Throwback Episode: Not All Laminitis Is Created Equal

I was watching what Mother Nature was having transpire and not pushing it one way or the other, you know, hopefully for the good, by anything I was doing.

I was just an observer of the process.

And I think a lot of vets don't admit that to themselves, that they're just an observer of the process that Mother Nature has put on this horse or the pathology that's been, you know, inflicted.

And because of that, then a lot of people in the industry have thought that, you know, laminitis can't be cured or laminitis can't be abated by what we do.

So having those two things, okay, I'm, um, gotta learn more stuff because I'm not helping these horses, and I've gotta learn it from the original person and not get secondhand information from anybody.

And then it's gonna be my responsibility, once I get the firsthand information, it's gonna be my responsibility to apply that information in the same manner, in the same situation that the original clinician or the original inventor, you know, of the idea does, okay? Because I see, you know, again, people blaming a method when really it was them.

And so I use an analogy from veterinary medicine on pharmacology.

There's drugs, gentamicin is a very, very widely used, very good aminoglycoside antibiotic for horses.

And so there's a lot of horses that would be dead right now if aminoglycoside didn't exist.

But also, veterinary medicine had to learn how to use them safely and appropriately.

So gentamicin can destroy the kidneys of a horse if you give it incorrectly.

And in the history of the evolution of how understanding that drug, we thought, "Oh, well, if it's toxic to the kidneys, we better give these little bitty doses multiple times a day so that we don't hurt the kidneys." And [chuckles] what we actually found was, was accurate, was when you do that, you never get a trough.

And the, the low trough within the cycle during the day is what protects the kidneys.

And so when you give those multiple doses, the bloodstream is always remaining above trough, and that's what's toxic to the kidneys.

What's not toxic to the kidneys is one really high peak that then falls below trough before you give another dose.

And so what we found was the opposite of what we thought.

We thought that we better give these little doses, sneak them in there so the kidneys don't notice or whatever.

But what we found to be true is we give this big dose one time a day and let that kill the bacteria and then let time elapse so that we get below trough.

So now we give it once a day, and it's very safe to use.

And so in the timeframe when we were hurting kidneys with that, we didn't just throw up our hands and say, "Gentamicin's a bad drug.

We should never use it." We said, no, we have to modify what we're doing, how we use it, so that we keep it safe.

And so we got to think about that in hoof care.

We can't just use something one time with partial information or use it in the wrong scenario and then throw up our hands and say, "That's a bad idea and we should never do that." You know? And in hoof care, there's no never and there's no always.

And so there's all these different scenarios where different things can work.

And so like on the laminitis cases, you know, I have some slides where watching all this transpire and the different types of laminitis that cause different pathologic failure of the lamina, different methods are gonna be more appropriate than others.