Treatment of Acute Laminitis

Pain is severe so it must be your goal to make the acute phase as short as possible. Your veterinarian is the first person you should call.

While you are anxiously waiting:

  • If possible identify the cause of the problem and do something about it e.g., don’t leave the horse in the paddock eating grass if you think that is the cause. If the horse is too sore to move stay with it in the paddock.
  • Prevent the horse eating anything else which you suspect has caused the laminitis e.g., take the new feed you have just started using three days ago away and don’t give it any more.
  • Hose the legs and feet with cold water. Or better yet, place the feet in an ice water bath. This is when cold therapy may decrease further damage and is the time when the feet should remain in the cold for as long as possible. Ice should always be floating in the water.
  • Rule: Never use ice directly onto skin, it will freeze and kill the cells.
  • Where possible, place in a sand yard or on a soft, friable surface while you wait for the vet - move the horse as little as possible to achieve the above listed goals.
  • In warm weather, keep the horse cool and provide water and shade. In winter also keep the horse comfortably cool.
  • If possible, clean and pick out the feet if packed up with mud or dirt causing sole pressure.
  • If you have experience with laminitis and are not calling the Vet, DMSO in a roll-on form can be bought from most saddleries. This is a powerful anti-inflammatory/antioxidant. It can be used as first aid if applied sparingly to the coronary band and distal limb. Wear gloves while handling this product and whenever touching this area after treatment and warn others to do the same. Do not use on damp skin as this causes a heating (exothermic) reaction which may blister the skin. Dry the skin first.
  • Reduce environmental stress. Do not separate the horse from its mates, bring the horse’s friend up to the stables with you and keep it nearby.

VETERINARY TREATMENT MAY INCLUDE:

  • It is most important to try and identifying the cause to speed treatment and prevent a recurrence.
  • Keep the horse standing in the ice bath during treatment.
  • Drenching (stomach tubing) to speed the transit of ingested material and reduce absorption of toxic byproducts which enter the blood stream from the gut (grass or grain induced).
  • Alkaline buffers to decrease acidity e.g. magnesium hydroxide (1st choice) or sodium bicarbonate (baking powder) administered by drenching tube or in feed.
  • Dolomite, which is a form of finely ground calcium and magnesium carbonate lime mineral and can also be administered by stomach tube or in feed.
  • IV fluids, if the animal has concurrent colic, acidosis or other problem, fluid therapy may be indicated to maintain normal hydration and metabolism.
  • Administering anti-inflammatory/pain relieving drugs. Too little pain relief prolongs the acute phase; too much allows the horse to walk around in a masked state of pain, aggravating the damaged laminae. This treatment must be monitored for the maximum benefit to the animal, with minimal side effects.
  • Low dose anti-endotoxic doses of the NSAID Flunixin if Gram negative bacteria are implicated due to grass/grain induced laminitis or infection.
  • DMSO topically for anti-inflammatory, anti-endotoxic and antioxidant effects.
  • Antihistamines T1 have been used in combination with anti-inflammatory drugs for the treatment of laminitis in cattle. This is to decrease the inflammatory effects of absorbed bacterial endotoxins. This is worth discussing with your Vet as another option during the acute phase of the disease.
  • Antibiotics, if there is evidence or risk of systemic infection. Remember that all drugs can also lead to laminitis.
  • Anti-ulcer treatments may be beneficial if it is likely that the patient isn’t eating because of stomach or foot pain, has a poor appetite, or if there is a risk of gastric ulceration as a side effect of NSAID use. Ask your Vet about the best choices and side effects of withdrawal from these medications.
  • The most important mineral at this stage is magnesium, which may be administered by nasogastric tube as an epsom salt solution. The most important vitamins are B1 and vitamin C which can both be given as an injection by your Vet.
  • Protecting the feet from sole pressure/trauma with soft foam padding and bandaging.
  • Radiographs (X-rays) may show inflammatory fluid (transudate), infection or gas between the distal phalanx and wall, and can indicate if drainage is necessary. They also help assess the loss of laminitic bond and position of the pedal bone in relation to the coronary band and sole. Treatment of the disease process which has caused the laminitis should always be the first priority.
  • Drainage at the toe may relieve pressure over the sensitive laminae and minimise damage to these structures if there is evidence of fluid, gas or separation on x-ray. à Refer to farrier/shoeing for more information of how, when and why to resect).
  • The Veterinarian will require the assistance of a farrier to remove the shoes and to trim and balance the feet for accurate x-rays; or to fit shoes for treatment.

Treatment summary
This information is presented for horse owners and Veterinarians as a guide only, and is not a suggested or definitive treatment protocol. I hope that it may give you ideas about other drugs or homeopathic remedies other than those you are familiar with. The supply or use of some of these drugs to a horse owner is illegal except under the supervision of a veterinarian.