Balanced Stride

Before we can explain what Laminitis is we must be aware that even though there have been major leaps forward with technology within the medical community the fact still remains that there are parts of the disease referred to as Laminitis that are still a mystery. We do know that the foot disorder  will and can affect the old horse as well as the young horse. It can affect the horse that is in a high state of training and is very conditioned and healthy and it can effect the horse that receives much less attention and might even be days or weeks before any type of work is asked of it. It can also effect any breed of horse that is known to this date.

The name of the disease tells us that there is an inflammation to a specific area or that there is an inflammatory reaction. In reality when laminitis does strike there can be little or even no clinical signs of the disease. It has been research in this area that is starting to link the disease to specific diseases that horse do suffer from, but in most cases it has been found that laminitis is a result of poor horse management.

The Three Stages of Laminitis

There are three phases of the disease that have been determined and defined within the disease of laminitis. The first is the “Developmental Stage”, the second is the “Acute Stage” and the third is the “Chronic Phase”.

·         The “Developmental Stage” is when the horse is exposed to the factors that can cause the condition to occur. This stage continues until the first indications of the second stage start to appear.

·         The “Acute Stage” has a varying length of developing time. This stage of the condition can start to affect all four of the feet of the horse, but in most cases only the front feet are involved. There is a noticeable pulse at the back of the fetlock or pastern area of the foot. There is obvious pain and a higher amount of heat that is emanated from the effected feet.

·         The “Chronic Stage” starts to come into the picture when the coffin bone, inside the foot itself, starts to rotate in a downward fashion or if pain has continued for a period of time that is 48 hours or greater. This is the most painful point for the horse and can continue for days, weeks, months, or for the rest of the life of the horse.

What Causes the “Developmental Stage” to Start?

 There are many factors that can start the initial stage of laminitis to move into action, they are:

1. The feeding of a lager than necessary amount of cereal grains into the horse's diet. This is often referred to as “Carbohydrate  Overload ”.  

2. It introduction of new or lush pasture grass to the horse when the horse is not conditioned to that item in their diet. This is referred to as excessive “Legume Consumption”.  

3. After a horse has been worked excessively and is very thirsty is then allowed to drink water that is too cold in too short a period of time into their warm body.  

4. The first stage can also be triggered by a bacterial infection known as “Septicemia”.  

5. Another factor that can trigger the first stage of laminitis into action is the working of a horse too hard or too long on too hard a surface. This causes excessive concussion to the feet and the impact that is received does not allow the foot to work correctly. This is referred to as “road founder”.  

6. There are times that the first stage is triggered by a hormonal change, such as the foaling process.  

7. This stage can also be started as an after effect of a high fever that a horse may have suffered. This is referred to as a “viral” reaction.  

8. There are times that horse might react to medical injections. This condition will always be associated with the giving of corticosteroids. This is referred to as “Pharmacologically Induced”.

What Happens Inside the Foot as the Stages Progress?

Once that the initial stage has begun to happen and the imbalance of the acid and endotoxins  start to enter the circulation system  there is an increase in the blood flow to the foot. Since there is only tendons and ligaments in the lower portion of the leg blood is moved out of the foot through motion. If the horse starts to become sore from excessive blood beginning to pool at the area of the hairline and then it is not being moved out of that area it will create a condition that starts with the creation of heat in that specific area of the foot that heat will then travel throughout the entire foot. It is at this point in the process that the circulation of the blood is becoming restricted and now starting a process that allows specific internal tissue to die due to the lack of nourishment. The pressure that is now present within the foot is staring to build to the point that will cause lameness to become a serious situation. Once that the internal structures have died there will be the high probability of abscessing and having the possibility of adding to the initial problem through the releasing of bacteria into the blood stream of the horse.

Once that the heat reaches the proper temperature it will expand the laminae tissue that completely covers and helps to support  the coffin bone in its proper position. Once that the expansion is initiated and the supportive nature of the laminae tissue is compromised the coffin bone will start the rotation process. If left unchecked, the coffin bone can continue to rotate to the point where it will eventually protrude through the bottom of the foot and which will then spread infection through the entire body of the horse.

In a nutshell that is how all three stages occur within the foot of the horse. But, as you now know it does not just start and end in the foot of the horse.

Clinical Signs of the “Acute Stage” of Laminitis  

 When a horse starts into the acute phase of founder most horses will show an increase in body temperature (show signs of a fever  and/or heavy sweating may appear) and their breathing will increase as well as their pulse rate will also rise. Other situations that may arise are the horse will refuse to eat  and the pulse at the digital artery (located at the rear of the foot) will also increase.

The feet that are affected by this stage of the problem will also be warm to touch, the horse may want to lie down and may not want to get up once that it has gotten down. After all, this situation is extremely painful and the need and desire to reduce or eliminate the pain is foremost in the mind of the horse.

 In some cases since all that is going on within their body and there is the raised body temperature the horse could start to sweat and could lose weight quickly. Soreness and a reluctance to walk may also be noticed.

If any of these signs are present it is the time to call the veterinarian and let them know what is happening ~ time is of the essence at this point. The faster that initial treatment can be started and the process slowed down the greater the opportunity for lessening the overall effect of the process will be.

 The area of the “Acute Stage ” of laminitis can be divided into four levels, they are:

 1.       Grade One .  Of all of the levels of severity this is the least. At this point the horse is uncomfortable standing on their feet. What will happen is the horse will stand on one foot and lift the other off of the ground and then they will reverse the process. This will be a continuous pattern that the horse will follow. The horse if in motion will not be lame at the walk, but as you progress to the trot their movement will become shortened and choppy in effect.

2.       Grade Two .  At this level the horse will be able to move easily into the walk but indications of soreness will be noticeable with movement.

3.       Grade Three .  It is at this stage of soreness that the horse will not be will to allow you to pick-up a foot. This is due to the pain that is suffered when more weight is placed on the opposite foot when trying to pick-up the foot. At this level the horse will move but it will be a labor to do so. The horse does not want to induce any pain to them.

4.       Grade Four .  It is at this level that the horse does not want to move at all and if you want them to move you have to use great effort to get any movement in a forward motion. There is constant heat present in the areas of the hoof wall and the hairline. There is also a very noticeable pulse at the back of the pastern area and the pain that the horse is in is quite noticeable. It is at the levels of two, three and four the horse will either spread its legs outward (like the legs of a saw-horse) or even inward (like it was standing inside the area of a pie plate) to help get away from the pain that is present in their feet. This condition is also where you need to monitor the horse for signs of shock.

What to Watch for

When the horse is standing in the manner that they are more spread out the horse will expend their front feet out in front of them and will rock from the front to the rear feet and appear to be standing on the heels of the front feet. This is done when the front feet are the main point of entire problem.

When the horse start to stand in one small are with all four feet together under themselves allows them to take some of their weight off of the rear feet since the rear feet are the main point of pain at this time. This is referred to as “standing in a pie plate” .

Treatment

Any time that someone is called into treat a horse that is suffering from “acute laminitis” has to treat the situation as an emergency situation. For it may the quick treatment that the horse initially receives that keeps that same situation from going into a “chronic” situation. The main point that any treatment has is the two goals that needs to be realized if possible one, the elimination of the cause and then two, to manage the effects that are going to be realized from the cause. If it is possible to aggressively treat the condition in the developmental stage you may then be able to prevent a case of laminitis from taking hold.

The treatment of a “chronic laminitis” situation is one to halt and prevent any further rotation of the coffin bone. Before any treatment to the “chronic laminitis” has been started there has to be a full assessment made. What has to be determined is what is the use of the horse and will it be able to go back to what it was doing before the condition was discovered, There is also the financial commitment that the horse owner must be willing to commit to. Then there is the commitment of the horse owner and/or the trainer are willing to make in the management of the horse in the future and finally there is the possibility of any future or additional conditions that may become evident as well as the possible damage that will be suffered has to be considered.

There has to be a very complete and regular x-ray program. A series of x-rays should be taken, no more than two weeks apart, that will allow for the proper monitoring of the changes and improvements as they happen.

There needs to be a change in diet right away. Any present program that has a high-energy carbohydrate base needs to be replaced with roughage. There should also be a lowering of salt intake this will reduce any hypertension.

Hoof Care for the  “Chronic” Horse

The care of the feet including proper trimming and correct shoeing  are very important in this part of treatment. The goal here is to give correct and maximum frog support so that the following is allowed to happen:

• Reduce the strain on the deep digital flexor tendon so that any tearing forces that may have been present can be reduced and then eventually eliminated.

• Protect and allow the laminae tissue to become strong and able to help in the supportive process thus allowing the coffin bone  to have much more integrity.

• Allow for any drainage that may have to be completed in a manner that will not interfere with the other areas of the healing process.

• To remove any and all dead and loose tissue that is possible while still allowing maximum support of the entire foot.

Proper Treatment for Founder Problems

In order to properly have the correct procedures be followed there has to be quite a few points that need to be both considered and accomplished. These points are easy enough to explain and sometime difficult to accomplish, since the correct decision and procedures have to be determined and accomplished that are correct for the particular situation that your horse is going through. Additionally, you are at the mercy of persons that may or may not know what is necessary or even required to set your horse onto the most comfortable path to recovery.

There has to be some very basic points that the farrier has to cover within themselves to make sure that they are able and experienced enough to accomplish what is necessary to both start and finish the task at hand. If they do not have the required abilities, they then have to be professional enough to help the horse by referring or bringing to your attention another person that is experienced enough to accomplish what may be necessary. A point of contention here is that just because the average farrier is quite capable of taking care of the day-to-day requirements of the average or good-footed horse, it does not mean that they have the highly skilled ability or the knowledge that is specifically required to help the horse correctly. There are people within the farrier industry that do specialize in what is referred to as “Corrective” or “Orthopedic” style of farrier work. This specialist is what is required at this point. It would also be a major point of progression for your particular farrier to assist the specialist so that knowledge and expansion of abilities can happen. The results of this can be two fold, the farrier gains the knowledge and the experience of the more advanced education and allows the same farrier the ability to be available in the event that the specialist is unable to get to the horse right away in the event that shoes may be thrown or minor adjustment might be required to be accomplished when the specialist is not readily available. Most specialty farriers have no problem with this arrangement since they have a great amount of workload from being a limited number of themselves to be able to accomplish all of the work that is out there. Any point that allows them to have a bit of the load removed will be greatly appreciated.

The farrier that is chosen to accomplish the work that is required needs not only the experience but the proper amount of confidence  has to be in place that will allow them to make the solid judgments that may be necessary as they appear and have to be dealt with in a positive way. The person that you have chosen to accomplish the necessary work must have a positive relationship with the veterinarian that you have been working with on this particular problem, for if you do not look at that point there could be major conflicts in the procedure to follow as the program progresses. Once an initial program has been started it has to be followed and not wavered from; this takes cooperation on both sides of the equation to end up with the correct answer that is right for the horse. The ability to understand the principles of allowing the horse to be balanced from the ground up through the entire body must also be understood, for understanding the complete balance principles there will be a complete understanding of the interior of the foot and its proper and correct operation and position.

 One of the most important abilities that a specialist type farrier can have is the ability of being able to look at the problem that is at hand and to visualize within their own mind the finished product before the work is even started. This one ability will allow them to have the finished product always looking them in the face as they progress through the various steps and procedures that will lead to the completion to the program. This is the same as filing a flight plan by a pilot to make sure that they follow the safest and most reasonable path and to get to their required destination in the required time.

 As the owner of such an animal that has suffered from this particular foot situation there are also requirements on your side of the fence. You have to be able to change ~ you have to remember that this situation did not occur overnight ~ and can’t be fixed overnight either. The changes that the owner has to make are that they have to be able to start to provide the necessary after care as both the veterinarian and the specialty farrier  direct you. What they will be doing is instructing you as to the everyday procedures that are necessary since this situation can be slowed down, but it will never go away. The horse can be made more comfortable, but never totally recover from this particular problem.

 There are many steps and stages that have to be approached and accomplished to help the horse through this problem. Each of them have to be done in a proper and correct sequence that will allow for the best and most complete method that is right for each foot and/or horse that is affected by this problem. Following the instructions of the professionals that have been chosen to accomplish this task is the best path for the owner to follow. There will also be specific jobs and responsibilities that the owner will be asked to accomplish. The next section will best explain what will be required of the owner once the veterinarian and the specialty farrier  have seen the horse and that the condition has been stabilized.

Responsibilities of the Owner

The particular situation that the horse has gone through will require a great deal of care on a daily basis. First and foremost the schedule that has been set for the treatment should be followed to the absolute letter of the law. In most cases the shoeing  cycle will range from four to six weeks depending on the severity of the particular situation. This cycle will continue for weeks, months and sometimes even years. As progress is determined to happen this cycle may be changed and the length of time between shoeing cycles may lengthen or even shorten to accomplish the required results.

If and when the horse suffers from abscesses they must be treated. The drawing out of the abscessed material within the foot does this. This is best done in a situation that allows for the soaking of the feet in an Epsom salt solution. Once that the soaking process has been accomplished you will need to protect the bottom of the foot from further damage, so it is best to place an “easy boot” on the foot with a layer of cotton or other cushioning material inside of them to make the horse more comfortable when wearing them at this time.

It is best to keep the horse in an area that is deeply bedded and if outside they need to have a softer than normal ground surface to deal with. The reason for this is that the horse may want to lay down quite a bit while going through the initial stages of healing and the soft ground will be easier on their body since the getting up and down on a hard surface will create sores and rubbed raw spots all over their body. This could be an additional problem for you to look after if not maintained now. With this problem the last thing that is needed is one more thing to look after.

Feeding changes and schedules should be obtained from the veterinarian since he may have your horse on a specific program.

As far as the outlook for the horse as to how long and to what extent as to the damage that your horse will suffer is a varied as the extent of the damage that has been accomplished by the process itself. There have been a few cases where I have seen horses recover in thirty days, but in most cases it takes close to a year or even longer. I have seen various stages and types of founder that require limited to extensive schedule to help them recover. The best to say is it all depends on two things ~ the extent of the damage done and the rate of recovery. I have seen horses that have recovered to be useable and have seen other that never get much relief from pain.

It should be noted that once that a horse suffers from this problem, it is much easier for them to suffer a second or third, etc., bout of the condition which was brought on with a lot less resistance. Horses that have suffered from this particular condition need to be monitored for the rest of their life in a manner that will present the least possible conditions in their life for a relapse.

Additionally there can be other side effects of this condition. Most of these side effects are easy monitored and maintained. One of the most noticeable is the “cresting” of the neck. It is as if there is also a reaction in that particular area of the body with the crest of the neck turning to a gristle-like material and becoming quite hard and has a tendency to flop from side to side as the horse moves about. This particular side effect will happen each time that the horse suffers a session of founder, that is to say the more times that a horse founders the larger the “cresting” will become. I have seen this situation so bad that the crest of the neck will actually lie to the side due to the hardness and the weight that has been created.

 Another point that happens is the change in the growth pattern of the foot. A foot that has gone through some of the more advanced stages of the condition, to the point of some rotation of the coffin bone will tend to grow more heel at a faster rate than the toe will grown in the normal shoeing cycle. This happens due to the change of the internal bone structure and needs to be corrected to allow for the maximum comfort of the horse.

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