The Laminitis Clinic
Mead House
Dauntsey
Chippenham
Wiltshire. SN15 4JA.
England.

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This is my list of things NOT to do.

Don't feed haylage; my personal feeling is that haylage is too acid for horses and ponies and that it may well contribute to Metabolic Syndrome.

Don't fit foam or rubber pads, or anything which is intended to make the horse bear weight through the sole.. Any form of sole pressure is likely to increase the animal's pain. Forcing the animal to stand on its soles can induce bruising and abscessation which is unneccesary and inhumane. Instead use TLC Frog Supports, they provide cushioning comfortable support in the part of the foot which is not painful and in a position which supports the remaining laminae.

Don't make or allow the horse to walk. Exercise was thought to be beneficial by increasing the blood flow to the foot. There is already a tremendous increase in the blood flow to the foot but there is little or no perfusion of the dermal laminae. No amount of exercise will improve this situation and may well mechanically tear the remaining laminae thereby worsening the founder.

Don't allow anyone to give the animal any drugs containing corticosteroids or use any tests which involve either the use of dexamethasone or ACTH.

Don't remove the shoes (other than to fit heart bar shoes) if the animal has a flat or convex sole. It will be more uncomfortable having to stand on it's sole. Better to fit TLC Frog Supports whether the animal is shod or unshod.

Don't starve the animal. Feed according to the animals bodily condition. Hay and bran alone provide a poor diet for horses and ponies. If the animal needs to be dieted do so gradually using a combination of alfalfa chop, straw chop, soaked sugar beet, hay and
Formula4 Feet supplement. Beware of rapidly dieting very fat or pregnant ponies, they may develop hyperlipidaemia which is often more serious than the original laminitis.

Don't remove large amounts of heel from acute founder cases, (including chronic founder type 1 cases suffering a secondary acute founder attack). this increases the tension in the deep digital flexor tendon and may result in more 'rotation'. First test by placing a wedge (equivalent in height to the amount of heel to be removed) beneath the toe of the foot and raise the contra-lateral limb. If the animal is more uncomfortable of if a depression appears at the dorsal coronary band, leave the heel alone.

Don't take non-weight bearing radiographs, they are of little diagnostic value.

Don't ask farriers to fit heart bar shoes without you having taken radiographs using markers. Good farriers will legitimately refuse to do so.

Don't forget to mark on the frog where you placed the drawing pin. If the farrier cannot appreciate where the pin was placed he is unable to fit the shoe.

Don't cut holes in the soles of laminitis or acute founder cases. This will result in granulating solar corium protruding through the hole which will be difficult to control. If there is sub-solar fluid present effect drainage by entering the foot through the dorsal wall at the level of the wall-sole junction. The horny sole is your biggest ally in treating laminitis and acute founder.

Don't ask the farrier to fit pads. You cannot evaluate the sole, the soles become wet due to trapped solar evaporation. Any solar pressure will further compromise the blood flow within the foot and cause pain.

Don't fight to fit nailed-on shoes to horses in pain. There are effective glue-on alternatives available.

Don't keep giving NSAID's (e.g. bute) if there is no improvement in the lameness. An acute laminitis case that is in significant pain after 7 days probably requires a change in treatment or management.

Don't nerve block the affected feet in order to reduce the animal's pain. The animal will further mechanically damage compromised laminae by walking on painless feet. Nerve blocks may affect the neuronal control of digital arteriovenous anastomoses and potentiate digital ischaemia.

Don't hope that antibiotics will help either 'gravel' or post-founder abscesses. They won't. Only when drainage has been provided will the lameness improve. Antibiotics are only indicated in foot infections if there is a developing cellulitis (infection going up the leg) or there is bone infection (such cases have a bad prognosis).

Don't think that because the movement of the distal phalanx has resulted in solar prolapse that is the end of the horse's working life. It is the means by which prolapse has occurred i.e., the amount of distal displacement which is important.