Laminitic horses benefit from botox
August 29, 2009
Some of the more serious complications of laminitis could be prevented through a new patented technique.
A lameness and laminitis study carried out by the United States Department of Agriculture found that in a one-year period, 2 per cent of horses are affected with the debilitating hoof condition. About 5 per cent of affected horses die or are euthanized, and a further 20 per cent suffer permanent damage.
Increased tension in the deep digital flexor tendon is implicated in the changes that occur within the foot.
Treatment of laminitis often includes trying to reduce the pull of the tendon on the pedal bone. This may be by means of shoeing, or by cutting the tendon.
Dr Daniel Carter, of West Florida Veterinary Associates, in Gulf Breeze Florida, and Dr Ben Renfroe, of the Child Neurology Centre of Northwest Florida, have developed a new procedure to reduce tension in the tendon.
The technique, which they described in the Journal of Equine Veterinary Science, involves injecting a diluted solution of botox (Botulinum toxin type A) into the deep digital flexor muscle in several places.
The skin is clipped and aseptically prepared before injection To make sure the muscle is injected correctly, they monitor the procedure with an electromyograph (EMG).
The botulinum toxin blocks the release of the neuro-transmitters from the nerve endings. This temporarily prevents the muscle contracting.
The report said the clinical changes are first noted about two days later, with peak benefit in about two weeks. The effects gradually wear off after about three months.
Carter and Renfroe described several laminitis cases that they have treated using this technique. They feel that the technique has promise, so much so that they have patented it so no-one can use it without authorisation.
"Administering botulinum toxin type A in our hands was safe and effective for the treatment and prevention of laminitis," they concluded. "Botulinum toxin chemically denervates the muscle belly, affecting the pull of the deep digital flexor tendon. The deep digital flexor muscle-tendon unit relaxes and decreases the pull on the palmar aspect of the distal phalanx, mimicking a deep digital flexor tenotomy."
The temporary nature of the botulinum toxin provides an intervention that is effective yet temporary, permitting the horse to return to a more normal routine after recovery from the laminitis.
They suggest that further work, including controlled studies, should be carried out to further assess the value of the technique.
A novel approach to the treatment and prevention of laminitis: Botulinum Toxin Type A for the treatment of laminitis.
DW Carter, JB Renfroe.
J Equine Vet Sci (2009) 29, 595 - 600.