This paper, published in The Veterinary Journal (Patterson-Kane et al. 2018) and co-authored by Professor Cathy McGowan BVSc MACVSc DEIM DipECEIM PhD MRCVS at the University of Liverpool, describes and summarises the advances that the last few years have brought in our understanding of equine laminitis.
The abstract states: “Laminitis, one of the most debilitating conditions of all equids, is now known to be the result of several systemic disease entities. This finding, together with other recent developments in the field of laminitis research, have provoked a rethink of our clinical and research strategies for this condition.”
The authors then go on to describe three paradigm shifts drawn from the results of many different studies.
The first paradigm shift is the realisation that laminitis is now considered to be a clinical syndrome associated with either a disease of the whole body or with altered weight bearing, rather than being a discrete disease in itself. This means that accurate diagnosis of the associated systemic (whole body) disease (or the presence of abnormal weight bearing) is pivotal in laminitis management, prognosis, and the prevention of recurrence.
The second paradigm shift is the recognition that hormonal laminitis (endocrine laminitis) is the most common cause of laminitis where horses present primarily for lameness. This means that we need to be vigilant is assessing laminitis cases for these diseases.
The third paradigm shift is in our understanding of what happens on a cellular level in the hoof during an episode of laminitis. This understanding suggests that there is a sub-clinical phase of the disease where horses do not show signs of pain, but where there are changes in the lamellar cells of the hoof. In some horses this sub-clinical phase is evidenced by the appearance of divergent hoof rings. This means that the presence of divergent hoof rings may signify a window of opportunity for treatment of early stages of laminitis before then progress to becoming painful for the horse.
The authors conclude that further research is needed to investigate these points.