One of the reasons veterinary medicine has come so far recently is the more widespread use of better diagnostic equipment. Gone are the days of waiting to develop single x-ray slides that may or may not have actually taken a picture of anything. Now there are a number of scans vets regularly use to determine the real nature of a lameness issue. MRI (Magnetic Resonance Imaging) has been the most useful of these for hooves. It takes images by using a magnetic field, allowing vets to see bone, soft tissue and fluids. This has had a huge impact on diagnosing hoof problems as MRI can get pictures of soft tissues inside the foot whereas ultrasound waves can’t penetrate.
A partial coronary epidermectomy was recently successfully tried in a laminitis case. Incisions were made in the coronary band, and the damaged tissue was peeled off. Corrective shoeing, fenestration (basically, removal of part of the hoof wall), and a deep digital flexor tenotomy (see below) followed. Treatment was intense, but the pony in question experienced a serious reduction in pain, was fully sound by Day 160, and had great looking feet.
Deep digital flexor tenotomy is a surgical option for horses struggling with chronic laminitis. Contraction of the DDFT has been linked to chronic laminitis, and when present, the tendon compounds laminitis problems by pulling on the coffin bone. This normal pull is usually counterbalanced by the laminar attachments in the foot, but in cases of laminitis, when the attachments are weakened, the coffin bone can rotate downwards away from the hoof wall. The tenotomy severs the tendon about halfway down the cannon bone, decreasing the amount of tension on the coffin bone. It’s not a complicated procedure, and it’s done under local anaesthetic. The tendon will scar over, and corrective shoeing will be essential post-surgery, but evidence shows that many horses can return to pasture soundness and even light riding.
An alternative to this surgery might be the injection of botox into the deep digital flexor tendon’s muscle. The botox acts as a relaxant and keeps the tendon from pulling on the hoof structures. It wears off after a couple of months, but could be useful as short-term therapy during acute phases of laminitis. The treatment is patented, though, so it’s not widespread.
Stem cell therapy is also a treatment of interest, although no formal studies have been done on its effects on laminitis cases. Clinical experience seems to show, however, that stem cells have the potential to heal tissue damage and grow healthy lamina cells in ways that laminitis damage usually prohibits.