The word "laminitis" can send a jolt of fear through any horse owner. Certainly, you need a healthy respect for the disease. But you can get control of laminitis by following a three-prong approach-diagnosis, diet and medications, and trim.
Laminitis can have many causes. The one we usually think of is when a horse overeats grain or large amounts of lush, green pasture grass. Other causes include severe colic, some drugs (corticosteroids), serious infections (such as salmonella), Potomac Horse Fever, systemic strangles, Lyme disease, retained placenta, and exposure to black walnut or other toxins.
To learn more about laminitis in horses, download a FREE guide—Learn About Chronic Laminitis in Horses: The risk, prevention, symptoms and treatment of this hoof disease.
When laminitis stems from one of the above, it's usually not difficult to identify the cause. However, a growing number of horses develop laminitis without any of these triggers, and the underlying cause for these cases is hormonal or metabolic. Recurrent problems are the rule rather than the exception, and the laminitis can get to the point that the horse is in pain more often than not.
The future of these horses has often been dim, with traditional treatments having low success rates. As we come to understand better what's going on, though, it's been possible to put together a plan for identifying the causes and bringing them under control at the same time as the feet are receiving correct care so that they can heal.
- Find the cause of the laminitis, so the culprit(s) can be eliminated or controlled.
- Feed the horse a proper balance of protein, vitamins and minerals to help repair his feet.
- Adjust his daily diet to achieve and maintain the ideal body weight.
- Discontinue use of anti-inflammatory drugs after the acute phase has passed.
- Get and maintain a correct trim to make the horse comfortable and to lower the risk of further damage.
Unless the cause of the laminitis is removed or controlled, it's unrealistic to expect long-term improvement. If the cause is unknown, your vet will need to do blood work to check for any signs of infection, a blood chemistry analysis for organ function, and a blood insulin level test (which means your horse gets nothing to eat except hay for at least four hours before having his blood drawn).
Middle-aged to older horses should also be screened for Cushing's disease, which is caused by a pituitary tumor. A serum ACTH level is the safest Cushing's test to perform in horses with a history of laminitis.
This detective phase is very important because the results will dictate what the horse needs for treatment, and if there are special dietary concerns.
Meals and Medications
Regardless of the cause of the laminitis, the horse will need a diet with adequate protein, vitamins and minerals to repair the feet. Because the horse won't be exercising until the repair process is completed, you'll need to carefully match how much the horse is fed to his body condition so that he doesn't become overweight, which mechanically stresses the feet.
Free-choice hay is usually the best place to start, along with a vitamin, mineral and protein supplement that matches your hay. If the horse is overweight, but developed laminitis from a cause other than insulin resistance, you can still use the insulin-resistance diet guidelines below or implement the tips in our "Lean Cuisine" article. (See the April 2006 issue of Perfect Horse.)
If your horse is laminitic because of insulin resistance, diet is absolutely critical. Even if the horse is insulin resistant because of Cushing's disease, odds are that medication may not be enough to completely control the insulin resistance and avoid laminitis.
The most critical point is to reduce your horse's level of sugar and starch. Both sugars and starch cause blood glucose levels to rise, and insulin along with them. Items on the forbidden list include:
Grain in any amount, including in treats or as an ingredient in complete or senior feeds
- Apples or other fruits
- Fresh grass
- Oat hay or other grain haysFor reasons that aren't clear, alfalfa hay can cause problems for some laminitic horses. Others are okay with it, and the sugar and starch level in alfalfa is often lower than in many grass hays.