Equine Laminitis

- Treatment of laminitis

 The goal of treatment in horses with laminitis was directed to minimize the predisposing factors, reduce the severity of pain and laminar damage, to improve digital and laminar haemo-dynamics and to prevent further rotation and sinking of the pedal bone within the hoof.

 1- Management

          Initial management usually includes stall rest to minimize movement, and deeply bedding the stall with shavings, straw, or sand. Exercise is slowly increased once the horse has improved, ideally in an area with good (soft) footing, beginning with hand-walking, then turn-out, and finally riding under saddle .

2-    Cryotherapy

-    Cooling of the hoof.  Feet placed in ice slurries were less likely to experience laminitis than "un iced" feet within the first 24 hours.

-   Cryotherapy reduces inflammatory events in the lamellae. Ideally, limbs should be placed in an ice bath up to the level of the knee or hock.

-  Hooves need to be maintained at a temperature less than 10 °C at the hoof wall, for 24–72 hours.

3-Drug therapies

1- Anti-inflammatories and analgesics

-    Nonsteroidal anti-inflammatory medications (NSAIDS) are often the first line of defense. Phenylbutazone is commonly used for its strong effect and relatively low cost (2.2–4.4 mg/kg I.V) for 5 days.

-   Flunixin (0.25 mg/kg, IV, q 8 h, or 1.1mg/kg, IV, q 12 h) for 5 days.

-   Nonspecific NSAIDs such as suxibuzone, or Firocoxib (0.1 mg/kg PO every 24 hours) for 10 days.

-    Dimethyl sulfoxide DMSO (0.1–1.0 g/kg diluted to 10% solution IV every 8–24 hours) for 5 ays.

-   Pentoxifylline (8.5–10 mg/kg IV or PO every 12 hours) for 3 days.

 

2- Vasodilators

-  Vasodilators are often used with the goal of improving laminar blood flow Isoxsuprine  to increase blood flow; isoxsuprine HClb (0.6 -2 mg/ kg, q 12 h) for 7 days .

-  Nitroglycerine d (60 mg as a 2% ointment on the skin over the digital vasculature) has also been applied topically in an attempt to increase blood flow two time daily for 3 days.

3-     Anticoagulant

       High doses of heparin (100 IU/kg, IV/ day in Ringers solution for 4 days) to prevent or ameliorate signs of laminitis caused by carbohydrate overload Heparin administered to horses intravenously in high doses rapidly results in a marked decrease in the hematocrit caused by agglutination of erythrocytes because the reticuloendothelial system removes the agglutinated erythrocytes from circulation.

4-  Systemic antibacterial (Penicillin and Streptomycin 5000 IU and 15 mg /Kg .day .I.M) to 3-5 days.

5-  Antihistamines (1mg /Kg / day I.V for 5 days).

6-  Electrolyte therapy (Ringers lactate 10-20 ml /kg. I.V) for 5 days.