Laminitis
The laminitis ( laminitis ) is occurring in ungulates disease. It is an aseptic diffuse inflammation of the hoof dermis, whereby the hoof capsule becomes detached from the dermis. Acute laminitis is an emergency and requires immediate treatment; in extreme cases it can lead to shoing . The chronic deer can lead to a coffin bone rotation .
causes
Laminitis can have several causes. What they have in common is that they disrupt the microcirculation of the blood in the area of the corium .
The load row is caused by overloading the hoof. It is mainly triggered by long walking on hard ground ( deer ) or by overloading a hoof e.g. B. after immobilizing the opposite leg. Long stall phases can also lead to deer due to the disruption of blood circulation that this triggers ( stable deer ).
The Futterrehe is the most widely used and laminitis is caused by incorrect feeding. A diet rich in carbohydrates promotes the development of metabolic disorders. Structureless, carbohydrate-rich feed (e.g. grain ) leads to an explosion of streptococci (carbohydrate-splitting bacteria ) in the large intestine and to a massive release of lactic acid . This causes a mass death of the crude fiber-digesting bacteria, a release of toxins ( endotoxins ) and over- acidification in the entire organism. Similarly, in the case of deer, the intestinal flora can probably be damaged and endotoxins released through the ingestion of large amounts of cold water . Contrary to previous assumptions, increased protein intake does not lead to laminitis.
A Geburtsrehe can by remaining small parts of the placenta in the uterus occur. This leads to bacterial decomposition and the absorption of endotoxins into the bloodstream.
When Vergiftungsrehe in the gut similar operations are triggered as in Futterrehe. Poisoning can occur when ingesting poisonous plants such as B. vetch , black locust , castor and acorns as well as herbicides , fungicides , pesticides , molds , fungal spores and snakebite . Occasionally, however, vaccinations and wormer cures are also the triggers for deer poisoning if there is a massive parasite infestation and large numbers of parasites die. Here there is an incubation period of 2 to 21 days.
Certain medications can be the cause of drug deer. Cortisone preparations are particularly suspected .
Roe deer can also develop as a sequel or concomitant disease to Cushing's syndrome , thyroid disease , men’s cycle disorders (permanent steed or absent steeds ), colic (poisoning through colon fermentation ) and intestinal inflammation as a result of diarrheal diseases and as a result of hyperlipidemia (increased blood lipids) or cross- breeding. Electricity or lightning strikes can also cause local inflammation and thus deer.
Pathogenesis
In the hoof it is pathogenic to an inflammation , which is a local blood flow disorder with outlet of tissue fluid and solid components ( blood cells comes) from the blood vessels of the dermis leaves. There is an edema and swelling. This leakage of fluid causes extreme pain due to the lack of expansion in the hoof . In addition, the leakage of liquid promotes the detachment process of the zipper-like interlocking dermis (inside) from the epidermis (outside).
In the early phase, an adrenaline release leads to a narrowing of the arterioles with a reduced blood flow (lasting only a few seconds to minutes). In the 2nd phase, the arterial spasm dissolves under the influence of the vegetative nervous system , which results in local blood overflow ( hyperemia ). Finally, so-called mediators lead to the narrowing of the venules with blood stasis, which is associated with sludge phenomena , platelet aggregation , thrombosis , permeability disorders and exudation .
If the inflammation persists for 48 hours, one speaks of chronic deer. The consequences can be a sinking of the coffin bone into the capsule, a rotation of the hoof around the coffin joint with the coffin bone tip tending towards the ground, or a combination of the two variants.
In heavy deer, the tip of the coffin bone exerts strong pressure on the sole. The tip of the coffin bone evades the pressure from below by deforming ( ski tip ) or by breaking down bone substance. In even more severe cases, the tip of the coffin bone breaks through the sole (coffin bone breakthrough).
The final stage is the shoing, in which the hoof capsule comes off completely. The majority of vets recommend releasing the animal at this stage. Here, too, healing is theoretically possible. With conventional treatment, however, the horse has to spend up to 2 years of its life mainly lying and hanging. The success of the therapy cannot be guaranteed.
Symptoms
At the beginning, a rather cool hoof than normal can be seen. However, since this condition only lasts within minutes, this first symptom is rarely noticed. If inflammation has already occurred, a warmer hoof is observed. The coronet is slightly swollen. The horses show a clammy, restrained gait, i. H. the steps become short and flat, later stiff. The stiffness of the movements becomes particularly evident when the horse turns tightly. Increased pulsation of the toe arteries can be felt on the back of the fetlock . When palpating the sole with the hoof examination pliers , there is increased pain.
If all four legs or only the front legs are affected by the deer, the horse places the rear legs forward under the stomach and shifts the weight to the hindquarters and the heels (ball of the foot). If the hind legs are diseased, the horse brings the front legs far back under the stomach, lowers the head as a counterweight and alternately loads the hind feet. If only one leg is affected, it will hold it up.
As a sign of the general disorder, there is an increase in breathing (normally 8–16 / min at rest) and pulse rate (normally 30–44 per minute), possibly with a fever (> 38.4 ° C). Other signs are frequent lying down, pain, anxiety and restlessness.
Acute laminitis is classified according to a four-stage model:
- Grade 1: At rest, the horse alternately lifts the hooves. There is no lameness in the walk, the gait is short and stiff at the trot.
- Grade 2: The horse walks willingly but stiffly forwards. Picking up a foot is possible without difficulty.
- Grade 3: The horse is extremely reluctant to move and fiercely refuses to attempt to lift a foot.
- Grade 4: the horse refuses to move. It can only be made to work by force. Eating may also be stopped due to excessive pain.
Immediate action
The immediate notification of a veterinarian is a top priority for deer.
Immediate and sustained cooling of the affected hooves with bare ice (ice cubes) is ideal. A sock is put on the horse beforehand and this is filled with ice - up to the coronet. Tests have shown that the horse does not suffer any frostbite even with long-term cryotherapy. Once started, however, the cooling process must not be interrupted. The horse is out of the acute hoof thrust when no more pulsation can be felt in the fetlock. With this method, horses suffering from an acute hoof flare can be brought out of the acute phase within 48–72 hours. Cooling with tap water is not enough because the temperature of tap water is not low enough. Studies by Christopher Pollitt / Andrew Van Eps from the University of Queensland / Australia have shown that the best results can be achieved with temperatures of 2 ° Celsius and less. In the case of sensitive horses, the crook of the fetlocks must be protected from mudguards with Vaseline.
After consultation with the veterinarian, acetylsalicylic acid can be administered if the arrival of the veterinarian takes several hours due to other emergencies .
An immediate change in feed is recommended for all types of deer, not just for feeder deer. Only hay and possibly straw should be fed. In the acute phase of the roe deer and for prophylaxis, it is advisable to use roughage with a low feed value (low fructan concentration , e.g. oat straw and seasoned hay) as the main food or to reduce the amount of hay and replace it with straw. High-pregnant (9th to 11th month) and lactating mares should, as they have an increased energy requirement, receive high-fat supplementary feed, as these do not cause deer activity according to the latest findings. The enzyme bromelain (in kiwis and pineapples ) is also assigned a protective function.
If possible, the horse should be placed on a soft surface and stress should be avoided at all costs. If transport is necessary, the hooves can be padded with sponges or bandages.
Therapy by the vet
In the case of acute deer, the focus is on promoting blood circulation and pain therapy . Here, for example, acepromazine , heparin (which can demonstrably prevent the formation of deer), Ginkgo biloba and acetylsalicylic acid used. Diuretics can reduce edema in the early stages by draining water . In addition, detoxifying (liver therapeutics) and kidney stimulating substances as well as homeopathic remedies can be administered, for which there is no proof of effectiveness.
Chronic reforms require the clarification of the changes by means of x-rays or computed tomography images.
Deer plaster
There are three types of deer plaster. The point is to completely relieve the painful, damaged toe by shifting your weight to the heel area and counteracting the pull of the deep flexor tendon in order to prevent or stop the associated rotation of the coffin bone.
- The lower deer cast is only applied to the hoof for light deer, with the advantages described above. It can easily be attached directly to the stable for immediate therapy.
- The middle deer cast already pulls the fetlock head to bear the body weight . The plaster of paris is laid around the entire hoof up to the fetlock to support the hoof below.
- The high deer gypsum is necessary for even more severe deer changes. This is attached to below the pastern joint in order to achieve a better distribution of the load. The medium and high rehe cast can and should only be applied under clinical conditions, as this requires difficult, absolute accuracy and a suspension device or several strong hold-ups and immediately accessible special tools for removing the incorrectly seated cast.
Rehegips make high demands on everyone involved. Changes in pressure under the sole can go unnoticed and unsupervised, chafing points with a risk of infection can be caused by the plaster of paris and the absolutely important cooling of the toe is not possible or only with difficulty. There is also an additional risk of injury from tripping. In addition, the structure of a deer cast should not be overwhelmed, especially with medium and high deer cast, otherwise it no longer has the supporting function in the desired form after a short time, as it bears the entire weight of the horse.
Bloodletting and leech therapy
During bloodletting , amounts of up to 5 liters of blood are drawn, depending on the size and weight of the horse. The correct amount is calculated as follows: 9% of the horse's body weight is blood, 10% of this amount of blood can be removed. However, the blood draw is usually kept at the lower limit in terms of quantity in order to avoid the risk of circulatory collapse . The exact mechanism of action is unknown.
Another so-called holistic method for treating deer is the local application of leeches . At least four leeches are placed on the coronet along the affected hoof.
There is no scientific proof of effectiveness for either process.
Treatment by various hoof workers (farrier, hoof trimmer, hoof orthopedist, hoof technician, hoof healer)
The farrier takes over the removal of the irons, if this is feasible, the production of a floating toe , the shortening or heightening of the heels, the milling of expansion joints, the production of a punctual hole, the removal of the stern horn and the attachment of a deer shoe.
Shorten or raise the heels
This is one of the biggest topics of controversy when it comes to laminitis. Some call for the heels to be raised immediately from the acute phase to complete healing. The others advocate shortening the costumes to a greater or lesser extent.
An increase in heel is indicated by the fact that the pull of the deep flexor tendons is reduced and the load is shifted to the less diseased areas of the vessels and sclera of the heel. Opponents of the heel elevation lead to the change of direction of the coffin bone tip downwards, an increased load on the suspension apparatus and coffin bone carrier and the reduced hoof mechanism and the reduced blood flow to the hoof.
For a heel shortening speaks the weight shift on the heels, which corresponds to the natural behavior of a deer horse and whose correct anatomical shape can be derived from the horse hooves of wild horses that have not been treated by humans. The shortening of the heel leads to a coffin bone that is more parallel to the ground, the shifting of weight onto the shortened heel strengthens the hoof mechanism and thus promotes better blood circulation and healing of the diseased dermis.
Wedges
The use of wedges is controversial, they have a number of disadvantages.
So-called weld -on wedges lead to an increase in the weight of the fitting, especially in the traditional costume area, and thus often cause a clear tendency towards traditional costume feet. However, they increase the punctual pressure on the heels under load and the deformation of the same ( heels pushed under ).
Wedges also have negative effects. The regrowing traditional costumes are pressed into the plastic wedge. The sinking of the heels into the wedge material acts as a mechanical brake on the hoof mechanism. Particularly in the case of hard horn qualities, there can be disconnections of the horn such as crevices, hollow and loose walls.
Resection of the dorsal hoof wall
Extensive corrective measures are required when cutting out a deer's hoof, and excess hoof horn must be removed. The goal of the dorsal hoof wall resection is to let the growth of the newly formed horn grow as closely as possible parallel to the coffin bone.
The floating toe
During the healing process, stress on the damaged toe should be avoided. The easiest way to do this is to remove the front toe wall at a right angle. This can also be done by an iron letting air at this point, but not by nailing the iron upside down. The minimum size is 3 mm floating, 5 mm is ideal.
Expansion joints and punctual holes
Both methods, the milling of expansion joints (two joints that extend from approx. 1 cm below the coronet to the base) and punctual drilling (milling a hole below the coronet) serve to reduce pressure. The horn is removed right up to the dermis and, if necessary, pierced with a sterile cannula. This allows the accumulated fluid to escape, the pain is immediately relieved and the loosening of the interlocking between the dermis and epidermis is reduced.
Barefoot trimming according to Straßer
The method of hoof trimming according to Hiltrud Straßer does not belong to evidence-based medicine . Strasser barefoot trimming leads to the overwhelming number of hoof diseases such as laminitis, inflammation of the hoof, lameness of unknown origin, positional errors in the joints of the horse's leg and various metabolic diseases, in a large number of cases due to an anatomically incorrect hoof shape and the negative consequences of hoofing.
The therapy of laminitis according to Straßer is carried out by attempting to restore a good supply of nutrients to the hoof dermis by removing the horseshoe and an anatomically correct cutting of the hoof, which is supposed to facilitate the hoof mechanism again and thus serve the healing of the damaged tissue. In most cases, the use of painkillers is not considered expedient because, according to Strasser, they lead to reduced blood flow and also switch off the body's own pain control loop, so that the newly formed tissue is immediately overloaded again. In contrast to traditional therapy, in which stall rest is usually prescribed, with Straßer the free movement of the deer-sick horse is part of the therapy, as this is seen as a prerequisite for a successful healing process.
The street method is controversial. In any case, it is essential to obtain a comprehensive assessment with X-rays from a veterinarian before the first treatment of the hooves.
Deer shoeing
Various shapes of horseshoes are used in deer shoeing . Alternatively, plastic fittings, adhesive shoes, artificial horn or buckle-on hoof boots can be used.
Movement of deer-sick horses
Proponents cite the circulation-promoting effect of movement under forced herd by conspecifics. The forced movement of 10 minutes per hour on soft ground while walking during the first 24 hours is also recommended in some plants. However, the opponents warn of the mechanical impact on the already damaged hanging device and the resulting irreparable damage. The natural protective function of pain is also cited, on the basis of which it is intended to specifically prevent the horse from loading the hoof. The majority of laminitis vets call for absolute restraint from the start.
Chances of recovery
The chances of recovery always depend on the degree of the disease, so a comprehensive examination by a veterinarian is essential. Age, accompanying symptoms, previous and additional illnesses, the ability to walk before and after the deer disease also play a role. If necessary, you can obtain additional security by obtaining a second opinion. A farrier who has experience in this area is also a good contact.
The scar horn, as a widening of the white line , forms a lamellar wedge between the dermis and the outer wall of the hoof when laminitis has survived. If this widening becomes gradually narrower, it means that the lamellar wedge grows out and the coffin bone resumes approximately its original (unrotated) position. In heavy deer, the coffin bone sinks so far into the hoof capsule that strong pressure is exerted on the sole. This then leads to a downward curvature of the sole (full hoof).
On the basis of so-called reheringe , the onset of the disease and its further course can be determined. The onset of the disease is visible as an extended groove, the horn above it, which otherwise grows down in parallel rings, now diverges in the area of the heels. If the deer survived, this can also be recognized by the rings that have grown down normally again. However, this only happens when comprehensive, continuous therapy is carried out.
With a coffin bone rotation of up to 5.5 °, the horse is likely to be able to work normally, with a rotation of 5.5–11.5 ° this is no longer as safe and with a rotation of over 12 ° a future use appears as Riding horse as unlikely.
The experts make the question of the prognosis for a horse sick with deer (and thus the question of the later rideability) dependent not so much on the degree of coffin bone rotation, but on the changes in the horse's living environment after the deer appeared. According to this method, which is not recognized by conventional medicine, it should be possible to anchor a lowered coffin bone or a second and third degree rotated coffin bone again with a healthy and stable suspension on the wall horn, if the negative environmental factors in the horse's habitat are eliminated. These include: incorrect hoof trimming of any kind (whether shoeing or barefoot), lack of herd husbandry (whereby a low-ranking horse should not be chased by the others), lack of controlled movement incentives, stalls. The healing process can take months and possibly years, depending on the previous damage and the course of the disease, complete healing of the disease is possible with a good prognosis if the owner behaves consistently and regularly corrects the diseased hoof. However, conventional medicine assumes that a horse with deer sickness does not have normal footing due to the pain in the dermis and thus itself contributes to an aggravation of the disease.
prevention
A species-appropriate attitude such as sufficient freedom of movement on a correspondingly large area and group housing as well as avoidance of stress and daily hoof care can avoid some triggering factors. To protect against deer poisoning, poisonous plants and mushrooms should be removed from the willows.
For the prophylaxis of deer, the afterbirth must not be pulled out and after its departure it must be checked for completeness. If this detachment of the afterbirth does not take place within 2 hours, a veterinarian should be notified.
To avoid stress rotation, trot and gallop should be avoided on hard surfaces. After long or strenuous rides and transports, the legs can be cooled or rubbed with rubbing alcohol or special gels. Bandaging of the stressed leg is recommended to prevent deer in the case of one-sided overload. It may be useful to hang up the horse for a short time in a suitable holder.
Obesity must be avoided at all costs for the prophylaxis of deer. Feed rich in crude fiber such as seasoned hay and oat straw should always be preferred. When feeding silage, the composition of the fresh grass is important, as grasses such as ryegrass and clover have a high proportion of water-soluble carbohydrates and thus also of fructan, which are responsible for the formation of deer. Pasture grass is subject to daily and seasonal fluctuations. Overgrown grass is best for deer horses. According to the nutritional value of the pasture, pasture area and grazing times should be coordinated with the needs of the horse. New feed should first be given in small quantities, a feed change must always be made slowly.
literature
- Romo Schmidt, Ulrike Häusler-Naumburger, Thomas Dübbert: Laminitis . Avoidance - early detection - healing ; Cham: Müller Rüschlikon, 2002; ISBN 3-275-01443-9
- Christopher Pollit: Color Atlas Huf. Anatomy and clinic ; Hanover: Schlueter, 1999; ISBN 3-87706-536-8
- Fritz Rödder: Healthy hoof - healthy horse. Guidance, practice, case studies ; Rüschlikon-Zurich, Stuttgart, Vienna: Müller, 1982; ISBN 3-275-00754-8
- Hiltrud Straßer: Laminitis: manifestations, causes and treatment ; Kirchentellinsfurt, Knirsch, 2003; ISBN 3-927091-65-0
- Konstanze Rasch: Diagnosis of laminitis ; Müller Rüschlikon, 2014; ISBN 978-3-275-01752-2
- Olivia Bickerle: The Leech - Parasite or Medical Miracle? The Hirudo medicinalis in animal naturopathy illustrated using the example of the horse , 2012, print: CreateSpace , ISBN 1-4781-1962-4
