The most common reason that laminitic horses fail to make a good recovery is because the horse is allowed to self-exercise too soon; it is common for affected horses to be "turned out" sooner than 6-8 weeks following initiation of treatment. These horses have often been stall-confined for several weeks (during treatment). Much too soon, they are turned out and (in light of their recent confinement) allowed to run around. Neither the owner nor the horse has any appreciation for the fact that the lamellar attachments have not completely healed. Although the horse perceives that his feet are okay, the weakened attachments can all too easily be re-damaged – leading to a major "flare-up" and worsening of the underlying disease process.
The specific treatment should be determined by the veterinarian who has examined the horse based on his findings and results of radiography of the affected feet.
Treatment Treat the primary problem if it can be identified
Rest
Application of hot or cold (depends on stage)
Appropriate pain relief
Thickly bedded stall
Drugs aimed at improving the blood flow to the feet (such as nitric oxide donors, acepromazine, pentoxifylline)
Drugs used to reduce inflammation which can develop when blood supply is poor (DMSO)
Frog support
Heparin therapy
Aspirin
Change the angle of the painful hoof
Use of frog support
Special trimming and farriery - chronic cases
Surgery (transect the DDF tendon)
Other than the pain relief and the antiinflammatory properties of non-steroidal anti-inflammatories, (bute, banamine, ketofen), no drug has been shown to affect the course of laminitis. Despite years of research, this disease continues to defy solutions, and that is likely due to the fact that it can either be too late by the time symptoms are present, or the underlying problem has not been fixed.
Special Points
Most affected horses are prone to further bouts of laminitis.
Most affected horses do not re-achieve the same level of performance that they had prior to developing laminitis.
Horse owners often undertake treatment without fully appreciating the potential cost (based on length of time and cost of drugs) and labor needed to care for affected horses. Many of those horses show episodic improvement during treatment, but overall continue to deteriorate.
Most veterinarians would agree, that laminitis is one major cause of suffering in horses, and it is difficult to know when to give up. Certainly, if the horse does not respond to pain medication, is relatively immobile, doesn't eat, has side effects of pain medication, if there is serious rotation of the coffin bone, hoof wall destruction, or infection, euthanasia should be considered.
These horses are suffering with little hope of relief. Eventually they will go down, and not get up. Although euthanasia is an extremely difficult decision, the picture is perhaps clearer with laminitis that with other diseases. You might want to set-up criteria for "suffering" and "indications for euthanasia," which may sound a little morbid, but if you put it on paper, that means you've thought about it. Talk it over with your veterinarian. They will be impressed and glad to help you further.
Prognosis
The prognosis is unpredictable, and it may be (and should be recognized as such) grave in some severe cases. Few "recovered" (remissive) horses will be able to work at a high level of performance.
