Continuous digital hypothermia for prevention and treatment of equine acute laminitis: A practical review

Ronaldo Avella Lavado; Jazlynn Lewis; Julia B Montgomery

doi:10.1016/j.tvjl.2023.106016

Continuous digital hypothermia for prevention and treatment of equine acute laminitis: A practical review

Vet J. 2023 Oct-Dec:300-302:106016. doi: 10.1016/j.tvjl.2023.106016. Epub 2023 Jul 26.

Authors

Ronaldo Avella Lavado¹, Jazlynn Lewis², Julia B Montgomery³

Affiliations

¹ Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada; Department of Medical Clinic, University of São Paulo, São Paulo, SP 05508-900, Brazil.
² Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada; Department of Agriculture, Angelo State University, San Angelo, TX 76909, USA.
³ Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada. Electronic address: julia.montgomery@usask.ca.

PMID: 37507002
DOI: 10.1016/j.tvjl.2023.106016

Abstract

Laminitis is a severely debilitating and life-threatening condition that occurs as a consequence of different primary triggering factors. Continuous digital hypothermia (CDH) is recommended in horses at risk of, or diagnosed with, acute laminitis due to its several physiological and biochemical alterations that may be positive for the prevention and early treatment of the condition, representing a low risk of adverse effects. Modulation of the inflammatory response, profound vasoconstriction, and prevention of tissue damage are the most notable protective effects of cryotherapy on the lamellae. This practical review aims to summarize the published literature evaluating CDH efficacy in the prevention and early treatment of acute laminitis in horses, highlighting the most important clinical findings and discussing the best methods to provide cryotherapy. Nineteen publications evaluated different CDH methods, including the use of commercially available ice boots or fluid bags filled with iced water or crushed ice, as well as alternatives to immersion in ice, e.g., frozen gel packs and a perfused cuff prototype. Although some techniques were effective for cooling and maintaining the hooves below the optimal temperature of 10 °C, relevant limitations such as labor intensiveness, reliance on an ice source and price make its use impractical in some clinical situations. Twelve experimental studies assessed the efficacy of CDH on the prevention or early treatment of laminitis, finding multiple positive effects in terms of clinical improvement, immunological and inflammatory modulation, and histological protection. After the analysis of the literature, the clinical importance of CDH in different stages of laminitis remains clear. However, it also highlights the need for a safer, more user-friendly, and more effective method of cryotherapy that can be used both in a hospital and an ambulatory setting.

Keywords: Continuous digital hypothermia; Cryotherapy; Equine laminitis; Prevention; Treatment.

Publication types

Review

MeSH terms

Animals
Foot Diseases* / prevention & control
Foot Diseases* / veterinary
Horse Diseases* / pathology
Horse Diseases* / prevention & control
Horses
Hypothermia* / therapy
Hypothermia* / veterinary
Hypothermia, Induced* / veterinary
Ice
Inflammation / prevention & control
Inflammation / veterinary

Substances

Ice