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Equine laminitis 1. Management in the acute stage

LAMINITIS has been an affliction of domesticated equids since at least 350BC when Aristotle made the first known reference to `barley disease'. A survey of 113,000 horses in the UK in 1996 found the prevalence of laminitis to be 7.1 per cent. Although extensive research has partially unravelled the pathogenesis, evidence is conflicting and the significance of the different theories remains to be substantiated. Most of the research has involved the induction of laminitis by oral administration of excess carbohydrate or black walnut extract. How these models compare with the development of laminitis associated with pasture, gastrointestinal disease or mechanical overload of a limb is unknown. There is sufficient evidence to indicate that many of the proposed theories are important and a common pathogenesis linking the theories may eventually be determined. Insufficient trials have been performed to evaluate the efficacy of treatments for laminitis and most recommendations are based on anecdotal reports and clinical impressions. Literature can be cited both to support and oppose most of the treatments currently used for laminitis. This article reviews the options for the treatment of acute laminitis and provides some comment on the arguments for and against their use. The management of horses with chronic laminitis will be discussed in Part 2 in the next issue.

David Rendle qualified from Bristol in 2001 and spent 18 months in large animal practice in Frome, Somerset, before moving to the Liphook Equine Hospital, Hampshire, to take up a housevet position. Currently, he is undertaking a three-year residency in equine internal medicine, sponsored by the Horserace Betting Levy Board, jointly at Glasgow veterinary school and the Liphook Equine Hospital.