Do all laminitics have metabolic dysfunction?

Wagtail

Wagtail

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A couple of livery clients of mine went to a course a few weeks ago on horse movement. I am not sure which course it was, but could find out. When they came back they said they had learnt that the current thinking regarding laminitis is that ALL horses that get the disease are either insulin resistant or have Cushings, and that the tests often give a false negative. What do others think about this? To me it makes sense. Otherwise why would one horse get lami after being on lush grass for only an hour whilst others can be on it 24/7 with no ill effects? I am currently trying to persuade one of my liveries to have the tests done on her gelding since he came down with lami for the first time this year. He has fat pads over his eyes. He broke out of his bare paddock yesterday into the hay field and was only in it an hour before he was discovered but that was enough to set him off. The vet keeps telling the owner it is unlikely he has IR and that many horses have fat pads over their eyes and it means nothing. :confused: (He's not my vet).
 
I'm certain that all horses that have laminitis must have had a metabolic event to trigger it. But (and I'm willing to be proved wrong about this) I don't think that all horses with laminitis MUST have IR or cushings. That would mean that every single horse that ever had any separation (flare, distal descent etc) has IR or cushings, which I don't think is the case?
 
This is an interesting thread. I lost a pony earlier this year to laminitis. My vets are now stating on their website that they consider all laminitis cases to be related to EMS or Cushings.
 
TwoStroke said:
I'm certain that all horses that have laminitis must have had a metabolic event to trigger it. But (and I'm willing to be proved wrong about this) I don't think that all horses with laminitis MUST have IR or cushings. That would mean that every single horse that ever had any separation (flare, distal descent etc) has IR or cushings, which I don't think is the case?
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This ^^^ would be my opinion too, I was certain my mare had cushings (although she doesnt have the tell tale fatty deposits etc.), she has had laminitis in one foot - (the other 3 feet absolutely fine and always have been!) - she has had 2 tests for cushings/IR, and both came back well within the 'normal' ranges...
 
Tbh, and I don't wish to offend anyone, but I think people are desperate to believe that there is something wrong with their horse, rather than their management of their horse. It can be hard to realise that the blame lies solely on our own shoulders, for not feeding and managing the horse in accordance to its evolution.

I can see the temptation to believe that it's because of a defect with the horse itself, but imo this often isn't the case. And in the cases in which the blame can be laid on IR - it needs to be recognised that this is also a man made problem, caused by the horse owner's management.
 
TwoStroke - I think you are right about IR/EMS. I mean it's a chicken and egg thing - if the pony was slim, it wouldn't necessarily have become IR/EMS. Few slim humans develop Type II diabetes. Many fat people who lose weight and improve their fitness can manage their diabetes with diet and need no medication. So I do think you need to keep an eye on their weight.

I am not sure what you can do about Cushings, I mean they either have it, or they don't.
 
Yes I am with my vets and referral vet at a leading Equine Hospital and believe ALL cases of Laminitis to have a metabolic cause - they do not have to have EMS or Cushings 'yet', but I believe at the time Lami was triggered, they had IR!

IR can be temporary and it can be reversed - I like to think of it more as the body being over-loaded and it saying 'I just cant cope anymore'! Whereas I think once they have EMS it has become a 'permenant' state of the body being unable to cope and of course Cushings is permenant.

A friend's pony is just recovering from Lami - he had fat pads above his eyes and a hard crest - neither of which the vet pointed out to the owner. They didn't test for EMS and Cushings and after being in off the grass for a couple of weeks on soaked hay, his fat pads have gone and his crest has reduced and is soft. They are going to test next week and I will lay money he will test negative as his body has recoved from his IR/Lami episode and will be back to normal.

This is just based on my observations after my boy tested negative following a bout of Lami and negative again later that same year, but positive EMS 2 years later when fat pads and a hard crest returned - the vet tested the day he went footy this time!

I think they have bouts of IR when the body gets over-loaded and continuous over-loading will lead to EMS.
 
TwoStroke said:
Tbh, and I don't wish to offend anyone, but I think people are desperate to believe that there is something wrong with their horse, rather than their management of their horse. It can be hard to realise that the blame lies solely on our own shoulders, for not feeding and managing the horse in accordance to its evolution.

I can see the temptation to believe that it's because of a defect with the horse itself, but imo this often isn't the case. And in the cases in which the blame can be laid on IR - it needs to be recognised that this is also a man made problem, caused by the horse owner's management.
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This is rather generalistic. I just lost my lean 16.3hh IDx to laminitis - she had stress laminitis, nothing to do with my management or feeding regime. Not all laminitis is feed induced or related to Cushings or IR.
 
YasandCrystal said:
This is rather generalistic. I just lost my lean 16.3hh IDx to laminitis - she had stress laminitis, nothing to do with my management or feeding regime. Not all laminitis is feed induced or related to Cushings or IR.
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I'm sorry for your loss, truly :(.

The premis of the thread, though, was that 'all laminitics have IR or Cushings', so picking me out as making generalisations is a little off.

It's also not only to do with weight. Starch overload will cause the laminae to break down, and this can happen in a fit, slim horse exactly the same as in a fat pony.
 
TwoStroke said:
I'm sorry for your loss, truly :(.

The premis of the thread, though, was that 'all laminitics have IR or Cushings', so picking me out as making generalisations is a little off.

It's also not only to do with weight. Starch overload will cause the laminae to break down, and this can happen in a fit, slim horse exactly the same as in a fat pony.
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Yes I know it's not just weight, but chances are a horse/pony on a high carb/starch/molasses/sugar diet will be carrying extra. Sorry this is just a sensitive topic for me at the moment.

My mare had fat pads above her eyes, but as she tested clear for cushings and IR I understood these were due to the toxins in her system.
Stress laminitis is not that common it seems and it can be as for my mare catastrophic sadly
 
YasandCrystal said:
Yes I know it's not just weight, but chances are a horse/pony on a high carb/starch/molasses/sugar diet will be carrying extra. Sorry this is just a sensitive topic for me at the moment.

My mare had fat pads above her eyes, but as she tested clear for cushings and IR I understood these were due to the toxins in her system.
Stress laminitis is not that common it seems and it can be as for my mare catastrophic sadly
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Sadly it seems research in this area is desperately lacking. I assume the stress has a metabolic impact which kills off some of the microflora in the gut, causing the laminitis. What can be done to prevent this, I'm not sure. I suppose unless it is possible to keep a horse 100% stress free, there will always be a risk of this happening. Particularly if the horse is already unwell and the delicate balance of digestive system under strain.

I did not mean to imply that all owners of laminitic horses should berate themselves for it, simply that the cause of the condition lies in the evolution of the horse's digestive system, and the key to preventing it is in understanding how it works, rather than broadly labelling all horses as IR, as if that is the root of the problem.

Cushings is another matter, of course, and makes the management needs of the horse so much more difficult for the owner.
 
I was interested in the recent 'Laminitic survey' put up by someone on this forum as one of the questions was whether the horse had any melanomas or tumours. I wondered then about links with tumours and laminitis.

My horse was a grey and she had some small growths under her tail which I know is very common in greys. It does get me wondering though if a horse has say tumours unbeknown to the owner whether a low or medium level constant pain could mean the horse was susceptible then to a stress episode causing the sudden release of toxins into the system. My mare was not stressy at all infact the calmest and most gentle horse ever. She was every vet's dream horse as she was so compliant always. I know what I believe was the cause of the stress. I had been trying to have her bf - using sole hardener daily and Boa boots to hack out in. She was quite footy especially as teh ground dried out. She got cast in her stable (assume this from marks on the wall) and was subsequently quite still for a couple of days. She was then shod in front and a week later turned out with a new livery (bonded 2 weeks over the fence so much so they were grazing nose to nose). The new livery I believe herded her around our track and this then at the end of the first day resulted in a very stiff laminitic gait.
However she uncharacteristically always showed an unwillingness to be caught to be ridden and this really went against her character. So I wonder and always will if there was something unbeknown to me going on with her as clearly this was a massive reaction which shouldn't happen in a normal healthy horse.
 
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Without wishing to speculate too much on a painful subject, from what you describe I would suspect some level of hind gut disturbance. But who knows, with mares it could also be ovaries, or as you say - related to the tumours. Or either of those two could cause the hind gut problems. I'm starting to suspect that many, many problems eventually come back to a disturbance in the gut - whether that is primary or secondary.
 
YasandCrystal said:
I was interested in the recent 'Laminitic survey' put up by someone on this forum as one of the questions was whether the horse had any melanomas or tumours. I wondered then about links with tumours and laminitis.

My horse was a grey and she had some small growths under her tail which I know is very common in greys. It does get me wondering though if a horse has say tumours unbeknown to the owner whether a low or medium level constant pain could mean the horse was susceptible then to a stress episode causing the sudden release of toxins into the system. My mare was not stressy at all infact the calmest and most gentle horse ever. She was every vet's dream horse as she was so compliant always. I know what I believe was the cause of the stress. I had been trying to have her bf - using sole hardener daily and Boa boots to hack out in. She was quite footy especially as teh ground dried out. She got cast in her stable (assume this from marks on the wall) and was subsequently quite still for a couple of days. She was then shod in front and a week later turned out with a new livery (bonded 2 weeks over the fence so much so they were grazing nose to nose). The new livery I believe herded her around our track and this then at the end of the first day resulted in a very stiff laminitic gait.
However she uncharacteristically always showed an unwillingness to be caught to be ridden and this really went against her character. So I wonder and always will if there was something unbeknown to me going on with her as clearly this was a massive reaction which shouldn't happen in a normal healthy horse.
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This is extremely interesting (though very upsetting what happened to your poor mare). The gelding that I am worried about at the moment has just undergone 6 months of intensive treatment for a massive sarcoid which resulted in him having a painful and gaping wound at the site for much of that time. The evening before his latest lami attack I brought his usual field mate into the sand with him due to the field being very wet that night, so that he could have some respite. (The lami prone gelding was having 6 hours a day on the paddock and coming in for 18 hours a day into his sand turnout.) I noticed that night that his fieldmate was herding him continuously around the sand. I put it down to the flies bothering him and him wanting to get his head near the other's tail. I also thought the gentle walking exercise would do the lami prone horse good. I thought he seemed a little footy the following morning but still put him out in the paddock as there was virtually no grass. It was then that he broke into the hay field and came down with the latest lami attack. :(
 
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TwoStroke said:
Without wishing to speculate too much on a painful subject, from what you describe I would suspect some level of hind gut disturbance. But who knows, with mares it could also be ovaries, or as you say - related to the tumours. Or either of those two could cause the hind gut problems. I'm starting to suspect that many, many problems eventually come back to a disturbance in the gut - whether that is primary or secondary.
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Yes I agree entirely and I sent off a mane sample to a kinesiologist and she said 'hindgut' was the source and she advised me to give detoxifying herbs (vet approved) and some aromatherapy treatments and reiki to the gut and prebiotics.

I gave my mare a supplement called Promix, which contains Amino acids and is for gut function for 6 weeks along with Probiotics and then the Prebiotic.

Sadly my mare had severe rotation and sinking in both fores and whilst I would have carried on she unfortunately after seeming to start improving got necrosis in the sole of her worst fore and with but 6mm between pedal bone tip and the ground I had to go with the vet's advice.
 
Wagtail said:
This is extremely interesting (though very upsetting what happened to your poor mare). The gelding that I am worried about at the moment has just undergone 6 months of intensive treatment for a massive sarcoid which resulted in him having a painful and gaping wound at the site for much of that time. The evening before his latest lami attack I brought his usual field mate into the sand with him due to the field being very wet that night, so that he could have some respite. (The lami prone gelding was having 6 hours a day on the paddock and coming in for 18 hours a day into his sand turnout.) I noticed that night that his fieldmate was herding him continuously around the sand. I put it down to the flies bothering him and him wanting to get his head near the other's tail. I also thought the gentle walking exercise would do the lami prone horse good. I thought he seemed a little footy the following morning but still put him out in the paddock as there was virtually no grass. It was then that he broke into the hay field and came down with the latest lami attack. :(
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Wagtail that sounds like it could possibly be a combination of the 2 things being the cause. It's scary that a herding episode can be a cause, but actually in my mare's case I think the herding was just the last straw and actually anything could ultimately have been a trigger.
 
From what I understand, there are two identified primary causes of laminitis:

Hyperinsulinaemia - Cushings/PPID (which has a side effect of insulin resistance) and Insulin Resistance (which can be genetic 'thrifty gene', obesity, EMS, EPSM...)

Systemic Inflammatory Disease (SID) - 'grain bin incident', shock, trauma, surgery, toxins, any other gut disturbance.

Current belief is that SID creates enzymes that 'eat' and break down the laminae connection, whereas hyperinsulinaemia is more chronic and causes in a poor quality connection being created in the first place.

Post surgery it is recommended to employ cryogenic therapy to prevent inflammation in the hoof - as this has been found to help stave off laminitis developing.
http://minnie.uab.es/~veteri/21231/Equine laminitis.pdf

I would consider any horse with a chronic problem and pain to be at risk of ulcers - which would then be at risk of SID.

Iron is known to inhibit insulin control and zinc is involved in creating good tissue and production and control of insulin. So the high levels of iron frequently found in our grazing and feeds is a cause for concern, as are the low levels of zinc often found. It is no wonder to me that horses frequently create a good quality wall connection following balancing these minerals.

Also - if you look at some shod hooves (and I am not picking on shoes - merely sharing my findings) - they load purely on the wall (which was not designed for that) and walls are often very long - with a levering effect on the laminae. When the wall gets too long, the horse cannot self trim and shed the excess with the shoe on, so they push up the coronet band - therefore X-rays often pick up that p3 is low in the hoof capsule. Is it that the bone is too low or the whole hoof capsule is too tense and high?
It is common to have an incidental finding of rotation to p3 on X-ray. That, coupled with a modern diet, is all a recepie for disaster.

We are just beginning to understand laminitis and there are still answers to be found.

To me - feeding a sensible diet and learning what a healthy hoof looks like, how to read them and to try keep them as healthy as possible is all we can do for now.
 
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TwoStroke said:
Tbh, and I don't wish to offend anyone, but I think people are desperate to believe that there is something wrong with their horse, rather than their management of their horse. It can be hard to realise that the blame lies solely on our own shoulders, for not feeding and managing the horse in accordance to its evolution.

I can see the temptation to believe that it's because of a defect with the horse itself, but imo this often isn't the case. And in the cases in which the blame can be laid on IR - it needs to be recognised that this is also a man made problem, caused by the horse owner's management.
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Unfortunately on our yard there is a clear division between the people who do manage their horse's needs and feeds and those who don't. On our yard the 3 ponies who have had laminitis, 1 being mine, 2 of them were diagnosed with cushings and the other with IR. None of these ponies were ever put on lush pastures and all have their weight watched by paranoid owners. The most grossly obese welsh cob currently in one paddock and a very fat horse in another paddock have never suffered from laminitis and their owners are blind to the damaging effect their ignorance will eventually have on the horse's health.

My pony was caught footsore a week and a half ago despite being muzzled 24/7 and being his spot on target weight. Within 2 days he was comfortable and trotting round just out on a bare paddock with soaked hay and a few nuts.:rolleyes:I won't accept the blame is 100% mine and have a vet booked for tomorrow to ensure his pergolide levels are correct. As owners of cushings or IR ponies, we have to indeed be vigilant with management but also be able to pick up small hints (such as my pony who wouldn't walk over stones)to be able to investigate whether our own management must be tweaked or medication is to be altered.
 
Sophstar said:
to be able to investigate whether our own management must be tweaked or medication is to be altered.
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Precisely my point :). It's a matter of management. Some will be easier than others, and often its the horses with owners who try the hardest that are the most difficult to manage - the owners with the fat, sound horses have not had their backs against the wall yet! Or they have, but are too blind or indifferent to see it :(.
 
YasandCrystal said:
This is rather generalistic. I just lost my lean 16.3hh IDx to laminitis - she had stress laminitis, nothing to do with my management or feeding regime. Not all laminitis is feed induced or related to Cushings or IR.
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I am very sorry for your loss!

My boy came down with Lami 4 weeks after I brought him with 14 degrees of rotation in one foot and 9 in the other and the vet at the time said it was stress lami due to the complete change in environment (moved from the Midlands to Surrey), new owner etc. This was backed-up by the ensuing viruses and infections he caught (he had lymphangitis, then a recurring eye infection and then bronchitis).

The vet said he wasn't fat - he weigh-taped at 510kg (he is 16hh purebred arab) and the physio agreed when she came to see him! He tested negative EMS and Cushings! You could easily feel his spine and see his ribs!

I had him tested again 6 months later and he was negative, but I put him on a diet anyway and got him down to 455Kg acording to the weigh tape (which he has remained at). All the time I was feeding him 'Lami' safe feeds: Hi Fi Lite and Top Spec Anti Lam. He also had Global Herbs Lami Prone and Formula 4 Feet and soaking his hay!

The next year in the October he injured his annular ligament and couldn't be ridden! After 3 months of shock wave and field rest it was decided surgery was his only option, so I had his shoes removed! It was mid-winter and snow and ice on the ground. After a week of being footy I called the vet as I was convinced it wasn't just adapting to not having shoes - he had fat pads and a hard (although small) crest. The vet was convinced he had Cushings (as he was now 15) and put him on pergolide whilst we waited for the results - they came back conclusively EMS!

I trust my vet 100% but he is only human and only knows what he knows! This, coupled with the other horses I have know to get Lami is why I believe what I believe, that all cases are metabolic and my vet now believes the same, that if you give a healthy horse steroids, put them under stress etc they will not get Lami - there is an underlying cause.

We dont know yet if it is genetic or management caused - it could be both! But I cringe when I hear of youngsters being pumped full of conditioning feed as they need it to grow... the damage could be done well before any of us ever get our hands on them and the sad thing is, most of these owners think they are doing the best by their horses.... I think the feed companies have a lot to answer for!
 
Very interesting tales on here, particularly yours Pasha. My mare was 17 years old. I found out that she had chronic grass sickness years ago and was one of only a handful of cases to ever survive this form. I know that she was hand fed vegetables for 18 months. My vet concurred that this episode could have had an underlying lasting effect on her.
 
Pasha said:
But I cringe when I hear of youngsters being pumped full of conditioning feed as they need it to grow... the damage could be done well before any of us ever get our hands on them and the sad thing is, most of these owners think they are doing the best by their horses.... I think the feed companies have a lot to answer for!
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I agree with this.

I also feel that acute laminitis can often kick off when the balance has been tipped too far.

Many horses cope with lami risk factors, but then you get the straw that broke the camel's back that just tips the scales.

Trimmers and barefoot people often get snorted at, "seeing laminitis everywhere and telling everyone their horse has chronic laminitis."

To me - it's no freaking joke :(
 
All this is very interesting and informative. I think that one day we will understand this terrible disease far better. But for now, forums such as this one are invaluable for sharing stories. It helps us to piece together the puzzle.

To me I think it is very similar to what triggers something such as migraine. It may be red wine, cheese, atmospheric pressure, flashing lights, stress, eye strain, hunger etc. But it is not usually just one of these things. Often two or more of them need to be present to trigger an attack. I think the same is often true of laminitis.
 
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When my mare came down with Laminitis a few years ago, i went through a lot of self torture thinking that my management had caused her Lami- despite the fact that she wasn't particularly overweight, was in a reasonable amount of work, was fit...there was potential for concussive laminitis having just competed on a really hot weekend on really hard ground. She'd also just gone in to season, and the vet reckons it might have been a hormal episode to bring it on.

She is no longer with me but with a friend who has had her for a couple of years now. She has been since tested for EMS/IR/Cushings (all negative). She is kept on the lean side and working quite hard. She does now and again (particularly after the ground has been hard) get a bit footy, but it passes quickly.
 
I've seen laminitis several times in horses/ponies that have recently moved yards, no other risk factors identified and reasonably young too. In two cases it was definatley down to stress which makes sense because stress results in increased circulating cortisol just the same as cushings disease. High levels of cortisol are directly toxic to the cells of the laminae.
 
I am very observent {sp} when it comes to my horses movement, yesterday one of my minis a 2 year old was walking slowly, no heat or swelling in her leg/feet but she had pulses in one front and back leg, i got her in the stable with some bute, this morning no pulses, she is slightly under weight, on not so good grazing. I can only think it is low grade laminitis, BUT i dont have a clue why :confused:
 
They don't have to be fat or have been fat to have a metabolic dysfunction - just the same as thin people can have high Cholesterol and have a heart attack - their can be fat around the organs which is much more dangerous than fat on the bum!

I own a pure bred Arab and class the breed as similar to native ponies in that they have evolved to survive on very little - in the wild a herd animal like horses would roam miles and miles burning huge amounts of calories on very sparse grazing, if they can find grass at all! I know horses have been domesticated for years, but the simple fact is we are just keeping them too well!

Most of the grazing here in the South East is Ryegrass - it is designed to put weight on cows and completely unsuitable for grazing or lesuire horses who get ambled about 5 times per week.

I also think that people still do not understand what is fat and what is fit and lean - I am guilty of letting my boy put on too much weight, although he looks like a racehorse compared to most!

Unfortunately the way we have to keep them nowadays just compounds the problem, but you can make sure your horse is grazing on old meadow grass and fed late cut meadow hay... unless they are in hard work or a poor doer that is all they should need! :D
 
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