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Veterinary

Endocrinology

Nutrition

Understanding, diagnosing and managing endocrinopathic laminitis

02 January 2024

Clinical

27 mins read

02 January 2024

Volume 8 · Issue 1

ISSN (print): 2516-0583

ISSN (online): 2516-0591

Figure 8. a) A lateral radiograph of a foot with chronic laminitis demonstrating remodeling (a ‘ski tip’ appearance, arrow) of the dorsodistal tip of the third phalanx, consistent with chronic laminitis. Note this horse also has a very long toe (asterisk) in need of a trim. b) A lateral radiograph of a foot with chronic laminitis demonstrating osteopenia (circled) of the dorsodistal tip of the third phalanx, consistent with chronic laminitis.

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Abstract

Endocrinopathic laminitis (or hyperinsulinaemia-associated laminitis) is the most common type of laminitis encountered in equine practice. Strict attention to risk factors and early recognition and diagnosis of insulin dysregulation – as part of equine metabolic syndrome or pituitary pars intermedia dysfunction – greatly decreases the risk of hyperinsulinaemia-associated laminitis. Early treatment and a committed client, veterinary and farriery team is critical to improve the prognosis. Treatment of hyperinsulinaemia-associated laminitis should encompass a three-pronged approach: treat the underlying cause (insulin dysregulation associated with equine metabolic syndrome or pituitary pars intermedia dysfunction); give anti-inflammatories and analgesics; biomechanically support the foot. The field of equine endocrinopathic disease is very active, so it is important to stay up to date on potential diagnostics and therapeutics.

Endocrinopathic laminitis, or hyperinsulinaemia-associated laminitis, is the most common form of laminitis affecting the equine population, accounting for almost 90% of clinical cases in horses and ponies (Karikoski et al, 2011). One-third of horses develop laminitis in their lifetime (Wylie et al, 2011) and, in spite of advances in diagnostics and therapeutics, it remains a top cause of euthanasia in horses. A study reviewing data from first-opinion UK veterinary practice records of 70 477 horses and ponies found an almost six-times higher mortality rate in those with a diagnosis of laminitis (in horses with at least two morbidities) compared to those with no chronic disease; 74% of cases with multiple morbidities that were euthanised had laminitis as one of their conditions (Welsh et al, 2016). While hyperinsulinaemia-associated laminitis has similarities to the other main types of laminitis (sepsis-associated and supporting limb laminitis), there are some specifics to the pathophysiology, presentation, diagnosis and treatment of hyperinsulinaemia-associated laminitis that are helpful to keep in mind when seeing these cases.

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endocrinology

laminitis

imaging

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