Descriptive epidemiological study of equine laminitis

Laminitis Updates: Sepsis/Systemic Inflammatory Response Syndrome-Associated Laminitis

Sepsis or systemic inflammatory response syndrome (SIRS) -associated laminitis is a sequela to primary inflammatory conditions (eg, colitis, ischemic intestinal injury, pneumonia, metritis) and results from a dysregulated systemic inflammatory response that ultimately affects the digital lamellae. Local chemokine production, leukocyte migration, and proinflammatory mediator production occur within the lamellae that can lead to catastrophic lamellar failure. Controlling the primary disease, providing supportive care and anti-inflammatory therapy, applying digital cryotherapy, and providing mechanical support are cornerstones to the prevention of sepsis/SIRS-associated laminitis. Novel therapies targeting specific signaling pathways may provide additional therapeutic options in the future.

Cross-sectional study to identify the prevalence of and factors associated with laminitis in UK donkeys

BACKGROUND

Laminitis causes lameness in donkeys, but its prevalence and factors associated with disease remain uncertain.

OBJECTIVES

To determine the prevalence of and identify factors associated with laminitis in donkeys.

STUDY DESIGN

Retrospective cross-sectional study.

METHODS

All donkeys at the Donkey Sanctuary, UK, October 2015 to March 2019 were included. For animals that had laminitis during this period, age, sex, weight, body condition score, and the onset date and type of each episode (first or recurrent, acute or chronic) were recorded. Additionally, management data, foot lesion score, endocrine data, other medical conditions, occurrence of foot trimming, surgical procedures, diagnostic imaging, behavioural modification therapy or movement between farms within the month prior were noted. Controls were animals that did not experience laminitis during this period and similar data were recorded. Multivariable logistic regression modelling assessed the differences between the control group and laminitis outcome groups (first, all laminitis, acute and chronic episodes).

RESULTS

Altogether, 707 animals were included; 364 were control animals; 343 had a first episode of laminitis during the study period, of which 200/343 had no further episodes and 143/343 had recurrent episodes resulting in a total of 512 laminitis episodes and the period prevalence was 48.5% over 42 months. Overall, 180/512 (35%) laminitis episodes were acute and 332/512 (65%) were chronic. Compared with control animals, the laminitic outcome groups were significantly (P < .05) more likely to be younger (first episode), less likely to get extra feed (all four groups) or have an additional medical problem (first episode), and less likely to have undergone dental work, movement, imaging (all four groups) or surgery (first; all laminitis, chronic episodes) in the month preceding the episode.

MAIN LIMITATIONS

These results may not be applicable to the wider donkey population.

CONCLUSIONS

Laminitis commonly affects donkeys, but factors associated with donkey laminitis differ from those reported in horses.

The influence of trimming of the hoof wall on the damage of laminar tissue after loading: An in vitro study

Laminitis is associated with failure of the suspensory apparatus of the distal phalanx (SADP) connecting the distal phalanx to the hoof wall. The specific aim of this study was to examine in vitro whether thinning of the hoof wall leading to increased deformability influences the damage of the laminar tissue created by loading of the hoof. Paired cadaver forelimbs from twelve horses were used. For each pair, the hoof wall from one hoof was thinned by 25%; this was ascertained by radiography. The contralateral hooves were used as controls. In a material testing machine, hooves were loaded in a proximodistal direction at 0.5mm/s until a cut-off value of 8kN or 14mm was reached. Afterwards, samples of the SADP were taken for histology. Image-based evaluation of the destruction of the SADP was performed using quantitative histogram analysis. Additionally, three examiners masked to treatment (trimmed/untrimmed) qualitatively evaluated SADP destruction. During hoof loading with forces from 0.5 to 1.8 times the body mass of the donor horses, hooves with thinned hoof wall underwent significantly more deformation (P<0.05). Quantitative histogram analysis detected a shift to higher brightness values and a higher pixel intensity in control hooves, representing disruption in the histologic analysis. Qualitative evaluation of histology sections showed significantly more disruption of the SADP in untrimmed hooves (P=0.03). These results confirm the hypothesis that reduced hoof wall thickness can decrease disruption of laminar tissue in vitro, thus supporting the evaluation of hoof wall reduction as a prophylactic measure in horses at imminent risk of SADP failure.

Case-control study of risk factors for pasture-and endocrinopathy-associated laminitis in North American horses

OBJECTIVE To investigate risk factors for the development of pasture- and endocrinopathy-associated laminitis (PEAL) in horses and ponies in North America. DESIGN Case-control study. ANIMALS 199 horses with incident cases of PEAL and 351 horses from 2 control populations (healthy horses [n = 198] and horses with lameness not caused by laminitis [153]) that were evaluated in North America between January 2012 and December 2015 by veterinarian members of the American Association of Equine Practitioners. PROCEDURES North American members of the American Association of Equine Practitioners were contacted to participate in the study, and participating veterinarians provided historical data on incident cases of PEAL, each matched with a healthy control and a lameness control. Conditional logistic regression analysis was used to compare data on PEAL-affected horses with data on horses from each set of controls. RESULTS Horses with an obese body condition (ie, body condition score ≥ 7), generalized or regional adiposity (alone or in combination), preexisting endocrinopathy, or recent (within 30 days) glucocorticoid administration had increased odds of developing PEAL, compared with horses that did not have these findings. CONCLUSIONS AND CLINICAL RELEVANCE The present study identified several risk factors for PEAL that may assist not only in managing and preventing this form of laminitis, but also in guiding future research into its pathogenesis.

Clinical occurrence and radiographic diagnosis of distal limb lameness in equine

The objectives of this study was to evaluate the hospital occurrence of various radiographic lesions of the distal limb (bones and joints) lameness in equine and to evaluate the role of nerve and joint blocks for the localization of lameness in equine. All the equine lameness cases (117), presented during the one year study period that were subjected to radiographic evaluation, were investigated. Out of these, 20 equine lameness cases were subjected to systematic evaluation including nerve / joint blocks to confirm, whether the clinically or radiographically detectedlesion was the primary cause for the lameness or not. Out of 117, 78 equine (66.67%), were diagnosed with 124 radiographic lesions involving 101 limbs. The majority (62.8%) of the equines had single radiographic lesion, whereas the remaining animals were detected with multiple lesions involving one (15.4%) or more limbs (21.8%). Majority cases of equine lameness were recorded in winter season. Highest per cent lesions were recorded in hoofregion (25.81%) with more common involvement of fore feet (68.75%) and in mares (54.54%). Hock and fetlock regions were second (22.6%) and third (21.8%) most common regions for occurrence of equine lameness. Fetlock joint of hindlimb (63%) was more commonly affected than that of the forelimb. In this study, 16 nerve / joint blocks were applied in 15 horses and these were found helpful in confirming the lameness lesions in 66.7% cases. In conclusion, high prevalence of multiple lesions involving one or more limb poses great diagnostic challenge. Forelimb hoof and the hock were most frequently involved in distal limb lameness in equine. Periostitis and arthritis were most prevalent lameness causing lesions in equine. Physical examinations, nerve/ joint bocks and radiography complement each other in confirming the site of lesion causing lameness.

A diagnostic pathologist's guide to carpal disease in racehorses

As a pathologist, postmortem examination of the equine carpus can be daunting. The anatomy is complex and oftentimes, small or subtle lesions have significant impact on lameness and secondary lesions such as catastrophic musculoskeletal fractures and other injuries. In performance horses, particularly racehorses, the carpus is a common site of injury and source of lameness. Given the predisposition of racehorses to developing carpal disease, familiarity with clinically relevant anatomy and common developmental, degenerative, traumatic, and inflammatory processes are imperative for thorough postmortem examination. Our aim is (1) to provide a concise summary of clinically relevant anatomy and function that serves as a guide for postmortem evaluation of the equine carpus, and (2) to review common carpal injuries and diseases in actively training, racing, or retired racehorses, including developmental lesions (incomplete ossification, osteochondromata), infectious and inflammatory lesions (septic arthritis and tenosynovitis), and degenerative and traumatic lesions (degenerative and traumatic osteoarthritis, osteochondral fragmentation, and polyostotic catastrophic "breakdown" fractures). Representative gross and histologic images are presented along with corresponding antemortem and postmortem diagnostic images, and a review of current scientific literature pertaining to the pathogenesis of these equine carpal lesions.

Demographics, Management, Preventive Health Care and Disease in Aged Horses

Gerontology has become increasingly important in equine veterinary medicine, with aged animals representing a significant proportion of the equine population. Horses are defined as geriatric or aged from age 15 years onwards but can have a life span of more than 40 years. Despite a high level of owner concern for the well-being of their geriatric animal, provision of preventive health care may be suboptimal. Owners seem to under-recognize some of the most prevalent diseases identified in geriatric horses. This review focuses on the demographic characteristics of the equine geriatric population and management and preventive care practices of older horses.

Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records

Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not initial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully.

Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study

The objective of this cross-sectional study was to compare the prevalence of selected clinical signs in laminitis cases and non-laminitic but lame controls to evaluate their capability to discriminate laminitis from other causes of lameness. Participating veterinary practitioners completed a checklist of laminitis-associated clinical signs identified by literature review. Cases were defined as horses/ponies with veterinary-diagnosed, clinically apparent laminitis; controls were horses/ponies with any lameness other than laminitis. Associations were tested by logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals, with veterinary practice as an a priori fixed effect. Multivariable analysis using graphical classification tree-based statistical models linked laminitis prevalence with specific combinations of clinical signs. Data were collected for 588 cases and 201 controls. Five clinical signs had a difference in prevalence of greater than +50 per cent: 'reluctance to walk' (OR 4.4), 'short, stilted gait at walk' (OR 9.4), 'difficulty turning' (OR 16.9), 'shifting weight' (OR 17.7) and 'increased digital pulse' (OR 13.2) (all P<0.001). 'Bilateral forelimb lameness' was the best discriminator; 92 per cent of animals with this clinical sign had laminitis (OR 40.5, P<0.001). If, in addition, horses/ponies had an 'increased digital pulse', 99 per cent were identified as laminitis. 'Presence of a flat/convex sole' also significantly enhanced clinical diagnosis discrimination (OR 15.5, P<0.001). This is the first epidemiological laminitis study to use decision-tree analysis, providing the first evidence base for evaluating clinical signs to differentially diagnose laminitis from other causes of lameness. Improved evaluation of the clinical signs displayed by laminitic animals examined by first-opinion practitioners will lead to equine welfare improvements.

Vasorelaxant effect of propentofylline in isolated equine digital veins

We evaluated the vasorelaxant effect of propentofylline (PPF), a methylxanthine derivative, and its mechanism of action in equine digital veins (EDVs). Cumulative concentration-response curves to PPF (1 nM-300 µM) were recorded in phenylephrine-precontracted EDV rings under different experimental conditions. PPF-induced relaxation was partially inhibited by endothelium removal, but was unaltered by CGS-15943 (an adenosine receptor antagonist; 3 µM). PPF-induced relaxation was partially inhibited in the presence of L-NAME (a nitric oxide (NO) synthase inhibitor; 100 µM), ODQ (an inhibitor of soluble guanylyl cyclase; 30 µM) or Rp-8-Br-PET-cGMP-S (a protein kinase G inhibitor; 3 µM). It was not modified by indomethacin (a non-selective cyclooxygenase (COX) inhibitor; 10 µM), and was slightly potentiated by H-89 (a protein kinase A inhibitor; 2 µM). In endothelium-intact EDVs, PPF-induced relaxation was associated with a 2.4- and 24.1-fold increase in the tissue cGMP and cAMP content respectively. PPF (100 μM) did not shift the concentration-response curve to phenylephrine (1 nM-300 µM) but reduced the maximal effect. To investigate whether PPF can affect cAMP- and cGMP-induced relaxations, relaxation curves to forskolin (an activator of adenylate cyclase) and to sodium nitroprusside (SNP, a NO donor) were recorded in EDV rings pretreated with PPF (100 µM). PPF only slightly potentiated the forskolin-induced relaxation without affecting the SNP-induced relaxation. We demonstrated that PPF-induced relaxation in EDVs is partially endothelium-dependent. The PPF-induced relaxation partially occurred via NO release and both cAMP and cGMP generation, through COX-independent mechanisms but could also result from the inhibition of cAMP-phosphodiesterase activity for the highest concentrations.

Risk factors for equine laminitis: a case-control study conducted in veterinary-registered horses and ponies in Great Britain between 2009 and 2011

Laminitis is a highly debilitating disease of the foot known to have a complex and multifactorial aetiology of metabolic, inflammatory, traumatic or vascular origin. The disease has major welfare implications due to unrelenting pain associated with degenerative changes, which often necessitate euthanasia on welfare grounds. Despite this, there have been few high-quality studies investigating risk factors for equine laminitis, and only a limited number of risk factors have been previously investigated. The aim of this study was to conduct a case-control study of risk factors for active episodes of veterinary-diagnosed laminitis in horses and ponies attended by veterinary practitioners in Great Britain, based on multivariable statistical analyses. Questionnaires were received for 1010 animals, comprising 191 laminitis cases and 819 controls. Factors associated with an increased risk of laminitis were weight gain in the previous 3 months, summer and winter months compared to spring, new access to grass in the previous 4 weeks, box rest in the previous week, owner-reported history of laminitis, lameness or foot-soreness after shoeing/trimming, existing endocrinopathic (pituitary pars intermedia dysfunction and equine metabolic syndrome) disease and increasing time since the last anthelmintic treatment. Factors associated with a decreased risk of laminitis were increasing height (cm), feeding of additional supplements in the previous week and transportation in the previous week. Novel associated factors were identified that may aid in the management and prevention of the disease in the veterinary-registered equine population.

Cellular and humoral immunity in chronic equine laminitis

Chronic equine laminitis causes persistent pain and lameness in affected animals and often necessitates euthanasia when pain management strategies become ineffective. Published studies as well as anecdotal reports suggest that this chronic inflammatory disease is associated with systemic alterations in immune responsiveness, perhaps involving an autoimmune component. We investigated this broad hypothesis by measuring a variety of immune indicators in healthy control horses (CON) and horses with chronic laminitis (LMN). We found that white blood cells from LMN horses produced more IFNγ than did cells from CON horses when stimulated in vitro with polyinosinic-polycytidylic acid [poly(I:C)], possibly due to an elevated number of circulating monocytes. No differences between groups were observed in plasma concentrations of IgG, IgA, IgM, IgE, or rheumatoid factor. Laminar tissue from LMN horses expressed elevated levels of keratinocyte damage-related genes as well as inflammatory cytokines and chemokines, which corresponded with a modest amount of neutrophil infiltration as shown by histological staining of fixed tissue and accumulation of neutrophil elastase protein. Taken together, our results do not support the hypothesis of an autoimmune component in chronic laminitis, although the strong induction of neutrophil chemokines and the presence of tissue neutrophils suggests that this cell type is likely involved in perpetuating the inflammation and tissue damage associated with this disease.

Plasma proteomics shows an elevation of the anti-inflammatory protein APOA-IV in chronic equine laminitis

Background

Equine laminitis is a devastating disease that causes severe pain in afflicted horses and places a major economic burden on the horse industry. In acute laminitis, the disintegration of the dermal-epidermal junction can cause the third phalanx to detach from the hoof wall, leaving the horse unable to bear weight on the affected limbs. Horses that survive the acute phase transition into a chronic form of laminitis, which is often termed “founder”. Some evidence suggests that chronic laminar inflammation might be associated with alterations in the endocrine and immune systems. We investigated this broad hypothesis by using DIGE to assess global differences in the plasma proteome between horses with chronic laminitis and controls.

Results

We identified 16 differentially expressed proteins; the majority of these were involved in the interrelated coagulation, clotting, and kininogen cascades. Clinical testing of functional coagulation parameters in foundered horses revealed a slight delay in prothrombin (PT) clotting time, although most other indices were within normal ranges. Upregulation of the intestinal apolipoprotein APOA-IV in horses with chronic laminitis was confirmed by western blot.

Conclusions

Our results support the hypothesis that localized laminar inflammation may be linked to systemic alterations in immune regulation, particularly in the gastrointestinal system. Gastrointestinal inflammation has been implicated in the development of acute laminitis but has not previously been associated with chronic laminitis.

Risk factors for equine laminitis: a systematic review with quality appraisal of published evidence

Epidemiological studies into the risk factors for naturally-occurring equine laminitis are limited. There are a small number of such studies, although the results are inconsistent and remain disputed. The reasons for the conflicting results remain unclear. The aim of this review was to critically evaluate previous research in order to identify publications which provide the best evidence of risk factors for naturally-occurring equine laminitis. A systematic review of English language publications was conducted using MEDLINE (1950-2010), CAB Direct (1910-2010) and IVIS (1997-2010). Additional publications were included by searching bibliographies. Search terms included laminitis, equine, risk factors and epidemiology. Publications which compared a case population to a control population and made inferences about parameters as risk factors for naturally-occurring equine laminitis were included. Information was extracted using predefined data fields, including 18 study quality indicators. In total, 17 publications were fully appraised. Six were considered to provide the most reliable information about risk factors for naturally-occurring laminitis. Information on signalment was well researched and there was good evidence for an association with chronic laminitis and increasing age. There remain inconsistent results for many other horse-level risk factors including gender, breed and bodyweight. Previous publications estimating risk factors for equine laminitis were of reasonable quality, although they were limited in the number and scope of the risk factors studied. High-quality, evidence-based studies are needed to identify further risk factors and to establish consensus over previously identified risk factors for different equine populations.

Epidemiological study of pasture-associated laminitis and concurrent risk factors in the South of England

A retrospective study of laminitis was carried out to identify risk factors associated with this disease on an East Anglian farm with approximately 1000 animals living in an area of 1000 acres. Medical records between January 1997 and May 2000 and between April 2005 and March 2008 were reviewed, and the age, sex, weight (kg), height (inches [in] and hands [H]) and weight-to-height ratio (kg/in) was recorded. The prevalence, incidence and seasonality of laminitis were determined and their relationship to the monthly temperature, rainfall and hours of sunshine was evaluated. Averaged over the six years, the highest prevalence (2.6 per cent) and incidence (16 cases/1000 animals) of laminitis occurred in May. The findings of a multivariate analysis revealed that females (P=0.007, odds ratio [OR] 1.46, 95 per cent confidence interval [CI] 1.1053 to 1.9646) and light animals (P ≤ 0.001, OR=0.995, 95 per cent CI =0.9932 to 0.9963) had the greatest risk of developing laminitis. A positive association was found between hours of sunshine and incidence (P=0.007, relative risk [RR] 1.009, 95 per cent CI 1.001 to 1.012) and prevalence (P=0.002, RR 1.008, 95 per cent CI 1.003 to 1.012) of laminitis. The data suggest that there is a relationship between season, sex of the animal and the development of laminitis.

Acute laminitis: medical and supportive therapy

Acute laminitis is a serious complication of many primary conditions in the horse. This article summarizes the most appropriate approach to management of the horse with acute laminitis, based on current information.

Therapeutic hypothermia (cryotherapy) to prevent and treat acute laminitis

Digital hypothermia successfully reduces the severity of experimentally induced laminitis. Continuous-distal limb cryotherapy may be a useful technique in clinical cases that are at risk of developing laminitis. This article examines the effects of hypothermia on tissue as well as the rationale, and suggested protocols for the usage of distal limb cryotherapy in the prevention and treatment of laminitis.

Corticosteroid-associated laminitis

A direct causal association between corticosteroid use and laminitis has yet to be proven scientifically, and there have been few studies specifically addressing this aspect. New evidence, however, is improving the understanding of the causes of laminitis, particularly related to endocrine factors. The focus of this article is discussing the circumstances under which steroids might cause this condition.

Equine laminitis model: cryotherapy reduces the severity of lesions evaluated seven days after induction with oligofructose

REASONS FOR PERFORMING STUDY

A previous preliminary study demonstrated the potential of distal limb cryotherapy (DLC) for preventing laminitis. Clinically, DLC must be effective for periods longer than 48 h and the preventive effect must extend beyond its discontinuation.

OBJECTIVES

To evaluate the effect of DLC, applied during the developmental phase of induced laminitis, on the severity of clinical laminitis and lamellar histopathology 7 days after dosing.

METHODS

Eighteen normal Standardbred horses were divided into 3 groups of 6. Continuous cryotherapy was applied for 72 h to the distal limbs of the first group. The second and third groups were administered laminitis inducing doses of oligofructose and 72 h of cryotherapy applied (immediately after dosing) to the second group. After clinical assessment all horses were subjected to euthanasia 7 days after dosing and hoof lamellar tissues were harvested and analysed.

RESULTS

In the laminitis induced horses clinical lameness and laminitis histopathology was significantly reduced in horses that underwent 72 h of DLC compared with untreated controls. Cryotherapy alone produced no significant lameness or other ill effect.

CONCLUSIONS

Continuous, medium- to long-term (72 h) cryotherapy applied to the distal limbs of horses safely and effectively ameliorates the clinical signs and pathology of acute laminitis.

POTENTIAL RELEVANCE

Pre-emptive distal limb cryotherapy is a practical method of ameliorating laminitis in ill horses at risk of developing the disease.

Equine laminitis: ultrastructural lesions detected 24-30 hours after induction with oligofructose

REASONS FOR PERFORMING STUDY

The pathology of equine laminitis has been well-documented 48 h after dosing with oligofructose when clinical lameness and lamellar disintegration is well advanced. Further analysis of the earliest lesions, by collecting lamellar samples at the first sign of foot lameness after oligofructose dosing is required in order to increase understanding of the disease.

OBJECTIVES

To investigate lamellar epidermal hemidesmosome damage and basement membrane dysadhesion by transmission electron microscopy (TEM).

METHODS

Eight clinically normal, mature Standardbred horses were divided randomly into 2 groups of 4. The treatment group were dosed with oligofructose (10 g/kg bwt) and subjected to euthanasia when shifting weight from one foot to other commenced and at the first sign of lameness during walking and turning. This occurred at 24 h in 3 horses and 30 h in one. The sham treatment control group were dosed with water and subjected to euthanasia after 48 h. Lamellar tissues of the front feet were harvested and processed for ultrastructural study using TEM.

RESULTS

Examination by TEM showed excessive waviness of the basement membrane zone and pointed tips of some secondary epidermal lamellae, an ultrastructural lesion typical of laminitis. The average number of hemidesmosomes/microm of basement membrane was decreased and their distance from the centre of the lamina densa of the basement membrane was increased.

CONCLUSIONS

Laminitis lesions are detectable 24 h after oligofructose administration.

POTENTIAL RELEVANCE

Hindgut events occurring in the first 24 h after dosing have begun the destruction of the hoof lamellar interface. Prevention and treatment strategies should precede lameness if they are to be efficacious.

Increased expression of MAIL, a cytokine-associated nuclear protein, in the prodromal stage of black walnut-induced laminitis

REASONS FOR PERFORMING STUDY

The mediators and signalling cascades important in the initiation of laminitis remain unclear. We therefore wanted to explore the genes and overall signalling mechanisms that play an important role in the developmental stage of laminitis.

OBJECTIVE

To use a broad genomic screening technique to identify novel genes that are differentially regulated in the equine lamellae during the developmental period of laminitis.

METHODS

Differential mRNA display (DRD) was performed to discover regulated genes, and real-time quantitative polymerase chain reaction (RT-qPCR) was then used to evaluate lamellar mRNA levels of a regulated gene (MAIL) and mediators related to that gene (IL-1beta and IL-6) in control horses (n = 5) and horses administered black walnut extract (BWE; n = 5).

RESULTS

Using DRD, MAIL was identified as a regulated gene. RT-qPCR indicated a 4-fold increase in expression of the MAIL mRNA in BWE lamellae compared to controls. A 30-fold increase in IL-1beta, and a 160-fold difference in IL-6 mRNA expression was present in BWE lamellae. Differences in MAIL, IL-1beta and IL-6 mRNA expression were statistically significant between groups (P < 0.05).

CONCLUSIONS AND POTENTIAL RELEVANCE

The data strongly support a role for inflammatory cytokines in the developmental stages of laminitis, possibly inducing the vascular and metabolic alterations reported to occur in the affected digit. These results potentially support the use of anti-inflammatory drugs in horses at risk of laminitis, and warrant further investigation of the link between systemic disease processes associated with laminitis and the reported digital inflammation.

Pasture-associated laminitis

Laminitis is a painful and debilitating condition of horses and ponies that has major economic and welfare implications. Anecdotal observations and the results of survey studies have indicated that most laminitis cases occur in horses and ponies kept at pasture (hence, the term pasture-associated laminitis). Risk for development of pasture-associated laminitis represents a dynamic interaction between animal predisposing factors (an insulin-resistant phenotype commonly termed equine metabolic syndrome) and environmental conditions, particularly the nonstructural carbohydrate (simple sugars, starches, and fructans) content of pasture forage. Countermeasures for avoidance of pasture-associated laminitis involve (1) mitigation of metabolic predisposition (insulin resistance and obesity) in high-risk horses and ponies and (2) dietary and pasture grazing management strategies that minimize exposure to the dietary conditions known to trigger laminitis in susceptible animals.

A survey of feeding , management and faecal pH of Thoroughbred racehorses in the North Island of New Zealand

AIM

To identify feeding and management variables associated with variation in faecal pH within a population of intensively managed Thoroughbred racehorses in New Zealand.

METHODS

A cross-sectional survey was conducted of 16 racehorse trainers in the North Island of New Zealand. Interviews were conducted at the trainers' stables to obtain information on feeding and management of horses, and faecal samples were collected and faecal pH measured.

RESULTS

Ninety-seven percent of the horses surveyed were confined in an area <or=5 x 5 m for >or=12 h/day. Trainer's age, number of years they had trained horses, age and gender of horses, weeks in race training, racing class, frequency of feeding, bedding type, and exercise workload had no effect on mean faecal pH. Acidic faecal pH (pH <or=6.32) was associated with stables with <or=12 horses, and trainers at stables with <or=12 horses offered more concentrate feed than those at stables with >12 horses. Acidic faecal pH was associated with trainers who offered 4 kg of grain as the only form of concentrate fed, or offered <or=2.25 kg hay/day. Horses that displayed stable vices had less acidic faecal pH than horses that did not display stable vices, viz pH 6.70 (standard error of the mean (SEM) 0.135) vs 6.43 (SEM 0.029) (p=0.04).

CONCLUSIONS AND CLINICAL RELEVANCE

Racehorse management in New Zealand is similar to that observed in other major racing countries. Trainers with <or=12 horses fed more concentrates and their horses had lower faecal pH than those of trainers with >12 horses. Irrespective of management system, it appears important to provide at least 2.25 kg of hay/day ad libitum, to buffer hindgut acidosis associated with diets high in soluble carbohydrate.

The effects of diet on blood glucose, insulin, gastrin and the serum tryptophan: Large neutral amino acid ratio in foals

High carbohydrate diets can affect the health and behaviour of foals, but the mechanisms are not always fully understood. The objective of this study was to compare the effects of feeding a starch and sugar (SS), or a fat (oil) and fibre (FF) rich diet to two groups of eight foals. Diets were fed from 4 to 42 weeks of age, alongside ad libitum forage. Faecal pH levels did not differ significantly between groups and endoscopic examination showed that the gastric mucosa was healthy in both groups at 25 and 42 weeks of age. At 40 weeks of age, SS foals had significantly higher total blood glucose and lower total blood gastrin than FF foals during the 6h period following ingestion of their respective diets, but insulin levels did not differ significantly. The ratio between serum tryptophan and other large neutral amino acids showed a trend towards an interaction between diet and sampling time. The results provide preliminary information about the effects of diet on the physiology of young horses.

Risk factors for development of acute laminitis in horses during hospitalization: 73 cases (1997–2004)

OBJECTIVE

To identify risk factors for development of acute laminitis in horses during hospitalization for illness or injury.

DESIGN

Retrospective case-control study.

ANIMALS

73 horses that developed laminitis (case horses) and 146 horses that did not develop laminitis (control horses) during hospitalization.

PROCEDURES

Case and control horses were matched in a 2:1 ratio by the date on which each horse was evaluated. Potential risk factors investigated included age, breed, and sex; highest and lowest values recorded during hospitalization for fibrinogen concentration, WBC count, PCV, and total solids concentration; and comorbid disease states, including pneumonia, endotoxemia, diarrhea, medically treated colic, surgically treated colic, pituitary adenoma, retained placenta or metritis, forelimb lameness, hind limb lameness, acute renal failure, and vascular abnormalities. A univariate screening of all potential risk factors was performed to determine which variables should be selected for further analysis. All factors found to be associated with development of laminitis were included in a multivariate conditional logistic regression model.

RESULTS

Development of laminitis was marginally associated with lowest and highest fibrinogen concentrations, highest PCV, and lowest total solids concentration and significantly associated with pneumonia, endotoxemia, diarrhea, abdominal surgery for colic, and vascular abnormalities. In the multivariate analysis, only endotoxemia was significantly associated with laminitis.

CONCLUSIONS AND CLINICAL RELEVANCE

Endotoxemia is an important risk factor for development of acute laminitis in horses during hospitalization for medical or surgical conditions. Early recognition of endotoxemia, or the potential for it to develop in certain disease states, and initiation of treatment directed at endotoxemia or its consequences may help prevent laminitis in horses during hospitalization.