Dr. Judith L. Mulholland

The laminitic equine is fragile. Therefore, these are “the rules”.

• Within the first 48 hours the horse or pony will still benefit from cold and ice water therapy. Use ice baths as much as possible (ice should never be used directly on the skin). After 48 hours they may begin to resist and I take this as a sign that it is no longer beneficial.
• The surface must be sand or very soft (e.g., shavings) so that it can easily dig its toes into it. If you can’t make a hole by shuffling your own toes it is too hard.
• The pony or horse must have shade and the feet and whole animal should be kept cool in warm weather over 18°C. The hotter the patient the longer the recovery! Only rug at night or in cool weather. If necessary create shade where the horse wants to be. In very cold weather keep the patient comfortably warm with 1 - 2 rugs - never hot.
• Feeding oaten hay and small mixed feeds is important, and the more often it is done the better, therefore 4 small feeds + supplements + hay per day are the minimum (see below).
• Feeding the suggested supplements e.g., antacids to a laminitic animal that does not like them and will not eat them defeats their purpose. Therefore, mix them into a paste and squirt this into the mouth or add a little molasses to the mix or delete them completely until the patient is eating. Don’t wait more than an hour or two to see if the patient will eat it. If no - start again. Therefore, no matter how much I believe in the benefits of these ingredients in the diet it is more important to have roughage in their gut at all times. Get the laminitic patient to eat fibre.
• Stick to the no grain diet, use other tasty treats to get it to eat e.g., a few grated carrots.
• A pony that is not eating is likely to have pain. If there are signs of pain ask the vet to check the horse for colic or worsening of the laminitis. Colic may cause laminitis, may follow laminitis, may be due to the treatments for laminitis or is concurrent with laminitis because the horse isn’t eating. The horse’s foot pain may have decreased the appetite and it is important to break the cycle by managing the pain effectively.
• Therefore, Try ice bathing the feet and then offer some food and monitor the dose of NSAIDs carefully.
• While you having any further conversation with your vet ask about treatment for prevention of ulcers and gastritis and how best to minimise the dose of NSAIDs and pain management.
• If the patient is not receiving antibiotics, probiotics can be given to help repopulate the caecum and colon with beneficial bacteria species.
• Take the feed and water to the pony.
• Place the feed at knee height, this takes some of the weight bearing off the front legs. Feed time is a good time to ice bath as well.
• Don’t put anything in the water that tastes funny! Keep it close and keep it clean.
• Ice bath the feet for as long as there is any signs of pain and heat. During the first few days I suggest every 2 - 3 hours during the day. Continue while are acute signs, heat, pain, swelling etc.
• DMSO roll on can be applied very sparingly every day while the acute symptoms persist. It is absorbed immediately and will get into the system despite the water baths.
• Check with your vet before combining NSAIDs such as Phenylbutazone, DMSO, Flunixin,  etc. These drugs work synergistically and the side effects from their combined actions are worse than that of any single drug.
• Do not change anything if the laminitic patient is getting better. If it’s not broken, “don’t fix it”.
• Do not separate the patient from its mates. Provide company, this is a good incentive to eat and be happy.
• What else can you do to make the patient comfortable?
• When everything is stabilised and the patient is free of pain. Wait another 30 days before moving the horse off sand. Maintain the diet indefinitely.
• Like all medical situations, good nursing leads to rapid recovery.

Advice to the owner from the Vet and Farrier - If we do not hear from you we often assume that all is well. If there is no improvement, please tell your vet and farrier “not everyone else”.

If the horse has pain, please “call the vet”. Ask lots of questions, research widely, and seek second opinions only from those who are qualified to give them. I encourage you to get as much information as you can. We must all learn from each experience and every laminitic horse is unique.

Please keep us informed. If you get a second opinion that is beneficial to the situation, convey the advice, even if you have to write a letter so that your vet and farrier may learn from it as well. Then they may go on to offer better service to other people in the future.