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Risk factors for development of acute laminitis in horses during hospitalization: 73 cases (1997–2004)

Corrina Snook ParsonsNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

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James A. OrsiniNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

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Robert KraftyNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

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Linda CapewellNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

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Ray BostonNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

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Abstract

Objective—To identify risk factors for development of acute laminitis in horses during hospitalization for illness or injury.

Design—Retrospective case-control study.

Animals—73 horses that developed laminitis (case horses) and 146 horses that did not develop laminitis (control horses) during hospitalization.

Procedures—Case and control horses were matched in a 2:1 ratio by the date on which each horse was evaluated. Potential risk factors investigated included age, breed, and sex; highest and lowest values recorded during hospitalization for fibrinogen concentration, WBC count, PCV, and total solids concentration; and comorbid disease states, including pneumonia, endotoxemia, diarrhea, medically treated colic, surgically treated colic, pituitary adenoma, retained placenta or metritis, forelimb lameness, hind limb lameness, acute renal failure, and vascular abnormalities. A univariate screening of all potential risk factors was performed to determine which variables should be selected for further analysis. All factors found to be associated with development of laminitis were included in a multivariate conditional logistic regression model.

Results—Development of laminitis was marginally associated with lowest and highest fibrinogen concentrations, highest PCV, and lowest total solids concentration and significantly associated with pneumonia, endotoxemia, diarrhea, abdominal surgery for colic, and vascular abnormalities. In the multivariate analysis, only endotoxemia was significantly associated with laminitis.

Conclusions and Clinical Relevance—Endotoxemia is an important risk factor for development of acute laminitis in horses during hospitalization for medical or surgical conditions. Early recognition of endotoxemia, or the potential for it to develop in certain disease states, and initiation of treatment directed at endotoxemia or its consequences may help prevent laminitis in horses during hospitalization.

Abstract

Objective—To identify risk factors for development of acute laminitis in horses during hospitalization for illness or injury.

Design—Retrospective case-control study.

Animals—73 horses that developed laminitis (case horses) and 146 horses that did not develop laminitis (control horses) during hospitalization.

Procedures—Case and control horses were matched in a 2:1 ratio by the date on which each horse was evaluated. Potential risk factors investigated included age, breed, and sex; highest and lowest values recorded during hospitalization for fibrinogen concentration, WBC count, PCV, and total solids concentration; and comorbid disease states, including pneumonia, endotoxemia, diarrhea, medically treated colic, surgically treated colic, pituitary adenoma, retained placenta or metritis, forelimb lameness, hind limb lameness, acute renal failure, and vascular abnormalities. A univariate screening of all potential risk factors was performed to determine which variables should be selected for further analysis. All factors found to be associated with development of laminitis were included in a multivariate conditional logistic regression model.

Results—Development of laminitis was marginally associated with lowest and highest fibrinogen concentrations, highest PCV, and lowest total solids concentration and significantly associated with pneumonia, endotoxemia, diarrhea, abdominal surgery for colic, and vascular abnormalities. In the multivariate analysis, only endotoxemia was significantly associated with laminitis.

Conclusions and Clinical Relevance—Endotoxemia is an important risk factor for development of acute laminitis in horses during hospitalization for medical or surgical conditions. Early recognition of endotoxemia, or the potential for it to develop in certain disease states, and initiation of treatment directed at endotoxemia or its consequences may help prevent laminitis in horses during hospitalization.

Contributor Notes

Supported by the Spot Castle Fund.

Address correspondence to Dr. Orsini.