Prognostic indicators of poor outcome studied at US referral hospital - Veterinary Practice
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Prognostic indicators of poor outcome studied at US referral hospital

DR James Orsini, director of the
Laminitis Institute at the University
of Pennsylvania, describes laminitis
as a very frustrating disease from a
number of standpoints, including
management.

“The pain and debility are often so
severe that euthanasia is often
considered, but this decision is not easy
because of our lack of data and
uncertainties about which horses are
more or less likely to recover,” he says.

To try to take the guesswork out of
predicting which horses are less likely to
recover from laminitis, Dr Orsini and
colleagues reviewed the medical records
from 247 horses treated for laminitis
that were euthanased or died.

These records were compared to the
records of 344 horses treated for
laminitis that survived and were
discharged from the University of
Pennsylvania’s Hospital for Large
Animals between 1986 and 2003.

One of the most important findings
of this study was that as the grade of
lameness increased (using the Obel
grading scheme from I-IV, where IV is
extremely lame and reluctant to walk),
the chance of a poor outcome also
increased.

Horses with an Obel grade II
lameness were three times more likely to
die or be euthanased than horses with
grade I lameness.

Horses with grade III and IV were
9.6 and 20 times more likely to have a poor outcome than the odds of a
similar horse deemed grade I.
The use of glue-on shoes significantly reduced the risk of death in
horses with laminitis.

The results of this study were
published under the title “Prognostic
indicators of poor outcome in horses
with laminitis at a tertiary care hospital”
in the June 2010 edition of the Canadian
Veterinary Journal
.

The full-length article is available for
free through PubMed Central.

  • The protective influence of glue-on
    shoes is interesting as farriers and
    veterinarians using this technology
    consider it a means to atraumatically
    support the laminitic foot,” says Dr
    James Orsini, the director of the
    Laminitis Institute at the University of
    Pennsylvania.

“Glue-on shoes allow the farrier and
clinician to adjust the angle of the shoe
relative to the weight-bearing surface of
the hoof and the orientation of P3 (the
coffin bone) relative to the rest of the
digit and to the ground surface.

This relieves compression on the
solar corium and tension on the dorsal
laminar corium and likely also improves
blood flow to these compromised areas.

“Glue-on shoe technology also
allows one to create a larger weight-
bearing surface which improves the
biomechanics of the foot by reducing
the concentration of load in the toe
region,” he says.

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