Fig. 118 illustrates the effects of a severe ostitis in pedal bones removed from hoofs with laminitis of several weeks’ standing.

(e) Chronic Laminitis.—­The most common complication—­or, perhaps, rather we should term it ’sequel’—­to acute laminitis is the chronic form of the disease.  For this condition we have reserved a separate section of our work.  It will be found described in Section B 1 of this chapter.

Diagnosis and Prognosis.—­One is almost tempted to state that the diagnosis of laminitis offers no difficulty.  In the very early stages, however, it may, as we have already indicated, be mistaken for the oncoming of Enteritis, Lymphangitis, or even Pneumonia.  The paddling of the feet may help us.  If this is absent, however, nothing but a most careful examination, or, if necessary, the withholding of our opinion until the following visit will prevent a blunder being made.

Even when well established, laminitis has been mistaken for paralysis, for tetanus, for rheumatic affections of the loins, or even for some undiscovered affection of the muscles of the arms and chest.  This latter is no doubt suggested to the uninitiated by the reluctance the animal shows to move the muscles apparently of that region, and led the older writers to give to the disease its name of ‘Chest-founder.’  It is only fair to add, however, that these blunders in diagnosis are nearly always committed by persons without a veterinary training.

Thus warned, the veterinary surgeon of average ability should have no difficulty in establishing a distinction between the diseases we have enumerated as likely to be confounded with it, and the one this chapter is describing.

The prognosis in laminitis should, in our opinion, always be guarded.  No advice given in a work of this description can be of any real use, for every case must be judged entirely on its merits.  The severity of the symptoms, the cause of the attack, the complications, and the idiosyncrasies of the patient, have all to be taken into account.  These the veterinarian must be left to judge for himself.

Treatment.—­The treatment of acute laminitis in its early stage must be based upon the fact that we have to deal with a congested state of the circulatory apparatus of the whole of the keratogenous membrane.  This fact was well enough known to the older veterinarians.  It is not surprising, therefore, to learn that jugular phlebotomy was at once resorted to as the readiest means of relieving the overcharged vessels of their blood.  As a matter of fact, bleeding from the jugular is still advocated by modern authorities.  We cannot say, however, that we unhesitatingly recommend it.  Mechanically, of course, the removal of a large quantity of blood is bound to result in a lowering of the pressure in the vessels.  The effect, however, is but transient.  Blood removed in this way is again quickly returned to the vessels so far as its fluid matter is concerned, and the pressure, removed for a time, is again as great as before.  With the other and more vital constituents of the blood-stream—­namely, the corpuscles—­restoration is not so rapid.  We have, in fact, a weakened state of the system, in which it is probable it will not so successfully combat the adverse conditions the disease may induce.