Paradigm shifts in understanding equine laminitis.

Area of Science:

• Equine Health
• Veterinary Medicine
• Pathophysiology

Background:

• Laminitis is a major cause of lameness and debilitation in equids.
• Recent research has shifted the understanding of laminitis from a discrete disease to a clinical syndrome.
• Systemic diseases are increasingly recognized as primary triggers.

Purpose of the Study:

• To re-evaluate clinical and research strategies for equine laminitis.
• To discuss new mechanistic hypotheses and research directions.
• To explore implications for future clinical management of laminitis.

Main Methods:

• Review of current laminitis research and findings.
• Analysis of systemic disease associations (endocrine, sepsis, SIRS).
• Examination of early pathophysiological events, including lamellar cell changes.

Main Results:

• Laminitis is now viewed as a syndrome associated with systemic disease or altered weight bearing.
• Endocrinopathic laminitis is identified as the predominant form in lame animals.
• Early laminitis involves a subclinical phase with lamellar cell stretching and elongation, revising previous basement membrane pathology concepts.

Conclusions:

• Laminitis requires a paradigm shift in understanding and management, focusing on systemic origins.
• New research directions are emerging based on revised pathophysiological insights.
• Clinical strategies must adapt to address the syndrome's systemic and early cellular components.