As farriers already know, one of the most frustrating aspects of laminitis is the inability to predict the clinical outcome of the disease.

Frank Nickels, an equine surgeon in the School of Veterinary Medicine at Michigan State University, says the degree of lameness and rotation are the major indicators used primarily to assess outcome. In fact, the outcome with this disease may be predicted in about 50 percent of the cases of laminitis based simply on the degree of lameness.

Nickels says an inverse relationship exists between the degree of rotation of the distal phalanx and the ability of the horse to return to athletic soundness. As a result, diagnostic radiographs are critical in treating laminitis.

Start With X-Rays

Radiographs at the onset, he says, are not only useful as a baseline for future comparisons, but are needed to determine the presence of pre-existing changes in the foot which may affect the results. However, using serial radiography in the early phase of treatment may sometimes be misleading when trying to assess the severity of laminar involvement, especially when an aggressive support system is used. Even with extensive damage, Nickels says the system works well enough that no rotation of the distal phalanx will be observed giving a false sense of security.

“Sometimes pain may not even differentiate these cases,” says Nickels. “In other cases, pain is the most useful indicator to determine the seriousness of radiographic changes. In chronic cases, other radiographic changes observed are air densities, lytic changes of…