New scale for tracking laminitis progression developed

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A new method of scoring horses and ponies with endocrinopathic-laminitis has been developed.
A new method of scoring horses and ponies with endocrinopathic-laminitis has been developed. Photo by Kyle Mackie

A new scoring method has been shown to be useful for monitoring the progress of cases of endocrinopathic-laminitis.

Endocrinopathic-laminitis or hyperinsulinaemia-associated laminitis (HAL) is a common form of the condition, typically encountered in overweight animals.

Being able to grade the severity of the signs is useful, both for assessing the response to treatment in clinical situations, but also for assessing potential new treatments when they become available.

The 4-point Obel scale has been used for many years to describe the severity of laminitic signs. It was devised for use with severe cases caused by sepsis or starch overload, and may not be as well suited to cases of HAL, which often show a more gradual onset.

The Obel method of laminitis diagnosis and severity grading.
The Obel method of laminitis diagnosis and severity grading (Obel, 1948). (Meier et al)

A new method was developed by Meier and colleagues, which examines five key clinical signs: Weight shifting, response to lifting a foot, gait at the walk and turning in a circle, and palpation of the digital pulse.

The value of this new method was investigated in a randomised controlled field study involving 80 horses and ponies with naturally occurring HAL, seen at 16 veterinary practices in Germany.

Independent veterinarians assessed the severity of laminitis using both the traditional Obel method and the Meier method. Assessments were made on the day of diagnosis then 4, 9, 14, 25 and 42 days later. Pain medications were withheld for 24 hours before clinical examination in all cases.

The ‘modified Obel’ or ‘Meier’ method of laminitis diagnosis and severity scoring.
The ‘modified Obel’ or ‘Meier’ method of laminitis diagnosis and severity scoring. (Meier et al)

The researchers found that the time taken for the laminitis to improve varied between individuals, and was difficult to monitor accurately using the Obel method. The Meier method could identify more subtle changes. They noted that there was considerable variation in the rate of improvement of individual clinical signs. For example, lameness when turning in a circle persisted longer than signs of weight shifting and reluctance to allow the front leg to be lifted.

A report of the work has been published in the journal BMC Veterinary Research. The authors conclude that the Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL.

They suggest that the pattern of improvement described in their study should provide a useful benchmark against which individual cases and new treatments can be assessed.

 

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

The study, published under a Creative Commons License, can be read here

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