Lameness of the Horse / Veterinary Practitioners' Series, No. 1

by John Victor Lacroix

Fig. 34—Showing the effects of laminitis. By permission, from Merillat's "Veterinary Surgical Operations."

Treatment.—Much depends upon the concomitant disturbances (or causes if one is justified in referring to them as such) as to the manner in which laminitis is to be treated. In all cases where digestive disturbances exist, the prompt unloading of the contents of the alimentary canal is certainly indicated. D.M. Campbell[31] in a discussion of laminitis has the following to say regarding the treatment of such cases:

Because superpurgation may be followed by laminitis, the advisability of using the active hypodermic cathartics is questioned. Neither arecolin nor eserin can cause superpurgation. The action of the former does not continue longer than an hour after administration and of the latter not more than eight hours. The action of either is mild after the first few minutes.

I do not think that anyone has recommended either arecolin or eserin where there is severe purgation. Where the intestinal canal is fairly well emptied and its contents fluid, I should be inclined to rely upon intestinal antiseptics to hold in check harmful bacterial growth.

The use of alum in the treatment of laminitis is held to be without reason other than the empirical one that it is beneficial. If laminitis is due chiefly to an autointoxication, good and sufficient reason for the administration of alum can be shown based upon its known physiological action. It is the most powerful intestinal astringent that I know of and has the fewest disadvantages. I have not noted constipation following its use nor diarrhea, nor a stopping of peristalsis, nor indigestion, and in any case its action lasts at most only a few hours, and if it did all these, it could not much matter. Quitman says, that it constricts the capillaries. If this is true, a thing of which I am not certain, is it not reasonable to suppose that as with other vaso-constrictors, e.g., digitalis, there is a selective action on the part of the capillaries (not of the drug) and those that need it most, i.e., those of the affected feet in laminitis, are constricted most? All body cells exert this selective action in the assimilation of food, the tissue needing most any particular kind of food circulating in the blood, gets it.

Our first consideration in laminitis should be to remove the cause—to stop the absorption of the toxin in the intestinal tract that is producing the condition. This we accomplish by partially unloading it by the use of the active hypodermic cathartics and stopping absorption by the surest and most harmless of intestinal astringents. Whether the astonishingly prompt and certain action of alum in this case is due wholly to its astringent action or whether alum combines with the harmful bacterial products chemically and forms an innocuous combination, I can only surmise, and it is unimportant. At any rate, when alum is administered, the onslaught of the disease is promptly stopped. Irreparable damage may already have been done if the case is a neglected one, but whether administered early or late in acute attacks, the progress of the disease is stopped immediately.

The same authority may be profitably quoted in the matter of handling all cases wherein the revulsive effect of agents which diminish vascular tension are chiefly indicated or necessary as adjuvants. In this connection, Campbell says:

The early and vigorous administration of aconitin in laminitis to its full physiological effect, is more logical. Assuming that laminitis is due to absorption of harmful products from the intestinal tract permitted through the deranged functioning of the organs of digestion, or assuming that it is due to an extension of the inflammation from the mucosa to the sensitive lamina, or that it is a reflex from a sudden chilling of the skin, we have in any of these conditions a disturbed circulation, and aconitin is the first and foremost of circulation "equalizers." Furthermore, in laminitis there is an elevation of the temperature, an almost invariable indication for aconitin. A speedy return of the temperature to normal, a very marked diminution of the pain and improved conditions generally, appear coincident with the symptoms of full physiological effect of aconitin when given in cases of laminitis, which constitutes assuredly an important part of its treatment.