Laminitis is unlike any other equine disease. The complex cascade of events that causes the soft tissues (laminae) within the hoof to swell, weaken and die begins before outward signs are apparent, and once the process has been initiated, it is extremely difficult to halt. What's more, a severe case of laminitis is likely to leave behind a permanent reminder: founder, an internal deformity of the hoof that occurs when the supporting laminae loosen their grip and allow the coffin bone to rotate downward.
Advances in research over the past decade or so have provided many insights into the progress of laminitis, and practitioners have used these findings to develop more effective ways to ease horses' pain and lessen the forces that threaten to pull hooves apart from within. Indeed, horses who once would have been considered lost causes now have favorable odds for surviving laminitis. Still, the condition continues to challenge researchers in the lab, veterinarians in the field and owners facing the prospect of lifetime care for a compromised horse.
For all that is known about laminitis and founder many questions remain, particularly when it comes to expectations and outcomes.
"Laminitis is one of the most complicated diseases there is," says William Moyer, DVM, who has treated hundreds of foundered horses in the past 30 years, first as a farrier and then as a veterinarian. "You can't always accurately predict what will happen from one day to the next, much less a month or a year from now," he says, and that can be a harsh realization for anyone dedicated to caring for a foundered horse, one forever changed by the disease.
Of course, through the knowledgeable counsel of veterinarians and farriers, it's possible for any of us to make well-reasoned decisions about a foundered horse's care, and many times, those decisions will yield positive results. Just as often, however, even the most-determined course of action will seem to have little or no effect, and there will be no apparent rhyme or reason for its failure. That's when many begin to feel the frustration of making critical decisions about a horse's long-term care without substantive scientific facts for guidance.
Lacking concrete answers in such situations, Moyer says he offers the best advice he can, based on his three decades of experience. Yet what he has to say isn't always what owners want to hear.
"All I can do is try to prepare them for the potentially rough road ahead," Moyer explains, and that usually involves taking a hard look at an owner's expectations for a horse's health and future in light of the likely realities of the situation at hand. Here are four areas of concern Moyer most often explores with owners who simply want to do what's best for a foundered horse.
A Cause, A Cure
The expectation: It's necessary to identify the original cause of a foundered horse's condition in order to initiate treatment.
The reality: Treatment can proceed even when no obvious agent or event emerges as the trigger.
"There is a very strong and completely understandable desire among horse owners to know what happened," Moyer says. "But there are times when we'll never know what caused a horse to founder."
Of course, there are times when the inciting incident is obvious and the course of treatment clear-cut. For instance, a horse develops laminitis immediately after colic surgery or as a result of an all-night grain binge. Then there are cases when efforts to identify the cause could prevent laminitis in other horses. For example, if two horses on a farm are stricken a few days after a new shipment of shavings arrives, it's worth ruling out the possibility of black walnut toxicosis.
In just as many other instances, however, the condition's cause is elusive. It isn't directly related to a horse's management or his health status, yet it's tempting to look for something--or someone--to blame. "At times I hear 'Oh, I just dewormed my horse, so the dewormer must have caused it," Moyer says, observing that a single incident does not make the case for a causal link. For example, he says, if a horse develops laminitis after receiving single injection, the two events are not necessarily associated, and it's important to avoid misdirecting blame.
Only the Best Will Do
The expectation: Choosing the most effective treatment regimen for a foundered horse is simply a matter of knowing as much as possible about the available options.
The reality: The reason so many options exist is that there is no one best way to manage a foundered horse. What works for one horse may not work for another, and in many cases, only time will tell whether a treatment is effective.