The management of equine acute laminitis

Figures & data

Table 1 Principles of acute laminitis therapy

1. Nutritional and medical management of the primary disease process

2. Cryotherapy achieving temperatures below 10°C continuously for at least 48 hours

3. Anti-inflammatory therapy for sepsis-related acute laminitis

4. Pain control

5. Biomechanical optimization

Table 2 Medications often used in equine acute laminitis

Medication	Dosage
Cyclooxygenase inhibitors
Phenylbutazone	2.2–4.4 mg/kg IV or PO every 12 hours
Flunixin meglumine	0.5 –1.1 mg/kg IV or PO every 12 hours
Firocoxib	0.1 mg/kg PO every 24 hours
Other anti-inflammatory drugs
Dimethyl sulfoxide	0.1–1.0 g/kg diluted to 10% solution IV every 8–24 hours
Pentoxifylline	8.5–10 mg/kg IV or PO every 12 hours
Pain control (supplements to cyclooxygenase inhibitors)
Lidocaine	1.3 mg/kg IV bolus, followed by 3.0 mg/kg/hour continuous rate infusion IV
Butorphanol	0.01–0.05 mg/kg three to six times daily IV, or 0.04–0.1 mg/kg three to six times daily intramuscularly
Combination continuous rate infusion
Lidocaine	1.3 mg/kg IV bolus, followed by 3.0 mg/kg/hour
Ketamine	0.4–1.2 mg/kg/hour
Butorphanol	18 μg/kg body weight, then 10–23 μg/kg body weight/hour
Neuropathic pain modulation
Gabapentin	20 mg/kg PO every 12 hours

Abbreviations: IV, intravenously; PO, orally.

Figure 1 Material on the hoof.

Notes: Once the impression material is mixed together, it is applied over the frog and collateral sulci. The material is pushed into place but does not extend to the apex of the frog. Slightly more material than is needed is applied and left bulging over the central sulcus of the frog. The foot is then placed on the ground and the contralateral limb is elevated briefly, which will extrude excess material caudally, behind the heel bulbs.

Figure 2 Material on ground.

Notes: The material has cured and is now firm. It will retain its shape; therefore, trimming of the material to fit the foot or unload specific areas can be performed without losing a secure fit.