Laminitis is a painful condition that affects the hoof and can be life-threatening. It causes inflammation in the sensitive laminae that attach the hoof wall to the pedal bone. Laminitis progresses through three phases - acute, sub-acute, and chronic. It is commonly caused by excessive weight bearing, lush grass consumption, or endocrine diseases. Clinical signs include reluctance to move and an abnormal gait. Treatment focuses on relieving pain, improving circulation, supporting the foot, and correcting hoof growth and alignment through trimming, shoeing, and sometimes surgery. Complete stable rest is needed to prevent further damage during acute laminitis.

2. LAMINITIS

3. NAME: AMEER HAMZA
CLASS# 01
DVM 4TH YEAR
8TH SEMSESTER
SESSION:2016-2020
SECTION :A
ASSIGNMENT SUBMITTED TO :
DR ZAHIR SHAH

4. INTRODUCTION
o Laminitis is a painful condition of the
sensitive laminae which attach the hoof wall
to the pedal (coffin) bone.
o It can affect one foot or more and most commonly affects the front feet as
theybear more weight than the hindfeet.
o Laminitisisa potentially-lifethreateningconditionand requiresan urgent
attention from aveterinarian

7.  Acute laminitis: initial phase of laminitis
accompanied by severepain
 Sub-acute laminitis: follows after acute phase, it
is alesspainful phase which involves either the
repair of or progressive damage to the
sensitive laminae
 Chronic laminitis: follows incomplete resolution of
laminitis, where the feet must accommodate to the
rotation or sinking of the pedal bone (pain is
variable)
.
LAMINITIS PROGRESSES IN THREE
PHASES

8. Theprimary diseaseswhich caneventually causelaminitis are usually systemic
abnormalities.
o Thedisease process causestoxins to be released into the blood stream, producing
toxemia and, eventually, laminitis.
o Primary conditions or diseases associated with laminitis:
1.ExcessiveLush GrassIntake
2. Excessive Carbohydrate Intake
3.ExcessiveWeight Bearing on Leg
4.ExcessiveWork on Hard Ground
5. Pituitary GlandTumors
6.Adverse Reaction to Corticosteroids
7.Thyroid Hormone Imbalance etc
CAUSES OF LAMINITIS CAUSES OF LAMINITIS

9. o The primary disease process results in the release of toxins
into the bloodstream causing toxemia.
o Toxemia produces spasm in the muscular walls of the blood
vessels supplying to the hoof laminae and as a result the
blood supply to the hoof laminae is restricted or abolished
and its cells begin to die.
o Cell death releases biochemical mediators (body
chemicals) into the surrounding
tissues, causing inflammation, fluid swelling and pain
(acute laminitis).
DEVELOPMENT OF LAMINITIS

10. Severeor persistent casesof laminitis:
 Damagedlaminae fail to support the pedal bone correctly and it
rotates or sinks within the hoof.
 Pedal bone separates uniformly around the hoof wall
(sinking)
 Pedal bone only separates at the front of the hoof wall
(Rotation)
DEVELOPMENT OF LAMINITIS

12. o Signsinclude an increased heart rate, depressed appetite, sweating,
trembling and rapid, shallow breathing.
o Theacutely laminitis horse stands and walks with its weight
shifted onto itsheels and hind limbs with atypical gait.
CLINICAL FINDINGS

13. o The horse is reluctant to move, prefer soft ground and
may prefer to lie down to keep weight off the feet.
o Affected feet are often warm tothe touch

14. CLINICAL EXAMINATION
o In chroniclaminitis
 Abnormal hoof growth
 long curled-up toes and collapsedheels
 Hoof rings (laminitic rings) sometimes
thickened sole

15. CLINICAL EXAMINATION
o In chroniclaminitis
 Wall cracks
 Changingin hoof angle
 Bruising (red) on the wall

17. TREATMENT
o Complete stable rest is required in acute laminitis to prevent further damage
to the laminar support structures.
o Radiographs:
 Radiographic examinations of the feet will determine to what
degree the pedal bones have rotated and, therefore, guide
treatment
o Euthanasia
 may be indicated in the followinginstances:
 Severe, acute caseswhere the horse is suffering uncontrollable pain
 Severe, chronic caseswhere the horse is suffering incurably
 Caseswhere the pedal bone haspenetrated the sole of the foot or
where the hoof wall completely separates from thefoot.

18. Goals of Treatmentare:
 Eliminate the initiating cause
 Excessivelush grassor grain intake: Horseis removed from grass
or grain source and laxatives (liquid paraffin, mineral oil) are
administered to remove intestinal toxins. Smallquantities of hay
and plenty of drinking water areprovided
 Excessiveweight bearing on leg: Lamenessaffecting other leg is
treated.
 Generalizedtoxaemia, pituitary gland tumours: Diarrhoea, liver
disease, or other initiating causeof toxin production are treated

19. Goals of Treatmentare:
Relieve the pain
 NSAIDS
(i.e. phenyl butazone @ 2.2-
4.4mg/kg, flunixin meglumine
@1.1-2.2mg/kg,
ketoprofen@0.3mg/kg)
Heart bar shoescan be
fitted to remove pressure on
the toes and hoof wall

20. Goals of Treatmentare:
 Improve the blood circulation in thefoot
 Vasodilators (i.e. acetylpromazine, etc) may help by
relieving the
vasoconstriction which occurs in the arteries of the
laminae of the hoof
 Nitroglycerine ointment 10-15 mg per foot,
applied locally, improves blood vessels repair
through cutaneous absorption

21. Goals of Treatment are:
 Provide support for the foot through
 Horse should be bedded on wet sand or wood
shavings (these materials pack up into the foot
supporting the sole)
 Feed intake should be reduced to lower body
weight,
 maintaining mineral, vitamin and trace element
supplementation, especially biotin, methionine,
and amino acids which
help encourage the growth of good quality hoof.

22. Goals of Treatment are:
trimming and shoeing and
corrective surgery
Corrective Surgery may be
helpful in some cases (dorsal
hoof wall resection DHR)

23. CORRECTIVE SURGERY
o Deep digital flexor tenotomy:
 The surgical section of the
deep digital flexor tendon
has been suggested as a
therapeutic option, but
results have beenvariable
o Dorsal wallresection:
 In appropriate cases,apartial or complete surgical
removal of thefront hoof wall is performed under
localanaesthesia
 May help by initially relieving pain and pressure and
allowing treatmentof infection
 If successful, the hoof re-grows intimately with the
pedal bone, creating a better angle between the pedal
bone, hoof walland sole

24. POST SURGERY CARE
Clinical condition must be carefully monitored
o Analgesic and vasodilator medication is carefully reduced over 2 to 4 week period
o Horseshould have box rest until fully treated.
o Heart bar shoeing and foot trimming should be continued asdetermined bythe
veterinarian
o Onceoff medication and clinical condition allows, there should be agradualreturn
to walking exercise

25. NO HOOF NO HORSE

26. REFERENCES
1. Dr. ALAA GHAZY
(Lecturer of Veterinary Surgery at Kafrelsheikh University)
2. MSD MANUAL VETERINARY MANUAL
3. AMERICAN COLLEGE OF VETERINARY SURGEONS

27. THANK YOU