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.
Publication Date: 2021-01-07 PubMed ID: 33413384PubMed Central: PMC7791853DOI: 10.1186/s12917-020-02715-7Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- 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
Researcher Affiliations
- Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
- Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
- Queensland University of Technology (QUT), School of Biology and Environmental Science, Brisbane, Queensland, 4000, Australia.
- 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.
References
This article includes 30 references
- Luthersson N, Mannfalk M, Parkin TD, Harris P. Laminitis: risk factors and outcome in a group of Danish horses.. J Equine Vet Sci 2017;1(53):68–73.
- Wylie CE, Collins SN, Verheyen KL, Newton JR. A cohort study of equine laminitis in Great Britain 2009-2011: estimation of disease frequency and description of clinical signs in 577 cases.. Equine Vet J 2013 Nov;45(6):681-7.
- Menzies-Gow NJ, Harris PA, Elliott J. Prospective cohort study evaluating risk factors for the development of pasture-associated laminitis in the United Kingdom.. Equine Vet J 2017 May;49(3):300-306.
- Patterson-Kane JC, Karikoski NP, McGowan CM. Paradigm shifts in understanding equine laminitis.. Vet J 2018 Jan;231:33-40.
- Asplin KE, Sillence MN, Pollitt CC, McGowan CM. Induction of laminitis by prolonged hyperinsulinaemia in clinically normal ponies.. Vet J 2007 Nov;174(3):530-5.
- de Laat MA, McGowan CM, Sillence MN, Pollitt CC. Equine laminitis: induced by 48 h hyperinsulinaemia in Standardbred horses.. Equine Vet J 2010 Mar;42(2):129-35.
- Meier AD, de Laat MA, Reiche DB, Pollitt CC, Walsh DM, McGree JM, Sillence MN. The oral glucose test predicts laminitis risk in ponies fed a diet high in nonstructural carbohydrates.. Domest Anim Endocrinol 2018 Apr;63:1-9.
- Obel N. Studies on the histopathology of acute laminitis. 1948.
- McGowan C. The role of insulin in endocrinopathic laminitis.. J Equine Vet Sci 2008;28(10):603–607.
- Pollitt CC. Equine laminitis.. Clin Tech Equine Pract 2004;3(1):34–44.
- van Eps A. General clinical aspects of the laminitis case.. Equine Laminitis 2017;6:183–190.
- Meier A, de Laat M, Pollitt C, Walsh D, McGree J, Reiche DB, von Salis-Soglio M, Wells-Smith L, Mengeler U, Mesa Salas D, Droegemueller S, Sillence MN. A "modified Obel" method for the severity scoring of (endocrinopathic) equine laminitis.. PeerJ 2019;7:e7084.
- Wylie CE, Shaw DJ, Verheyen KL, Newton JR. Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study.. Vet Rec 2016 Apr 23;178(17):420.
- Hunt RJ, Wharton RE. Clinical presentation, diagnosis, and prognosis of chronic laminitis in North America.. Vet Clin North Am Equine Pract 2010 Apr;26(1):141-53.
- Orsini JA, Parsons CS, Capewell L, Smith G. Prognostic indicators of poor outcome in horses with laminitis at a tertiary care hospital.. Can Vet J 2010 Jun;51(6):623-8.
- Gardner AK, van Eps AW, Watts MR, Burns TA, Belknap JK. A novel model to assess lamellar signaling relevant to preferential weight bearing in the horse.. Vet J 2017 Mar;221:62-67.
- van Eps AW, Pollitt CC. Equine laminitis induced with oligofructose.. Equine Vet J 2006 May;38(3):203-8.
- Pollitt CC. Basement membrane pathology: a feature of acute equine laminitis.. Equine Vet J 1996 Jan;28(1):38-46.
- Al Naem M, Litzke LF, Failing K, Burk J, Röcken M. Hoof kinetic patterns differ between sound and laminitic horses.. Equine Vet J 2021 May;53(3):503-509.
- Pollard D, Wylie CE, Newton JR, Verheyen KLP. Incidence and clinical signs of owner-reported equine laminitis in a cohort of horses and ponies in Great Britain.. Equine Vet J 2019 Sep;51(5):587-594.
- Walsh DM, McGowan CM, McGowan T, Lamb SV, Schanbacher BJ, Place NJ. Correlation of plasma insulin concentration with laminitis score in a field study of equine Cushing's disease and equine metabolic syndrome.. J Equine Vet Sci 2009;29(2):87–94.
- de Laat MA, Reiche DB, Sillence MN, McGree JM. Incidence and risk factors for recurrence of endocrinopathic laminitis in horses.. J Vet Intern Med 2019 May;33(3):1473-1482.
- Meier A, Reiche D, de Laat M, Pollitt C, Walsh D, Sillence M. The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies.. PLoS One 2018;13(9):e0203655.
- . 2018 ACVIM Forum Research Report Program. Seattle, Washington, June 14 - 16, 2018.. J Vet Intern Med 2018 Nov;32(6):2123-2143.
- Kheder MH, Sillence MN, Bryant LM, de Laat MA. The equine glucose-dependent insulinotropic polypeptide receptor: A potential therapeutic target for insulin dysregulation.. J Anim Sci 2017 Jun;95(6):2509-2516.
- Carroll CL, Huntington PJ. Body condition scoring and weight estimation of horses.. Equine Vet J 1988 Jan;20(1):41-5.
- Fitzgerald DM, Anderson ST, Sillence MN, de Laat MA. The cresty neck score is an independent predictor of insulin dysregulation in ponies.. PLoS One 2019;14(7):e0220203.
- Comets E, Lavenu A, Lavielle M. SAEMIX: stochastic approximation expectation maximization (SAEM) algorithm, vol. 1: R package version. 2011.
- Kuhn E, Lavielle M. Maximum likelihood estimation in nonlinear mixed effects models.. Comput Stat Data Anal 2005;49(4):1020–1038.
- Akaike H. Selected papers of Hirotugu Akaike. A new look at the statistical model identification. 1974; pp. 215–222.
Citations
This article has been cited 2 times.- 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.
- 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.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
