Non-toxic, suitable branches to nibble on as an activity
- No grazing (this increases the risk of a subsequent relapse enormously)
- Supportive feeding with mineral feed (sugar-free) tailored to laminitis horses
What are the chances of recovery from laminitis?
The earlier laminitis is recognized in the acute stage and the faster suitable measures are taken, the greater the chance of reducing or even preventing changes in the horn capsule.
Once the inflammation has subsided, x-rays provide information about the damage that has occurred. In rare, fortunate cases, the coffin bone is still in its old position and the connection to the hoof capsule has been preserved. After a few weeks, it is possible to speak of healing and the horse is spared a chronic course.
In typical chronic cases, healing can only take place if the original shape and functionality of the hoof can be restored. Depending on the severity of the damage, this can take months to years or may not be possible at all.
How do I prevent laminitis?
- The most important measure to prevent feed-induced laminitis is to avoid overweight horses. The calculation of the body condition score, a horse scale and advice from the vet make it easier to assess the feed condition.
- Correct feeding and grazing with a sense of proportion as well as sufficient training stimulate the metabolism and reduce the risk of EMS.
- The right hoof protection or a really suitable surface to walk on, both in the paddock and when riding out, should ensure that the horse moves around a lot and enjoys it.
- Starch and sugar-reduced feed, hay from low-energy grass varieties, plenty of activity and exercise stimuli are the basis.
- The vet can provide advice on all hoof predispositions due to pre-existing conditions.
Which horse breeds are particularly at risk of laminitis?
The greatest danger certainly exists for horse breeds that genetically come from an area with a rather meagre, low-energy feed supply. These include in particular the robust horse breeds such as Icelandic horses, ponies, Norwegians and Haflingers, but also Iberian horses, breeds from South America and Arabian horses. These horses are not genetically bred for our Central European pastures with their rich feed supply - especially not in combination with too little work.
Basically, the lighter a horse is, the more likely it is to become overweight and the higher the risk of metabolic laminitis. However, the risk of obesity affects all types of horses here.