Quirine Tettelaar MVetMed MRCVS CF is a horse vet and owner of Manor Equine Vets Ltd based in Co. Down. She graduated from Ghent University in 2013 with equine specialisation and has been working as a horse vet in the Netherlands, England and Northern Ireland. She has spent a couple of weeks at the podiatry department of Rood and Riddle Equine Hospital in KY, USA. Last year, she became a Certified Farrier of the American Farriers Association, which gives her a huge understanding in podiatry.
THE first time I heard of laminitis, I was about nine years old. My sister’s pony called ‘Sarina’ – a Welsh Mountain type A and always overweight – had opened her stable door at night and let herself into the feed room at our family home. We found her standing in the hall way, not able to walk, the next morning. The vet was called and ‘Sarina’ was diagnosed with laminitis based on the symptoms – her stance, a digital pulse and heat in all four feet.
‘Sarina’ had always been a bit on the heavy side. My mother would say: “She gets fat just looking at an apple!”
Nowadays, I am aware the cause of her obesity was the huge amount of hard feed, hay, haylage, grazing, apples, carrots and other treats! Native breeds are very good doers.
There are hormonal, dietary, bacterial and mechanical causes to laminitis. Laminitis is an emergency, so please contact your vet in case you suspect your horse, pony or donkey is suffering from laminitis! You or your vet should also get in touch with your farrier. The best results are reached with teamwork. I would always advise radiographic images at the start and during the follow up, as the images will be very valuable to your farrier and it will increase the ability to help the patient, whether for trimming or special shoeing. A recent study has shown laminitis occurs just as much as colic – and all year round.
Laminitis is an inflammation of the ‘laminae’, hence the term ends with -itis. These laminae are the connection between hoof wall and pedal bone. This connection can be visualised as microscopic fingers interlocking like the fingers of two clasped hands. Laminitis can cause rotation or sinking of the pedal bone. The deep flexor tendon is attached to the bottom of the pedal bone. When the connection gives at the dorsal part of the hoof wall, the pull of the deep flexor can cause the pedal bone to rotate (see radiograph). When the connection fails at the whole circumference of the hoof wall, the complete pedal bone can sink. The sinkers are the more challenging cases! Usually, laminitis comes with damage to the vascular system of the hoof. Laminitis can be active and chronic.
This time of year, when Northern Ireland is at its most enchanting and fields are green and lush, many of our beloved pets are turned out day and night again. With a mild winter, having been rugged up and fed more than enough during the winter months, equines have not shed their excess weight. Basically, at this time of the year, laminitis is mostly due to obesity and hormone related issues! Obesity can result in ‘Equine Metabolic Syndrome’ (EMS) – it can be compared to Diabetes type II – Insulin Resistance. When a horse or pony suffers from EMS, it does not even have to be overweight. Also, older equines can suffer from ‘Pituitary Pars Intermedia Dysfunction’ (PPID) or better known to most of you as ‘Cushing’s disease’. Ask your vet about the free blood test if you suspect your pet to suffer from PPID.
My basic approach with a laminitis patient is
– Clinical history; finding and addressing the cause
– Dietary management
– Blood test PPID and/ or EMS
– Podiatry: Radiographic views from the front and the side of affected feet; contact the farrier; frog support
– Pain relief
– Box rest; restrict movement as much as possible
Interested to learn more? You are welcome to join a laminitis talk at Enniskillen in June – date to be confirmed. Speakers include Martin Payne AWCF, Seán Rooney BVSc MRCVS and Quirine. It will be held for students and horse owners.