Associations of health status and conformation with longevity and lifetime competition performance in young Swedish Warmblood riding horses: 8,238 cases ( 1983-2005)

Journal of the American Veterinary Medical Association
June 15, 2014, Vol. 244, No. 12, Pages 1449-1461

Lina Jönsson, PhD; Agneta Egenvall, DVM, PhD; Lars Roepstorff, DVM

Design‚ÄĒCohort study and genetic analysis.

Animals‚ÄĒ8,238 horses.

Procedures‚ÄĒHorses were examined for health, conformation, and performance from 1983 to 2005, when they were 4 to 5 years old, and competition results from 1983 to 2012 were evaluated. Associations between conformation, health, and talent scores of young horses and longevity (years in competition) and lifetime performance were analyzed. Odds ratios of competing later in life among horses with joint flexion test reactions were determined. Genetic correlations between young horse health, conformation, and talent scores and longevity and lifetime performance were determined.

Results‚ÄĒGood overall 4- to 5-year-old health, conformation, and talent scores for performance were phenotypically and genetically associated with greater longevity and lifetime performance. Good health was genetically correlated (rg = 0.3) to longevity and lifetime performance. Among conformation traits, body type and movements in the trot were most strongly associated with future longevity; these were genetically correlated (rg = 0.2 to 0.3) to longevity and lifetime performance. Intermediate-sized horses were associated with highest longevity and lifetime performance. Positive flexion test results were associated with lower ORs (OR, 0.59 for moderate to severe and 0.76 for minor reactions) of competing later in life, compared with no reaction, and were associated with lower longevity (0.4 years).

Conclusions and Clinical Relevance‚ÄĒHorses with good health and conformation at a young age had better longevity in competitions than the mean. Positive correlations suggested that improvement of health and conformation of young horses will enhance their future athletic talent and performance.

The effect of hay net design on rate and amount of forage consumed by adult horses

K. Martinson, E. Glunk and W. Weber
Description of the problem

Horses have evolved to consume several small forage-based meals throughout the day, often spending greater than 14.5 hours grazing each day. However, many of today’s horses are housed in boxstalls or drylots, fed two large meals each day, and have limited opportunity to forage. To mimic a more natural feeding pattern many horse owners provide unlimited access to hay. In many cases, this results in obesity because the horses tend to consume hay in excess of their energy requirement. Therefore, it is of interest to identify feeding methods that reduce excess intake, but extend the foraging period beyond a few hours around meal time.

To investigate the effect of hay net design on the rate and amount of forage consumed by adult horses.
Materials and methods

Eight adult horses in were fed in individual boxstalls. Horses were fed hay off the boxstall floor (control), or from one of three hay nets: large net (6 inch openings), medium net (1.75 inches) and small net (1.0 inch). Horses were acclimated to their assigned treatment for 2 days, followed by 3 days of data collection, and a wash-out period of 2 days. Horses had access to hay inside the nets for two 4hour periods: 7:00 to 11:00 am and 4:00 to 8:00 pm each day. Throughout the trial, grass hay was fed at 1% body weight twice each day. To determine forage consumption rate, stopwatches were started once horses began eating, and stopped once horses either finished all offered hay, were no longer interested in eating, or the 4 hour time period had expired. All refuse hay was collected and weighed. Total forage consumed was calculated by subtracting amount of refuse from hay offered.

Mean consumption rates were 3.3, 2.9, 2.4, and 1.9 pounds per hour for the control, large net, medium net and small net respectively. Horses were able to consume all hay from the control and large during the 4hour feeding period, but not all horses finished the hay meal when fed from the medium and small nets. Mean percentage of offered hay consumed was 95, 95, 89 and 72% for the control, large net, medium net and small net, respectively. A second study revealed that horse feeding from the medium net took just over 5 hours to consume the hay meal, while horses eating from the small nets took 6.5 hours to consume the meal. Both the control and large net resulted in consumption times of 3.2 and 3.4 hours, respectively.
Benefits to the equine industry

These results demonstrate that the small or medium nets were effective in decreasing rate and amount of forage consumed and increasing the total time of forage consumption by adult horses. If small or medium hay nets were used for twice daily feedings in a boxstall setting, the anticipated amount of time horses would spend foraging would be 10 to 13 hours each day; more closely mimicking a horse’s natural grazing behavior. Small and medium hay nets represent simple and affordable management tools for extending foraging time when meal feeding horses. However, use of the small and medium hay nets is not likely practical for all horses and it does take time (usually 4 to 5 feedings) for horses to acclimate to feeding from the nets.

Effects of intrabursal administration of botulinum toxin type B on lameness in horses with degenerative injury to the podotrochlear apparatus

Santiago D. Gutierrez-Nibeyro, DVM, MS; Marcos P. Santos, DVM.

Objective‚ÄĒTo determine the safety and short-term efficacy of intrabursal administration of botulinum toxin type B (BTXB) to alleviate lameness in horses with degenerative injury to the podotrochlear apparatus (PA).

Animals‚ÄĒ10 Quarter Horses with degenerative injury to the PA.

Procedures‚ÄĒDegenerative injury to the PA was confirmed with diagnostic analgesia and imaging. Then, BTXB (3.8 to 4.5 U/kg) was injected into the podotrochlear (navicular) bursa of each horse. Three horses were used in a safety evaluation. Subsequently, video recordings of lameness evaluations were obtained for 7 client-owned horses 5 days before (baseline) and 7 and 14 days after BTXB treatment and used to determine the effect of BTXB injection on lameness; 1 horse was removed from the study 8 days after BTXB treatment. Three investigators who were unaware of the treated forelimbs or time points separately reviewed the recordings and graded the lameness of both forelimbs of the horses.

Results‚ÄĒImprovement in lameness of the treated forelimbs was detected at 1 or both time points after BTXB administration in all horses. However, all horses had some degree of lameness at the end of the study. Two horses developed transient increases in lameness 48 to 72 hours after treatment; lameness resolved uneventfully.

Conclusions and Clinical Relevance‚ÄĒIntrabursal injection of BTXB temporarily alleviated chronic lameness in horses with degenerative injury to the PA, without causing serious short-term adverse effects. Further investigation into the potential use of BTXB in horses affected by degenerative injury to the PA is warranted.

Influence of emotional balance during a learning and recall test in horses

Modern day horse-human relationships entail different types of sport and riding activities, which all require learning. In evaluating the interaction between learning and emotions, studying normal coping strategies or adaptive responses to the surroundings is critical. 34 horses were involved in a cognitive test, in the absence of physical effort, to analyze performance, as well as physiological and behavioral responses related to learning, memorization and recall, associated to the capacity to reverse a learned model. Synthetic Equine Appeasing Pheromone (EAP) was used in 17 horses in order to modulate their emotional state and evaluate differences in cognitive-emotional response during cognitive effort in comparison to the control group (placebo group). Both groups showed statistically significant changes in heart rate during the test, indicating emotional and physio-cognitive activation. The EAP group produced fewer errors and made more correct choices, showing behaviors related to increased attention, with less influence from environmental stimuli. The capacity to learn to learn, as shown in the bibliography, allows animals to establish conceptual learning, when a normal or positive emotional state (in this case modulated by semiochemicals) is used to control limbic system activation and, consequently, decrease stressful/fearful reactions, resulting in better learning capacities during the cognitive test.

Risk factors associated with health disorders in sport and leisure horses in the Netherlands.

Risk factors associated with health disorders in sport and leisure horses in the Netherlands.

J Anim Sci. 2013 Dec 18;

Authors: Visser EK, Neijenhuis F, de Graaf-Roelfsema E, Wesselink HG, de Boer J, van Wijhe-Kiezebrink MC, Engel B, van Reenen CG

Horses are used for a wide variety of purposes from being used for recreational purposes to competing at an international level. With these different uses, horses have to adapt to numerous challenges and changes in their environment, which can be a challenge itself in continuously safeguarding their welfare. The objective of this study was to assess the prevalence of health disorders with clinical examination and identify possible risk factors of health disorders affecting horse welfare in professional husbandry systems in the Netherlands. With the use of fixed protocols for recording health aspects in horses, 150 horse farms voluntarily participating in the study were assessed by trained assessors. On each farm 20 horses were clinically examined, in total almost 3000 animals. This study recorded on basis of the clinical examinations: the respiratory system (i.e. abnormal breathing (1%), coughing (1%), nasal discharge (1.9%)), body condition (i.e. 18.8% fat body condition and 6.4% poor body condition), locomotion (14.5% exhibited irregularity of locomotion and 4.8% were lame), back palpation (a light response 22.6% and moderate to severe response 8.4%), mouth (i.e. irregularities on mouth corners (3.4 %) and bars (3.4 %)), and ocular discharge (12%). Risk factor analysis, stepwise using mixed model regression, demonstrated several risk factors for health aspects. Horses used for instruction (riding lessons) were almost two times more at risk to develop moderate to severe back pain compared to horses used for recreation (OR = 0.54) or for competition (OR = 0.61). Horses used for instruction (riding school lessons), breeding or recreation all had a higher risk for irregular locomotion or lameness compared to competition horses (OR = 0.42, OR = 0.55, OR = 2.14 respectively). Horses used for recreation were more prone to have a higher Body Condition Score compared to horses used for breeding (OR = 3.07) and instruction (OR = 2.06). The prevalences of health problems and the identified risk factors are valid for the horses in the present study in which farms voluntarily participated. Furthermore, the results may provide the basis for horse welfare and health programs on farm and horse industry levels. With the development of a valid welfare monitoring system for the horse industry, the welfare of horses can be increased through improving awareness and stimulating changes in management.
PMID: 24352963

Evaluation of the safety of a combination of oral administration of phenylbutazone and firocoxib in horses.

Evaluation of the safety of a combination of oral administration of phenylbutazone and firocoxib in horses.

J Vet Pharmacol Ther. 2013 Dec 20;

Authors: Kivett L, Taintor J, Wright J

Simultaneous administration of a nonselective COX inhibitor and a COX-2 specific NSAID has not been previously reported in horses. The goal of this study was to determine the safety of a 10-day dosage regimen of phenylbutazone and firocoxib, both at their standard dosages, in horses. Six horses were administered 2.2 mg/kg of phenylbutazone and 0.1 mg/kg of firocoxib by mouth, daily for 10 days. Horses were assessed daily for changes in behavior, appetite, fecal consistency, signs of abdominal pain, and oral mucous membrane ulceration. Horses were assessed prior to and on the last day of treatment for changes in serum creatinine, albumin, total protein, and urine-specific gravity. Horses underwent endoscopic examination of the esophagus, stomach, and pylorus prior to and 24 hours after the last treatment. A significant change in serum creatinine and total protein was observed on day 10 of treatment. No other significant findings were noted during the experiment. Results indicated that co-administration of phenylbutazone and firocoxib may cause renal disease.
PMID: 24354928

Manuka Honey and Wound Care

Manuka Honey and Wound Care
by Nancy Loving

With increasing emphasis by horse owners on approaching their horses‚Äô health issues through more ‚Äúholistic‚ÄĚ and ‚Äúnatural‚ÄĚ strategies, one such ‚Äúnatural‚ÄĚ and relatively inexpensive treatment might include the use of honey for wound care. As a veterinarian you need to understand the physical and financial aspects of potentially using this option.

Honey application to cutaneous wounds is far from a ‚Äúnew‚ÄĚ treatment; honey has been used since Egyptian times dating as far back as 2,000 B.C. as a means of managing wounds and inhibiting bacterial infection.

Yet it is important to know that not all honey is created equal. Manuka honey, derived from floral sources Leptosperum spp in New Zealand and Australia, has specific antibacterial and antioxidant properties that are absent in other honeys. Manuka honey is reported to have osmotic and pH effects; for example, it creates a more acidic pH environment that counteracts the alkaline pH of an infected wound, which is helpful for wound contraction. By lowering wound pH, protease activity is decreased and fibroblast activity and oxygen release are increased, all of which facilitate wound healing.

In addition, while bacterial-generated biofilm is known to impair healing, manuka honey has potent anti-biofilm properties: methylglyoxal, the bactericidal component of manuka honey, kills biofilm-embedded bacteria.

With the resurgence of the use of honey for wound care, licensed, medical-grade manuka honey is commercially available in therapeutic wound dressings: Medihoney¬† (Derma Sciences) and Active Manuka Honey UMF 18+ (Manuka Honey USA). A medical-grade product is one that has been ‚Äústerilized by gamma irradiation and has a standardized antibacterial activity.‚ÄĚ

Use of non-sterilized honey has the potential to contaminate a wound with aerobic bacteria or fungi, therefore it should not be used.

Application of medical-grade manuka honey on a wound has the potential to reduce both the duration and expense of systemic antibiotic treatment while achieving favorable therapeutic results for the patient and client.

“Nutritional Management of Insulin Resistance in Horses”

Nutritional Management of Insulin Resistance in Horses

By Alexandra Beckstett, The Horse

Managing Editor December 9, 2013 8:00

When it comes to caring for insulin-resistant (IR) horses, diet plays a very important role in managing insulin levels and preventing associated diseases such laminitis. Insulin resistance and hyperinsulinemia are key features of equine metabolic syndrome (EMS) and can also occur in horses with pituitary pars intermedia dysfunction (or equine Cushing’s disease). These animals often need to lose weight and consume fewer carbs.

To that end, Ray Geor, BVSc, PhD, Dipl. ACVIM, a professor and researcher at Michigan State University’s department of large animal clinical sciences, shared best feeding practices for IR horses at the 2013 International Equine Conference on Laminitis and Diseases of the Foot, held Nov. 1-3 in West Palm Beach, Fla. He first discussed weight loss, then carbohydrate consumption.

Managing Obesity

Geor explained that dietary restriction and exercise are two key components to curbing obesity in IR horses. “Dietary restriction is not rocket science,” he said. “But it requires owner/trainer compliance and patience and sticking to the program (to be successful). Diet changes are likely a lifelong pursuit, especially for horses with EMS that are easy keepers and have a tendency to become obese.”

Geor recommended owners of affected horses institute a weight loss program with the goal of improving the animal’s metabolism to reduce his risk of developing associated laminitis. He offered the following guidelines for developing a program:

Base your horse’s diet on forage or a forage substitute, and eliminate grain and calorie-dense feeds (e.g., sweet feeds) if possible. – Feed a lower-quality, low-energy forage, such as late-maturity hay, at between 60 and 80% of your horse’s daily energy requirements based on his body weight.
When feeding a low-quality forage, add a ration balancer¬†to help your horse meet his vitamin E, copper, zinc, and other requirements. “Alternatively, forage-based, low-calorie feeds that contain added vitamins and minerals are now available commercially,” Geor said. “This type of feed offers convenience and may be used as a substitute for hay or fed as a component of the ration along with hay.”
Although all weight loss programs need to be individually tailored, as a general guide start by restricting your horse’s daily dry matter intake (DMI) to 1.5% of his body weight in total feed. The rate of weight loss will vary between horses but in general at least six to eight weeks of dietary restriction is needed for noticeable weight loss to occur, Geor said. If your horse’s weight loss response is less than desired, you might need to restrict his DMI to 1.25% body weight. If he still doesn’t lose weight after another six to eight weeks, you can restrict his DMI even further to 1% body weight, but Geor recommended never feeding lower amounts than that for health and behavior reasons. “Hay feeders and slow feeders (e.g., hay nets with multiple small holes) are one way to extend your horse’s hay supply if you’re not feeding much,” he said.
Restrict or eliminate pasture grazing using a grazing muzzle or a drylot for turnout. “It should be noted that simply restricting the time allowed for grazing may not be an effective strategy for weight loss,” Geor cautioned. “Ponies have been observed to consume up to 1% of body weight within three hours of pasture turnout.”
And as with any diet changes, make feed changes gradually and avoiding withholding food from your horse for long periods. Divide rations into three to four small meals, and do not bed a dieting horse on straw or shavings to reduce the risk of him eating them and potentially suffering an impaction, Geor said.
Geor encouraged owners to use a number of simple tools to monitor their horses’ weight loss, including body condition scoring and measurements of girth and abdominal (‚Äėbelly‚Äô) circumference. “Body condition score is not always a sensitive indicator of weight loss,” he added. “However, girth and belly circumference measurements will decrease with weight loss, and I recommend recording these measurements at three- to four-week intervals.”

But once your horse meets his targeted weight and condition, you can’t just stop there: “Develop and continually update an appropriate weight maintenance program,” Geor said. “It should include monthly assessment of body weight and BCS to ensure that the feeding program is appropriate for the current level of physical activity and other environmental influences on energy requirements.”

Controlling Carbohydrates

Veterinarians and researchers have long associated laminitis with increased nonstructural carbohydrate (NSC) intake‚ÄĒespecially in pastured horses. And because NSCs can contribute to exaggerated insulin responses, it’s particularly important to restrict their intake in IR horses.

Geor offered suggestions for controlling NSC intake:

Feed a forage-based diet with a low NSC content (less than 12%). “Soaking hay can help lower NSC levels, but it’s not a panacea,” he said.
Eliminate grain and sweet feed (both high in NSCs) from the diet.
Restrict or eliminate pasture access. At certain times of year (e.g., during spring and early summer growth periods, after summer or fall rains, or after drought or frost) pasture forages’ NSC content is quite high, so Geor advised keeping IR horses off pasture during these periods to reduce the risk of developing laminitis. He said a grazing muzzle might be the best way to safely restrict grass consumption (studies show it can decrease pasture intake by about 80%), as simply providing a smaller space to graze can lead to an overgrazed area, which will still have high NSC content due to stress. Also, “beware the ‘Hoover’ pony,” Geor said. “They can adapt and consume around 40% of their daily DMI in just two to three hours.”
In conclusion, Geor said correcting obesity and restricting NSCs are not a cure for insulin resistance but these strategies can help to prevent laminitis in affected horses.

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.

Diagnoses, clinical pathology findings, and treatment outcome of geriatric horses: 345 cases (2006-2010).

Diagnoses, clinical pathology findings, and treatment outcome of geriatric horses: 345 cases (2006-2010).

J Am Vet Med Assoc. 2013 Dec 15;243(12):1762-8

Authors: Silva AG, Furr MO

Objective-To compare clinical, clinical pathology, and outcome variables between geriatric and nongeriatric horses. Design-Retrospective case-control study. Animals-690 horses (345 horses ‚Č• 20 years old and 345 horses > 1 and < 20 years old) examined at a referral hospital. Procedures-Medical records were examined, and data collected included horse description, diagnosis, outcome, and CBC and serum biochemical analysis results. Cases were horses ‚Č• 20 years old, and controls were horses > 1 and < 20 years old. Results-Mean ¬Ī SD age was 23.9 ¬Ī 4.6 years for cases and 9.2 ¬Ī 3.6 years for controls. Arabian and pony breeds were significantly overrepresented in the geriatric group, compared with the control group. Diagnoses related to the digestive system, musculoskeletal system, and respiratory system were most common in this hospital population overall (cases and controls). Colic was the most common health problem overall. Digestive system disorders were significantly more prevalent among cases. Short-term survival rates for most categories of colic were no different for cases than for controls, with the exception of the category idiopathic colic. Considering all conditions, cases were significantly more likely to be nonsurvivors than were controls. Minor differences in serum biochemical results were found in some disease subcategories. Geriatric horses with colic were not more commonly euthanized than were adult nongeriatric horses. Conclusions and Clinical Relevance-Results indicated that in this population of horses in a referral hospital, age was associated with the prevalence of specific disease conditions. Few differences between cases and controls were found in serum biochemical values. PMID: 24299549 [PubMed - in process]

Pain Management for Horses with Laminitis: Where Are We Now?

Pain Management for Horses with Laminitis: Where Are We Now?
By Alexandra Beckstett, The Horse Managing Editor
Updated: Monday, December 2, 2013
Originally published on

When an owner makes the difficult decision to euthanize a horse with laminitis, it’s often because the horse is simply in too much pain to justify prolonging treatment. For this reason, researchers are continually trying to come up with improved analgesic (pain relief) methods. Andrew van Eps, BVSc, PhD, MACVSc, Dipl. ACVIM, senior lecturer in Equine Medicine at The University of Queensland School of Veterinary Science, reviewed current pain management options for laminitic horses at the 2013 International Equine Conference on Laminitis and Diseases of the Foot, held Nov. 1-3 in West Palm Beach, Fla.

The pain laminitic horses experience might stem from several sources, van Eps said, including inflammation, submural (beneath the hoof wall) pressure, tearing of submural tissues, ischemia (lack of blood flow), the distal phalanx (P3, or coffin bone) applying pressure to the sole, and neuropathic mechanisms (those caused by nerve damage and described, in humans, as throbbing, stabbing, sharp pain).

We, as humans, want to control horses’ pain not only for welfare reasons but also because it interferes with the animal’s function. However, we can’t simply eliminate pain completely, as it does serve an important purpose in self-preservation, van Eps said.

“Without pain, weight-bearing and ambulation are not restricted in horses with laminitis, so consequently there can be increased mechanical distractive forces on the lamellar tissue and progression of the lesion itself,” he explained.

The first step in determining how to manage a laminitic horse’s discomfort is to assess his pain level objectively and routinely, said van Eps. This might include:

Performing a lameness exam.
Observing the horse’s posture and stance.
Hoof testing, although this can vary among cases, van Eps cautioned.
Obtaining systemic measurements such as heart rate, respiratory rate, and blood pressure. “These are reasonably sensitive, especially in hospital settings where horses are monitored serially,” he said.
Using tools such as force plates and pedometers to evaluate weight distribution. “Incessant shifting of weight is one of the first and most subtle signs of laminitis pain,” van Eps said. “Recently, the use of human pedometers (to document weight-shifting frequency) ‚Ķ proved to be much more sensitive than visual assessment alone.”
Performing behavioral analysis. “Serial recording of events such as teeth grinding, interactions with people, and position in the stall (back corner vs. close to the door) can be useful markers of pain that are more subtle,” he said.
Van Eps said owners and veterinarians also need to consider disease stage and what they are trying to achieve‚ÄĒlong-term or short-term pain relief. Then they can choose from the two categories of analgesic therapies what makes the most sense for that individual horse: a systemic or regional approach.

Systemic Therapy
Systemic therapies are those that travel through the bloodstream. This primarily involves non-steroidal anti-inflammatories (NSAIDs) such as phenylbutazone, flunixin meglumine, and ketoprofen. While this drug class is potent and effective in most acute and chronic laminitis cases, van Eps said it’s also associated with side effects such as gastric/colonic ulcers and kidney damage because it targets not only the pain and inflammation-causing COX 2 enzyme, but also the protective COX 1 enzyme.

Thus, “more COX 2-selective NSAIDs, such as firocoxib and meloxicam, are potentially associated with fewer side effects,” he said. “However, their analgesic efficacy and long-term safety compared with non-COX-specific NSAIDs requires further investigation.” He added that some studies have recently confirmed these drugs are both safe and effective, although expensive.

When NSAIDs alone are insufficient, van Eps suggested using a combination of other systemic drugs to provide additional analgesia.

“The concept of multimodal analgesia involves the use of different types of analgesic drugs that act by different mechanisms at different sites in the nervous system to provide superior analgesia with fewer side effects,” he explained. “The use of multimodal analgesia is often reserved for laminitis cases that do not respond to conventional therapy.”

Drugs van Eps said veterinarians might use in a multimodal approach including:

Intravenous (IV) lidocaine, which he said can be effective for acute laminitis, but comes with a risk of toxicity/neurologic sign development during infusion if an overdose occurs. “This can happen if the horse receives even a transient overdose (inadvertent increase in the infusion rate),” van Eps explained. “Therefore this therapy is best done in hospital situation with infusion pumps and a dedicated IV catheter.”
Opioids, which van Eps said are not particularly effective alone, but might be useful in combination with drugs such as lidocaine, ketamine, morphine, detomidine, and acepromazine;
Ketamine, an anesthetic that acts through decreasing central sensitization;
Alpha-2 agonists, which he described as short-lasting sedatives useful for managing unrelenting pain; 
Amitriptyline, which van Eps said has been used effectively as an antidepressant and analgesic in humans, but not in horses; and
A promising anti-inflammatory (soluble epoxide hydrolase inhibitor) currently under investigation at the University of California, Davis.
The last systemic therapy van Eps described was gabapentin, a drug originally used to treat neuropathic pain and seizures in humans. Much is still unknown about this drug’s effects and appropriate dosage in horses, although he said IV or oral gabapentin might be useful when treating acute laminitis cases.

“We routinely administer gabapentin to clinical cases with acute and chronic laminitis without ill-effect,” he said. “Unfortunately, it is very difficult to accurately assess whether gabapentin improves analgesia in these cases.

“The main side effect of gabapentin administration in horses is mild sedation and tranquilization,” he added. “However, this may actually be of benefit in acute laminitis cases, as recumbency and reduced ambulation are encouraged, as they protect the tissues from further damage caused by weight-bearing.”

Regional Therapy
Regional analgesic techniques, as the name implies, aim to treat a specific area. Examples of regional methods used in laminitis cases include:

Continuous peripheral nerve block of the palmar nerves. Van Eps said veterinarians might use this method when performing a painful procedure such as hoof resection.
Epidural analgesia, in which the veterinarian administers long-term pain management (e.g., opioids, alpha-2 agonists, local anesthetics) via an epidural catheter. “It can be useful to control pain associated with hind-limb laminitis,” van Eps said. “Morphine is probably the most useful, as its analgesic effects are long-lasting (12-14 hours) and it does not cause ataxia (incoordination).”
Therapeutic hypothermia, or cryotherapy, has both anti-inflammatory and nerve conduction effects.
Take-Home Message
Because there’s no one-size-fits-all formula to managing laminitic horses’ pain, van Eps recommended owners work with their veterinarians to tailor a multimodal approach for each individual case. “Equine analgesia is evolving,” he said. “There’s more evidence for COX 2 selective drugs than 10 years ago, and now that we recognize the contribution of neuropathic pain in laminitis, we’re beginning to investigate drugs that can help to control this.”

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.