Update on laminitis – causes and management
Laminitis is now considered to be a clinical syndrome associated with systemic disease (sepsis or systemic inflammatory response syndrome [SIRS] or endocrine disease) or altered weight bearing rather than being a discrete disease entity. Thus, laminitis can be divided into three forms, namely sepsis-associated, endocrinopathic and supporting limb laminitis (SLL). Sepsis-associated laminitis occurs in association with severe gastrointestinal disease and endotoxaemia. Endocrinopathic laminitis is the commonest form of laminitis and encompasses laminitis linked with insulin dysregulation, as occurs in association with equine metabolic syndrome, pituitary pars intermedia dysfunction and glucocorticoid administration. SLL is uncommon; however, it is a major contributor to treatment failure in painful limb conditions such as fractures and refractory cases of synovial sepsis. Treatment should be initiated as soon as possible and aimed at providing analgesia and foot support. Additionally, cryotherapy is indicated in certain circumstances and additional therapies are warranted if an underlying endocrinopathy is confirmed.
- Understand the current theories relating to the pathogenesis of the three forms of laminitis.
- Devise plans for the management of each form of laminitis