Thorough Exams Key To Laminitis Care by Paulick Report Staff|01.25.2018|9:28am Laminitis is a painful hoof condition where the laminae inside the hoof capsule becomes inflamed or injured. The laminae are soft tissue structures that hold the coffin bone in place with in the hoof capsule. While many equine laminitis cases are obvious, with hooves that are hot to touch, a rapid digital pulse and the horse's reluctance to bear weight on the front limbs, not all cases have these classic signs. Because of this, treating veterinarians must aware of other symptoms as they come up with a treatment plan. Laminitis was a hot topic at the 2017 American Association of Equine Practitioners Convention, held Nov. 17-22 in San Antonio, Texas. James Belknap, DVM, PhD, Dipl. ACVS, spoke on how to evaluate horses suspected of suffering from laminitis and what information to note, reports The Horse. Belknap noted that there are three different types of laminitis, but all result in the same general outcome, which is structural failure of the laminae and coffin bone displacement. The types of laminitis include: Supporting-limb laminitis This type of laminitis develops in a limb that is opposite a severely lame limb. It can take weeks or months to develop. Sepsis-related laminitis Developing usually between 36-48 hours after the onset of sepsis, this type of laminitis is common in horses that have had pleuropneumonia, enterocolitis or endometritis (an infection of the uterus, common after mares have foaled). As soon as the horse is diagnosed, it should be stood in an ice/water mixture for several days. Endocrine laminitis This type of laminitis is slower to occur and does not always present with the classic laminitic signs as the coffin bone displacement is much slower. This type of laminitis is the most common and is often associated with equine metabolic syndrome and pituitary pars intermedia dysfunction. Belknap focused on the extremely painful equine patients for his presentation, encouraging vets to get a thorough history, including time frame of when the episode started, previous lameness issues, infections and any dietary changes. A detailed look at the hooves, looking for any abnormalities, is also paramount. A key indicator of pain is heart rate if the case is not complicated by sepsis. Moderate laminitis cases may result in the horse having a heart rate between 45 and 55 beats per minute, Belknap said, but extremely painful cases may result in heart rates in the 70s and 80s. If the horse is able to move, the vet can perform a lameness exam at the walk, which could include walking a straight line and figures of eight on both hard and soft surfaces. The horse could be asked to jog on a soft surface if endocrine laminitis is suspected. The main concern is to determine how much the coffin bone has been displaced, if at all. X-rays need to be taken. Blocking the nerves in the horse's front feet can help reduce pain and allow for a better X-ray. Once the X-rays are read, the vet can determine both prognosis and treatment. Belknap recommended ongoing X-rays to monitor coffin bone displacement. Read more at The Horse.