Critical Care Medicine: Laminitis

Question 1

Fill in the blanks

Answer 1

Pink: Lamina

Orange: Coronet Band

Dark blue: Long pastern bone/ P1

Light blue: Deep digital flexor

Question 2

What is the key to te successful treatment of a laminar abscess?

Answer 2

Drainage

Question 3

Define laminitis.

What indicates the presence of inflammation?

Answer 3

Inflammation of the lamellae of the inner hoof capsule

Pain indicates inflammation of the lamellae

Question 4

What is the main drug class that can induce laminitis?

Answer 4

Steroids

Question 5

Which of the following IS NOT involved in the mechanism of laminitis:

Glucose metabolism imbalance

Hypoxia/ Decreased blood supply

Anorexia

Inflammatory cells

Bacteria

Systemic involvement

Answer 5

Anorexia

Question 6

Swelling in response to infalmmation of the lamellae created a _________ syndrome.

Answer 6

Compartment

Question 7

What hormone can trigger laminitis in horses?

Answer 7

Insulin

Question 8

What causes laminitis-like symptoms in foals?

Answer 8

Salmonellosis

Question 9

What is represented by A-E.

What causes sinking? What causes rotation?

Answer 9

A: Weight of the horse, Vertical force

A Creates sinking effect of P3

B: Ground force

C: DDFT, Tensile force

C Creates rotation effect

D: Lamina attached to dorsal hoof wall

E: Extensior tendon

Question 10

What causes a more generalized loss of the lamina attachment and thus a worse clinical presentation, rotation or sinking?

Which occurs first?

Answer 10

Sinking

Rotation occurs first

Question 11

At what Obel grade will the horse resist any attempt to lift a foot?

Answer 11

Grade III (3)

Question 12

What 3 things should be included in a physical examination?

Answer 12

HR

RR

Rectal temperature

Question 13

This picture is the characteristic stance of a horse with laminitis on which feet?

Answer 13

All 4

Question 14

This picture is the characteristic stance of a horse with laminitis on which feet?

Answer 14

Front feet

Question 15

Which Obel Grade is present when weight shifting is occuring?

Answer 15

Grade 1

Question 16

What pulse quality of the digital pulses is indicative of laminitis

Answer 16

Bounding pulses

Question 17

What is this thingy called?

Why is it used?

Answer 17

Hoof Tester

To localize/evaluate pain of the hoof

Question 18

At what Obel grade will the horse “grunt” and be immobile?

Answer 18

Grade IV

Question 19

At most, in an adult (1000lb) horse, ow far appart should the extensor process and the coronary band be? What does it indicate if the distance is greater than that?

Answer 19

12 mm

Sinking

Question 20

At most, in an adult (1000lb) horse, how wide should the hoof wall-lamina structure zone be? What does it indicate if the distance is greater than that?

Answer 20

16-18mm

Swelling

Question 21

What Obel grade is present when the horse is showing pain/lameness when turning?

Answer 21

Grade II (2)

Question 22

How deep should the sole of the hoof of an adult 1000lb horse be?

Answer 22

10mm

Question 23

What treatment can be used in the developmental phase to treat the primary cause of laminitis and prevent it’s development?

Answer 23

Cryotherapy

Question 24

What drugs are used to manage the acute phase of laminitis? What is the treatment of choice?

Answer 24

NSAIDs

Pain meds: Torb, Lidocaine, Morphine, Ketamine

DMSO

Pentoxifylline

Cryotherapy is treament of choice- anti-inflammatory and analgesic

Question 25

What therapy can be used to shorten breakover and improve dorsopalmar balance wihtout sacrificing hoof capsule strength?

What can you put in a horses stall to ease discomfort in the acute stage of laminitis?

Answer 25

Therapeutic shoes

Sand

Question 26

What is a horse with chronic laminitis who shows displacement of the hoof in the horizontal plane called?

Answer 26

A sinker

Question 27

A horse with chronic unstable laminitis will require which surgery?

Answer 27

Tenotomy of the DDFT

(Must de-rotate hoof with specialized shoe prior to tenotomy)