Prophylactic digital cryotherapy is associated with decreased incidence of laminitis in horses diagnosed with colitis

Kullmann, A.; Holcombe, Susan J.; Hurcombe, Samuel D.A.; Roessner, H. A.; Hauptman, Joe G.; Geor, Raymond J.; Belknap, James K.

doi:10.1111/evj.12156

Cited by 67 publications

(66 citation statements)

References 28 publications

(49 reference statements)

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“…In study subjects in which laminitis was induced using various models of SRL, marked increases in a wide range of proinflammatory mediators were detected when compared to nonseptic control horses 4, 5, 6, 7, 8. Similar to the reports from the use of moderate regional hypothermia (approximately 30°C) in human patients to limit damage to vital organs in cases of inflammatory injury, continuous marked digital hypothermia (5–10°C) limited the structural failure of the lamellae both in horses with clinical sepsis and in experimentally induced laminitis 7, 9, 10, 11, 12. Initiation of cryotherapy at the time of oligofructose (OF) administration (before the onset of sepsis or lameness) has been linked to a marked decrease in expression of molecules associated with inflammatory signaling when compared to limbs maintained at ambient temperature 7.…”

supporting

confidence: 69%

Effect of Delayed Digital Hypothermia on Lamellar Inflammatory Signaling in the Oligofructose Laminitis Model

Dern

Watts

Werle

et al. 2017

Veterinary Internal Medicne

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BackgroundIn the oligofructose (OF) model of sepsis‐related laminitis (SRL), digital hypothermia (“cryotherapy”) initiated before the onset of clinical signs is reported not only to limit lamellar injury, but also to cause marked inhibition of lamellar inflammatory signaling.Hypothesis/ObjectivesBecause hypothermia also has been reported to be protective when not initiated until the onset of lameness in the OF model of SRL, we hypothesized that the lamellar protection conferred by hypothermia is caused by local lamellar inhibition of inflammatory signaling as described when hypothermia was initiated earlier in the disease process.AnimalsEight Standardbred geldings aged 3–11 years with no lameness and no abnormalities of the feet detectable by gross or radiographic examination.MethodsUsing the OF model of SRL, lamellar mRNA concentrations of proinflammatory cytokines, chemokines, and endothelial adhesion proteins were compared between samples from treated limbs (CRYO, submerged in ice water for 36 hour starting at the onset of lameness), untreated limbs (NON‐CRYO, opposite limb from CRYO limbs maintained at ambient temperature), and untreated limbs from normal horses in which laminitis was not induced (CON).ResultsAlthough OF administration resulted in increases in lamellar mRNA concentrations of several inflammatory mediators in NON‐CRYO limbs (vs CON), digital hypothermia had no significant effect on these increases.Conclusions and Clinical ImportanceThe lack of inflammatory inhibition in lamellar tissue samples in our study indicates that the protective effects of digital hypothermia instituted at the onset of clinical signs of laminitis do not arise from inhibition of inflammatory pathways.

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supporting

confidence: 69%

Effect of Delayed Digital Hypothermia on Lamellar Inflammatory Signaling in the Oligofructose Laminitis Model

Dern

Watts

Werle

et al. 2017

Veterinary Internal Medicne

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“…Just as in human medicine, the common practice of applying cold therapy has been used over many years almost universally to prevent and reduce inflammation and injury in the equine limb (Ramey, 1999). For example, cryotherapy is considered an important aspect in the treatment of acute laminitis in the horse (Kullmann et al, 2014). However, while there are several different types of cold therapy , there has been little research done to provide empirical evidence towards the efficacy of the practice of applying cold therapy with the use of ice boots on the distal limb of the horse.…”

Section: Introductionmentioning

confidence: 99%

“…While it is well documented that cryotherapy is beneficial in the treatment of laminitis (Kullmann et al, 2014), there is little information available to support the widespread use of ice boots. The objective of this study is to determine the effects of a commercially available cold therapy on the equine limb.…”

Section: Introductionmentioning

confidence: 99%

Thermodynamic effects of commercially available ice boots

Quintanar¹,

Millar²,

Burd³

2018

Open Vet J.

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The limb of the equine athlete is subjected to all types of various stressors during exercise. To ensure the health of the horse and to prevent the possibility of lameness, it has been a common practice to apply cold therapy to the distal limb of the horse pre-and post-exercise. Commercially available boots are widely available for the application of cold therapy. To test the effectiveness of the boot, 6 healthy performance level sport type horses were exercised at a walk, trot, and canter in a round-pen and then subjected to the application of the ice boot for 20 minutes on a treatment leg, and no ice boot on an untreated leg. Thermal images were taken of the 3 rd metacarpal region pre-exercise, postexercise, post-ice boot, and every 2 minutes after until the difference between the temperatures of the control leg and the treatment leg became zero. The images were analyzed using an analysis software (FLIR Tools) to determine the average temperature of the 3 rd metacarpal region at each time point. The measured temperatures between treatments were found to be significantly different due to the application of the ice boot, providing evidence that the boot sufficiently cools the leg (P<.01). Thereafter, a 95% confidence interval was created to depict the average time it took for the cooled leg to return to average temperature post-ice boot, suggesting that it takes about 14.67 minutes for the difference between the temperatures of the cooled leg versus the non-cooled leg to become zero. This finding is significant to horse owners, trainers, and veterinarians that use this commonly available tool. These findings lend evidence to support the common practice of using cold therapy in treatment of disease in the horse.

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“…89 Continuous digital hypothermia, or cryotherapy, is the sole intervention that has been proven effective in preventing and treating early stages of SIRS-induced laminitis both experimentally and clinically. 99,100 In addition to shoe modifications designed to minimize the biomechanical strain on compromised digital laminae, management strategies for both the treatment and prevention of laminitis should be directed at mitigating the likely inciting cause.…”

Section: Diagnosismentioning

confidence: 99%

Musculoskeletal Pathology

Peat

Kawcak

2015

Veterinary Clinics of North America: Equine Practice

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The current understanding of pathology as it relates to common diseases of the equine musculoskeletal system is reviewed. Conditions are organized under the fundamental categories of developmental, exercise-induced, infectious, and miscellaneous pathology. The overview of developmental pathology incorporates the new classification system of juvenile osteochondral conditions. Discussion of exercise-induced pathology emphasizes increased understanding of the contribution of cumulative microdamage caused by repetitive cyclic loading. Miscellaneous musculoskeletal pathology focuses on laminitis, which current knowledge indicates should be regarded as a clinical syndrome with a variety of possible distinct mechanisms of structural failure that are outlined in this overview.

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Prophylactic digital cryotherapy is associated with decreased incidence of laminitis in horses diagnosed with colitis

Abstract: Laminitis occurred in more clinically compromised horses. Use of ICE reduced the incidence of clinical laminitis in the study population suggesting that digital cryotherapy is an effective prophylactic strategy for the prevention of laminitis in horses with colitis.

Cited by 67 publications

References 28 publications

Effect of Delayed Digital Hypothermia on Lamellar Inflammatory Signaling in the Oligofructose Laminitis Model

Effect of Delayed Digital Hypothermia on Lamellar Inflammatory Signaling in the Oligofructose Laminitis Model

Thermodynamic effects of commercially available ice boots

Musculoskeletal Pathology

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