This document discusses several hoof diseases that are specific to older horses, including Equine Metabolic Syndrome (EMS), Cushing's Disease (PPID), and laminitis. EMS is characterized by obesity, insulin resistance, and increased risk of laminitis in horses age 5 and older. Cushing's Disease affects horses age 12 and older and causes a long shaggy coat, excessive urination, weight loss, and increased susceptibility to infections. Laminitis, an inflammation of the laminae in the hoof, has multiple systemic causes and a poor prognosis depending on the case. The document emphasizes monitoring weight, nutrition, and signs of these diseases to promote early testing and treatment.

1. Hoof Diseases Specific
to Older Horses
EDUARDO DE LA CRUZ, DVM
LOOMIS BASIN EQUINE MEDICAL CENTER

2. Hoof Diseases Specific
to Older Horses?
THERE ARE NONE!!!

3. Outline
 Equine Metabolic Syndrome
 Cushing’s
 Laminitis

4. Equine Metabolic Syndrome
“EMS”

5. Main Features
 Obesity
 Insulin Resistance/Dysfunction
 Laminitis/Founder

6. “Easy keepers”
 Genetic Predisposition
 BLM’s
 Mustangs
 Morgans
 Ponies
 Donkeys
 …
 Age Group???
5+

7. Obesity
 FAT horses!!!
 Regional adiposity….Fat pads

8. Insulin Resistance/Dysfunction
 Insulin directs glucose/sugar
(energy) into liver, fat, and muscle
 IR/ID
 Insulin not as effective and glucose builds up
 Pancreas increases insulin production to keep
up
 Leading to hyperinsulinemia and laminitis

9. Diagnosis
 Insulin/Glucose Blood Panel
 Ideally Fasting (1 flake of hay night before)
 Insulin/Glucose Blood Panel with OST
 Oral Sugar Test
 Ideally Fasting (1 flake of hay night before)
 Owner Gives 100cc Light Karo Syrup Orally
 Vet Pulls Blood after 1-1.5hrs

10. Management
 Weight Control
 NO… Sugar…
 Apples
 Carrots
 Green Grass
 Sweet Feed
 Alfalfa hay/pellets
 YES….Orchard Grass Hay
 1-1.5 pounds of hay per 100 pounds per day….10 - 15
pounds per day
 MAYBE…Low Starch Pelleted Feed if warranted
 Mineral Block

11. Management
 Exercise
 Walking
 Light Ridding
 20-30 minutes 2-3 times a week
 Build up to 5 days a week…SLOWLY…Be nice!
 If Laminitic/Foundered… Ask Vet!

12. Management
 Medications
 Thyro-L (Levothyroxine)
NOT HypOthyroid… Used for weight loss
 Metabarol (Resveratrol)
 Claims to improve the sensitivity of
insulin

13. EMS Summary
 Monitor weight
 Can develop at early age
 Test for Glucose/Insulin
 High life-threatening risk of Laminitis/Founder

14. Pituitary Pars Intermedia Dysfunction
(PPID)
CUSHING’S

15. What is it?
 Uncontrolled Growth of a Section of the Pituitary Gland
 Oxidative damage to PPI
 PPI is set to Overdrive
 Increase in Hormone Production
 Leads to Deterioration of Normal Hormonal Functions

16. Who is Affected?
 Same Breeds as EMS horses
 Age Group???
 Most common in 12+years

17. Main Features
 Long Shaggy Hair Coat
 Loss of Top Line
 Excessive Urination (PU)
 Excessive Water Consumption (PD)
 Decrease Performance
 Non-resolving Infections
 ± Obesity
 ± Insulin Resistance/Dysfunction
 ± Laminitis/Founder
 ……

18. Early Signs
 Changes in Behavior
 Lethargy
 Docility
 Decline Performance
 Muscle Loss “Topline”
 Changing form Obese to Lean
 Secondary Infections
 Whiteline Desease
 Hoof Abscesses
 Recurent Corneal Ulcers
 Sinusitis

19. Midway Signs
 Same as Early Signs Plus:
 Focal Hair coat Changes
 Laminitis
 PU/PD
 Fat Pads
 Sweating Abnormally

20. Late Signs
 …..
 Generalized Hair Coat Changes
 Skinny with Potbellied Appearance

21. Diagnosis
 ACTH Blood Test
 Ok for late stage of disease
 OR
 ACTH + TRH +ACTH (10 min later)
 More sensitive than single ACTH
 Research on the way to determine better more
sensitive testing assays/methods
 DON’T TREAT THE LAB WORK… TREAT THE HORSE!!!

22. Why Test?
 Reinforcing Suspicion
 Differentiating form EMS
 “Proof” of Diagnosis when Starting Life-Long
Therapy
 Monitoring Dose and Efficacy of Therapy
 Prognosis
 DO NOT WAIT FOR A “POSITIVE” RESULT TO TREAT IF
EARLY SIGNS ARE INDICATIVE…Tests are not the
best yet!

23. Treatment
 Prascend (Pergolide)
 Oral Tablet
 Daily
 For Life

24. Nutraceuticals???
 Metabarol (Resviratrol)
 May help with EMS
 Chastberry
 Made it worse based on control study in 2002
 Magnesium
 May benefit people, NO data in horses
 Chromium
 No change in EMS (2011)
 Psyllium
 Mild changes in EMS (2013)

25. Management
 Consistent Medication Administration
 Proper Nutrition
 Thin?
 Fat?
 EMS?
 Fresh Water at All Times
 Proper Care of Teeth
 Proper Care of Hooves

26. Laminitis/Founder

27. LAMINITIS/FOUNDER
 Laminitis = Founder
 Inflammation of the lamina that suspends
the coffin bone within the hoof capsule

28. LAMINITIS/FOUNDER (ROTATION)

29. LAMINITIS/FOUNDER (SINKING)

30. LAMINITIS CLINICAL SIGNS

31. LAMINITIS CLINICAL SIGNS
 Summary of Clinical Signs
 Increased respiratory rate
 Lameness (Tight circles)
 Reluctance to walk
 Laying down
 Weight shifting
 Tucked under stance
 Bounding digital pulses

32. LAMINITIS/FOUNDER DIAGNOSTICS

33. LAMINITIS/FOUNDER
 Systemic Causes
 Metabolic Disease (Insulin Resistance)
 Cushing’s (Pituitary Pars-Intermedia Dysfunction)
 Obesity (Fat=inflammatory organ)
 Grain Overload (Carbohydrate)
 Spring Pasture (Carbohydrate)
 Colic
 Diarrhea
 Retained Placentas
 Corticosteroid-associated
 Many more……….

34. LAMINITIS/FOUNDER
 Treatment?
 Controversial...
 No one treatment is applicable for all
 KEY: Determine and treat the underlying cause

35. LAMINITIS/FOUNDER
 Treatment
 What do most of us agree on?
 NSAID: Bute, Banamine, Previcox, etc.
 Good Team:
 Veterinarian
 Farrier/Trimmer
 Stoic patient
 Dedicated owner with deep pockets
 Good Luck!

36. Toss-up!

37. LAMINITIS/FOUNDER
 Prognosis
 Case dependent…
AVOID IT!

38. Key Points
 Monitor Weight
 Watch What You Feed
 Spoil Them with Love and Attention… NOT Food
 Monitor for Subtle Coat Changes
 Monitor for Lameness
 Test Early
 Treat Early
 Be Proactive!

39. QUESTIONS?

40. THANK YOU!!!!
Eduardo De La Cruz, DVM