Inflammatory, Non-inflammatory and Vascular Laminitis

Three papers in this journal each reviewed a type of laminitis. Although the mechanical result (failure of the lamellar bond between the hoof wall and the coffin bone) is essentially the same regardless of the cause, laminitis is broadly considered to be caused by one of three underlying conditions:

1. Sepsis and/or a systemic inflammatory response.
2. Hormonal abnormalities causing metabolic disease (called endocrinopathic laminitis). 
3. A reduction of normal blood flow in a supporting limb opposite a limb that cannot bear weight normally.

Mechanically, each type of laminitis can benefit from the same principles of coffin bone support and cooling affected limbs in ice water baths or cold boots (cryotherapy) can dramatically help prevent lamellar damage. However, there are differences in how the lamellae are affected, as well as other preventive and treatment strategies more specific to the underlying causes.

Sepsis and Systemic Inflammatory Response Laminitis

Laminitis attributable to sepsis and systemic inflammatory response is perhaps the broadest category of disease including what commonly may have been called endotoxemia in the past, as well as conditions such as intestinal disorders (colic, diarrhea), pneumonia, retained placenta and grain overload.

These problems all cause an intense, generalized inflammatory response that can produce organ failure — with the lamellae of the hoof included as one of those organs. Fever, increased heart and respiratory rates and a low or high white blood cell count are all characteristic of sick horses at risk for multiple organ dysfunction or failure including laminitis.

Treatment…