Veterinary journal (London, England : 1997)2017; 231; 33-40; doi: 10.1016/j.tvjl.2017.11.011

Paradigm shifts in understanding equine laminitis.

Abstract: Laminitis, one of the most debilitating conditions of all equids, is now known to be the result of several systemic disease entities. This finding, together with other recent developments in the field of laminitis research, have provoked a rethink of our clinical and research strategies for this condition. First, laminitis is now considered to be a clinical syndrome associated with systemic disease (endocrine disease, sepsis or systemic inflammatory response syndrome, SIRS) or altered weight bearing rather than being a discrete disease entity. Next, laminitis associated with endocrine disease (endocrinopathic laminitis) is now believed to be the predominant form in animals presenting (primarily) for lameness. Third, the designation of laminitis as a primary and severe basement membrane pathology now requires revision. Instead, current data now proposes a variable subclinical phase associated with gross changes in the hoof capsule, with stretching and elongation of the lamellar cells an early and key event in the pathophysiology. These findings have fuelled new mechanistic hypotheses and research directions that will be discussed, together with their implications for future clinical management.
Publication Date: 2017-11-22 PubMed ID: 29429485DOI: 10.1016/j.tvjl.2017.11.011Google Scholar: Lookup
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Summary

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The research revises the understanding of laminitis—a debilitating horse condition—indicating it may result from several systemic diseases, requires a rethinking of management strategies, and proposes new theories for its pathophysiology.

Understanding Laminitis as a Clinical Syndrome

  • The study presents a key shift in the understanding of laminitis. Previously considered a discrete, standalone disease, laminitis is now treated as a clinical syndrome attached to broader systemic diseases such as endocrine disease, sepsis or Systemic Inflammatory Response Syndrome (SIRS).
  • This signifies that the approach towards diagnosis, clinical management and research needs to incorporate an understanding of laminitis as a manifestation or component of more complex, systemic health issues.

Endocrinopathic Laminitis

  • The study suggests that laminitis associated with endocrine diseases—referred to as endocrinopathic laminitis—is prevalent in animals presented principally with lameness.
  • This implies that conditions relating to the endocrine system are not only potentially triggering laminitis, but are also mostly seen in cases where the animal shows lameness. Thus, it urges for more research and targeted clinical strategies in this direction.

Revising Laminitis as Basement Membrane Pathology

  • The previous designation of laminitis as a primary and severe basement membrane pathology is now being revised.
  • Recent data proposes a new understanding of the disease, suggesting it has a variable subclinical phase i.e., the period when the disease exists but does not show noticeable signs. This phase is associated with significant changes in the hoof capsule—specifically, elongation and stretching of lamellar cells.
  • This means that there is a need for early detection methods that can identify these subclinical shifts in the animal’s hoof structure to prevent the progression of the disease.

Implications for Future Research and Clinical Management

  • These paradigm shifts invite new paths for scientific exploration and theories regarding the causes and progression of laminitis. This could potentially lead to breakthroughs in preventing, diagnosing or managing the condition.
  • The alterations in approach towards laminitis also necessitate changes in clinical management strategies, hinting at the need for systemic treatment instead of isolated actions against laminitis alone.

Cite This Article

APA
Patterson-Kane JC, Karikoski NP, McGowan CM. (2017). Paradigm shifts in understanding equine laminitis. Vet J, 231, 33-40. https://doi.org/10.1016/j.tvjl.2017.11.011

Publication

ISSN: 1532-2971
NlmUniqueID: 9706281
Country: England
Language: English
Volume: 231
Pages: 33-40
PII: S1090-0233(17)30229-0

Researcher Affiliations

Patterson-Kane, J C
  • Flagship Biosciences, 7575 W 103rd Ave #102, Westminster, CO 80021, USA.
Karikoski, N P
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie49, FIN-00014 Helsinki, Finland.
McGowan, C M
  • Institutes of Veterinary Science and Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK. Electronic address: cmcgowan@liverpool.ac.uk.

MeSH Terms

  • Animals
  • Foot Diseases / etiology
  • Foot Diseases / pathology
  • Foot Diseases / physiopathology
  • Foot Diseases / veterinary
  • Hoof and Claw / pathology
  • Hoof and Claw / physiopathology
  • Horse Diseases / etiology
  • Horse Diseases / pathology
  • Horse Diseases / physiopathology
  • Horses

Citations

This article has been cited 27 times.