Prevent Spring Laminitis Now!                         

Horseback Magazine                                                     1-10-14                                                                  Pete Ramey

I specialize in the farrier-half of laminitis (founder) treatment and rehabilitation; I handle the nasty stuff for a dozen or so veterinarians in my home area. Every spring, starting in late March, my phone rings off the hook and I drive from teary-eyed horse owner to teary-eyed horse owner trying my best to help their horses survive the ordeal. The sobering truth is that most of these problems, often permanently damaging to the horse, could have easily been predicted and prevented. Here's how:

Understanding Laminitis

Laminitis can be triggered by countless problems that horses face: any sudden change in diet, any sickness, periods without food, medications, excessive concussion, even emotional stress, and the list goes on. The most common cases, and within the scope of this article, are triggered by excessive dietary sugars. Horses are designed from the ground-up, to eat almost constantly - up to 20 hours per day - but they are designed to eat non-cultivated grasses that are growing sparsely and are relatively low in sugar. If they get too much sugar in their diet, the byproducts of digesting that sugar can literally poison the horse. Additionally, the horse's body naturally creates more insulin to help process the excess sugar. The extra insulin circulating in the blood stream can weaken and damage the laminae, thus breaking down the bond of hoof to horse.

Over the course of 24-36 hours after these initial triggers, there is a cascade of events. The damaged dermal laminae become inflamed and swell, as would any other wounded tissue, but this live tissue is stuck between a rock and a hard place - between the coffin bone and the hoof wall. As the soft tissue within the foot swells, blood circulation (through micro-vessels within the foot) becomes restricted, and more critical connective tissue dies. The results are severe pain, a thumping pulse at the fetlock, and a sometimes-fatal destruction of the laminae that bond the hoof to the horse.

The Writing on the Wall

All horses are at some risk of developing laminitis, but you can learn to tell at a glance, which ones are most likely to need extra attention. If the horse is carrying pads of fat on his neck, back and croup, he has probably been eating more sugar than his body can utilize for a while; he is at greater risk than a fit athlete. Ironically, if the horse is too thin, lacking healthy muscle definition, he is at an increased risk as well.

If the hoof walls flare or have a concaved or bell shape in any areas of the wall, the laminae are already compromised, stretched or separated in these areas. This points to past or present problems, and I always assume the horse is at an increased risk of a more-serious bout of laminitis.

If there are ripples or red stripes in the hoof walls there were past problems when that specific area was being produced at the coronet. A series of these ripples or red stripes tells me the horse has been going through a series of dangerous episodes over time. That horse is more likely to suffer a catastrophic hoof problem than a horse with smooth, straight walls.

If you own a horse that demonstrates one or more of these warning signs, talk to your vet and farrier about it, and consider making some changes in the horse's diet and lifestyle. This is very important, because in my experience, it is VERY rare for horses with truly-healthy hooves to suddenly develop severe laminitis. What is way-more common is that these warning signs are first ignored for years. 

This was a very typical "spring laminitis case" on the first day I saw her. The steeper wall growth at the coronet, the flared/bell-shaped wall, the series of ripples and red stripes down the wall, and the thin sole should have been early warning signs - this happened over the course of years before the horse "suddenly" reached a point that walking was impossible.  This case turned out just fine, but the excruciating pain, the vet bills, and much of my bill could have been prevented if the owner had read the "writing on the wall" and taken earlier action. The dietary changes necessary to heal these problems could have also prevented them. Every step of this horses healing process is shown in disc 10 of the DVD series Under the Horse. Photo reprinted from the book Care and Rehabilitation of the Equine Foot.

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Routine Farrier Care

A sad truth I have noticed throughout my career is that at least 3/4 of spring laminitis cases are actually winter neglect cases. Soak on that for a minute.

When hoof walls overgrow and flare, they exert a far-greater lever force on the laminae - the horse's entire weight is hanging from this delicate attachment as every step tries to pry the hoof wall away from the horse. A good trim reduces these dangerous forces, and allows the sole, bars, frog, and hoof wall to share the load, thus reducing stress on the laminae. This can't stop the horse from eating too much sugar, but it can (and does) greatly reduce the damage that comes afterwards. Routine hoof trimming needs to be a year-round habit. An ounce of prevention is truly worth a pound of cure.

Competent Farrier Care

There is a very common mistake I need to point out here: removing too much of the sole at the toe. Horses are tough, and can often run around for years with a significant coffin bone/hoof capsule rotation.  When the hoof wall and coffin bone separate, the toe wall will usually develop a long, more sloping angle - a "duck foot." What needs to happen, is a new, steeper wall needs to grow in that is well-attached to the bone. But a lot of farriers will misread the situation and try to "stand the horse up," leaving an excessive amount of heel. They will then thin the sole at the toe - often until the horse bleeds - in an attempt to make the foot appear more normal. This is the opposite of what needs to be done, and in my opinion, it lands more horses in vet hospitals than any other single man-made issue. This is why, in the past 10 articles, I have tried to teach readers about reading sole thickness and hoof wall location relative to the bone. You need to educate yourself, and you need to pay attention. If you are lucky enough to find a really-sharp farrier, pet him/her well.


Understanding Grass Sugars (condensed from Kathryn Watts' studies)

Total grass sugars can vary from 0% to over 30%. They change constantly with the weather and time of day. If the sun is hitting live grass with adequate water and nutrition, it is producing sugar. Whenever the grass is actively growing, it is consuming much of this sugar as it is being produced. So the most dangerous times occur when the weather is cold and sunny - the cold weather (highs below 40F for most grass species) slows or stops growth, while the sun continues to generate sugars. When there are three consecutive days of this weather pattern, I clear my schedule to accommodate the new laminitis calls I know will come. The flip-side of this is that after 3 cloudy days in a row, there is almost zero sugar in the grass. Study these cycles and learn when to feed grass, and when to switch to hay ( or my book Care and Rehabilitation of the Equine Foot are the best sources I know of to study grass sugar fluctuations).

Pasture Management

Most people are surprised to learn that the "dreaded" lush spring grass is usually lower in sugar than parched, drought-stricken grass. The rapid growth of spring grass utilizes the sugars as they are produced, preventing excessive buildup. The big issues with spring grass, though, are volume and palatability! It may not be the highest in sugar, but horses will eat considerably more of it when given a chance - this is what makes it dangerous.

Beware of overgrazed areas. Grass stores more sugar in the base of the plant. Plus, an overgrazed plant is stressed, growing slower, and thus higher in sugar than a healthy, fast-growing plant. This is why horses will keep nipping 1/4-inch-tall grass down to ground level, while ignoring the same exact species growing a foot-tall right beside their ears; the short stuff is like candy. Often people will look at an eaten-down pasture and think there is nothing out there for the horses to eat. But if you took the horses off the pasture, the grass would grow long, right? This means that when the horse is grazing an overgrazed pasture, they are consuming the grass at its growth rate. So if a weather change causes an increase in the growth rate, the horse gets a dietary increase without your knowledge. This one catches up with a lot of otherwise savvy horse owners.

Become a student of pasture management. Interestingly, everything you can do to decrease grass sugars also increases the annual yield of the grass. For instance, using the above example of an overgrazed section, overgrazed grass is stunted (it grows slowly). If you rotate the horses off of the section (before overgrazing occurs) and feed hay for a while, the growth rate of the grass will increase. So at the end of the year, you will probably find you had to buy less hay than if you had tried to "stretch" the pasture farther. Same goes with fertilizing, lime and irrigation; generally speaking, when you increase yield, you decrease sugars in each blade of grass. Then, if you keep the volume the horse eats in check (pasture division/rotation, grazing muzzles, rotation into a dirt paddock with hay), the chances the horse will get laminitis goes down.

A Quick Word about Hay

Depending on these same factors, hay varies in sugar content just like grass, but typically loses some of its sugar during the drying process. Also, the sugar levels are more consistent from day-to-day, instead of constantly fluctuating like living grass. These two factors make it considerably safer to feed than open pasture. That said, with particularly at-risk horses, hay consumption may need to be regulated and/or the hay may need to be soaked to remove additional sugars. This is a matter to discuss with your vet concerning your individual horse.

Sweet Treats and Grain

By now it should be obvious that adding any additional sugars can only increase these risks. Grain, molasses, fruits, nuts, carrots, cookies and candy are all-too-common at barns plagued by founder. Is there a place for these things in the horse world? Maybe so (not in my horses), but they do increase risk, while providing little or nothing that actually benefits the horse - not a great trade-off in my book. A high-performance horse in training may need such calorie-dense supplements, but an overweight couch potato standing knee-deep in a spring pasture? No. None.

Exercise and Fitness

Unlike dogs and humans, horses have no way to shut off the continuous production of stomach acids that are an early part of the digestion process. Remember I mentioned that horses are designed to nibble almost constantly? A near-constant intake of forage naturally dilutes these acids. If you try to eliminate laminitis problems by denying your horse "chew-time," laminitis can be triggered when the horse's own "unused" digestive acids overflow into the hindgut. Too little feed can be worse than too much.

The best way to defeat this paradox is to provide near-constant access to forage (hay and grass) while increasing the horse's exercise. Get out and ride, be sure your horse has room to move, and be sure your horse is living in a herd. Separate hay, salt and water to far corners of the pasture or paddock - anything you can think of to keep your horse more active. Increasing exercise is probably more important than reducing the dietary sugars, though at-risk horses will typically need both.

Grass is not the enemy. Grass is the horses' natural feed, and it is essential to them. When we made the decision to fence horses onto irrigated, cultivated pastures, though, we changed the deal - their nutrition became our responsibility. Grass (and hay) should make up most of the horse-s diet and be almost constantly available. It is our job to find ways to protect them from the risks associated with overeating and to provide missing vitamins and minerals, without adding excessive sugars in the process. Don't leave this to chance, take action.

I don't know of a way to guarantee your horse will never fall to laminitis - the risk is always there. But I can tell you that if everyone followed these simple protocols, I would get to spend much more of my springtime fishing. So, if not for your horse, do it for me.