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Ideas for Avoiding Laminitis/Founder....by AnnMarie Cross

Recently, we had 2 ponies let themselves out into a farmer's field where the corn had just been harvested. You guessed it, they found a large pile of fresh, moist corn, and ate their fill. We estimate each ate approximately 5 lbs of straight corn. That might not sound like a lot of corn, but you have to realize they each eat 2 lbs of processed pelleted feed per DAY, with little to no corn in that feed whatsoever.

The first panic -- colic. Not sure what to do if your horse might be colicking? Surf the web. You'll find hundreds of articles. And, most horse owners have been this route and know what to check. They had good gut sounds. They were grazing on grass and/or hay when provided. They were energetic, eager to be walked. All in all, we saw no signs of colic. Phew!

Now, the second fear -- founder. Thousands of American horses suffer laminitis, resulting in founder, every year. 

This image, from Recoveryeq.com's website, clearly shows the end result of laminitis. Read their site for a very medically technical explanation of laminitis and founder. Note: this article implies RecoveryEq might be a good choice for pain relief and anti- inflammatory properties. We have not checked with any veterinarian and have never used the product.

 There are volumes written on dealing with laminitis once it has onset, and on the lifelong work to help that horse stay sound and comfortable once it has happened. Here are some interesting resources:
  1. Bayer Equine has a good article with clear images of a rotating coffin bone. 
  2.  The Horse has an ondemand webinar on dealing with laminitis. 
  3. RecoveryEq (see left)
  4. Hood to Coast Equine (see right).

These images, from hoodtocoastequine, clearly show a healthy x-ray vs a severe founder with the coffin bone actually protruding out the bottom of the sole. Sadly, this article had little else helpful to offer. 

But, have you ever tried to find an article on how to AVOID a laminitic incident? We could find none at the time (but later found the recoveryeq article referenced above, which agrees with most of the information from our vets, below right).

After calls to several vets, this was the rough guideline we assembled. Please, remember, we aren't vets, and this is intended only as a starting point and a guideline until you can talk to your own veterinarian. Our outcome was positive -- neither pony colicked at all, and neither had any symptoms of laminitis/founder.

Understand the basic concept of what can happen... ...and take steps to stop it BEFORE there is damage... The steps recommended to us...
Horse consumes large quantities of simple sugars/carbohydrates (corn, rich spring green grass, sweet feed, etc.). Nothing we can do here. He's already gotten into the sugar/feed/etc. BUT we can avoid adding to the problem. 1. Grains: No grain for 48 hours.

2. Hay/roughage: Provide long stem hay/grass, as dry and sugar-free as possible (no alfalfa!), without going drastically different from their normal feed. We had hay baled off our pasture to feed them.

Excessive amounts of sugars/carbs get past the stomach without being digested, to the hindgut where roughage is normally digested.

(Sugars are normally all digested in the stomach. The hindgut's microbes are only intended to digest roughage -- grass, hay, etc.)

 While we cannot slow the food down at the stomach, we can speed it up so that is ALSO gets passed the hindgut without being digested by the microbes.

CAUTION: NO Corticosteroids! Steroids such as Dexamethasone, which we've used for other health reasons on numerous occasions, is absolutely counter indicated in a suspected laminitic incident. Some references even indicate that it may cause or worsen a laminitic incident if the horse is already at risk.

*NOTE: Banamine may require a prescription; be sure to talk with your vet, ideally BEFORE a possible laminitic incident, for his advice. Be certain the horse is not dehydrated prior to giving Banamine.

 3. Stomach Tube: If you find out what happened within a few hours of eating the carbohydrates, our vet recommends a stomach tube with mineral oil to rush the feed through. If it's more than a few hours, the stomach tube will do little good. (We were too late for this step.)

4. Banamine*: Additionally, we gave a full dose of Banamine (prescription), which relaxes the muscles and eases pain, is anti-inflammatory (crucial!) and may have an anti-endotoxic effect. This will help avoid a colic as well.

5. Avoid colic: Keep them normally active, on soft footing, particularly if colic remains a possibility. Walking, turnout, whatever. Physical movement helps keep the gut moving and helps speed the feed past the hindgut. 

Note: Once colic risk is gone, several reference sources recommended deep, soft bedding and even encouraging lying down.
One type of beneficial microbe is overwhelmed / thinned down by the sugar overload. Another bacteria responds positively to the sugar, digesting it in huge quantities, resulting in a toxin output.

"The Horse article states "Concurrent events included rapid, explosive proliferation of hindgut Streptococcus bacteria and the absence of Enterobacteriaceae bacteria," said van Eps. ...the carbohydrate ... in the cecum promotes rapid, massive S. bovis overgrowth. ...essentially what's happening in the hindgut mirrors what's happening in feet."

 Balance the microbes. There are books written on the importance of the populations in the hindgut. Keeping this balance is key to keeping a horse's digestion of grasses/hays functioning. 6. Probiotics: We gave a full dose of probiotics, to help restore the proper balance. We're told that probiotics are often used in potential colic cases for this purpose.
Toxin in the horse's blood stream causes  swelling & raised temperature in the hooves. The swelling leads to constriction of the blood vessels to the hooves. Watch for symptoms of endo toxicity. The instructions from our vet & the U of I vet were clear -- if the horse appears to be suffering these symptoms, get him/her to a vet or hospital. 7. Endotoxic? Watch carefully for fever, raised heart rate, raised respiration rate, and especially a change in the ratio of heart-to-respiration rates.
This swelling/fever/restriction causes limited blood flow to and deterioration of the laminae. Laminae are thin strands that keep the hoof wall attached to the inner structures, and keep the coffin bone in the proper position by tying it to the hoof wall, balancing against the pull of the flexor tendon.  Minimize the fever and increase blood flow in the hooves. Ice treatment and the other steps taken above are key.

Basically, if you see signs of laminitis in the hooves, you're already too late. So, we have to assume it COULD be happening, and do all we can to avoid it.

The Horse article's take home message states, "Efficacious therapy should commence before 12 hours; we need to treat these horses very early if we want to prevent damage."

 8. Keeping Cool: Cool your horse's hooves as much as you can, as often as you can. Use medical boots with ice packs inside. Use standing soaking boots. Stand him/her in a water bucket or tub of ice cold water at least 5 minutes per hoof every 2 hours.
Some or most of the laminae die, allowing separation of the hoof wall from the internal structures including the coffin bone. Without laminae holding in place, the tendon pulls the back of the coffin bone upward (the toe shifts downward) = founder.  While we cannot do anything to stop the pull of the tendon, we CAN decrease the load on the laminae, thus decreasing the risk of the laminae being torn, and thus decreasing the chance of rotation and permanent damage. We do so by trimming the hooves, special pads or shoes, soft bedding, and encouraging the horse to lay down. 9. Hoof Trims: By trimming back the hoof walls and allowing the load to be mostly on the soles, including an aggressive pasture roll, we minimize load on the wall - the tearing force. Thus, even if the laminae have limited blood flow and thus decreased strength, there isn't a strong force pulling the wall away from the coffin bone.