hoof diseases for older horses
DESCRIPTION
This presentation was given at the Loomis Basin Equine Medical Center's 2014 Open House.TRANSCRIPT
Hoof Diseases Specific to Older Horses
EDUARDO DE LA CRUZ, DVM
LOOMIS BASIN EQUINE MEDICAL CENTER
Hoof Diseases Specific to Older Horses?
THERE ARE NONE!!!
Outline
Equine Metabolic Syndrome
Cushing’s
Laminitis
Equine Metabolic Syndrome
“EMS”
Main Features Obesity Insulin Resistance/Dysfunction Laminitis/Founder
“Easy keepers”
Genetic Predisposition BLM’s
Mustangs
Morgans
Ponies
Donkeys
…
Age Group???
5+
Obesity
FAT horses!!! Regional adiposity….Fat pads
Insulin Resistance/Dysfunction
Insulin directs glucose/sugar (energy) into liver, fat, and muscle
IR/ID Insulin not as effective and glucose builds up
Pancreas increases insulin production to keep up
Leading to hyperinsulinemia and laminitis
Diagnosis
Insulin/Glucose Blood Panel Ideally Fasting (1 flake of hay night before)
Insulin/Glucose Blood Panel with OST Oral Sugar Test
Ideally Fasting (1 flake of hay night before)
Owner Gives 100cc Light Karo Syrup Orally
Vet Pulls Blood after 1-1.5hrs
Management
Weight Control NO… Sugar…
Apples
Carrots
Green Grass
Sweet Feed
Alfalfa hay/pellets
YES….Orchard Grass Hay
1-1.5 pounds of hay per 100 pounds per day….10 - 15 pounds per day
MAYBE…Low Starch Pelleted Feed if warranted
Mineral Block
Management
Exercise Walking
Light Ridding
20-30 minutes 2-3 times a week
Build up to 5 days a week…SLOWLY…Be nice!
If Laminitic/Foundered… Ask Vet!
Management
Medications Thyro-L (Levothyroxine)
NOT HypOthyroid… Used for weight loss
Metabarol (Resveratrol) Claims to improve the sensitivity of
insulin
EMS Summary
Monitor weight
Can develop at early age
Test for Glucose/Insulin
High life-threatening risk of Laminitis/Founder
Pituitary Pars Intermedia Dysfunction (PPID)
CUSHING’S
What is it?
Uncontrolled Growth of a Section of the Pituitary Gland Oxidative damage to PPI
PPI is set to Overdrive
Increase in Hormone Production
Leads to Deterioration of Normal Hormonal Functions
Who is Affected?
Same Breeds as EMS horses
Age Group???
Most common in 12+ years
Main Features Long Shaggy Hair Coat
Loss of Top Line
Excessive Urination (PU)
Excessive Water Consumption (PD)
Decrease Performance
Non-resolving Infections
± Obesity
± Insulin Resistance/Dysfunction
± Laminitis/Founder
……
Early Signs Changes in Behavior
Lethargy
Docility
Decline Performance
Muscle Loss “Topline”
Changing form Obese to Lean
Secondary Infections Whiteline Desease
Hoof Abscesses
Recurent Corneal Ulcers
Sinusitis
Midway Signs
Same as Early Signs Plus:
Focal Hair coat Changes
Laminitis
PU/PD
Fat Pads
Sweating Abnormally
Late Signs
…..
Generalized Hair Coat Changes
Skinny with Potbellied Appearance
Diagnosis
ACTH Blood Test Ok for late stage of disease
OR
ACTH + TRH +ACTH (10 min later)
More sensitive than single ACTH
Research on the way to determine better more sensitive testing assays/methods
DON’T TREAT THE LAB WORK… TREAT THE HORSE!!!
Why Test? Reinforcing Suspicion
Differentiating form EMS
“Proof” of Diagnosis when Starting Life-Long Therapy
Monitoring Dose and Efficacy of Therapy
Prognosis
DO NOT WAIT FOR A “POSITIVE” RESULT TO TREAT IF EARLY SIGNS ARE INDICATIVE…Tests are not the best yet!
Treatment
Prascend (Pergolide)
Oral Tablet Daily For Life
Nutraceuticals???
Metabarol (Resviratrol) May help with EMS
Chastberry Made it worse based on control study in 2002
Magnesium May benefit people, NO data in horses
Chromium No change in EMS (2011)
Psyllium Mild changes in EMS (2013)
Management
Consistent Medication Administration
Proper Nutrition Thin?
Fat?
EMS?
Fresh Water at All Times
Proper Care of Teeth
Proper Care of Hooves
Laminitis/Founder
LAMINITIS/FOUNDER
Laminitis = Founder
Inflammation of the lamina that suspends the coffin bone within the hoof capsule
LAMINITIS/FOUNDER (ROTATION)
LAMINITIS/FOUNDER (SINKING)
LAMINITIS CLINICAL SIGNS
LAMINITIS CLINICAL SIGNS Summary of Clinical Signs
Increased respiratory rate Lameness (Tight circles) Reluctance to walk Laying down Weight shifting Tucked under stance Bounding digital pulses
LAMINITIS/FOUNDER DIAGNOSTICS
LAMINITIS/FOUNDER
Systemic Causes Metabolic Disease (Insulin Resistance) Cushing’s (Pituitary Pars-Intermedia Dysfunction) Obesity (Fat=inflammatory organ) Grain Overload (Carbohydrate) Spring Pasture (Carbohydrate) Colic Diarrhea Retained Placentas Corticosteroid-associated Many more……….
LAMINITIS/FOUNDER
Treatment?
Controversial...
No one treatment is applicable for all
KEY: Determine and treat the underlying cause
LAMINITIS/FOUNDER
Treatment
What do most of us agree on? NSAID: Bute, Banamine, Previcox, etc.
Good Team:
Veterinarian
Farrier/Trimmer
Stoic patient
Dedicated owner with deep pockets
Good Luck!
Toss-up!
LAMINITIS/FOUNDERPrognosis
Case dependent…
AVOID IT!
Key Points
Monitor Weight
Watch What You Feed Spoil Them with Love and Attention… NOT Food
Monitor for Subtle Coat Changes
Monitor for Lameness
Test Early
Treat Early
Be Proactive!
QUESTIONS?
THANK YOU!!!!Eduardo De La Cruz, DVM