Thursday, March 27, 2008

What Might Be the Next Big Hope for Laminitis Therapy?

James Giaccopuzzi


Disclaimer: This post is published as "food for thought" only. Please contact your veterinarian about the possible benefits for individual cases of laminitis and remember that this article is based on a veterinarian's anecdotal experience with its use in a combined medication/therapy program and that this medication's use is countered by other laminitis experts quoted at the end of the article.

The medication's primary use was discovered by accident, during clinical trials. The drug’s active ingredient is a cardiovascular drug that was being tested for its ability to lower blood pressure. Test subjects started asking for more.

Since then, the medication has helped rare Panda bears regain interest in breeding at zoos. The newest hope is that it may be a potent treatment for jet lag. Hamsters recovered from jet lag 50 percent faster than those without it.

Studies at Tufts University's Cummings School of Veterinary Medicine and published by the American College of Veterinary Internal Medicine (ACVIM) found the drug  helpful for dogs with pulmonary hypertension. Veterinary researchers in Turkey found it helpful in canine wound healing.

A quick search of the web suggests that the drug is being tested for EIPH (“bleeder syndrome”) in racehorses and for breeding problems in some stallions in Europe. Horse and Hound reported that a German judge ordered it for a stallion during a post-sale dispute, and in Italy, racehorses have tested positive for the drug.

But what about laminitis?

California's James Giacopuzzi DVM, who started his career as a farrier and now calls himself “a shoeing vet”, strongly recommends it for laminitis therapy.

His treatment regimen for laminitis includes most traditional medications used by other equine-specialist veterinarians, plus the Platinum Performance supplement Hemoflow, in hopes of nitric oxide enhancement.

His therapy is roughly ten days on followed by ten days off, so he can monitor the pulse in the foot. “If the pulse comes back, I put them back on it,” he said.

In a telephone interview with Hoofcare and Lameness Journal, Dr. Giccopuzzi said that he thought about laminitis as a potential application as soon as he read about the drug’s chemical composition. “I started using it on the next founder case,” he said. “And I’ve been using it ever since.” He noted how difficult it was to stimulate blood flow to the damaged capillary beds in the horse’s foot.

I’d rather see people spend money on it for their foundered horses than (to spend it) on Bute,” he said.

He also recommends it for specific cases of sore heels, along with corrective shoeing, when indicated by scintigraphy. “I can see the change in the nuclear scan after 30 days,” he said.

Not everyone agrees it’s worth a try. In May 2007, the Blood-Horse.com conducted an interactive web interview with Dr. Dean Richardson, head of surgery at the George D. Widener Hospital for Large Animals at the University of Pennsylvania’s New Bolton Center.

During that interview, an anonymous Texas veterinarian queried the famous surgeon about the viability of the medication in laminitis therapy, saying that he was having excellent results combining mechanical de-rotation (of the foot) with it (as medical therapy).

Richardson responded: “(It) regulates blood flow in a very specific manner. The problem with (this group of drugs) is that they are highly variable in terms of which tissues they affect and there is also considerable variation among species.

“I don't believe that there is yet any good evidence about efficacy or safety of it or any other commercially available related drug in horses.”

When asked about the potential use for laminitis, researcher David Hood DVM PhD of the Hoof Project in Bryan, Texas was quiet for a minute, then responded, “Well, yes, but we don’t really know. It has never been studied. There are no tests.

“Another drug to consider along those lines,” he continued, “is Minoxidil (Rogaine), the hair-growth treatment. You could make a similar argument for it.”

Thanks to Dr. Giacopuzzi for sharing his success stories and enthusiasm and imagination.

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