How to recognize the early signs of laminitis

Illustration of founderCatching laminitis early can help minimize permanent damage to the internal structures of the hoof. However, the signs can be subtle.

Laminitis can be sudden — brought on by a fever or an overload of carbohydrated — or it can be gradual. So, what should you look for? Keep in mind that no one symptom indicates laminitis and in some cases, a horse might not exhibit a common system, such as heat in the hoof, and still have it.

Foot soreness — while this can also be an abscess or bruising, if your horse becomes tender-footed, make sure to check his digital pulse and determine if there’s any heat in the hoof and ask your vet to apply hoof testers. An abscess typically

Reluctance to move – if your horse appears to be very stiff and is reluctant to move, check his feet.

Hind feet tucked underneath its body – laminitis more typically presents in the front feet so if your horse is standing with his hind feet further under his body than usual, it may be a sign that the front feet are sore.

Lethargy or reluctance to eat - if your horse typically has a good appetite and turns up its nose at grain, lack of appetite can be a symptom of laminitis.

Atypical weight bearing – a horse that has a limb injury can cause a horse to put too much weight on the opposite limb, triggering an episode of laminitis.

The best defense is to know your horse and take all deviations in “normal” behavior seriously.

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Knowing when to call the vet

Fortune was stocked up

When I first saw Fortune I realized she was uncomfortable but I thought it was her hind legs — her injury is on her RH but her LF was quite stocked up. Later I found out it was her front feet.

One of the only things I don’t like about being in a co-op barn is that when a horse looks not-quite-right, it’s up to the person feeding that day to

a) notice,
b) know what to do, and
c) decide whether you have identified a problem or are just being alarmist.

No one thanks you if you call the vet unnecessarily; no one is happy if you don’t call the vet and there’s a problem.

On Tuesday, it was my turn.

Luckily, it was a morning where I’d chosen not to hunt. I’ve been feeling behind for days, if not weeks, and I thought a nice quiet day would do me good.

So, I wasn’t in a hurry when I fed. Which was just as well because Fortune just didn’t look right. She’s been on stall/paddock rest for the past two and a half months recovering from a fractured sesamoid and a torn suspensory ligament. But she’s been a good patient and has been looking pretty content.

That was not the horse that greeted me. She was lethargic, not interested in her breakfast, her hind legs were quite stocked up and she was reluctant to move (normally she walks cheerfully into her paddock for her grain). What bothered me the most was how she was standing. Her hind legs were too far under her body and too close together. And she was shifting the weight on her front feet.

I watched her for a few long minutes. One of the advantages of taking care of the horses is that you get to know them pretty well so that differences in their attitudes or posture stand out. I know my own horse very, very well but it’s harder with another person’s horse. I tried to encourage her to walk. She looked stiff and uncomfortable but she wasn’t running a fever and there was fresh manure in her stall. I didn’t want to unnecessarily panic her owner so I called the vet. One of the things I really, really appreciate about the practice that we use is that they are happy to talk to you on the phone. She listened to my observations, and agreed that a farm call was probably in order. So I called Fortune’s owner who scheduled the visit.

I had just gotten back from my ride when the vet (a different one from the one I’d spoken to earlier) showed up. I explained what I’d seen and showed her some photos I’d taken of her hind legs which showed the swelling. I still felt a bit sheepish about having the vet come out but hoped it wasn’t something serious. When I left, they’d ruled out colic and the vet was pulling out her hoof testers.

An hour and a half later I was back at the barn . . . and the vet was still there. Not good. It was the early stages of laminitis and they were already icing her feet. Her discomfort had been real but instead of hind legs, it was her front feet.

Fortune was moved to the vet’s clinic for the next few days so they could manage her care. Luckily, the films show only a tiny (2 degree) rotation of the coffin bone. The vet thinks the laminitis was brought on by a combination of rich second cut hay and inactivity, but it’s hard to know.

I am glad I was paying attention and glad that I suggested a vet visit. Delaying would have only caused the situation to become worse.

Generally, for my own horse I call my vet if something seems wrong just to give them a heads up and find out when they plan to be in the area. I only get a vet out immediately for a wound, a serious colic (I’d call and give Banamine first), or an incident like choke. Often if a horse looks slightly off or has a puffy leg, I’ll cold hose, ice and wrap it first to see how it responds (when Freedom injured his check ligament I knew right away that it wasn’t just a sprain. It looked serious). But it’s so much easier to make those decisions with your own horse. I’ve had other barn members want to wait before calling a vet — in fact, several years ago a pony at our barn was showing classic signs of laminitis but I couldn’t convince the owner to call in a vet. The pony foundered quite severely and while she recovered, it was touch and go for awhile.

When do you call the vet about someone else’s horse? I have to say that it was one of the days when I really would have liked to turn the whole thing over to a barn manager!

Current thinking on the role of spring grass in laminitis

Freedom Grazing

Right now our pastures are close as we wait for the grass to grow in. But Freedom looks at the tender green grass with longing!

During the spring our pastures are closed for two reasons: first, we need the grass to get established and second, I’ve always worried that excessive amounts of lush, spring grass might be the cause of health issues such as laminitis.

However, according to an article on Fran Jurga’s Hoof Blog, it’s a bit more complicated. The majority of horses that experience laminitic episodes triggered by spring grass also have an underlying endocrinopathic condition.

Read more about this new way of thinking about the causes of laminitis here.

Change your horse’s feed gradually

How to change over your horse's feed

Read guidelines on how to change over your horse's feed at EquestrianHow2.

For horses, consistency in their diet is key to good health. Horses develop a microbial population in their intestines that is specific to what they are being fed. Changing it can cause digestive upset that can lead to colic and, in extreme cases, laminitis. According to a recent SmartPak Webinar, 10 Guidelines for Smarter Feeding, changing hay can increase the risk of colic by a factor of 10; changing other feeds increases the risk of colic by a factor of 5.

It takes time for the gut to develop a new bacterial population so most people recommend changing no more than 25% of your horse’s ration at a time, giving its intestinal bacteria time to develop. Of course, if you feed just a handful of grain or a small amount of ration balancer you can change over more quickly than a horse eating 8 to 12 pounds of a complete feed, so use your judgment.

Here are some guidelines that can help the process.

Free Laminitis Diagnosis Webinar

This film shows acute laminitis. In this case the horse has foundered, meaning it's coffin bone has rotated and actually punctured the sole of its hoof.

Several years ago a pony at my barn foundered. She had looked ouchy for awhile and her owners took a wait and see approach. Finally, one day I looked at her and as she stood there, she was shifting her weight in a way that I had read laminitis can present. Still they didn’t call the vet. I had never seen a case of laminitis and didn’t push it probably as hard as I should have.

The next day a woman visited the barn who happened to be a vet. She looked at the mare, checked for a digital pulse, and said, “call your vet yesterday.” The pony foundered, experiencing 12% and 14% rotations of both front coffin bones.

Everyone should learn about laminitis so that they can recognize the early signs and hopefully prevent their horse or pony from foundering. Early treatment can make a huge difference.

Here’s a good start. Laminitis Diagnosis and Treatment is a FREE webinar offered by http://www.thehorse.com. It is a practical explanation of laminitis, diagnostic imaging, interpretation, and treatment principles. The presenteres include Amy Rucker, DVM, Midwest Equine; Joanne Kramer, DVM, Dipl. ACVS, University of Missouri Clinical Assistant Professor; Nicholas Frank, BSc Hons, DVM, PhD, Dipl. ACVIM, Section Chief of Large Animal Medicine at the University of Tennessee and it includes questions from those who attended the webinar.

As for the pony at my barn? She recovered and is now sound. However, it was a very traumatic event both for the pony and her owners that went on for weeks, during which it was unclear whether she would make it. No horse, pony or human should have to suffer through that.

More on laminitis in a future post!

The Great Escape: Van and Freedom on the Loose

Yesterday I got one of the calls that all horse people dread: my horse and his pasture mate were loose and spotted about a mile from the barn running on the road. Someone had opened the gate and the two horses had simply left.

I drove the five minutes to the barn in record speed. The horses were, thankfully, back in their pasture. A quick inspection revealed that both horses had no cuts, scrapes or puncture wounds. Hooves that were supposed to be shod still had shoes. Neither horse had fallen or been hit by a car. I could tell though, that at least my gelding was uncomfortable and stiff just from how he was standing.

I am lucky enough to live in a town where one of the police officers also has a horse. Even luckier, he was on duty yesterday and was able to herd them back home and catch them. Thank goodness they waited until after rush hour, ran away from the commuting route, and stayed on back roads where people generally don’t drive too fast. I heard that they mostly stayed on the right side of the road too!

So, what should you worry about once your horse returns from an unscheduled outing on pavement? Laminitis and tying up.

Road founder is laminitis that is brought on by excessive concussion of a horse’s feet from running on the road. It’s actually a misnomer since laminitis refers to an inflammation of the laminae of the hoof. Founder refers to laminitis that is so severe that the bond between the coffin bone and the hoof capsule breaks causing the coffin bone to rotate and/or sink. While all horses that founder have laminitis, not all horses with laminitis founder. Quick action can prevent founder in many cases.

Tying up (exertional rhabdomyolysis) occurs when there is a lack of blood flow to the muscles of an exercising horse. One of the causes can be sudden and intense exercise, such what can happen when a horse gets loose. When a horse ties up, the symptoms are muscle stiffness and cramping. The horse may look stiff, show reluctance to move, and have hard, tight muscles, especially in its hindquarters. What you can’t see is that ER can cause muscle damage.

A call to my vet advised giving them a dose of Banamine and icing their feet in case the concussion of running on the roads brought on founder. The first 24 hours are the most critical when facing the potential of laminitis and icing can make a huge difference.

Check the digital pulse at the back of the fetlock join.

Check the digital pulse at the back of the fetlock join.

I checked their digital pulses and both horses seemed normal. I was very glad that there was still enough snow in one part of the pasture where I could stand them and have them iced up and over their coronary bands. Freedom was stiff and his muscles felt tight. I used some massage techniques and got some big releases.

Hoof testers are used to check for sensitivity.

Hoof testers are used to check for sensitivity.

Later that afternoon my vet stopped by to check on the two escapees. I wanted to make sure there was no hoof sensitivity, triple check the digital pulse and draw blood. He found no sensitivity and a normal digital pulses when he checked both horses.

By that time Freedom’s muscles had relaxed. The combination of Banamine, the several mile run, and a massage left him sleepy. Van, on the other hand, was showing signs of tying up. His muscles were tight and he was walking stiffly. To help him recover, the vet tubed him with Dimethylsulfoxide (DMSO), which is both an anti-inflammatory and a radical scavenger, and also gave him electrolytes.

Having the vet come by and check them probably allowed me to sleep last night. I was so relieved that they were doing so well. At 11:30 last night they were both still doing fine and this morning they were a little stiff and highly annoyed that they are not to have grain until Wednesday or Thursday!

Read more about laminitis and tying up:

Grass Clippings Don’t Make Good Forage for Horses

Every couple of years a “kindly” landscaper or home owner offers our horses grass clippings from their lawns. Their intentions are good, but the consequences to horses can be severe.

Yes, horses eat grass, so why not grass clippings? There are several reasons why it’s not a good idea:

  1. When grass is mown and especially when it’s bagged, the clippings can start to ferment and mold which can cause problems such as colic if your horse eats them.
  2. Because the cut grass is easily consumed, it encourages horses to eat too rapidly and swallow without much chewing. This can result in choke.
  3. The small particle size of the clippings can cause rapid fermentation in the horse’s digestive system. This can potentially lead to colic, or can cause laminitis if the horse isn’t used to grass.
  4. Lawns often are treated with chemicals that can be harmful to horses.
  5. Lawn clippings can contain bits and pieces of ornamental plants like oleander or Japanese yew, which are highly toxic to horses.
  6. The turf grasses used for lawns generally aren’t nutritionally balanced for horses any way so they wouldn’t be a good choice to feed.

There is a difference when you are talking about the clippings that result from mown pasture. This situation is unlikely to cause the types of problems listed above. For one thing, it’s the same grass that they normally eat, so it will not contain fertilizers or pesticides. Since the clippings are not bagged, they will generally dry and become like hay or straw, rather than mold or ferment and because they are spread around the pasture, there is no risk for choke. While some people choose to keep their horses off freshly mown fields for 12-24 hours as a precaution, the risks are generally very low.