Mind your language - laminitis/LGL/Sub Clinical Laminitis

No pictures today.  Just a bit of a health warning.

You have probably realised that the words laminitis and navicular are used a lot. But unfortunately they mean very different things depending on who is using them.

For example there has been some research publicised this year which promotes the finding that fructans do not cause laminitis.  Now this might very well be the case.  But for this particular piece of research the definition of laminitis does not include all those horses which we barefooters observe going footy after X length time out on grass.  The definition for the research is quite limited and only includes (if I understand my source correctly) cases where there has been (their words not mine) rotation of the pedal bone.

My source tells me that for the purposes of the research (and in other areas too) laminitis is viewed in the same way as a heart attack; kind of on or off.  It is not viewed as something with a continum.  So the spectrum of symptoms/degrees of problem that many barefooters are so familiar with are not recognised by the veterinary community involved in the research.  Or if a back office technician wants to recognise it they are not allowed to because of the directives they are working under.

Second element of health warning.  The research also promotes the idea that obesity alone is the causal factor for laminitis.  This research seems to quietly ignore all the thin horses that get laminitis and the separate piece of research that shows that a high proportion of in work/fit racehorses also have sub clinicial laminitis.  I did raise this point and it is not that the researchers are unaware of these points, but they don't fit the story and are not allowed to discuss them. Which naturally makes me then question the research; because research shouldn't have an agenda and findings should not (in my opinion) be reported 'pick and mix' style.

So what does the research show?  Well to be grossly over simplistic; if you put a large and completely unnatural bolus of fructans by stomach tube into a horse then they won't get rotation of the pedal bone.  And that is about it - from a practical point of view.

How does it help the barefooter who knows that 30 mins on spring/summer grass will make their thin/fit horse lame?  Not at all. So it is back to bare paddocks and grazing muzzles for now.

Now onto 'navicular'.  Not everyone is aware that the diagnosis of 'navicular' is a rather loose one.  That changes to the navicular bone on x-ray can be pretty meaningless, that lots of horses have changes and are perfectly sound and lots don't have changes and are lame.  Equally 'navicular disease' is confused with 'navicular syndrome'.  Again unfortunately the latter tends to be the diagnosis when the horse has caudal heel pain (pain in the back of the foot) and the source of pain can not be identified.

What research does show is that soft tissue damage of the DDFT happens in advance of damage to the navicular bone.  What is starting to happen is that people (a very small minority) are realising that poor foot health is a key contributor and if the foot is brought back to health (yes you have guessed, good diet, appropriate exercise, natural trim) then the symptoms resolve.  No need for drugs or expensive shoes.

But it is important to distinguish between 'disease'; usually referring to damage to the navicular bone and 'syndrome' which is a catch all that sometimes involves damage to the DDFT but not always. I don't know anyone who is claiming that the barefoot approach mends diseased bones.

Please also be aware that 'syndrome' can include any kind of caudal heel pain, even if the horse only actually has a bad case of thrush. (and that comes from personal experience)

So in summary be very careful to check that when you are having a discussion about laminitis or navicular that all parties are talking about the same thing.  Unfortunately at the moment, it can't be guaranteed.