E
Endocrinology
Endocrinopathic laminitis
Endothelin-1
Endotoxins - endotoxaemia
EOTRH
Epidemiology (of laminitis)
Euglycemic Hyperinsulinemic Clamp (EHC)
Euthanasia - including Saying Goodbye
Exercise - including returning to work after laminitis
Exunguilation
Eyes
Endocrinopathic laminitis
Endothelin-1
Endotoxins - endotoxaemia
EOTRH
Epidemiology (of laminitis)
Euglycemic Hyperinsulinemic Clamp (EHC)
Euthanasia - including Saying Goodbye
Exercise - including returning to work after laminitis
Exunguilation
Eyes
Endocrinology
Endocrinology is the study of hormones and the endocrine system.
Some useful references:
Vertebrate Endocrinology - David O Norris 2007
Some useful references:
Vertebrate Endocrinology - David O Norris 2007
Endocrinopathic laminitis
Potential pathophysiological mechanisms for endocrinopathic laminitis:
Elliott J, Bailey SR.
A review ofcellular and molecular mechanisms in endocrinopathic, sepsis-related and supporting limb equine laminitis.
Equine Vet J. Published online 27 February 2023. doi: 10.1111/evj.13933. PMID: 36847165. Open Access.
Keywords: basal epithelial cell stress; horse; insulin dysregulation; laminitis pathogenesis; signalling pathways.
FAEP 49th Annual Ocala Equine Conference Oct 2011
Endocrinopathic laminitis
Nicholas Frank
Elliott J, Bailey SR.
A review ofcellular and molecular mechanisms in endocrinopathic, sepsis-related and supporting limb equine laminitis.
Equine Vet J. Published online 27 February 2023. doi: 10.1111/evj.13933. PMID: 36847165. Open Access.
Keywords: basal epithelial cell stress; horse; insulin dysregulation; laminitis pathogenesis; signalling pathways.
FAEP 49th Annual Ocala Equine Conference Oct 2011
Endocrinopathic laminitis
Nicholas Frank
Endothelin-1
Morgan RA , Keen JA, Walker BR, Hadoke PWF
Vascular Dysfunction in Horses with Endocrinopathic Laminitis
PLOS One September 29, 2016 http://dx.doi.org/10.1371/journal.pone.0163815
The study found endothelial dysfunction associated with endocrinopathic laminitis but noted that this dysfunction could be a cause or a consequence of disease.
Gauff FC, Patan-Zugaj B, Licka TF
Effect of short-term hyperinsulinemia on the localization and expression of endothelin receptors A and B in lamellar tissue of the forelimbs of horses
Am J Vet Res. 2014 Apr; 75(4): 367-374
Gauff F, Patan-Zugaj B, Licka TF
Hyperinsulinaemia increases vascular resistance and endothelin-1 expression in the equine digit
Equine Veterinary Journal online Jan 2013
Söder J, Bröjer JT, Nostell KEA
Interday variation and effect of transportation on indirect blood pressure measurements, plasma endothelin-1 and serum cortisol in Standardbred and Icelandic horses
Acta Veterinaria Scandinavica 2012, 54:37 (Full)
Notes from full paper:
Systemic hypertension seen in obese humans with Metabolic Syndrome and Insulin Resistance "is partly due to a vascular endothelial dysfunction with a decreased production of the vasodilator nitric oxide and an enhanced endothlin (ET-1) mediated vasoconstriction."
Plasma ET-1 concentrations were measured with a commercial ELISA-kit (Endothelin (1-21) enzyme immunoassy, Biomedica Medizinprodukte GmbH & Co KG, Wien). Intra-assay CV for plasma ET-1 was 6.7%.
One Icelandic horse had ET-1 concentrations of 16.41 pg/ml and 14.59 pg/ml - these were considered unreasonably high and excluded.
Another Icelandic horse had ET-1 concentrations of 3.09 pg/ml and 14.59 pg/ml - the variation was considered too great and these results were excluded.
One of the above Icelandic horses had ET-1 concentrations above the detection limit 12 hours after transportation - these results were excluded.
Mean plasma ET-1 concentration was significantly higher at least 12 hours after being transported for 1 hour to a new stable (compared to home) - likely due to a stress reaction. Blood pressure was not affected.
Different ELISA assays for ET-1 may cause discrepancies between results. The concentrations of ET-1 in this study were higher for both Icelandic horses and Standardbreds than those for healthy TBs and Standardbreds in previous research, and similar to those reported for horses with RAO and endotoxaemia.
ET-1 showed an acceptable interday variation.
Icelandic horses had significantly higher mean plasma ET-1 concentrations than Standardbred horses. There was considerable individual variation in plasma ET-1 concentrations in both breeds, and greater in the Icelandic horses. The difference between breeds could be related to genetic or management differences.
"Previous studies in ponies and Icelandic horses have reported that they are partially insulin resistant compared to normal horses [21-23]. Insulin is known to stimulate the production of nitric oxide as well as the production of ET-1 in endothelial cells [24-26]. In the healthy state there is a balance between the insulin stimulated release of NO and ET-1 from the endothelium. In individuals with IR or hyperinsulinemia the production of nitric oxide is decreased but the stimulatory effect of insulin in ET-1 is preserved leading to vasoconstriction and hypertension [27]. This could also explain the higher ET-1 values seen in the Icelandic horses compared to the Standardbred horses, as elevated insulin levels could cause an increase in ET-1 concentration [28]. The higher plasma ET-1 levels seen in the Icelandic horses in the present study did not cause an elevation of the systemic blood pressure."
Endotoxins - endotoxaemia
Do endotoxins cause or contribute to laminitis?
Lipopolysaccharide (LPS), an endotoxin, is a major component of gram negative bacteria. Researchers have not been able to induce laminitis by administering endotoxins.
Tadros EM, Frank N
Endotoxemia as a predisposing factor for laminitis in horses
ACVIM 2012
Bailey SR, Adair HS, Reinemeyer CR, Morgan SJ, Brooks AC, Longhofer SL, Elliott J
Plasma concentrations of endotoxin and platelet activation in the developmental stage of oligofructose-induced laminitis
Vet Immunol Immunopathol. 2009 Jun 15;129(3-4):167-73. Epub 2008 Nov 7
"Absorption of endotoxin (lipopolysaccharide; LPS) into the plasma has been observed in one experimental model of laminitis, but does not cause laminitis when administered alone. Thus, the potential role of endotoxin is unclear. Platelet activation has previously been demonstrated in the developmental stage of laminitis.""These data indicate that small quantities of endotoxin may move into the circulation from the large intestine after the sharp decrease in pH that occurs as a result of carbohydrate fermentation. Correlating these findings with in vitro studies suggests that LPS may primarily activate platelets, leading indirectly to the activation of leukocytes. Therefore, endotoxin may contribute in the initiation of the early inflammatory changes observed in experimental models of acute laminitis."
Lipopolysaccharide (LPS), an endotoxin, is a major component of gram negative bacteria. Researchers have not been able to induce laminitis by administering endotoxins.
Tadros EM, Frank N
Endotoxemia as a predisposing factor for laminitis in horses
ACVIM 2012
Bailey SR, Adair HS, Reinemeyer CR, Morgan SJ, Brooks AC, Longhofer SL, Elliott J
Plasma concentrations of endotoxin and platelet activation in the developmental stage of oligofructose-induced laminitis
Vet Immunol Immunopathol. 2009 Jun 15;129(3-4):167-73. Epub 2008 Nov 7
"Absorption of endotoxin (lipopolysaccharide; LPS) into the plasma has been observed in one experimental model of laminitis, but does not cause laminitis when administered alone. Thus, the potential role of endotoxin is unclear. Platelet activation has previously been demonstrated in the developmental stage of laminitis.""These data indicate that small quantities of endotoxin may move into the circulation from the large intestine after the sharp decrease in pH that occurs as a result of carbohydrate fermentation. Correlating these findings with in vitro studies suggests that LPS may primarily activate platelets, leading indirectly to the activation of leukocytes. Therefore, endotoxin may contribute in the initiation of the early inflammatory changes observed in experimental models of acute laminitis."
EOTRH - Equine Odontoclastic Tooth Resorption and Hypercementosis
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EOTRH is a slowly progressive disease found in older horses that involves the resorbtion (destruction) of the roots of incisor and canine teeth, often with abnormal excessive formation of cementum (thought to be the body's reaction to try to stabilize the teeth). The teeth become infected and may become loose or fracture, and the disease may extend into the jaw bone. EOTRH is very painful and may cause weight loss, loss of appetite, increased salivation, and signs of pain including changes in attitude, reluctance to wear a bridle or be ridden, head shaking. The cause of EOTRH is still unknown but there is some suggestion that horses with PPID and/or EMS may be at greater risk of developing EOTRH. Clinical signs of EOTRH are often seen during a routine dental exam, and include: |
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reddening, petechia (small red dots) and/or ulcers on the gums, signs of abscesses/pus draining, receding gums and/or swollen gums, abnormal incisors and canines (visible cementosis, discolouration, change in shape), bad breath, discomfort.
X-rays are taken to evaluate changes to the teeth below the gums.
Treatment is to extract the affected teeth, usually under standing sedation. Horses generally recover well and quickly after tooth extraction, and although a soft mash or soaked hay pellets diet will usually be given following the tooth extractions, many horses are able to continue to eat hay and grass using their lips and tongue.
X-rays are taken to evaluate changes to the teeth below the gums.
Treatment is to extract the affected teeth, usually under standing sedation. Horses generally recover well and quickly after tooth extraction, and although a soft mash or soaked hay pellets diet will usually be given following the tooth extractions, many horses are able to continue to eat hay and grass using their lips and tongue.
EOTRH: Equine Odontoclastic Tooth Resorption and Hypercementosis - Dr Leah Limone, SmartPak
Albers L, Albers J, Dullin C, Staszyk C, Bienert-Zeit A
Early incisor lesions and Equine Odontoclastic Tooth Resporptio and Hypercementosis: Reliability of radiographic findings
Equine Vet J. 2022 Mar 18. doi: 10.1111/evj.13577. Epub ahead of print. PMID: 35302672.
Feeding the EOTRH Horse - February 2022, Kristen Janicki www.thehorse.com
Górski K, Tremaine H, Obrochta B, Buczkowska R, Turek B, Bereznowski A, Rakowska A, Polkowska I
EOTRH Syndrome in Polish Half-Bred horses - Two clinical cases
Journal of Equine Veterinary Science published online 24 February 2021. https://doi.org/10.1016/j.jevs.2021.103428
Vahideh Rahmani, Lotta Häyrinen, Ilona Kareinen, Mirja Ruohoniemi
History, clinical findings and outcome of horses with radiographical signs of equine odontoclastic tooth resorption and hypercementosis
Veterinary Record 10 October 2019
Common Dental Procedures and Pathology - Cornell University College of Veterinary Medicine
EOTRH: Facing a Scary-Sounding Dental Disease - Wendy Krebs, February 2020, www.thehorse.com
Clinical Signs of EOTRH - Tufts Cummings School of Veterinary Medicine December 2019
EOTRH - NorthEast Equine Veterinary Dental Services - photos and x-rays showing progressive stages of EOTRH
EOTRH Syndrome in Horses brochure - Midwest Veterinary Dental Services
Hole SL, Staszyk C
Equine odontoclastic tooth resorption and hypercementosis
Equine Veterinary Education published online July 2016
Arnbjerg J
Dental resorption in an old pony: Case report
Dent Oral Craniofac Res 2 23 May 2016. Doi: 10.15761/DOCR.1000161
Smedley RC, Earley ET, Galloway SS, Baratt RM, Rawlinson JE
Equine Odontoclastic Tooth Resorption and Hypercementosis Histopathologic Features
Veterinary Pathology June 2015
EOTRH Case Summary - Dr. Jennifer Rawlinson, Colorado State University E-Rounds Vol 4 Ed 4 2014
Researchers Identify EOTRH Risk Factors - Alexandra Beckstett - www.thehorse.com - Jan 2014
Pearson AM, Mansfield G, Conaway M, Koput K
Associated risk factors of equine odontoclastic tooth resorption and hypercementosis
AAEP 2013
Jennifer Rawlinson, DVM
Equine Odontoclastic tooth resorption and hypercementosis: techniques for extraction of canine and incisor teeth
ACVS 2012
Focus on Dentistry Proceedings September 2011
Those aren't "old horse teeth!" That's EOTRH- a painful condition of equine incisors - Lisa Kivett, DVM - Foundation Equine Mobile Medicine and Dentistry
Examples of EOTRH cases
Equine Dental Clinic 14 February 2021
Taking dental radiographs
AVDC Dental Radiographic Techniques for the Horse - Dr Robert Baratt
Diagnostic Tools: Equine Dentistry - Dr Chris Blevins, Kansas State University Veterinary Health Center
Every Practitioner Can Take Good Dental Radiographs - Jack Easley 2018
Henry TJ, Puchalski SM, Arzi B, Kass PH, Verstraete FJM
Radiographic evaluation in clinical practice of the types and stage of incisor tooth resorption and hypercementosis in horses
EVJ July 2017 Vol 49 I 4 p 486-492. First published: 12 November 2016 https://doi.org/10.1111/evj.12650
Teeth & PPID (not necessarily EOTRH)
Nitzsche AM, Fey K, Buttner K, Grof M, Staszyk C
The gingiva of horses with Pituitary Pars Intermedia Dysfunction: A macroscopic anatomical evaluation
Frontiers in Veterinary Science January 2022. https://doi.org/10.3389/fvets.2021.786971 Open Access.
Epidemiology (of laminitis)
Epidemiology is the study of the incidence and cause of diseases. Why does laminitis occur, how many horses are affected by laminitis, which horses are most at risk are questions that epidemiology might try to answer. Research looking at the epidemiology of laminitis includes:
Potter S, Bamford N, Harris P, Bailey S
Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia
Aust Vet J published online Sept 2017 95: 370–374. doi:10.1111/avj.12635
A survey of 233 horses and ponies owned by Pony Club members in Victoria, Australia found that 15% (35/233) had had laminitis, and of these, more than half had had more than one episode of laminitis. 31 of the 35 laminitics were ponies (21.8% of 142 ponies in the survey), and 4 of the 35 were horses (4.4% of 91 horses in the survey).
Wylie CE, Shaw DJ, Verheyen KL, Newton JR
Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study
Vet Rec. 2016 Apr 23;178(17):420. doi: 10.1136/vr.103588. Epub 2016 Mar 11
Luthersson N, Mannfalk M, Parkin TDH, Harris P
Laminitis: Risk factors and outcome in a group of Danish horses
JEVS published online Mar 2016
Wylie CE, Newton JR, Bathe AP, Payne RJ
Prevalence of supporting limb laminitis in a UK equine practice and referral hospital setting between 2005 and 2013: implications for future epidemiological studies
Vet Rec. 2015 Jan 17;176(3):72. doi: 10.1136/vr.102426. Epub 2014 Sep 26
Wylie CE, Collins SN, Verheyen KL, Newton JR
Risk factors for equine laminitis: a case-control study conducted in veterinary-registered horses and ponies in Great Britain between 2009 and 2011
Vet J. 2013 Oct;198(1):57-69. doi: 10.1016/j.tvjl.2013.08.028. Epub 2013 Sep 4
Wylie CE, Collins SN, Verheyen KLP, Newton JR
A cohort study of equine laminitis in Great Britain 2009-2011: estimation of disease frequency and description of clinical signs in 577 cases
Equine Veterinary Journal online Jan 2013
Vet J. 2012 Jul;193(1):58-66. doi: 10.1016/j.tvjl.2011.10.020. Epub 2011 Nov 21
Risk factors for equine laminitis: a systematic review with quality appraisal of published evidence
Wylie CE, Collins SN, Verheyen KL, Newton JR
Wylie CE, Collins SN, Verheyen KL, Newton JR
Frequency of equine laminitis: a systematic review with quality appraisal of published evidence
Vet J. 2011 Sep;189(3):248-56. doi: 10.1016/j.tvjl.2011.04.014. Epub 2011 Jun 12
Karikoski NP, Horn I, McGowan TW, McGowan CM
The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion/referral equine hospital.
Domest Anim Endocrinol. 2011 Jun 7 (PubMed)
Longland and Byrd 2006 suggested that the incidence of laminitis in the USA is 2% and increases to 5% in the spring and summer.
However, this does not appear to be correct, as this claim is based on
Kane AJ, Traub-Dargatz J, Losinger WC, Garber LP
The Occurrence and Causes of Lameness and Laminitis in the U.S. Horse Population
AAEP Proceedings Vol. 46 2000
which reported the findings of interviews across 28 US states applying to between 24,163 and 28,026 horses and foals (no ponies, miniatures, donkeys or mules) in spring, summer and winter 1998-99, and found an incidence of 2.1%. of laminitis in the previous 12 months. More horse operators (with 3 or more horses) reported cases of laminitis on the day of the interview in spring (20 Apr-12 Jun - 4.9% of operators) and summer (15 Jun-11 Sep - 4.5% of operators) than in winter (02 Nov-26 Feb - 1.8% of operators), but less than 1% of horses had laminitis on any of the 3 interview days.
Dr Al Kane confirmed that "Although 5% of operations may have reported having at least one case of laminitis that doesn't mean that the incidence among horses was 5% during that same time period." (personal message).
Of the most recent cases of laminitis described, grazing lush pasture was suggested as the cause of 45.6%, feed problems/injury/obesity/pregnancy were suggested as the cause of 26.9% and grain overload/colic/diarrhoea and retained placenta suggested as the cause of less than 15%.
Hinkley and Henderson 1996
In a survey of 113,000 horses in the UK, the prevalence of laminitis was 7.1%.
Studies looking at the incidence of deaths due to laminitis
Pollard D, Wylie CE, Verheyen KLP, Newton JR
Owner-reported equine mortality in a cohort of horses and ponies in Great Britain
Equine Veterinary Journal Volume 49, Issue Supplement S51, Version of Record online: 31 Aug 2017
Clinical Research Abstracts of the BEVA Congress 13-16 Sept 2017
6% (111) of 1837 horses and ponies (of a variety of breeds and aged 1 to 38 years with a median age of 14) died while they were enrolled in the CARE About Laminitis study in the UK from August 2014 to December 2016. 98.2% were euthanased. The major reasons given for the death of 109 of the horses were :
Colic 17.4% (19 horses)
Non-laminitic musculoskeletal problems 17.4% (19 horses)
Laminitis 15.6% (17 horses). 13 (11.9% of 109) of the 17 horses had laminitis alongside other conditions given for the reason for death.
For 19.3% (21 horses), age related deterioration contributed to the reason for death, and the age of horses that did not survive the study period was significantly older than those that did survive.
TLS comment: This was a study of laminitic horses, alongside non-laminitic controls, so is unlikely to be representative of a general population.
Epidemiology is the study of the incidence and cause of diseases. Why does laminitis occur, how many horses are affected by laminitis, which horses are most at risk are questions that epidemiology might try to answer. Research looking at the epidemiology of laminitis includes:
Potter S, Bamford N, Harris P, Bailey S
Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia
Aust Vet J published online Sept 2017 95: 370–374. doi:10.1111/avj.12635
A survey of 233 horses and ponies owned by Pony Club members in Victoria, Australia found that 15% (35/233) had had laminitis, and of these, more than half had had more than one episode of laminitis. 31 of the 35 laminitics were ponies (21.8% of 142 ponies in the survey), and 4 of the 35 were horses (4.4% of 91 horses in the survey).
Wylie CE, Shaw DJ, Verheyen KL, Newton JR
Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study
Vet Rec. 2016 Apr 23;178(17):420. doi: 10.1136/vr.103588. Epub 2016 Mar 11
Luthersson N, Mannfalk M, Parkin TDH, Harris P
Laminitis: Risk factors and outcome in a group of Danish horses
JEVS published online Mar 2016
Wylie CE, Newton JR, Bathe AP, Payne RJ
Prevalence of supporting limb laminitis in a UK equine practice and referral hospital setting between 2005 and 2013: implications for future epidemiological studies
Vet Rec. 2015 Jan 17;176(3):72. doi: 10.1136/vr.102426. Epub 2014 Sep 26
Wylie CE, Collins SN, Verheyen KL, Newton JR
Risk factors for equine laminitis: a case-control study conducted in veterinary-registered horses and ponies in Great Britain between 2009 and 2011
Vet J. 2013 Oct;198(1):57-69. doi: 10.1016/j.tvjl.2013.08.028. Epub 2013 Sep 4
Wylie CE, Collins SN, Verheyen KLP, Newton JR
A cohort study of equine laminitis in Great Britain 2009-2011: estimation of disease frequency and description of clinical signs in 577 cases
Equine Veterinary Journal online Jan 2013
Vet J. 2012 Jul;193(1):58-66. doi: 10.1016/j.tvjl.2011.10.020. Epub 2011 Nov 21
Risk factors for equine laminitis: a systematic review with quality appraisal of published evidence
Wylie CE, Collins SN, Verheyen KL, Newton JR
Wylie CE, Collins SN, Verheyen KL, Newton JR
Frequency of equine laminitis: a systematic review with quality appraisal of published evidence
Vet J. 2011 Sep;189(3):248-56. doi: 10.1016/j.tvjl.2011.04.014. Epub 2011 Jun 12
Karikoski NP, Horn I, McGowan TW, McGowan CM
The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion/referral equine hospital.
Domest Anim Endocrinol. 2011 Jun 7 (PubMed)
Longland and Byrd 2006 suggested that the incidence of laminitis in the USA is 2% and increases to 5% in the spring and summer.
However, this does not appear to be correct, as this claim is based on
Kane AJ, Traub-Dargatz J, Losinger WC, Garber LP
The Occurrence and Causes of Lameness and Laminitis in the U.S. Horse Population
AAEP Proceedings Vol. 46 2000
which reported the findings of interviews across 28 US states applying to between 24,163 and 28,026 horses and foals (no ponies, miniatures, donkeys or mules) in spring, summer and winter 1998-99, and found an incidence of 2.1%. of laminitis in the previous 12 months. More horse operators (with 3 or more horses) reported cases of laminitis on the day of the interview in spring (20 Apr-12 Jun - 4.9% of operators) and summer (15 Jun-11 Sep - 4.5% of operators) than in winter (02 Nov-26 Feb - 1.8% of operators), but less than 1% of horses had laminitis on any of the 3 interview days.
Dr Al Kane confirmed that "Although 5% of operations may have reported having at least one case of laminitis that doesn't mean that the incidence among horses was 5% during that same time period." (personal message).
Of the most recent cases of laminitis described, grazing lush pasture was suggested as the cause of 45.6%, feed problems/injury/obesity/pregnancy were suggested as the cause of 26.9% and grain overload/colic/diarrhoea and retained placenta suggested as the cause of less than 15%.
Hinkley and Henderson 1996
In a survey of 113,000 horses in the UK, the prevalence of laminitis was 7.1%.
Studies looking at the incidence of deaths due to laminitis
Pollard D, Wylie CE, Verheyen KLP, Newton JR
Owner-reported equine mortality in a cohort of horses and ponies in Great Britain
Equine Veterinary Journal Volume 49, Issue Supplement S51, Version of Record online: 31 Aug 2017
Clinical Research Abstracts of the BEVA Congress 13-16 Sept 2017
6% (111) of 1837 horses and ponies (of a variety of breeds and aged 1 to 38 years with a median age of 14) died while they were enrolled in the CARE About Laminitis study in the UK from August 2014 to December 2016. 98.2% were euthanased. The major reasons given for the death of 109 of the horses were :
Colic 17.4% (19 horses)
Non-laminitic musculoskeletal problems 17.4% (19 horses)
Laminitis 15.6% (17 horses). 13 (11.9% of 109) of the 17 horses had laminitis alongside other conditions given for the reason for death.
For 19.3% (21 horses), age related deterioration contributed to the reason for death, and the age of horses that did not survive the study period was significantly older than those that did survive.
TLS comment: This was a study of laminitic horses, alongside non-laminitic controls, so is unlikely to be representative of a general population.
Euglycemic Hyperinsulinemic Clamp (EHC)
Lindåse S, Nostell K, Söder J, Bröjer J
Relationship Between β-cell Response and Insulin Sensitivity in Horses based on the Oral Sugar Test and the Euglycemic Hyperinsulinemic Clamp
Journal of Veterinary Internal Medicine published online Aug 2017. doi: 10.1111/jvim.14799
Nostell KEA, Lindåse SS, Bröjer JT
Blood pressure in Warmblood horses before and during a euglycemic-hyperinsulinemic clamp
Acta Veterinaria Scandinavica. 2016;58(Suppl 1):65. doi:10.1186/s13028-016-0247-y
Bröjer J, Lindåse S, Müller C, Nostell K
Comparison between the euglycemic-hyperinsulinemic clamp and the use of proxies for determination of insulin sensitivity in horses
Acta Veterinaria Scandinavica. Sept 2015;57(Suppl 1):O3. doi:10.1186/1751-0147-57-S1-O3
Pratt-Phillips SE, Geor RJ, McCutcheon LJ
Comparison among the euglycemic-hyperinsulinemic clamp, insulin-modified frequently sampled intravenous glucose tolerance test, and oral glucose tolerance test for assessment of insulin sensitivity in healthy Standardbreds
Am J Vet Res. 2015 Jan;76(1):84-91
Lindåse S, Nostell K, Söder J, Bröjer J
Relationship Between β-cell Response and Insulin Sensitivity in Horses based on the Oral Sugar Test and the Euglycemic Hyperinsulinemic Clamp
Journal of Veterinary Internal Medicine published online Aug 2017. doi: 10.1111/jvim.14799
Nostell KEA, Lindåse SS, Bröjer JT
Blood pressure in Warmblood horses before and during a euglycemic-hyperinsulinemic clamp
Acta Veterinaria Scandinavica. 2016;58(Suppl 1):65. doi:10.1186/s13028-016-0247-y
Bröjer J, Lindåse S, Müller C, Nostell K
Comparison between the euglycemic-hyperinsulinemic clamp and the use of proxies for determination of insulin sensitivity in horses
Acta Veterinaria Scandinavica. Sept 2015;57(Suppl 1):O3. doi:10.1186/1751-0147-57-S1-O3
Pratt-Phillips SE, Geor RJ, McCutcheon LJ
Comparison among the euglycemic-hyperinsulinemic clamp, insulin-modified frequently sampled intravenous glucose tolerance test, and oral glucose tolerance test for assessment of insulin sensitivity in healthy Standardbreds
Am J Vet Res. 2015 Jan;76(1):84-91
Euthanasia
The word euthanasia comes from the Greek meaning a "good death", and is the term used for putting a horse to sleep to relieve or prevent pain or suffering.
Saying Goodbye - poems, quotes and support for when you have to say goodbye.
"Losing any animal is hard but with horses it is often doubly difficult as so few of them pass away naturally. Owners frequently have to make the decision about when the time has come to end their companion’s life. Even when this is unquestionably the right thing to do, it often leads to feeling of guilt." - BHS Euthanasia and Friends at the End
Euthanasia Plan
If you have a horse, you should have a euthanasia plan - make plans for your horse's last day long before you expect to need them.
When? With a chronic illness or old age, it can be difficult to know when it's time to say goodbye - usually your horse will tell you. The BHS Advice on Euthanasia leaflet has guidelines to help.
How? This will depend on regulations in your country, and should be discussed with your vet in advance. Sedation followed by a lethal injection of pentobarbital is a common, humane method.
Where? At home, in a calm environment, avoiding stress, with absolutely no compromise of the horse's welfare.
Friends. It is generally recognised that pair bonds and close friends should be allowed to see the body (see below). Try to have a friend or partner with you for support.
Body disposal. Again, this will depend on regulations in your country, and should be discussed in advance - your vet should be able to help. You may be able to have your horse buried on your land, or the body may have to be taken away. If not an emergency, consider access for collection transport.
"we owe it to our horses to understand the process and to be prepared (as far as is possible) should the worst happen. Providing
the right care at the end of a horse’s life is the last, and possibly greatest, thing we can do for them.
The BHS Welfare Department are always willing to talk to owners about euthanasia and provide any information, advice and support that may be
needed at a difficult time." BHS Advice on Euthanasia
Euthanasia: What to expect - Equine Matters Spring 2019 (page 12)
Vets for Equine Welfare - Equine Euthanasia
"ACCEPTABLE METHODS OF EQUINE EUTHANASIA (preferred method)
Pentobarbital or a Pentobarbital Combination: This is the best choice for equine euthanasia. Because a large volume of solution must be injected, use of an intravenous catheter placed in the jugular vein will facilitate the procedure. In order to facilitate catheterization and minimize equine anxiety and stress, a tranquilizer such as acepromazine, or an alpha-2 adrenergic agonist should be administered."
A Thoughtful Goodbye - Nikki James - www.flyingchanges.com
Euthanasia - How it's done - Habitat for Horses
"If horses don't go to Heaven, then Heaven's no place for me."" We always let the other horses come see the body. They need to do this, to understand what happened. The one time we didn't the horse's mate wandered the pasture for days hunting for her, neighing for hours on end. Let them know what happened. Horses understand more than we give them credit for. They need that few minutes with the body."
Euthanasia and body disposal in France - Charente Horse Group
Support Groups:
BHS Friend at the End - UK
Euthanasia leaflet and how to contact a BHS "Friend at the End" welfare officer who will help and support you through making this difficult decision.
HoofBeats in Heaven
Poems, quotes and support for when you have to say goodbye
Saying Goodbye - poems, quotes and support for when you have to say goodbye.
"Losing any animal is hard but with horses it is often doubly difficult as so few of them pass away naturally. Owners frequently have to make the decision about when the time has come to end their companion’s life. Even when this is unquestionably the right thing to do, it often leads to feeling of guilt." - BHS Euthanasia and Friends at the End
Euthanasia Plan
If you have a horse, you should have a euthanasia plan - make plans for your horse's last day long before you expect to need them.
When? With a chronic illness or old age, it can be difficult to know when it's time to say goodbye - usually your horse will tell you. The BHS Advice on Euthanasia leaflet has guidelines to help.
How? This will depend on regulations in your country, and should be discussed with your vet in advance. Sedation followed by a lethal injection of pentobarbital is a common, humane method.
Where? At home, in a calm environment, avoiding stress, with absolutely no compromise of the horse's welfare.
Friends. It is generally recognised that pair bonds and close friends should be allowed to see the body (see below). Try to have a friend or partner with you for support.
Body disposal. Again, this will depend on regulations in your country, and should be discussed in advance - your vet should be able to help. You may be able to have your horse buried on your land, or the body may have to be taken away. If not an emergency, consider access for collection transport.
"we owe it to our horses to understand the process and to be prepared (as far as is possible) should the worst happen. Providing
the right care at the end of a horse’s life is the last, and possibly greatest, thing we can do for them.
The BHS Welfare Department are always willing to talk to owners about euthanasia and provide any information, advice and support that may be
needed at a difficult time." BHS Advice on Euthanasia
Euthanasia: What to expect - Equine Matters Spring 2019 (page 12)
Vets for Equine Welfare - Equine Euthanasia
"ACCEPTABLE METHODS OF EQUINE EUTHANASIA (preferred method)
Pentobarbital or a Pentobarbital Combination: This is the best choice for equine euthanasia. Because a large volume of solution must be injected, use of an intravenous catheter placed in the jugular vein will facilitate the procedure. In order to facilitate catheterization and minimize equine anxiety and stress, a tranquilizer such as acepromazine, or an alpha-2 adrenergic agonist should be administered."
A Thoughtful Goodbye - Nikki James - www.flyingchanges.com
Euthanasia - How it's done - Habitat for Horses
"If horses don't go to Heaven, then Heaven's no place for me."" We always let the other horses come see the body. They need to do this, to understand what happened. The one time we didn't the horse's mate wandered the pasture for days hunting for her, neighing for hours on end. Let them know what happened. Horses understand more than we give them credit for. They need that few minutes with the body."
Euthanasia and body disposal in France - Charente Horse Group
Support Groups:
BHS Friend at the End - UK
Euthanasia leaflet and how to contact a BHS "Friend at the End" welfare officer who will help and support you through making this difficult decision.
HoofBeats in Heaven
Poems, quotes and support for when you have to say goodbye
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A personal note from TLS:
We recommend allowing companion horses to see the body. When we lost Homer to colic, Dan, his companion of 11 years, was nearby (but behind a fence) as we fought to save Homer, and watched as his friend peacefully slipped away. Straight afterwards we let Dan in, he sniffed at Homer's body, then just once put his foreleg on Homer's quarters and gave him a little shake, as if to say "come on mate, time to get up", then he just stood quietly with us for about half an hour, before going back to graze with Chantelle. Chantelle, who hadn't known Homer as long and wasn't his pair bond, didn't come to see his body, as far as we know. Dan was deeply affected by Homer's death, we grieved together for months. We feel it is very important to give the remaining horses, especially a pair bond, as much time as they need to come to terms with losing their friend. |
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Exunguilation
Exunguilation is the complete physical separation of the hoof capsule from the underlying connective tissues, i.e. when the laminae totally separation. This is seen with sepsis-related and supporting-limb laminitis, but rarely seen with endocrinopathic laminitis.
Exunguilation is the complete physical separation of the hoof capsule from the underlying connective tissues, i.e. when the laminae totally separation. This is seen with sepsis-related and supporting-limb laminitis, but rarely seen with endocrinopathic laminitis.
Exercise
Effects of exercise on insulin sensitivity / weight
Dr Nicholas Frank in the University of Minnesota webinar EMS and Ponies said that exercise increases the rate of weigh loss and improves insulin sensitivity. The horse must be sound with no active laminitis and the work should be increased gradually. He suggested a minimum of 30 minutes in trot and canter (plus time to warm up and cool down) 4 to 7 times a week.
Bamford NJ, Potter SJ, Baskerville CL, Harris PA, Bailey SR
Influence of dietary restriction and low-intensity exercise on weight loss and insulin sensitivity in obese equids
Journal of Veterinary Internal Medicine December 2018 33(1) DOI: 10.1111/jvim.153
de Laat MA, Hampson BA, Sillence MN, Pollitt CC
Sustained, Low-Intensity Exercise Achieved by a Dynamic Feeding System Decreases Body Fat in Ponies
J Vet Intern Med. 2016 Sep;30(5):1732-1738. doi: 10.1111/jvim.14577. Epub 2016 Sep 17 (PubMed)
Equine Veterinary JournalVolume 44, Issue Supplement s42, Article first published online: 13 SEP 2012 (Abstract #28 from BEVA 2012)
THE EFFECT OF EXERCISE ON CIRCULATING CONCENTRATIONS OF INFLAMMATORY MARKERS IN NORMAL AND LAMINITIS PRONE PONIES
Wray, H, Elliott J, Bailey SR, Harris PA and Menzies-Gow NJ
Long-term low intensity (10 minutes of walking and 5 minutes of trotting) exercise has an anti-inflammatory effect.
Carter RA, McCutcheon LJ, Valle E, Meilahn EN, Geor RJ
Effects of exercise training on adiposity, insulin sensitivity, and plasma hormone and lipid concentrations in overweight or obese, insulin-resistant horses
Am J Vet Res. 2010 Mar;71(3):314-21. doi: 10.2460/ajvr.71.3.314
"CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that moderate exercise training without concurrent dietary restriction does not mitigate insulin resistance in overweight or obese horses. A more pronounced reduction in adiposity or higher volume or intensity of exercise may be necessary for improvement in insulin sensitivity in such horses."
Equine Vet J Suppl. 2006 Aug;(36):226-32 (PubMed)
Effects of short-term training on insulin sensitivity and skeletal muscle glucose metabolism in standardbred horses
Stewart-Hunt L, Geor RJ, McCutcheon LJ
"CONCLUSIONS:Short-term training resulted in increases in whole body insulin sensitivity, and GLUT-4 protein content and glycogen synthase activity in skeletal muscle. The enhancements in insulin sensitivity, GLUT-4 protein and glycogen synthase activity were still evident after 5 days of inactivity.
POTENTIAL RELEVANCE:Insulin resistance in equids has been associated with obesity and predisposition to laminitis. Regular physical activity may mitigate risk of these conditions via enhancement of insulin sensitivity and/or control of bodyweight."
Powell DM, Reedy SE, Sessions DR, Fitzgerald BP.
Effect of short-term exercise training on insulin sensitivity in obese and lean mares.
Equine Vet J Suppl. 2002 Sep;(34):81-4. doi: 10.1111/j.2042-3306.2002.tb05396.x. PMID: 12405664.
Obese insulin-resistant mares worked at a trot to a heart rate of not more than 140 bpm for 30 minutes in a round pen had higher glucose infusion rates after 7 days of light exercise.
"The results of this study suggest that improvement in insulin sensitivity occurs in obese mares without a long interval of exercise training and in the absence of a change in bodyweight."
The study involved 12 16 to 20 year old mares that had been at grass with no forced exercise for 2 years.
6 lean (BCS 4-5/9) and 6 overweight (BCS 8-9/9) mares were divided into groups of 3 and either had no exercise (sedentary), or were exercised in trot for 30 minutes for 7 consecutive days. Fasted baseline insulin and glucose and a euglycaemic hyperinsulinaemic clamp were carried out before the 7 day exercise period started, 24 hours after the 7th/last day of exercise, and 9 days after the exercise period finished (insulin tested by RIA).
Dr Nicholas Frank in the University of Minnesota webinar EMS and Ponies said that exercise increases the rate of weigh loss and improves insulin sensitivity. The horse must be sound with no active laminitis and the work should be increased gradually. He suggested a minimum of 30 minutes in trot and canter (plus time to warm up and cool down) 4 to 7 times a week.
Bamford NJ, Potter SJ, Baskerville CL, Harris PA, Bailey SR
Influence of dietary restriction and low-intensity exercise on weight loss and insulin sensitivity in obese equids
Journal of Veterinary Internal Medicine December 2018 33(1) DOI: 10.1111/jvim.153
de Laat MA, Hampson BA, Sillence MN, Pollitt CC
Sustained, Low-Intensity Exercise Achieved by a Dynamic Feeding System Decreases Body Fat in Ponies
J Vet Intern Med. 2016 Sep;30(5):1732-1738. doi: 10.1111/jvim.14577. Epub 2016 Sep 17 (PubMed)
Equine Veterinary JournalVolume 44, Issue Supplement s42, Article first published online: 13 SEP 2012 (Abstract #28 from BEVA 2012)
THE EFFECT OF EXERCISE ON CIRCULATING CONCENTRATIONS OF INFLAMMATORY MARKERS IN NORMAL AND LAMINITIS PRONE PONIES
Wray, H, Elliott J, Bailey SR, Harris PA and Menzies-Gow NJ
Long-term low intensity (10 minutes of walking and 5 minutes of trotting) exercise has an anti-inflammatory effect.
Carter RA, McCutcheon LJ, Valle E, Meilahn EN, Geor RJ
Effects of exercise training on adiposity, insulin sensitivity, and plasma hormone and lipid concentrations in overweight or obese, insulin-resistant horses
Am J Vet Res. 2010 Mar;71(3):314-21. doi: 10.2460/ajvr.71.3.314
"CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that moderate exercise training without concurrent dietary restriction does not mitigate insulin resistance in overweight or obese horses. A more pronounced reduction in adiposity or higher volume or intensity of exercise may be necessary for improvement in insulin sensitivity in such horses."
Equine Vet J Suppl. 2006 Aug;(36):226-32 (PubMed)
Effects of short-term training on insulin sensitivity and skeletal muscle glucose metabolism in standardbred horses
Stewart-Hunt L, Geor RJ, McCutcheon LJ
"CONCLUSIONS:Short-term training resulted in increases in whole body insulin sensitivity, and GLUT-4 protein content and glycogen synthase activity in skeletal muscle. The enhancements in insulin sensitivity, GLUT-4 protein and glycogen synthase activity were still evident after 5 days of inactivity.
POTENTIAL RELEVANCE:Insulin resistance in equids has been associated with obesity and predisposition to laminitis. Regular physical activity may mitigate risk of these conditions via enhancement of insulin sensitivity and/or control of bodyweight."
Powell DM, Reedy SE, Sessions DR, Fitzgerald BP.
Effect of short-term exercise training on insulin sensitivity in obese and lean mares.
Equine Vet J Suppl. 2002 Sep;(34):81-4. doi: 10.1111/j.2042-3306.2002.tb05396.x. PMID: 12405664.
Obese insulin-resistant mares worked at a trot to a heart rate of not more than 140 bpm for 30 minutes in a round pen had higher glucose infusion rates after 7 days of light exercise.
"The results of this study suggest that improvement in insulin sensitivity occurs in obese mares without a long interval of exercise training and in the absence of a change in bodyweight."
The study involved 12 16 to 20 year old mares that had been at grass with no forced exercise for 2 years.
6 lean (BCS 4-5/9) and 6 overweight (BCS 8-9/9) mares were divided into groups of 3 and either had no exercise (sedentary), or were exercised in trot for 30 minutes for 7 consecutive days. Fasted baseline insulin and glucose and a euglycaemic hyperinsulinaemic clamp were carried out before the 7 day exercise period started, 24 hours after the 7th/last day of exercise, and 9 days after the exercise period finished (insulin tested by RIA).
Effects of exercise / movement on foot health
On 08 October 2019 The Humble Hoof posted (on Facebook):
At the NEAEP Symposium, Dr. Andrew Van Eps mentioned that only load cycling (movement/walking) improves perfusion in the hoof. This means that careful movement can be incredibly important in cases of hoof rehabilitation, and Dr. Van Eps mentioned walking might even prevent supporting limb laminitis in an injury case."
Exercise was an important part of Dr Debra Taylor's published laminitis rehab protocol in which 14/14 laminitic horses (some with ~30 degrees of palmar and dorsal rotation, significant sinking and solar necrosis/prolapsed solar coriums) returned to their pre-laminitis level of soundness.
"2.5. Management Protocol: Exercise
Turnout in a grass-free paddock or daily in-hand exercise was encouraged after the following (1) hooves had been trimmed to minimize weight bearing by the hoof wall; the desired heel plane and palmar angle (≤ 10 degrees) had been established by trimming; and when the hooves had been protected by soft protective hoof boots with pads (as described in Section 2.3) that provided enough comfort for the horse to have a heel-first hoof landing. In-hand exercise was increased daily by adding 5- to 10-minute increments to each exercise session until horses were walking 30 to 45 minutes 2 or 3 times daily. Owners were instructed to observe for the intended heel-first impact of the hoof boot and to walk the horse only while the hoof boots were securely in place. They were instructed not to walk the horse if the hoof impact appeared to be toe-first and to discontinue daily walking (and call the veterinary/hoof care provider team) if the horse seemed to have increasing pain after walking."
Taylor D, Sperandeo A, Schumacher J, Passler T, Wooldridge A, Bell R, Cooner A, Guidry L, Matz-Creel H, Ramey I, Ramey P
Clinical Outcome of 14 Obese, Laminitic Horses Managed with the Same Rehabilitation Protocol
Journal of Equine Veterinary Science Volume 34, Issue 4, Pages 556–564, April 2014 (online 05 Feb 2014)
On 08 October 2019 The Humble Hoof posted (on Facebook):
At the NEAEP Symposium, Dr. Andrew Van Eps mentioned that only load cycling (movement/walking) improves perfusion in the hoof. This means that careful movement can be incredibly important in cases of hoof rehabilitation, and Dr. Van Eps mentioned walking might even prevent supporting limb laminitis in an injury case."
Exercise was an important part of Dr Debra Taylor's published laminitis rehab protocol in which 14/14 laminitic horses (some with ~30 degrees of palmar and dorsal rotation, significant sinking and solar necrosis/prolapsed solar coriums) returned to their pre-laminitis level of soundness.
"2.5. Management Protocol: Exercise
Turnout in a grass-free paddock or daily in-hand exercise was encouraged after the following (1) hooves had been trimmed to minimize weight bearing by the hoof wall; the desired heel plane and palmar angle (≤ 10 degrees) had been established by trimming; and when the hooves had been protected by soft protective hoof boots with pads (as described in Section 2.3) that provided enough comfort for the horse to have a heel-first hoof landing. In-hand exercise was increased daily by adding 5- to 10-minute increments to each exercise session until horses were walking 30 to 45 minutes 2 or 3 times daily. Owners were instructed to observe for the intended heel-first impact of the hoof boot and to walk the horse only while the hoof boots were securely in place. They were instructed not to walk the horse if the hoof impact appeared to be toe-first and to discontinue daily walking (and call the veterinary/hoof care provider team) if the horse seemed to have increasing pain after walking."
Taylor D, Sperandeo A, Schumacher J, Passler T, Wooldridge A, Bell R, Cooner A, Guidry L, Matz-Creel H, Ramey I, Ramey P
Clinical Outcome of 14 Obese, Laminitic Horses Managed with the Same Rehabilitation Protocol
Journal of Equine Veterinary Science Volume 34, Issue 4, Pages 556–564, April 2014 (online 05 Feb 2014)
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Returning to work after laminitis
Exactly when a horse should be encouraged to move, and eventually return to work following laminitis, will be individual to every case and depend on the extent of damage to the feet, but here are some guidelines:
See ECIRhorse.org - DDT Trim |
When a horse has significant laminar separation, as shown by the full length gas line on this x-ray, it would be advisable to wait until the gas line has grown out and new laminar connections grown down from the coronet before starting formal exercise.
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Once the feet are realigned and correctly balanced, i.e. the palmar angle is correct (usually around 3 - 5 degrees) and breakover is in the correct place, the horse has been off NSAIDs/pain relief for at least 48 hours and is comfortable, the cause of the laminitis has been removed/treated and there is no further active laminitis, most horses can be allowed increased free choice movement in a small, safe enclosed area with the feet fully supported and protected as necessary, e.g. with boots and thick pads, and/or on a supportive, conforming surface e.g. sand, pea gravel, mud.
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At The Laminitis Site, rehabilitating horses start in a large deep-bedded shelter.
As they become more comfortable they are encouraged to move around by putting hay, feed and water in different areas of the shelter. Their area is expanded slowly, a couple of meters at a time, along a grass-free strip of mud. Boots and pads will normally be worn, unless the ground is soft, and at all times if the sole is thin. They are encouraged to move up and down the strip by putting hay, feed and water at either end. When they are moving freely around their strip, they will start walking in-hand around a large flat field, in straight lines as much as possible, with large curves around the corners, starting with no more than 5 minutes and building up slowly lap by lap, with several short sessions a day. This will increase until they are walking for 30 - 60 minutes a day in two or more sessions. Then an element of training may come into the exercise programme, depending on the horse's needs, so perhaps some short in-hand sessions in the sand school, walking around other fields with slight slopes, starting to walk on roads and tracks, and long-reining - all unmounted and avoiding tight turns and circles. Ride and lead - leading the rehabilitating horse - can be done if you have a safe and sensible horse to ride. We like to have horses comfortably trotting for short periods in hand/on long-reins before introducing a rider - remember that the weight of a rider will increase the pressure on the feet. The horse will be ridden for short, increasing periods following the same pattern as the in-hand work, so straight lines as much as possible, on good ground. When the horse is comfortably being ridden in walk for an hour or so, short periods of trot can usually be introduced and again slowly built up, and circles, turns and school shapes slowly re-introduced. We try to avoid lunging for some time as this puts pressure on the inside feet and legs. We also delay canter until the horse is working well in trot, and ideally has grown a whole new hoof capsule since the laminitis, as canter puts all the horse's weight on one leg. Avoid jumping, high speed work and sharp turns for as long as possible. See Herbie's Diary for full details of her rehabilitation. |
Horses should get better, not worse, with exercise - any muscle stiffness should reduce, they should be be happy to take longer strides, have a relaxed carriage, show no signs of pain or distress.
Stop immediately if the horse starts to show signs of pain or distress, starts to stumble or show signs of being tired, or is reluctant to move forwards. Try to work out why this has happened - ensure foot support and protection is correct, reassess the trim, ensure there is no active laminitis and management is tight. Be prepared to go back a few steps in your exercise programme. Checking that the horse is happy to move freely when loose can indicate the difference between "can't" move and "won't" move!
Exercise is likely to increase both the boundingness and rate of the digital pulse, and may increase heat in the feet. Checking the heart rate by taking the mandible pulse can help identify a "normal" reaction to exercise if both digital and mandible pulse increase pretty much in line.
More details about when and how to return a horse to work after laminitis, including feeding the insulin resistant horse for work, can be found in Dr Eleanor Kellon's online course Cushing's and Insulin Resistance, which runs several times/year.
Stop immediately if the horse starts to show signs of pain or distress, starts to stumble or show signs of being tired, or is reluctant to move forwards. Try to work out why this has happened - ensure foot support and protection is correct, reassess the trim, ensure there is no active laminitis and management is tight. Be prepared to go back a few steps in your exercise programme. Checking that the horse is happy to move freely when loose can indicate the difference between "can't" move and "won't" move!
Exercise is likely to increase both the boundingness and rate of the digital pulse, and may increase heat in the feet. Checking the heart rate by taking the mandible pulse can help identify a "normal" reaction to exercise if both digital and mandible pulse increase pretty much in line.
More details about when and how to return a horse to work after laminitis, including feeding the insulin resistant horse for work, can be found in Dr Eleanor Kellon's online course Cushing's and Insulin Resistance, which runs several times/year.
Guidelines for when to begin exercise are given in the Hoof Rehabilitation Protocol on Pete Ramey's website:
Hoof Rehabilitation Protocol - Debra Taylor, Ivy Ramey, Pete Ramey
Please read the full hoof rehabilitation protocol to ensure you have addressed the trim and cause of laminitis before considering returning
the horse to movement following laminitis, then follow these recommendations:
"Turnout and daily in-hand exercise are encouraged when laminitic horses have been trimmed, stabilized and have a heel first landing in boots. Riding in padded hoof boots is encouraged when all of the following are achieved:
Debra Taylor presented successful case studies of horses with chronic laminitis that returned to work after correct trimming, diet and exercise at the 2013 International Equine Conference on Laminitis and Diseases of the Foot - see www.thehorse.com Rehabilitating Horses with Obesity-Associated Laminitis
Hoof Rehabilitation Protocol - Debra Taylor, Ivy Ramey, Pete Ramey
Please read the full hoof rehabilitation protocol to ensure you have addressed the trim and cause of laminitis before considering returning
the horse to movement following laminitis, then follow these recommendations:
"Turnout and daily in-hand exercise are encouraged when laminitic horses have been trimmed, stabilized and have a heel first landing in boots. Riding in padded hoof boots is encouraged when all of the following are achieved:
- When the horse walks or trots comfortably in padded boots.
- When the proximal half (new growth) of the hoof wall becomes well connected as indicated by physical and radiographic appearance of the hoof.
- When the sole thickness exceeds 8mm (as indicated by radiograph).
- If the booted horse moves comfortably and all feet impact heel first with the added weight of the rider."
Debra Taylor presented successful case studies of horses with chronic laminitis that returned to work after correct trimming, diet and exercise at the 2013 International Equine Conference on Laminitis and Diseases of the Foot - see www.thehorse.com Rehabilitating Horses with Obesity-Associated Laminitis
Don't forget horses that have been on box rest and/or weight loss diets are likely to need a change in their diet to meet their increased energy, protein and mineral needs when they return to work. See Feeding recovered laminitics when back in work - Dr Eleanor Kellon.
Eyes
Horses with PPID often have accumulation of fat under the lower eyelid, giving a puffy appearance to the eye, and these eyes are often mucky. Fat can also be seen in the hollows above the eyes - see:
Video comparing PPID symptoms and normal aging
Pituitary Pars Intermedia Dysfunction
Horses with PPID often have accumulation of fat under the lower eyelid, giving a puffy appearance to the eye, and these eyes are often mucky. Fat can also be seen in the hollows above the eyes - see:
Video comparing PPID symptoms and normal aging
Pituitary Pars Intermedia Dysfunction
Miller C, Utter ML, Beech J
Evaluation of the effects of age and pituitary pars intermedia dysfunction on corneal sensitivity in horses
Am J Vet Res. 2013 Jul;74(7):1030-5
"Corneal sensitivity decreased with both age and PPID. Because decreased corneal sensitivity is associated with impaired wound healing, increasing age and PPID may increase the risk for nonhealing or recurrent corneal ulcers in ho
Evaluation of the effects of age and pituitary pars intermedia dysfunction on corneal sensitivity in horses
Am J Vet Res. 2013 Jul;74(7):1030-5
"Corneal sensitivity decreased with both age and PPID. Because decreased corneal sensitivity is associated with impaired wound healing, increasing age and PPID may increase the risk for nonhealing or recurrent corneal ulcers in ho