A comparison of seven methods for continuous therapeutic cooling of the equine digit.
Authors: van Eps, Orsini
Journal: Equine veterinary journal
Summary
# Editorial Summary: van Eps & Orsini (2016) — Equine digit cooling methods compared Therapeutic digit cooling shows promise for both preventing and treating laminitis, yet the efficacy of methods routinely used in clinical practice had not been systematically evaluated. Van Eps and Orsini compared seven commercially available cooling devices plus a prototype perfused cuff by measuring hoof wall surface temperature (HWST) continuously over 8 hours in four horses using a crossover design with adequate washout periods. Results revealed striking differences in cooling capacity: immersion methods covering the foot and extending at least to the pastern achieved the most aggressive cooling, with the ice boot reaching median HWST of just 2.7°C and the fluid bag 5.2°C, whilst dry-interface ice packs confined to the foot achieved only 19.8–21.5°C, and devices covering the distal limb without the foot failed to cool effectively (25.7°C). A prototype perfused cuff with dry interface performed comparably to immersion methods at 5.4°C, suggesting technological innovation may improve practical cooling without the complications of water immersion. For practitioners, these findings underscore that cooling efficacy varies dramatically between methods—those targeting laminitis prophylaxis or acute therapy require full foot immersion or equivalent technology to achieve the sustained temperatures (<10°C) likely necessary for therapeutic effect, whereas commonly used ice packs or partial-coverage devices may provide inadequate protection.
Read the full abstract on PubMed
Practical Takeaways
- •Full immersion of the foot and pastern in ice-water is the most effective cooling method clinically, achieving temperatures below 10°C needed for laminitis therapy
- •Dry ice packs applied only to the foot are largely ineffective; if using dry methods, ensure coverage extends to include distal limb, though results remain inferior to immersion
- •Method selection significantly impacts cooling efficacy—ensure your chosen protocol includes foot submersion or prototype perfused devices, not just distal limb coverage alone
Key Findings
- •Ice and water immersion methods including the foot and extending to at least the pastern achieved the lowest hoof wall surface temperatures: 2.7°C for ice boot and 5.2°C for fluid bag
- •Dry interface ice pack applications confined to the foot only resulted in median HWST of 19.8-21.5°C, significantly higher than immersion methods
- •A prototype perfused cuff device with dry interface achieved sustained HWST of 5.4°C, comparable to immersion methods
- •Ice boots excluding the foot but covering distal limb resulted in inadequate cooling with HWST of 25.7°C