Supportive care is intended to alleviate or treat disease-related symptoms and treatment-related side effects. In the context of laminitis, this means we are predominantly talking about horses that are so severely injured that they cannot stand for long periods of time, or are unable to even stand at all. The intensity of this care should not be underestimated; you may wish to consult with your veterinarian about whether your horse would not better off in a veterinary clinic. Let’s have a look at the steps you can take if you do choose to provide supportive care for your horse yourself.
Lying down for too long
Both respiratory and circulatory problems may develop in horses that lie down for a prolonged period of time. One common circulatory-related complication is painful pressure sores (decubitus). Sores might appear at the joints (hip, shoulder, hock, knee, fetlock) and at the head. Every 2 to 3 hours you will need to help the horse change their position. Try to keep the horse in the sternal position as much as possible. If you rug the horse, for their safety use only a spandex horse blanket that is fastened with Velcro. Metal or hard plastic closures can injure the horse. This also applies to the edges and closures of hoof boots.
Apply a thick layer of bedding. Ideally the horse will lie on 30 centimetres of straw or sawdust with a top layer of peat moss. Keep the bedding clean, removing dirt, urine and manure immediately after defecation. Clean the genitals and surrounding skin with lukewarm water and soft soap after urination. Fluff up the bedding a few times a day. If, despite these precautions, there are still pressure sores, clean them with Betadine and apply an oily, non-perfumed skin ointment.
If your horse is wearing hoof boots for an extended period of time, use hoof socks, bandages or tape to protect the coronary band, bulb groove and hoof balls. Socks, bandages or tape should be changed and the heel bulbs checked on a daily basis for any areas of rubbing.
Install an anti-insect lamp to prevent your horse from being attacked by flies and, if necessary, provide a fly mask. Keep his eyes clean; dust particles or sawdust can get into his eyes because of the prolonged recumbence.
A recumbent horse cannot easily lose his heat, so make sure that the ambient temperature is low, especially if it has a fever. If the horse sweats less, the risk of developing pressure sores is lower. Fresh air is also important because dust particles can make breathing more difficult. So, ventilate well.
A horse that cannot get up or reposition itself can easily injure itself. Often it tries to change position by ‘clawing’ with only the front or hind legs. This might result in the horse becoming cast. Attention should be paid if the horse manages to stand up too, as it may fall due to a disturbed sense of balance, due to stiff muscles after lying down for too long or because his feet are too painful. Also, think of your own safety and that of the vet and hoof care practitioner. A falling horse can be dangerous! Make sure that the place where your horse is located is large enough and clear of any objects that could injure it. Cover concrete or brick walls with wood, insulation boards and / or tarpaulin.
Regularly check that your horse is still safe and comfortable. Consider installing an observation camera. Some horses react differently in the presence of people than when they feel they are unwatched. In the latter case, they may show different and / or more pain reactions. In case of an impending coronary band separation or prolapse, some horses nibble their hooves. You will also want to make sure you observe the early signs of a colic caused by lying down for too long.
Nutrition and hydration
It is imperative that the horse is offered high quality hay or soaked beet pulp, a salt lick and fresh drinking water. With a horse that does not stand up, stay seated until it has drunk, after which you should remove the bucket. If he does not want to drink in your presence, retreat and come back later to take the bucket away. You do not want it to be hurt by an empty bucket. Repeat this at least every two hours.
Physical and mental well-being
Pay attention to whether there are changes in physiological characteristics or your horse’s behaviour. Important physiological indicators of a worsening condition include: strong pulse with an increased frequency, muscle tremors, excessive sweating, signs of dehydration, dilated pupils, excessive blood flow to the eye mucosa, widened nostrils, ears stiffly turned backwards, increased respiratory rate, increase in body temperature. Behavioural indicators of concern may include irritability, anxiety, being withdrawn, tired sighing and / or groaning. The degree of pain experience of your horse can be assessed using the ‘horse grimace scale’. Communicate notable changes to any of these physiological, behavioural or pain-related indicators directly to your veterinarian. In particular, changes in the pulse and respiratory rate are important.
Spend time with your ill horse. A prey animal that feels it can no longer flee if needed feels particularly vulnerable. Be there with your horse and provide it with reassurance and encouragement. Social interaction – also with the owner – is of great importance for the mental and emotional well-being of a horse and whoever feels better heals better. Even if this were not true, your own motivation and perseverance in the fight against laminitis will be bolstered.