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Laminitis

What is laminitis?

Laminitis in its simplest sense is inflammation of the laminae (the soft tissue that attaches the pedal bone to the inner hoof wall) causing pain and lameness. Although often viewed as a condition that only affects the feet, it is merely expressed in the feet. Laminitis is likely to be the result of a complex cascade of events which may involve multiple systems within the body. If you suspect your horse or pony may have laminitis call the vet immediately, even in seemingly mild cases as prompt treatment is key to recovery and the prevention of further damage to the laminae.

 

 

 

 

  • Who is at risk from nutritionally induced laminitis?

    Although commonly thought of as a condition that only affects fat ponies in spring, laminitis can affect any horse or pony at any time, regardless of their breed, age, body condition or the time of year. However risk factors include:

    • Genetics e.g. native breeds or being a pony 
    • Recent weight gain & obesity (particularly those with a BCS >7)
    • Regional fat deposits including a cresty neck
    • Cushing’s Syndrome (PPID - see Cushing’s insight for more information)
    • A history of laminitis - high intakes of starch, sugar & fructan – particularly from grazing
    • Insulin dysregulation - a collective term used to describe high circulating blood insulin levels and/or an increased insulin response to a starch/sugar load and/ or insulin resistance

    The role of insulin dysregulation in the development of laminitis has become an area of increased interest in recent years. Whilst there certainly seems to be a link between an abnormal insulin response and some cases of laminitis, the significance of this is still unclear. The reason why some horses and ponies get laminitis and others do not is still not fully understood and consequently, managing as many of the risk factors as possible is still the best known way to reduce the risk.
     

  • How nutrition plays a role

    Reducing the risk of laminitis should focus on maintaining a healthy body condition score (BCS) and providing a diet that is high in fibre and low in non-structural carbohydrate (NSC). Put simply, NSC is the sum of starch, sugar and fructan, the storage form of sugar in grass.

  • Body Condition
    • Try to maintain a BCS of 4.5-5 on a 1-9 scale
    • Look out for regional fatty areas such as a cresty neck, a fat pad behind the shoulder and lumpy fat over the ribs and above the tail head. This should act as an alarm bell that metabolic changes may be occurring that may make your horse or pony more prone to laminitis
    • Allow good-doers to slim down in winter months as nature intended to help avoid excess weight gain in the spring
    • Do not allow BCS to drop below a score of 4.5, even if your horse/ pony still has large crest
  • Feeding & Management Tips
    • Try to maintain a BCS of 4.5-5 on a 1-9 scale
    • Choose fibre based feeds that are low in starch and sugar
    • Balancers are the ideal way to ensure that good doers receive suitable levels of vitamins, minerals and quality protein without feeding excess calories, starch and sugar
    • Avoid cereals and mixes – high starch diets may encourage rapid weight gain & increase the risk of insulin dysregulation
    • Consider choosing feeds approved by The Laminitis Trust but remember that these are not the only suitable options
    • If weight gain is required oil can be added at up to 100mls per 100kg of bodyweight per day to provide additional energy (calories). However simply adding oil on top of your horse’s current feed may the unbalance diet, so consider choosing a feed that already contains a higher level of oil – speak to nutritionist for more advice
    • Feed small meals – a maximum of 2kg for horses, less for ponies
    • Do not restrict forage intake to less than 15g per kilogram bodyweight per day dry matter. In practise this equates to approximately 18g of hay per kilogram of bodyweight per day in horses and ponies without access to grazing - speak to a nutritionist for more advice.
    • Have your forage analysed for water soluble carbohydrate (WSC - sugar plus fructans) which should ideally be less than 10%
    • Soaking hay for 12-16 hours in tepid water can reduce WSC by up to 50% but results are variable and in hot weather soaking for more than 6 hours is not recommended. Alternatively consider feeding a hay replacer
    • Make all changes to the diet slowly, this includes changes in forage and grazing
    • Maintain a regular exercise programme where possible
  • Grazing Tips
    • Grass can continue to grow for most of the year, however it grows more rapidly in spring and autumn therefore extra care should be taken during these periods
    • Consider turning out late at night until early morning when fructan levels are likely to be at their lowest - remove from pasture by mid-morning at the latest
    • Avoid pastures that have not been properly managed by regular grazing or cutting. Mature stemmy pastures and those stressed by drought or overgrazing may actually contain high levels of fructans
    • Restrict grass intake by using a grazing muzzle (that still allows for drinking), grazing with sheep, turning out in a sparse paddock or by strip grazing (remember to back fence and not give access to too much grass in one go)
    • Turning out for short periods unmuzzled may encourage ‘gorging’ and may therefore be counterproductive – in a recent study ponies were seen to consume almost 1% of their bodyweight in only 3 hours
    • Make use of ménages and wood chipped areas for turnout time without access to grass
    • Do not turn horses out onto pasture that has been exposed to low temperatures in conjunction with bright sunlight i.e. sunny frosty mornings
    • Do not allow grazing on recently cut stubble such as after hay harvest
    • In known laminitics, consider no grazing whilst providing suitable forage