Continuous digital hypothermia initiated after the onset of lameness prevents lamellar failure in the oligofructose laminitis model

Authors
A. W. van Eps, C. C. Pollitt, C. Underwood, C. E. Medina-Torres, W. A. Goodwin and J. K. Belknap
Date
Sept 2014
Journal
Equine Veterinary Journal
Volume
46
Number
5
Pages
625-630

Reasons for performing study

Prophylactic digital hypothermia reduces the severity of acute laminitis experimentally but there is no evidence for its efficacy as a treatment once lameness has already developed.

Objectives

To investigate the therapeutic effects of digital hypothermia, applied after the onset of lameness, in an experimental acute laminitis model.

Study design

Randomised, controlled (within subject), blinded, experimental trial.

Methods

Eight Standardbred horses underwent laminitis induction using the oligofructose model. Once lameness was detected at the walk, one forelimb was continuously cooled (CRYO), with the other forelimb maintained at ambient temperature (NON-RX). Dorsal lamellar sections (proximal, middle and distal) harvested 36 h after the onset of lameness/initiation of cryotherapy were analysed by 2 blinded observers: laminitis pathology was scored (0 [normal] to 4 [severe]) and morphometric analyses performed.

Results

Median (interquartile range) histological scores were greater (P<0.05) in NON-RX (proximal 2.8 [2.5–4]; middle 3.5 [2–4]; distal 2.5 [2–3.8]) compared with CRYO limbs (proximal 0.5 [0.5–1.4]; middle 1 [0.6–1]; distal 0.75 [0.5–1]). There was complete physical separation of lamellar dermis from epidermis (score of 4) in 4 of the NON-RX feet at one or more section level(s), which was not observed in any CRYO sections. Histomorphometry was thus limited to sections that remained intact; there was a trend of increased total (TELL) and secondary (SELL) epidermal lamellar length and decreased secondary epidermal lamellar width (SELW) in NON-RX limbs compared with CRYO at all 3 levels; differences were significant (P<0.05) for SELL and SELW in the distal sections.

Conclusions

Digital hypothermia reduced the severity of lamellar injury and prevented lamellar structural failure (complete dermoepidermal separation) when initiated at the detection of lameness in an acute laminitis model. This study provides the first evidence to support the use of therapeutic digital hypothermia as a treatment for acute laminitis.