Laminitis (Founder)

Below and to the left are photos of a chronically foundered AQHA stallion.  This is an extreme case, but it is illustrative of the ramifications of improper hoof care and diet.  This horse was in significant pain and was barely mobile.

I suspect that significant coffin bone degeneration would be present upon X ray, and the coffin bone has remodeled itself in response to this extreme hoof distortion.

Our ultimate goal would be to prevent the horse from reaching this level of distortion.  Proper diet and farrier care could have prevented this tragic display. 
Laminitis and Insulin Resistant Protocol-Brief Overview

Diet:

This is the most important part of treating the affected horse. The first part is to cut out all sugar intake. Before you feed anything to your horse, ask yourself if there is any sugar in it. If there is do not feed it. You need to start them on a specific diet to eliminate all sugar stores in the body. The following protocol should be followed. Any deviation will delay the horse from recovering.
1.Feed one flake of grass hay, twice a day. No Alfalfa! Alfalfa is high in sugar. Before feeding soak the hay in water for at least 2 hours. Sugar is water soluble. Soaking the hay will dissolve the sugar from the hay and it will float to the top of the water. Drain the water from the bucket and then feed the hay.
2.ADM has manufactured a feed called MMP (Metabolic Mineral Pellets). It is specifically designed for the Laminitic and Insulin Resistant horse. It is low in sugar and starches, but has the essential vitamins and minerals needed to help feed and grow a new hoof.
3.Probiotics. The essential “bugs” in the horse’s digestive system have been compromised and diminished. We now need to restore them to a healthy level. The MMP already has probiotics in the feed, but it is a good idea to add more to the diet. You cannot overfeed probiotics, and the more chronic the case, the more the horse will need supplementation. Some very good probiotic sources are: Fastrack, DAC Digestive Aid, and Probios. These are a few that I am familiar with, not to say that there are not other good products out there.

Hoof rebuilding and pain management:

We will start by applying a pad and Magic Cushion the horse’s feet. This should help with the pain and get the horse back to a more comfortable state. By doing this, we should be able to then work on the feet without the horse being in too much pain. Bute is also a good option to alleviate some of the discomfort.

At this point, we can apply a shoe and a pad and Magic Cushion for a more long term treatment.
I would like to stress that what we do to the foot i.e.: shoes, pads, Magic Cushion, is just to make the horse comfortable during the healing process. The problem cannot be cured through farrier work. The metabolic system has to be regulated and adjusted back to a healthy state through diet and mild exercise. The horse has to grow a new healthy, well attached hoof.
Laminitis and Insulin Resistance is an entirely manageable condition through proper diet and hoof care.
Please note, your horse may need adjustments in treatment protocol to insure his specific needs are being met.

Link to a printable version of this discussion is below.

Insulin Resistance induced Laminitis:  An Overview

Insulin resistance (IR) is a metabolic disorder.  This is intended to be a brief overview of the cause, symptoms and treatments of this disorder.

What is Insulin Resistance (IR)?
IR is similar to type 2 Diabetes in humans.  Blood carries glucose, i.e. sugars, to the cells for energy.  Insulin is the chemical that allows the glucose to get through the cell wall.  With IR horses, the body does not use all the glucose that is taken in through the diet.  The cells become filled with glucose, and the cell wall then becomes resistant to the insulin.  Now the cells along with the blood are filled with excess glucose.  What happens to the excess glucose?  It turns into fat stored energy.  These fat stores create yet another problem, an extreme inflammatory response.  The body’s solution to this problem is to produce cortisol, which has an anti inflammatory effect.  The problem lies in that, cortisol pulls proteins from the connective tissues in the body, which in turn weakens the connective tissue of the tendons, ligaments and the laminae holding the coffin bone to the hoof wall.  This compromise in laminae integrity is the cause of the extreme pain horses feel in their feet during a metabolic episode.  It is the principle cause of the problems we observe with laminitic horses’ feet.

Symptoms:

Fat deposits:  Cresty neck, fat behind the shoulder, around the tail head, sheath, and under the eye.  Don’t mistake all fat for IR related fat deposits, they are specific to the discussed areas.  The horse may not look overweight, but can still have the fat pockets.  These horses tend to drink and urinate more often and may act hungry.  Traditionally “easy keeping” breeds tend to be more susceptible to IR related laminitis, they include but aren’t limited to:  Paso Fino, Arabians, Gaited horses, ponies and Mustangs.

Treatment:
Let me begin by stating that this is a very manageable problem.  It is NOT a death sentence!  Through diligent stewardship, these horses can live long, happy, productive lives.

Diet:
This is the single most important piece of the puzzle.  The horses’ metabolic system is in complete disarray.  Without proper diet management, the IR laminitic horse will not get any better. 
The following recommendations are what have worked in my practice.  This is not to say that this protocol is by any means the only fix, but it is what has worked well for us.  Also, each horse is an individual case.  There is no one, cookie cutter, one size fits all cure, but it is a place to start.  Please realize there is no cure for this disorder, we simply manage the horse to prevent the catastrophic symptoms.
NO STARCH, NO SUGAR!!!!   Always consider sugar and starch content before feeding ANYTHING to your IR laminitic horse.  No sweet feed, carrots, cookies, apples, molasses or alfalfa hay.

•Low starch feeds are made by almost every feed manufacturer.  ADM has a feed called MMP (Metabolic Mineral Pellets).  It is specifically designed for the IR laminitic horse.  It consists of low sugar and starch, but contains the essential vitamins and minerals needed to support the body and good healthy hooves.  Remember, horses need nutritional support.  Starvation is not an option, you must feed a low sugar, balanced diet.
•Grass hay.  Grass hay can be lower in sugar than alfalfa, but under certain conditions it can still be high in sugar.  The only way to know for sure is to have your hay tested.  If you are unaware of the sugar level in your hay, you can soak it in water.  Sugar is water soluble, and soaking the hay will help reduce the sugar.  Simply soak the hay for 2 hours, pour the water off (DO NOT give the water to the horse, it contains the excess sugar) and feed the hay.  For winter conditions, using hot water decreases the soak time to approximately 45 minutes.
•Probiotics.  The essential “bugs” or the bacterial flora in your horses’ digestive system.  Whenever the horses’ system is stressed, it can lead to lower levels of these essential “bugs”.  You cannot overfeed probiotics.  Some good probiotic sources are probios, DAC Digestive Aid, and Fastrack.
Again, these recommendations are a starting point.  They may need to be fine tuned at some point for your particular application.  These products are just what have worked for me in my practice.  There are many other good products not mentioned here.

Veterinary Assistance:
Getting blood work on your horse can confirm a metabolic condition.  Your vet may also want to prescribe anti inflammatory agents as well as pain medications to help speed recovery.  Radiographs may be needed to diagnose the extent of damage inside the hoof capsule.

Hoof Management:
There are a few different approaches to treating the affected hoof.  As I stated earlier, there is no one size fits all treatment for these horses.  We will start with a trim and/or pads to begin alleviating the pain the horse is experiencing.  Next, we will try to find a more long term solution to get the horse back to a more comfortable state.  This may be through a shoe, a wedge, casting or a therapeutic clog.  There are many factors in deciding how to proceed; we will discuss your individual situation to decide on a course of action.  In reality, this condition has existed for some time, but it is usually only addressed following the pain involved with this disorder. 

Exercise is important!  It is imperative to burn off the excess sugar stores.  At first, small amounts of exercise will suffice.  Remember, if the horse is in pain, that indicates damage is occurring.  This is where we will decide the best course of action to make the horse comfortable.  As the horse becomes more at ease, we can then ask for more exercise, i.e. hand walking, or turnout in a dirt lot or with a grazing muzzle (we definitely don’t need high sugar green grass at this point!).

I hope this discussion is of help in managing your IR laminitic horse.  I cannot stress strongly enough that management of the diet and thus the metabolic state is the ONLY way to treat IR.  Your vet or farrier cannot do it alone.  Only you as the owner and caretaker of your horse can fix this problem. 

Link to a printable version of this discussion is below.