Chronic laminitis: current treatment strategies.

Summary

# Chronic Laminitis: Current Treatment Strategies Parks and O'Grady examine the management of horses progressing beyond acute laminitis, typically from 2–4 weeks post-onset onwards, when the inflammatory crisis has subsided but structural damage to the laminae necessitates longer-term therapeutic intervention. Their review synthesises treatment approaches that address the chronic phase—characterised by ongoing lamellar failure, hoof capsule deformation, and the risk of distal phalangeal rotation or sinking—which requires fundamentally different strategies than the emergency protocols applied acutely. The authors emphasise that successful chronic management integrates farriery interventions (including bar shoes, rocker modifications, and palliative trimming), targeted analgesia, dietary manipulation, and in some cases surgical techniques to stabilise the distal phalanx and restore biomechanical function. Understanding the transition from acute to chronic laminitis as a distinct clinical phase has substantial implications for practice: it shifts the focus from preventing progression to optimising recovery trajectory, reducing secondary complications such as infection and contracture, and informing realistic prognosis discussions with owners about timescales measured in months rather than weeks. For equine practitioners across disciplines, this framework clarifies why acute crisis management alone is insufficient and highlights the necessity of coordinated, phase-appropriate protocols to maximise functional outcomes.

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Key Findings

• •Laminitis progresses through four distinct phases: developmental, acute, subacute, and chronic
• •Chronic laminitis treatment begins after acute phase therapy ends, typically 2-4 weeks post-onset of clinical signs
• •Distinction between acute and chronic phases is critical for appropriate treatment strategy selection

Conditions Studied