It’s as painful as horses wearing high heels, QF expert says of equine disease

Think of a horse going from wearing comfortable trainers to wearing stilettos and not being able to take them off, that is what Laminitis feels like. It is one of the most common disabling and painful disease in horses that affects their feet.

The most common horse breed in Qatar is the Arabian, and unfortunately, it is genetically predisposed to certain conditions that cause Laminitis. This means Arabians are more likely than other breeds to suffer from severe Laminitis, often requiring them to be hospitalized for extended periods of time.

“Laminitis refers to the inflammation of the laminae in the horse’s foot. The laminae are sensitive tissues that are located between the hoof wall and the coffin bone. They secure the bone to the hoof wall and keep it in place,” said Dr. Jessica Johnson, Senior Clinical Veterinarian at Qatar Foundation’s Equine Veterinary Medical Center (EVMC).

Think of laminae as a piece of strong Velcro that hold the bone in place. Dr. Johnson explains that severe inflammation of laminae can weaken and damage them, making them unable to hold the bone in place. With nothing to hold the bone in place, it can either sink within the hoof or rotate downwards – both of which are extremely painful and can results in lameness.

“In extreme cases the bone can even protrude through the sole of the hoof which is excruciatingly painful. In such cases, euthanasia may be the only option to end the horse’s suffering.”

Aware of the debilitating pain it can cause, Dr. Johnson started a project to address this issue.

“Laminitis in Arabians is not well-documented, even though we know that the Arabian breed is predisposed to this condition.” Dr. Johnson explained that Arabians have smaller, more upright feet – a slightly different conformation to other breeds. So what might be a normal measurement for another breed doesn't necessarily apply to the Arabian.

Dr. Johnson is using X-ray images to create the first reference for normal foot measurements in the Arabian.

Laminitis is incurable but it can be slowed down and managed. Aside from prevention, the most important thing in Laminitis management is early detection. “We don’t want it to get to a point where it is so bad that it is causing the horse visible discomfort. The most effective way for early detection is through X-ray imaging which detects very subtle changes in the angulation of the bone, so even if there is a slight rotation in the bone, indicating early onset of Laminitis, this can be seen in the X-ray.”

To create this reference, Dr. Johnson is taking X-ray measurements of the feet of over 100 healthy Arabians. Once the reference is created, there will be a better understanding of what is “normal” for an Arabian, and the reference will be used to detect very subtle changes in the bone angulation.

“A reference specific to the Arabian breed will allow early detection, which is key to preventing the disease from progressing and getting to a point where surgical intervention is needed. If detected early, simpler interventions like change in diet, foot support, hoof trimming and changes in physical activity can be enough to significantly slow down the condition.”

Another reason why Arabians might be more predisposed to this condition, one that can be easily controlled, is over-feeding.

“Arabians are beautiful horses that are often used as show horses. In the show world, a curvy, fat horse is considered beautiful. The easiest way to achieve this is by intensively feeding them a high-sugar diet, and such a diet is known to trigger Laminitis. The heavier the horse, the more the pressure on the lamina and increased chances of it being damaged.”

Dr. Johnson said obesity in horses is a common contributor to insulin dysregulation, which is a known precursor for Laminitis. “Combating obesity is key to prevention; the issue is many horse owners simply don’t recognize their horses are overweight until it’s too late.

“The Arabian breed has been selected to look a certain way and perform a certain way, which inadvertently gives rise to certain health conditions, and Laminitis is certainly one of those.”

Speaking on what kind of signs horse owners should look out for, Dr. Johnson said: “Be mindful of changes in your horse’s behavior, especially their stance and trot. If you notice it shifting weight or favoring one leg, that might be indicative of a problem.”

She added that routine foot care including trimming of hooves is vital. Horse owners must ensure their horses undergo routine health checks on an annual basis. This is imperative for picking up small changes in advance of them developing into something bigger.

At EVMC, treatment options for Laminitis are tailored specifically for individual horses. Dr. Johnson said: “We take a multidisciplinary approach to caring for laminitic cases here at EVMC, combining expertise from a team of specialists, with a variety of services that are all available on-site. These include not only medical treatment and remedial farriery, but also surgical techniques and even stem cell therapy.”