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