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BMC veterinary research2021; 17(1); 16; doi: 10.1186/s12917-020-02715-7

The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting.

Abstract: Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a 'normal' pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, using two different scoring methods. Eighty horses and ponies with suspected HAL were enrolled in a study conducted at 16 veterinary practices across Germany. The severity of laminitis was assessed by independent veterinarians using both the traditional Obel method and a modified Obel method developed by Meier and colleagues. Assessments were made on the day of diagnosis (d 0), then on days 4, 9, 14, 25 and 42 during the intervention period. Pain medications were withheld for 24 h prior to clinical examination in all cases. Results: Time to marked improvement from laminitis varied between individuals, but was difficult to monitor accurately using the Obel method, with the median grade being 2/4 on days 0 and 4, then 0/4 from d 9 onwards. More subtle changes could be identified using the Meier method, however, and the median scores were seen to follow the form of an exponential decay model in most horses, improving from 8/12 on d 0, to 0/12 on d 25. Within this composite scoring method, considerable variation was observed in the rate of improvement of individual clinical signs, with the average time taken for each sign to reach a median score of 0 ranging from 4 days (foot lift and weight shifting) to 25 days (gait when turned in a circle) across all 80 horses. Conclusions: The Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL, and despite the variability, the pattern of improvement described here should provide a useful benchmark against which individual cases and new treatments can be assessed.
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Publication Date: 2021-01-07 PubMed ID: 33413384PubMed Central: PMC7791853DOI: 10.1186/s12917-020-02715-7Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research evaluates a new method of scoring laminitis in equines, a common and incapacitating foot disease. The study aims to understand the disease’s natural progression and its response to treatments, using both traditional and modified scoring methods in 80 horses and ponies across Germany. The modified method shows more accurate monitoring of improvements in clinical signs over time, providing a reliable benchmark for assessing individual cases and new treatments.

Objective and Methodology of the Research

  • The research aimed to develop a better, more reliable and consistent method to monitor the clinical signs of laminitis, a common foot disease in horses
  • The researchers assumed that by understanding the natural progression of the disease, they could design and evaluate the effectiveness of new treatments more accurately
  • The study involved 80 horses and ponies with suspected equine endocrinopathic laminitis (EEL) across various veterinary practices in Germany
  • The severity of the disease was assessed using two different methods: the traditional Obel method and a modified version of it developed by Meier and colleagues
  • The assessments were done at different intervals: on the day of diagnosis, then on the 4th, 9th, 14th, 25th, and 42nd day. All horses were not given pain medications 24 hours prior to the clinical examination

Results of the Study

  • The findings demonstrated that the traditional Obel method was challenging to monitor accurately. The median grade was a score of 2 out of 4 on day zero (the day of diagnosis) and day 4, then a score of zero from the 9th day onwards
  • In contrast, the Meier method allowed for more sensitive tracking of changes. The median scores followed an exponential decay model, improving from an 8 out of 12 on day zero to a 0 on day 25
  • With the Meier method, variations were observed in the rate of improvements in individual clinical signs. Time taken for each sign to reach the median score of zero ranged from 4 days for foot lift and weight shifting, to 25 days for gait when turned in a circle, across all 80 horses

Conclusions

  • Altogether, the study concludes that the Meier method offers a dependable and consistent approach for monitoring the clinical status of horses suffering from EEL
  • Despite the observed variability, the Meier method gives insight into the pattern of improvement, providing a useful benchmark against which individual cases and new treatments can be assessed

Cite This Article

APA
Meier A, McGree J, Klee R, Preuß J, Reiche D, de Laat M, Sillence M. (2021). The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting. BMC Vet Res, 17(1), 16. https://doi.org/10.1186/s12917-020-02715-7

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 17
Issue: 1
Pages: 16
PII: 16

Researcher Affiliations

Meier, A
  • Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
McGree, J
  • Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
Klee, R
  • Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
Preuß, J
  • Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
Reiche, D
  • Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
de Laat, M
  • Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
Sillence, M
  • Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia. martin.sillence@qut.edu.au.

MeSH Terms

  • Animals
  • Disease Progression
  • Female
  • Foot Diseases / veterinary
  • Germany
  • Hoof and Claw / pathology
  • Horse Diseases / pathology
  • Horses
  • Hyperinsulinism / veterinary
  • Lameness, Animal
  • Male
  • Severity of Illness Index

Conflict of Interest Statement

RK, JP and DR are employees of the company that funded this research: Boehringer Ingelheim.

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Citations

This article has been cited 2 times.
  1. de Tonnerre DJ, Medina Torres CE, Stefanovski D, Robinson MA, Kemp KL, Bertin FR, van Eps AW. Effect of sirolimus on insulin dynamics in horses. J Vet Intern Med 2023 Mar;37(2):703-712.
    doi: 10.1111/jvim.16650pubmed: 36840433google scholar: lookup
  2. Sillence M, Meier A, de Laat M, Klee R, Reiche D. Demographic, morphologic, hormonal and metabolic factors associated with the rate of improvement from equine hyperinsulinaemia-associated laminitis. BMC Vet Res 2022 Jan 18;18(1):49.
    doi: 10.1186/s12917-022-03149-zpubmed: 35042535google scholar: lookup
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