If you want to truly correct the problem, efforts are made to stabilize and correct the coffin bone rotation, but at the same time strides are made to correct the underlying internal problems.<\/p>\n
What is the “Internal Problem” in the Laminitic Horse?<\/span><\/h3>\nThe bottom line problem in the laminitic horse is cellular dysfunction, which means that various cells are not performing their duties properly.\u00a0 These may be cells associated with metabolism, thyroid function, insulin secretion and function, circulation, digestive function, hoof growth, and a variety of other vital functions.\u00a0 It is not just one cell type, such as the hoof tissue, but usually multiple.\u00a0 Thus, in the typical chronic metabolic horse, you see not just evident coffin bone rotation and pain, but also metabolism problems, thyroid dysfunction, insulin resistance, and other concerns.\u00a0 Multiple organ systems and cellular pathways are impacted.\u00a0 It’s not just the feet.\u00a0<\/strong><\/p>\nResearch indicates that cellular dysfunction is at the root of many health problems not just in horses, but in people.\u00a0 So, why don’t these cells function correctly?\u00a0 Inflammation, that is the reason.\u00a0<\/strong> Inflammation is a broad, complex cellular process that can impact cell function, through DNA activation and also mitochondrial function.\u00a0 This is a very deep reaching process and goes much further than just associating pain with inflammation.\u00a0 Pain is just one outcome to inflammation.\u00a0 Cell dysfunction and tissue damage is the other.<\/p>\nStating and proving that inflammation is at the root of the laminitis is relatively easy to do, but solving that problem proves to be another problem in an of itself.<\/strong>\u00a0 Why?\u00a0 Mainly due to the reason that there are many contributors to the inflammatory process and these contributors will vary from one horse to the next.\u00a0 This is partially why no single regimen provides benefits for every horse and why in most cases, better management is gained through a personalized type of approach.\u00a0 This is also why no single cure will ever be developed for this disease condition. Despite this, if you can ‘see’ the bigger picture, then in most cases you can really analyze your horse’s situation and make better decisions regarding care.\u00a0 This can help immensely in creating a better outcome.\u00a0 If an owner is actively aware and involved, it is far better than just relying on another to solve the problem.\u00a0 The reason being is that in many cases, there is something being done in regards to supplementation, medications, diet, and even exercise that may be creating resistance to recovery.\u00a0 The more involved you become, the more you can see these factors, eliminate them or modify them and enhance recovery.<\/p>\nFactors Involved with Inflammation and Laminitis in the Horse<\/span><\/h3>\nThe process of inflammation is tightly connected with laminitis in the horse.\u00a0 This is well known, but where does it come from?\u00a0 What starts it?\u00a0 The answers to this are as numerous as the horses that develop the condition.<\/p>\n
You have to step back and look at laminitic patients.\u00a0 They fall into one of two categories; acute or chronic.\u00a0 A laminitic horse that is acute is one that often is directly associated with another event such as a grain overload, endometrial infection post-foaling, endotoxemia, or contralateral lameness condition. These horses are in severe pain, have moderate to minimal rotation, but are very difficult to stabilize, deteriorating rather quickly and ending in euthanasia in many cases.\u00a0 In the acute laminitic horse, those\u00a0 primary events triggered the inflammatory response in the patient either on a direct or gut level<\/strong>.<\/p>\nA horse with chronic laminitis is much different.\u00a0 These horses are often overweight to varying degrees, more sedentary in their exercise patterns, lazy in their habits, low metabolism, and often exhibit varying levels of foot pain throughout the year.\u00a0 Their conditions tend to wax and wane, good one day, bad the other, but persist for many years.\u00a0 These patients are really comparable to type II diabetics in human medicine with a metabolic syndrome type of classification.\u00a0 If they haven’t been diagnosed as ‘metabolic patients’ with insulin function, given them some time and it will change.\u00a0 This is due to the progressive nature of the condition and inflammatory damage on a cellular level.\u00a0 The chronic laminitic equine patient is like a smoldering pile of inflammatory embers, igniting at times and creating marked damage, while at others, more controlled.\u00a0\u00a0<\/strong><\/p>\nInflammation really stems from a few factors:<\/p>\n
\n- Dietary factors<\/li>\n
- Ongoing inflammatory problems<\/li>\n
- Gastrointestinal dysfunction<\/li>\n
- Stress<\/li>\n
- Genetic influences<\/li>\n
- Exercise<\/li>\n
- Medications<\/li>\n<\/ul>\n
Although these factors seem to be separate, they are really connected with one contributing to another. For example, if a horse has underlying digestive issues, then the food they consume may not digest properly and thus low levels of nutrients may be absorbed impacting cell protection and tissue health.\u00a0 If a horse has an ongoing joint or tendon concern with high levels of inflammation, then this by itself can contribute to more inflammation through the stress pathways in the patient.\u00a0 Stall confinement associated with an injury recovery or as just part of the normal routine can also contribute to more stress, which gets the cycle going again.\u00a0 The act of putting a horse with metabolic problems on a dry lot will also greatly contribute to more internal stress and inflammation, which can also add to the digestive concerns.\u00a0 As an owner, you make changes to accommodate your laminitic patient with all good intentions, but some efforts may work against the end goal.\u00a0The cycle repeats and compounds<\/strong>.<\/p>\nThe impact of the microbiome and digestion is a huge player in the development of equine laminitis and an area of heavy research by myself for the past several years.\u00a0 A high percentage of these laminitic patients demonstrate a dysbiosis or shift in the normal population of bacteria in the hindgut.\u00a0<\/strong> This then greatly contributes to the inflammatory process in the patient.\u00a0 I have discussed the microbiome concerns in another article<\/a><\/span>.<\/p>\nAlthough I have been studying this phenomenon for years, and have arrived at solutions for many patients, it is readily clear that yet again, there are many factors involved.\u00a0 This can be seen in the chart below.![\"\"](\"https:\/\/nouvelleresearch.com\/wp-content\/uploads\/GI-Biome-Interaction-1024x791.jpg\")
<\/p>\n
The Bottom Line In Equine Laminitis<\/span><\/h3>\nIn many cases, the average reader will often be more frustrated after reading this information than what they were originally.\u00a0 This is not and was not my intention when creating this article.\u00a0 My hope was to relay a better understanding of the problem at hand, realizing hopefully that the concerns in the foot regarding rotation and pain are really an effect, rather than the cause.\u00a0 The rotation of the coffin bone and subsequent pain are an end result, not the primary problem.<\/strong><\/p>\nDoes this mean that we just ignore the feet?<\/strong>\u00a0 No.\u00a0 Again, this is analogous to the leaning building.\u00a0 You have to make every effort to realign the external structures, but even more important is to recognize and manage the internal ones.\u00a0 Keep in mind here that I said, “realign the structures”, which implies that proper trimming is done to physically re-establish balance to the foot and with that, realignment of the internal structures over time.\u00a0 This is much different than just relying on various shoes to provide support or redistribute weight.<\/p>\nSo many owners that I have interacted with as a veterinarian and consultant have mainly focused on the feet in various ways, while then attempting to remedy the internal problems via a low starch feed, reduced quality hay, and no pasture turnout.\u00a0 Supplements are used but are often misguided, thinking that one nutrient or one herb may be the solution.\u00a0 Then on top of this, often there are medications not just to aid in management of pain, but to control other secondary processes including blood sugar management and insulin function.\u00a0 In some patients, there are even medications to support pituitary function, as in the case of a PPID patient.\u00a0 These approaches are helpful in some patients, but technically speaking, they are band-aids at best, meaning to control other disturbed cellular process impacted by inflammation.\u00a0 A high percentage of these laminitic patients are still experiencing recurrent flare-ups year after year, despite their supplementation or medication regimens.<\/strong>\u00a0 This should tell you that there is more to the story that is possibly overlooked.<\/p>\nIf you can properly control the inflammatory response, which can involve several different approaches, then the cellular function is often readily improved on all levels.\u00a0 Pain is improved, but so is metabolism, thyroid function, insulin receptivity, tissue health, hoof growth, and circulation. Cellular function is improved, normal functions in the body are restored and with that, health is dramatically enhanced!<\/p>\n
How do you do this?<\/strong><\/p>\nThe Type II Diabetic as a Guide for Laminitic Management<\/span><\/h3>\nA type II human diabetic is not too far removed from equine laminitis in my opinion, especially the chronic laminitic patient that has equine metabolic syndrome or EMS.\u00a0 <\/strong>\u00a0In both examples you have an overweight patient in most cases.\u00a0 The overweight body condition by itself has been known to precipitate a higher level of inflammation in that patient. This is then compounded by a poor overall diet lacking in proper nutrients and a lower level of exercise, which further fuels the inflammation.\u00a0 Interestingly enough, both groups also have a demonstrated dysbiosis or negative shift in the populations of bacteria in the digestive tract.\u00a0 Just like laminitis equine patients, human diabetic also have dysregulated blood sugar, insulin function, and altered nerve function and circulation.\u00a0 Humans don’t experience coffin bone rotation, but do experience circulatory issues in the lower extremities which is very comparable and life altering.\u00a0 All of these health conditions or developments are a result of the progressive inflammatory damage on a cellular level, getting worse over time.<\/p>\nSo…the two are not too dissimilar.<\/p>\n
If you then look at human research, one avenue that provides moderate improvement in patients is through modification of diet and lifestyle factors.\u00a0 Instead of processed foods, patients readily improve via a whole-food, plant based diet.\u00a0 They also respond readily to various herbs, often in combination, taken as a supplement or used as a part of their cooking practices.\u00a0 Exercise then becomes a big factor in these patients, improving metabolism, weight, blood sugar, inflammation, and overall mental outlook. Through these approaches, when fully applied, human patients can do quite well with significant control of their medical condition without the need for medications.\u00a0 In fact, most actually do better on this regimen than they did on numerous medications each day.\u00a0 All of these efforts by the patient modify the inflammatory status within their body.\u00a0 Reduce or better manage that inflammation and cellular function can be restored and with that healing is enhanced.<\/strong><\/p>\nThis is the approach that we need to be taking in the equine laminitic patient, seeing the bigger picture and taking into consideration all factors involved.\u00a0 Through this approach, the process of inflammation is more readily managed on a higher level, impacting cell function throughout the body.\u00a0 In many cases, due to a change in the diet, the microbiome within the gastrointestinal tract rebalances on its own, which then impacts inflammation additionally.\u00a0 This shift in the microbiome can come directly as a result of the foods consumed, via prebiotic effect or phytochemical influence, or the positive shift can come about due to reduced stress on the body through other avenues pursued by the patient.<\/p>\n
How do we do this in the equine laminitic patient?\u00a0 That is for part two<\/a><\/span><\/strong> of this article, relaying our current and future approaches that we use in patients every day.<\/p>\n
Research indicates that cellular dysfunction is at the root of many health problems not just in horses, but in people.\u00a0 So, why don’t these cells function correctly?\u00a0 Inflammation, that is the reason.\u00a0<\/strong> Inflammation is a broad, complex cellular process that can impact cell function, through DNA activation and also mitochondrial function.\u00a0 This is a very deep reaching process and goes much further than just associating pain with inflammation.\u00a0 Pain is just one outcome to inflammation.\u00a0 Cell dysfunction and tissue damage is the other.<\/p>\n Stating and proving that inflammation is at the root of the laminitis is relatively easy to do, but solving that problem proves to be another problem in an of itself.<\/strong>\u00a0 Why?\u00a0 Mainly due to the reason that there are many contributors to the inflammatory process and these contributors will vary from one horse to the next.\u00a0 This is partially why no single regimen provides benefits for every horse and why in most cases, better management is gained through a personalized type of approach.\u00a0 This is also why no single cure will ever be developed for this disease condition. Despite this, if you can ‘see’ the bigger picture, then in most cases you can really analyze your horse’s situation and make better decisions regarding care.\u00a0 This can help immensely in creating a better outcome.\u00a0 If an owner is actively aware and involved, it is far better than just relying on another to solve the problem.\u00a0 The reason being is that in many cases, there is something being done in regards to supplementation, medications, diet, and even exercise that may be creating resistance to recovery.\u00a0 The more involved you become, the more you can see these factors, eliminate them or modify them and enhance recovery.<\/p>\n The process of inflammation is tightly connected with laminitis in the horse.\u00a0 This is well known, but where does it come from?\u00a0 What starts it?\u00a0 The answers to this are as numerous as the horses that develop the condition.<\/p>\n You have to step back and look at laminitic patients.\u00a0 They fall into one of two categories; acute or chronic.\u00a0 A laminitic horse that is acute is one that often is directly associated with another event such as a grain overload, endometrial infection post-foaling, endotoxemia, or contralateral lameness condition. These horses are in severe pain, have moderate to minimal rotation, but are very difficult to stabilize, deteriorating rather quickly and ending in euthanasia in many cases.\u00a0 In the acute laminitic horse, those\u00a0 primary events triggered the inflammatory response in the patient either on a direct or gut level<\/strong>.<\/p>\n A horse with chronic laminitis is much different.\u00a0 These horses are often overweight to varying degrees, more sedentary in their exercise patterns, lazy in their habits, low metabolism, and often exhibit varying levels of foot pain throughout the year.\u00a0 Their conditions tend to wax and wane, good one day, bad the other, but persist for many years.\u00a0 These patients are really comparable to type II diabetics in human medicine with a metabolic syndrome type of classification.\u00a0 If they haven’t been diagnosed as ‘metabolic patients’ with insulin function, given them some time and it will change.\u00a0 This is due to the progressive nature of the condition and inflammatory damage on a cellular level.\u00a0 The chronic laminitic equine patient is like a smoldering pile of inflammatory embers, igniting at times and creating marked damage, while at others, more controlled.\u00a0\u00a0<\/strong><\/p>\n Inflammation really stems from a few factors:<\/p>\n Although these factors seem to be separate, they are really connected with one contributing to another. For example, if a horse has underlying digestive issues, then the food they consume may not digest properly and thus low levels of nutrients may be absorbed impacting cell protection and tissue health.\u00a0 If a horse has an ongoing joint or tendon concern with high levels of inflammation, then this by itself can contribute to more inflammation through the stress pathways in the patient.\u00a0 Stall confinement associated with an injury recovery or as just part of the normal routine can also contribute to more stress, which gets the cycle going again.\u00a0 The act of putting a horse with metabolic problems on a dry lot will also greatly contribute to more internal stress and inflammation, which can also add to the digestive concerns.\u00a0 As an owner, you make changes to accommodate your laminitic patient with all good intentions, but some efforts may work against the end goal.\u00a0The cycle repeats and compounds<\/strong>.<\/p>\n The impact of the microbiome and digestion is a huge player in the development of equine laminitis and an area of heavy research by myself for the past several years.\u00a0 A high percentage of these laminitic patients demonstrate a dysbiosis or shift in the normal population of bacteria in the hindgut.\u00a0<\/strong> This then greatly contributes to the inflammatory process in the patient.\u00a0 I have discussed the microbiome concerns in another article<\/a><\/span>.<\/p>\n Although I have been studying this phenomenon for years, and have arrived at solutions for many patients, it is readily clear that yet again, there are many factors involved.\u00a0 This can be seen in the chart below. In many cases, the average reader will often be more frustrated after reading this information than what they were originally.\u00a0 This is not and was not my intention when creating this article.\u00a0 My hope was to relay a better understanding of the problem at hand, realizing hopefully that the concerns in the foot regarding rotation and pain are really an effect, rather than the cause.\u00a0 The rotation of the coffin bone and subsequent pain are an end result, not the primary problem.<\/strong><\/p>\n Does this mean that we just ignore the feet?<\/strong>\u00a0 No.\u00a0 Again, this is analogous to the leaning building.\u00a0 You have to make every effort to realign the external structures, but even more important is to recognize and manage the internal ones.\u00a0 Keep in mind here that I said, “realign the structures”, which implies that proper trimming is done to physically re-establish balance to the foot and with that, realignment of the internal structures over time.\u00a0 This is much different than just relying on various shoes to provide support or redistribute weight.<\/p>\n So many owners that I have interacted with as a veterinarian and consultant have mainly focused on the feet in various ways, while then attempting to remedy the internal problems via a low starch feed, reduced quality hay, and no pasture turnout.\u00a0 Supplements are used but are often misguided, thinking that one nutrient or one herb may be the solution.\u00a0 Then on top of this, often there are medications not just to aid in management of pain, but to control other secondary processes including blood sugar management and insulin function.\u00a0 In some patients, there are even medications to support pituitary function, as in the case of a PPID patient.\u00a0 These approaches are helpful in some patients, but technically speaking, they are band-aids at best, meaning to control other disturbed cellular process impacted by inflammation.\u00a0 A high percentage of these laminitic patients are still experiencing recurrent flare-ups year after year, despite their supplementation or medication regimens.<\/strong>\u00a0 This should tell you that there is more to the story that is possibly overlooked.<\/p>\n If you can properly control the inflammatory response, which can involve several different approaches, then the cellular function is often readily improved on all levels.\u00a0 Pain is improved, but so is metabolism, thyroid function, insulin receptivity, tissue health, hoof growth, and circulation. Cellular function is improved, normal functions in the body are restored and with that, health is dramatically enhanced!<\/p>\n How do you do this?<\/strong><\/p>\n A type II human diabetic is not too far removed from equine laminitis in my opinion, especially the chronic laminitic patient that has equine metabolic syndrome or EMS.\u00a0 <\/strong>\u00a0In both examples you have an overweight patient in most cases.\u00a0 The overweight body condition by itself has been known to precipitate a higher level of inflammation in that patient. This is then compounded by a poor overall diet lacking in proper nutrients and a lower level of exercise, which further fuels the inflammation.\u00a0 Interestingly enough, both groups also have a demonstrated dysbiosis or negative shift in the populations of bacteria in the digestive tract.\u00a0 Just like laminitis equine patients, human diabetic also have dysregulated blood sugar, insulin function, and altered nerve function and circulation.\u00a0 Humans don’t experience coffin bone rotation, but do experience circulatory issues in the lower extremities which is very comparable and life altering.\u00a0 All of these health conditions or developments are a result of the progressive inflammatory damage on a cellular level, getting worse over time.<\/p>\n So…the two are not too dissimilar.<\/p>\n If you then look at human research, one avenue that provides moderate improvement in patients is through modification of diet and lifestyle factors.\u00a0 Instead of processed foods, patients readily improve via a whole-food, plant based diet.\u00a0 They also respond readily to various herbs, often in combination, taken as a supplement or used as a part of their cooking practices.\u00a0 Exercise then becomes a big factor in these patients, improving metabolism, weight, blood sugar, inflammation, and overall mental outlook. Through these approaches, when fully applied, human patients can do quite well with significant control of their medical condition without the need for medications.\u00a0 In fact, most actually do better on this regimen than they did on numerous medications each day.\u00a0 All of these efforts by the patient modify the inflammatory status within their body.\u00a0 Reduce or better manage that inflammation and cellular function can be restored and with that healing is enhanced.<\/strong><\/p>\n This is the approach that we need to be taking in the equine laminitic patient, seeing the bigger picture and taking into consideration all factors involved.\u00a0 Through this approach, the process of inflammation is more readily managed on a higher level, impacting cell function throughout the body.\u00a0 In many cases, due to a change in the diet, the microbiome within the gastrointestinal tract rebalances on its own, which then impacts inflammation additionally.\u00a0 This shift in the microbiome can come directly as a result of the foods consumed, via prebiotic effect or phytochemical influence, or the positive shift can come about due to reduced stress on the body through other avenues pursued by the patient.<\/p>\n How do we do this in the equine laminitic patient?\u00a0 That is for part two<\/a><\/span><\/strong> of this article, relaying our current and future approaches that we use in patients every day.<\/p>\nFactors Involved with Inflammation and Laminitis in the Horse<\/span><\/h3>\n
\n
<\/p>\nThe Bottom Line In Equine Laminitis<\/span><\/h3>\n
The Type II Diabetic as a Guide for Laminitic Management<\/span><\/h3>\n