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  Discussion on Result Study: LMW Heparin Prophylactic for Post Surgery Laminitis?
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DrO

Posted on Tuesday, Oct 6, 2009 - 12:32 pm:

The more things change the more they stay the same...sort of.

A recent retrospective study found the use of low molecular weight (LMW) heparin was prophylactic for post colic surgery laminitis. Low-molecular-weight heparin consist of short chains of polysaccharide and have an average molecular weight of less than 8000 daltons. Unfortunately the review I read did not give numbers on how effective this treatment was just that the improvement was statistically significant. Time will be needed to verify these results and to see if a more general application is indicated.

Many of the older horse owners probably remember when heparin was considered part of standard therapy for horses with laminitis. The practice has been largely discontinued because of a clinical impression that it did not change the outcome. There is a big difference between preventing a disease and treating it and it could be that the changes that the heparin induced, possibly lower thrombus formation, to lower the incidence and severity are already in place by the time treatment for laminitis is instituted.
DrO
J Vet Emerg Crit Care (San Antonio). 2009 Feb;19(1):113-9.
Evaluation of low-molecular-weight heparin for the prevention of equine laminitis after colic surgery.

de la Rebière de Pouyade G, Grulke S, Detilleux J, Salciccia A, Verwilghen DR, CauDrOn I, Gangl M, Serteyn DD.

Department of Clinical Sciences, Large Animal Surgery, University of Liège, Sart Tilman, 4000 Liège, Belgium. G.delaRebieredePouyade@ulg.ac.be

OBJECTIVES: The aim of this study is to describe the prevalence of postoperative laminitis in colic cases and to determine if low-molecular-weight heparin (LMWH) is effective in preventing this complication. DESIGN: Retrospective clinical study. ANIMALS: Client-owned horses. Interventions- SC administration of enoxaparin during the postoperative period. MEASUREMENTS AND MAIN RESULTS: Medical records of 360 horses undergoing surgery for colic and surviving at least 3 days were evaluated. Fifty-six horses admitted before 1995 did not receive LMWH (control group) and 304 admitted after 1995 received LMWH as a prophylaxis for laminitis (treatment group). Three grades of severity were defined for laminitis. Prevalence and severity of laminitis were compared between the 2 groups. Several parameters recorded on admission (sex, age, breed, site and nature of the disease, heart rate, PCV, gravity score, and shock score) and the administration of LMWH were tested as risk factors in the development of laminitis in a logistic regression procedure. Prevalence and grade of laminitis were significantly lower in the treatment group. Only the absence of LMWH was recognized as a significant risk factor in the logistic regression model. CONCLUSIONS: The administration of LMWH appears to be effective in the prophylaxis of laminitis following colic surgery and may be useful in the postoperative management of these horses.
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