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When I was younger I really wanted a Swiss Army knife. I mean really, what kid wouldn’t? It's a knife AND scissors AND a nail file AND tweezers AND there is even a fake plastic toothpick! But as we were taught, with great tools comes great responsibility and Swiss Army knives weren’t just given out on a whim. I can’t remember which birthday it was (9th or 10th) when I finally got the small black Classic SD. But there was a trade off; if I was old enough to receive the coveted multi-tool device that also meant I was old enough to mow the lawn. So to me, mowing the lawn was part of an important rite of passage. I was now deemed responsible enough for not only a small sharp object, but a large, sharper motorized one!  And I enjoyed mowing the lawn, the challenge of getting it started (holding the pull cord with two hands and throwing myself back with all my might), the instant gratification, the smell of fresh cut grass. So when we moved to our current house, that sits on ¼ acre with a small fenced in backyard, I was happy to volunteer for lawn trimming services….until I met our mower.
“Its great,” he said. “It's a real mower.”  “As opposed to a ‘fake’ mower?” I responded. “No, a R-E-E-L mower,” he said with a smile. And then I saw it. It is a modern version of the old fashioned, non-motorized, blades spin in a circle in some scissor like motion, who even knows how the grass gets cut, probably what Tom Sawyer used after he was done white-washing Aunt Polly’s fence, mower. To get it to work, the blades have to be moving fast enough for it to cut the grass, rather than just bend it over, which (without a motor) takes a bit of work, and in such a tiny yard as ours, there’s not a lot of room to get a running start. And if the grass is too long it won’t work, you have to raise the blades, cut it once, lower the blades and cut it again! That is NOT what I consider instant gratification. But as much as I complain and refuse to ever help out in the yard (this also has to do with Chiggers, which we do not have where I grew up and who consider me a delicacy), the reel mower is cheaper (no gas/oil), quieter (he has no excuse not to listen to me while he mows) and is much better for the grass. So that now, just a week into spring, our lawn is thick and lush and needs to be mowed (by someone other than me) at least once a week.

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Rotation of the coffin bone.
And while it is beautiful to look at, fresh, thick lush grass can also be dangerous. Pasture associated laminitis begins to occur after the growth of grass in the spring. In cases of laminitis, the lamina separates between the pedal bone (P3) and the inner hoof wall causing unrelenting pain and characteristic lameness. It is the most serious disease of the equine hoof that leads to devastating loss of function and sometimes loss of the horse. While there are many different conditions that can lead to laminitis, pasture associated laminitis, or “grass founder” can be traced back to the high sugar content of the grass.

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When a horse takes in a large meal containing sugars, they develop a temporary inflammatory condition in the GI tract called “carbohydrate overload.” Starch and sugars are normally digested and absorbed in the stomach and small intestine. The transit time through this portion of the GI tract is about 90 minutes and with a balanced meal, most of the carbohydrates will be absorbed before the feed passes into the cecum and large colon. However, if the meal is too high is sugars, too many sugars enter the small intestine and instead of being properly absorbed, some pass through to the large colon. This leads to a shift in fermentation and acidity of the colon contents and allows dangerous toxins to leak out of the gut into the bloodstream. There is also a large spike in glucose and insulin in the blood stream.  These toxins, inflammatory substances, glucose and insulin reach the hoof and contribute to the formation of laminitis. Prevention of pasture associated laminitis can be as simple as limiting your horses’ access to lush grass.

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However, some horses and ponies are more likely to develop laminitis (have a lower threshold) after consuming a high starch/sugar meal and require more than just limiting turnout time to prevent laminitis. All ponies and some breeds of horses (Warmbloods, Morgans and all “easy keepers”) are genetically predisposed to develop Equine Metabolic Syndrome (EMS). EMS is a disease characterized by obesity, abnormal fat deposition (crest neck, fat around tailhead and above eyes) and insulin resistance (IR). The cells in overweight horses stop responding to insulin and therefore cannot process sugars normally. Because of this, smaller amounts of grass may trigger a laminitic event in these animals. Diagnosis of EMS can be made by clinical signs, body weight and body measurements, and blood testing (insulin and glucose). Once an animal is diagnosed, the condition can be treated with diet, exercise and in some cases, medication.  Dietary recommendations include removing all concentrates (grain) from the diet (or feeding specially formulated low starch feeds), feeding grass hay only (no alfalfa) and limiting access to pasture. Any horse or pony who is obese, considered an “easy keeper,” or who has had a previous laminitic event should be tested for EMS. Equine Cushing’s disease can also lower the threshold for laminitis in horses on pasture. Older horses (>15 years) and horses with clinical signs of Cushing’s (curly haircoat, cresty neck, potbellied appearance, recurrent laminitis) should be tested and appropriately treated. These horses often have IR concurrently and testing for EMS is warranted in all cases of Cushing’s. Horses can be easily treated for Cushing’s disease with daily medication. Like EMS cases, Cushing’s horses should be managed even more carefully on pasture in the spring and summer.

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The following suggestions are just a few things you can do to prevent pasture associated laminitis and keep your horses happy and sound throughout the spring and summer.

  1. Identify the horses and ponies who are at a higher risk of developing laminitis. Test “easy keepers,” geriatric horses and those with a history of laminitis for EMS and/or Cushing’s Disease.
  2. Treat any predisposing condition with diet, exercise and proper medications.
  3. For horses with a lower threshold, consider a zero grazing environment, such as a dry lot (while providing the horse with suitable forage alternatives).
  4. Limit turnout of pasture when grass is lush and when fructans are high.
  5. Turn horses out to pasture when fructan levels are likely to be at their lowest, such as from late night to early morning, removing them from the pasture by mid-morning.
  6. Employ the use of grazing muzzles to allow horses out on pasture but still limit their intake of grass.
  7. Maintain pastures regularly to prevent grass from becoming mature and stemmy (they contain high levels of fructans). 


If you have any questions about pasture associated laminitis and whether your horse is at a higher risk, contact your veterinarian for proper testing and specific recommendations that will work for you.

 
 
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The old saying goes, “No hoof, no horse” and truer words have never been spoken. Any horse owner knows that trouble starts from the bottom up and hoof issues can put you on the sidelines for far too long. This is a problem that one of my clients is facing. Her horse is suffering from White Line Disease (WLD) in all four feet and while her farrier and local veterinarian are doing exactly the right things to get her back in the saddle, as a graduate of both the Beginner and Advanced Equine Education Courses she has a thirst for knowledge and asked me for a little more information on the process. And I thought I would share my answer with all of you.     White line disease is a problem of the equine hoof that is seen throughout the world and is still poorly understood by the veterinary and farrier community.  It is characterized by the separation of the inner zone of the hoof wall. This separation that occurs on the solar surface of the hoof can begin at the toe (which is where the old layman’s term “seedy toe” comes from) or the quarter or the heel. The area of separation is then invaded by bacteria and fungus from the environment (remember the separation starts on the bottom of the hoof, which spends most of its time in the dirt). The separation, and infection, can progress proximally up the hoof wall towards the coronary band. Interestingly, the coronary band never becomes infected, which is why the term onychomycosis (a nail bed infection in humans or dogs) is inappropriate to use when describing WLD.

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In vet school I was lucky enough to learn equine orthopedics from Dr. Dean Richardson, the surgeon who cared for Barbaro, and if there is one thing every Penn Vet grad remembers about equine orthopedics, its that you have to know your ANATOMY, ANATOMY, ANATOMY! (though all capital letters cannot truly convey the emotion, or volume, with which DWR screamed this during lectures).
So to understand WLD better, lets review the ANATOMY of the hoof as it pertains to this problem. The Solar Surface of the Hoof     The hoof wall consists of three layers; the stratum tectorium (external layer), the stratum medium (the middle layer), and the stratum lamellatum (the inner layer). The stratum tectorium is the thin layer of cells that give the wall its smooth shiny appearance. The stratum medium forms the bulk of the wall and is the densest part of the hoof wall. The stratum lamellatum arises from the laminae, is nonpigmented, and is responsible for attaching the hoof wall to the third phalanx, and is what gives us so much trouble in cases of laminitis or founder. The junction where the sole attaches to the wall of the hoof is formed by interdigitation of lamellae and horny tubular tissue. This is the area known as the White Line, though in real life it is often yellow in color.

So how does separation occur between the sole and the hoof wall? And the question most owners ask, “Why is this happening to my horse?” While there are a lot of theories out there about what causes WLD, none of them have been confirmed. It can affect horses of any age, sex or breed. It can affect one foot or a combination of all four. Horses with shoes get WLD and barefoot horses get WLD. Horses in every country can be affected and you may have one case on a farm or multiple ones. Mechanical stresses that are constantly being put on the hoof can contribute to the separation and chronic hoof problems and poor conformation may also be a cause.     Some people believe that moisture plays a role because, just like Scratches, it is so often seen in horses that spend time in wet paddocks or show horses who are bathed daily. However, it is also seen in arid climates. Moisture may soften the foot, allowing easier access for bacteria and debris, but hot, dry conditions make hooves prone to cracking, allowing the microbes to invade. And don’t try to blame the housekeeper, because WLD is seen equally in areas of poor hygiene as well as clean, well-managed stables.
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Not all horses that have WLD will become lame. It is often an incidental finding at a routine farrier appointment. However when the separation becomes so extensive that there is destabilization of the whole hoof, horses will become sore. The diagnosis is made by your vet or farrier examining the hoof and investigating if there is a gap between the hoof wall and the inner structures. Radiographs (x-rays) can be very helpful because they show the extent of the damage and if there are any other structural problems with the hoof or the coffin bone.

Treatment involves opening up the spaces by removing the overlying hoof wall (with a dremel tool). Once every cavity is exposed, topical antiseptics can be used judiciously (no more than once or twice a week) to clear up the infection. Afterwards corrective shoeing will help support the hoof while it regrows the resected portions. Acrylic can be applied to the area to prevent recontamination, or for cosmetics, but should only be used once the infection is completely resolved. 

    Because we don’t know the exact cause, it’s difficult to make recommendations on how to prevent WLD. But daily hoof care on your part and proper trimming and shoeing performed by a well-trained farrier is the first step to recognizing a problem early on. Horses that have had WLD should be monitored all the more closely as the can have spontaneous recurrence of the disease.

            So keep your eyes open and your horse’s feet well cared for and you can stay on the trail or in the ring without problems!
 

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