Equine Laminitis

- Diagnosis of laminitis

A-   Case history

 By gathering the following information 

1-     Current diet, including any recent changes in diet.

2-     All current medications.

3-     Whether this is the first incidence of laminitis or a chronic issue.

4-     Any current medical conditions, such as Pituitary Pars Intermedia Dysfunction (PPID) or Equine Metabolic Syndrome (EMS).

5-     Current health status including if the horse is being treated for things like diarrhea, infection, or musculoskeletal injury.

B.    Radiographic measurement

Several radiographic measurements, made on the lateral view, allow for objective evaluation of the episode:

1-     Coronary extensor distance (CE) the vertical distance from the level of the proximal coronary band to the extensor process of P3. It is often used to compare progression of the disease over time, rather than as a stand-alone value. A rapidly increasing CE value can indicate distal displacement (sinking) of the coffin bone, while a more gradual increase in CE can occur with foot collapse. Normal values range from 0–30 mm, with most horses >12–15 mm.

2-     Sole depth (SD) the distance from the tip of P3 to the ground (A sole depth at the toe of <15 mm).

3-     Digital break over (DB) distance from the tip of P3 to the breakover of the hoof (dorsal toe).

4-     Palmar angle (PA) the angle between a line perpendicular to the ground, and a line at the angle of the palmar surface of P3(Solar margin angle 3–8º)

5-     Horn lamellar distance (HL) the measurement from the most superficial aspect of the dorsal hoof wall to the face of P3. 2 distances are compared: a proximal measurement made just distal to the extensor process of P3, and a distal measurement made toward the tip of P3.

These two values should be similar. In cases of rotation, the distal measurement will be higher than the proximal. In cases of distal displacement, both values will increase, but may remain equal. 

Fig.7 Coronary extensor distance (CE), Horn lamellar distance (HL), Sole depth (SD),

Digital break over (DB) and palmar angle (PA).

Fig.8 the coffin bone position.