CHRONIC laminitis commences when structural changes occur within the digit as a result of the pathophysiological processes outlined in Part 1 of this article (In Practice, September 2006, volume 28, pp 434–443). Chronic laminitis may develop rapidly as a progression from acute or subacute laminitis or over months or years without prior evidence of digital pain or lameness. The clinical presentation is determined by the degree of laminar separation and any secondary pathologies that occur. The diverse nature of the disease has led to the development of definitions based on clinical findings to allow more precise description and evaluation of cases. This article discusses the management of chronic equine laminitis, and provides some guidelines on assessing prognosis. Treatment options for acute laminitis were reviewed in Part 1.
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