Laminitis Info

The Problem

Laminitis is technically "inflammation of the lamina". The lamina are the layers of soft tissue that suspend the horse's weight between the coffin bone and the hoof capsule. If all the lamina within a horses hoof was placed flat, it would cover the area of a tennis court, so an insult may be small or it may be disastrous, depending on how much area is damaged.

Since the lamina is encapsulated within the hoof wall, when an inflammatory insult occurs, this causes extreme pain for the horse. At a point in the laminitis process, the microcirculation to the feet is impaired and this decrease in circulation means less or no oxygenated blood flow to the laminar tissues and they become hypoxic and can die.

When the lamina is no longer able to support the coffin bone, the mechanical pull from the deep digital flexor tendon (DDFT), which is exacerbated by feet that are not trimmed properly, adds even more pressure and pain as the coffin bone can separate from the lamina and pull away from the hoof wall. This is referred to as 'rotation' and should be evaluated radiographically. Without adequate blood flow, proper support, and management of the inflammation, laminitis is not only extremely painful, it can result in permanent mechanical damage, lameness or death.

Addressing the laminitis issue is like a puzzle and all the pieces must fit into place for the best possible outcome. Here we will cover the basics of how NitrOxide can help supply essential pieces to this puzzle.

NitrOxide is "Vital" to the laminitis horse whether acute or chronic. NitrOxide will stimulate the body to produce more nitric oxide for up to 3 hours with every dose. Nitric oxide is a molecule in the blood that is responsible for circulation and also decreasing inflammation. It opens the blood vessels and smoothes them, so that the oxygenated blood flow can get to where it is needed most, the hypoxic, dying laminar tissues.

Another key factor is the inflammatory process. Without reducing the tissue swelling due to inflammation, the circulation can not be increased as there simply is no more room within the hard, unforgiving hoof wall. Nitric oxide targets the protein within the endothelial cells (NSF) that stimulates inflammation and blocks the ability of the NSF to begin the inflammatory process. By increasing the nitric oxide molecule in the body with NitrOxide, you are not only decreasing the harmful inflammation, but are increasing the essential oxygenated blood flow to the tissues in which microcirculation is seriously impaired.

Non-steroidal anti-inflammatories (NSAIDs) such as phenylbutazone (Bute) block inflammation quickly, but do so by inhibiting the body's ability to utilize and or formulate the nitric oxide molecule. So with NSAIDs the inflammation is decreased, but there is also a vasoconstrictive effect which is exactly the opposite of what the feet need during a laminitic episode. For more information on the vasoconstrictive effects of NSAIDs see Acute renal failure associated with NSAIDS or Adverse effects of nonsteroidal anti-inflammatory drugs on the gastrointestinal system (each will open a new window).

How We Address It

Dosing the acutely laminitic horse with NitrOxide is time-consuming in the beginning. While a dose will last up to 3 hours in the horse's system forming more nitric oxide, in the horse with intense inflammation and pain the dosing of NitrOxide must be aggressive and consistent. Begin dosing with a double dose (6cc powder per 100# bodyweight for a horse, with ponies/drafts at 12cc per 100# bodyweight), and dose every 45 to 60 minutes up to 4 consecutive doses.

The reason for the "hyper dosing" is to help break through the intense inflammatory process, so adequate perfusion can be restored. Monitor the horse's comfort level and digital pulses in all 4 feet, and it is recommended to keep a written log. Strong bounding pulses that are easily detectable, are a sign of decreased circulation.

When pulses are difficult to detect, adequate perfusion is being reestablished (it is advised that all owners know what is normal for their horse in digital pulse palpation so they may recognize even a slight increase in pressure). As horse continues to stabilize, gradually decrease and spread out your doses until you are down to 1 single 3cc per 100# bodyweight (pony/mini/draft breeds minimum 6cc per 100# bodyweight) per day for the duration of the horse's recovery.

For the chronic laminitis horse: Begin double dosing 2x daily at 6cc powder (horse) 12cc powder (pony/draft breed) per 100# bodyweight, for a minimum of 2 weeks. As the horse becomes more comfortable and stable, decrease down to single dose of 3cc per 100# bodyweight (horse breed, ponies/drafts 6cc per 100#) daily.

Most laminitis horses-due to the intense stress on their bodies and likelihood of NSAID use-will suffer from either gastric or colonic ulcers, or both. It is recommended if ulcers are suspected to add GastroPLUS into your program. Begin the day with a double dose of GastroPLUS 1 hour before your morning feeding and dose NitrOxide in the afternoon.

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      Hello! My name is Rona Lane. My name is Maria da Cunha, I'm a med student living in Providence.
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