Laminitis Guide

Laminitis is an Emergency

Laminitis is a serious and debilitating disease and can ultimately result in the death of the horse. If you suspect that your horse has laminitis you should contact your vet immediately as the longer the problem goes untreated, the greater the risk of irreparable damage occurring.

What is Laminitis?

The term laminitis means quite simply 'inflammation of the laminae'. The laminae bond the hoof wall to the pedal bone, which supports the entire weight of the horse or pony. Severe cases of laminitis can result in the pedal bone rotating downward (see photograph). These changes can occur within hours, to varying degrees, and are irreversible. Laminitis can affect all four feet but is seen more frequently in just the front feet.

Nutrition related causes of laminitis are the most common but there are others including excessive concussion, stress, infections in mares that retain placenta after foaling and administration of steroids. Older horses and ponies with Cushing's Syndrome are more susceptible to laminitis and so need to be managed as if they are prone to laminitis even if they haven't had it previously.

Photograph provided by "The Laminitis Trust"

Symptoms of Laminitis

Extreme pain, pounding digital pulse and warm feet.
Discomfort, shifting weight from one foot to another.
Slow and stilted walk and trot, difficulty in turning, especially on hard ground
Classic laminitis stance - rocking back onto hind limbs taking weight off the front feet.

Horses and ponies with laminitis are usually reluctant to move and in more severe cases may even lie down. With an extreme case, the pedal bone can sink or rotate through the sole within 24 hours, this normally requires the animal to be euthanased

In less severe cases the laminae will heal, and the bond between the hoof wall and the pedal bone will mend. The prognosis for your horse and pony will largely be determined by how quickly you act. It is also vital that your vet and farrier work closely together and that they are experienced in dealing with laminitis.

Frequent and careful attention by a farrier is essential for all horses and ponies that suffer from laminitis.

What Goes on Nutritionally?

Research has shown that in contrast to what was believed for many years, laminitis is NOT caused by feeding excess protein. We now know that the main culprits are likely to be water soluble carbohydrates (sugars) and starch, the main sources of which are grass and cereals. Research has shown that specific grass sugars known as fructans, play an important role in triggering laminitis. It has also been discovered that high starch diets can cause other digestive upsets such as colic and gastric ulcers and increased acidity in the stomach is thought to be the reason horses crib bite.

It's important to remember that horses and ponies evolved to eat a high fibre diet, on a little and often basis. Research suggests that horses and ponies that are overfed water-soluble carbohydrates or starch, through an excessive intake of cereals or grass sugars, develop an increase in hind gut acidity.

The sugar and starch in feed is normally digested and absorbed in the small intestine within about 90 minutes. If a large cereal-based concentrate meal is fed or the horse or pony has access to large amounts of spring or autumn grass, the sugar and starch is pushed through the small intestine and into the hindgut before it is fully digested. Once in the hindgut, certain types of bacteria ferment the sugar and starch rapidly creating an acidic environment (acidosis). The bacteria that normally digest fibre cannot survive these acidic conditions and start to die. As they die, their cell walls rupture and endotoxins (poisons) are released. The acid environment can damage the gut wall which allows the toxins to be absorbed from the gut into the blood stream. Horses and ponies react to these poisons by releasing chemical substances, including hormones. These hormones are believed to affect the blood flow throughout the body including the capillaries to the feet. The blood flow becomes restricted and the foot effectively has a 'stroke'.An alternative view from Dr Chris Pollitt suggests that the changes in the horses or pony's feet may be due to a dissolving of the lining membranes of the laminae rather than a primary problem with blood flow.

MY HORSE HAS LAMINITIS - WHAT NOW?

As soon as laminitis is suspected veterinary attention must be sought immediately and the suspected cause removed.
Stable the horse or pony on soft, deep bedding such as shavings.
Re-assess your horse or pony's diet ensuring that you feed one with a high fibre, low starch and low sugar content.

A good quality forage should be used as this will help to meet more of the horse or pony’s requirements allowing little or no cereal to be fed. A quality forage will provide good levels of essential amino acids which are needed to build and repair tissues such as muscles and hooves. It will also contain good levels of calcium which research has shown is beneficial for improving hoof growth and quality (Vet Record, 1987). The forage should also be low in sugars and starch.

Alfalfa fulfils all these criteria. The graph and table below clearly illustrate that alfalfa is low in both sugar (including fructans) and starch. Additionally, alfalfa is a rich source of calcium as well as the essential amino-acids lysine and methionine, which are required for healthy hoof growth.

Extensive trials of a mix of chopped alfalfa and oat straw mixed together with a low sugar coating, have been carried out at the Laminitis Clinic and Redwings Horse Sanctuary as well as by many independent horse and pony owners. A blend of alfalfa and oat straw has an energy value equivalent to hay but with a lower sugar content. This combination has been fed and recommended by the Laminitis Clinic and Redwings Horse Sanctuary as well a being used by many independent horse and pony owners.

FEEDING TO HELP PREVENT LAMINITIS

Maintain your horse and pony at a sensible bodyweight, feed according to work done.
If horses and ponies are fed energy or 'calories' in excess of their daily requirements they will put on weight.
Restrict access to grazing, particularly in the spring and autumn, and remember to remove droppings frequently to avoid a large worm burden. Limit grass intake by using a grazing muzzle.
Feed highly digestible fibre feeds that are low in sugar or starch e.g. alfalfa. Try to feed little and often to mimic the horse and pony's natural grazing behaviour and to help ensure that any sugars and starch are fully digested in the small intestine.
Feed a live yeast culture to improve fibre digestion and to help to increase the number of cellulytic (friendly) bacteria in the hindgut.
If more energy is required for additional work or weight gain, use feeds that are high in fibre and oil with a low starch content. Soya oil, for example, is a “safer” source of energy than cereals as it contains no sugar or starch.

THE LAMINITIS TRUST

The Laminitis Trust was formed in 1998 following consultation with the Veterinary Medicines Directorate. The Trust has awarded certain feeds "Laminitis Trust seal of approval". Dengie are pleased to announce that Hi-Fi Lite, Alfa-A Lite, Healthy Hooves and Alfa-Beet have all been awarded this approval, illustrating their suitability for the healthy maintenance of horses and ponies prone to laminitis. Dengie Horse Feeds is the only manufacturer with 4 products approved by The Laminitis Trust.

Remember that ANY horse or pony is susceptible to laminitis, from a Native pony on spring grass to a Thoroughbred. Do be careful not to overfeed, overweight horses and ponies are more likely to suffer from laminitis - a 500kg horse can consume up to 65kg of fresh grass a day, i.e. 12.5kg of dry matter or over 3kg of simple sugars!

TECHNICAL ADVICE

Dengie offers a full technical support service including ration evaluation, nutritional advice and individual yard consultations by their equine nutritionists. Please contact us on 0845 345 5115 if you would like help with your horse's diet.

Content of water-soluble carbohydrates (WSC), starch and fructan in different feeds (g/kg DM)
	SUGARS (WSC)	STARCH	FRUCTAN
Oats	11	430
Barley	25	570
Spring grass	40-300	10	Up to 400
Hay	110	3
Alfalfa & Oat Straw with a low sugar coating	40	18	20
Unmolassed Alfalfa and Sugar Beet	70	20	10
Unmolassed Alfalfa Pellets	70	20	23
Lightly molassed Alfalfa	95	20	55