References
Medical management of acute laminitis
Abstract
Laminitis is a medical emergency. It encompasses three distinct forms: sepsis-related laminitis, supporting limb laminitis and endocrinopathic laminitis. The latter is most commonly encountered in equine practice and is associated with hyperinsulinaemia. Regardless of the underlying cause, management of acute laminitis involves treatment of the underlying cause, and providision of analgesia and biomechanical support of the foot.
Laminitis is a painful and severely debilitating condition commonly encountered in equine practice (Figure 1). Three distinct forms of laminitis have been identified; inflammatory or sepsis-related laminitis, supporting limb laminitis and ‘endocrinopathic’ laminitis (van Eps and Burns, 2019), but endocrinopathic laminitis accounts for the vast majority of cases seen in practice and likely parallels the rise of obesity in equids (Donaldson et al, 2004; Potter et al, 2016; Patterson-Kane et al, 2018). The acute phase of laminitis begins at the onset of clinical signs which may include varying degrees of lameness, increased digital pulses, stiff gait, weight shifting, reluctance to move or sensitivity to hoof testers over the sole, particularly towards the toe (van Eps, 2010a). Laminitis should always be considered a medical emergency and treatment should be instituted immediately at the onset of clinical signs. Irrespective of the primary mechanism, medical management of acute laminitis focuses on treating the underlying cause, providing analgesia and supporting the foot. Regular assessment of the patient is imperative to gauge clinical response, adjust treatment and minimise suffering.
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