Cryotherapy of the distal limbs: an effective treatment for equine laminitis following onset of lameness?

PICO question In horses with acute laminitis, does cryotherapy of the distal limbs applied after onset of clinical signs lead to improved clinical outcomes compared to horses treated without cryotherapy?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically appraised; there were three randomised, controlled trials, and one retrospective cohort study. Strength of evidence Weak Outcomes reported There were reduced histological changes and lamellar injury in limbs treated with cryotherapy in the randomised controlled trials and reduced clinical severity of laminitis in horses treated with cryotherapy in the retrospective cohort study. Conclusion In horses with acute laminitis there is weak evidence to suggest that cryotherapy of the distal limbs is an effective treatment option when applied following onset of clinical signs. Further randomised, controlled trials should be performed to assess clinical outcomes of cryotherapy in order to draw definitive conclusions.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.