Prognosis for the horse with chronic laminitis

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Introduction

Ideally, the prognosis in a horse with long-standing, chronic laminitis is a medical estimate that is based on the presence and relative severity of digital pathologies, coupled with the presence or absence of systemic pathologies that impact the foot (e.g. pituitary pars intermedia dysfunction, equine metabolic syndrome). In practice, both medical and nonmedical factors may complicate the process of forming an accurate prognosis.

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Approach to defining the prognosis

Our efforts to establish the prognosis for the different stages of laminitis are being completed, using horses in the Hoof Project Foundation (HPF) rehabilitation research program. These efforts have identified and classified approximately 50 specific digital pathologies affecting the hoof capsule, the distal phalanx, or the digital interface that may be present in the horse with long-term, chronic laminitis. The strength of the associations between the presence and severity of each pathology

Displacement of the hoof capsule and distal phalanx

Radiographic measurements of capsular and phalangeal rotation are poorly associated with pain-induced lameness or successful rehabilitation. Similarly, vertical displacement of the capsule relative to the distal phalanx shows little association with long-term rehabilitative success. While these measurements indicate the magnitude of digital collapse and altered growth patterns, and are necessary for rehabilitation, they should not be used to determine the prognosis.

Pathologies affecting the foot’s axial core

Numerous pathologies are

Conclusions

An accurate medical prognosis for the horse with chronic laminitis is based on the presence and severity of the digital pathologies possible, and as such facilitates decisions on whether to attempt rehabilitation of the individual horse. The accumulating data suggest that returning the feet of horses with long-term, chronic laminitis to normal is rarely possible due to the inability to resolve the pathologies. A significant number of horses can, however, be returned to performance or pasture

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