Equine Laminitis Expert Gives Talk at OVCMarch 2019

Story by: Jackie Bellamy-Zions

OVC Equine Club members were afforded the opportunity to attend a lunchtime lecture on March 14th given by Dr. Lorenzo D'Arpe, a Professor at the University of Bologna in Italy (the oldest University of the west world, founded in 1088 A.D.). D’Arpe, a speaker at global events, including the Bluegrass Laminitis Symposium in Louisville, KY, is highly regarded for his expertise on the topic of Laminitis.

Leading off with the question, Is it really a pump? Dr. D’Arpe discussed the long held belief that the frog is instrumental in pumping blood back up the leg and then shared his studies on circulation in the hoof. In his preliminary studies, he discovered it is the action of P2 that affects circulation squeezing the blood and in more of a hydraulic pump action ending in 2009 formulation, the “5 hearts Theory.” 2014 ended with the “5 Brains Theory” reattributing to the foot the function of a hydraulic shock absorber and discovering that the muscles of the leg influence the blood-flow according to the Human foot-pump theory when static and when in movement.

A venogram of the horse hoofIn 2009 D’Arpe did his thesis on the Standardization of the Clinical Application of Digital Venography in Laminitis. A venogram is an X ray of the foot after contrast media has been injected into the foot’s blood supply, so you can see if there is any compromise of vascular architecture. He discussed the importance of multiple sequential venograms in diagnosis and management of Laminitis, “One is not useful as you need as you will need a second picture to see if P3 is going north or south.” Speed and velocity of degenerative or regenerative process can predict what will happen next. D’Arpe explained, with venograms you can see where the compression is and if the tissue is alive or dead. If there is no blood flow, tissues die. The venogram will let you know if you are in time and make treatment decisions.

D’Arpe touched on his use of the podoblock in conjunction with taking venograms, standing the horses foot on it and changing the foot angles in a controlled manner to evaluate the related changes in the blood flow. He also described corrective shoeing to protect the arterial plexus, with shoes not like a banana but rocked forward. In pathologies, you lose bone if there is no fluid in arterial plexus so it is important to protect it.

D’Arpe shared cases he had been involved with, including one case with an incredible comeback to champion competition after treatment that included 4 months in stall, cryotherapy, and a sling.

A common thread to every case discussed was the importance of speedy diagnosis and following up with venograms to evaluate progress. More on Venography and it’s clinical application in this published study.