The crusade continues. This month's magazine focuses on the 14th Annual Laminitis Symposium, held January 25-27th in Louisville, Kentucky. Ever since a lanky horseshoer from Lubbock, Texas (the late, and sorely missed, Burney Chapman) shattered the accepted protocols of veterinary research, i.e., as a farrier lecturing to veterinarians instead of just listening to them, the disease has had to face a two-front war-one from research veterinarians and the second from farriers working in the field. Laminitis is not the leading killer of horses, but the leading crippler. It is also one of the most frustrating and expensive illnesses in the animal world. It's a disease that loves to tease the practitioners that have to deal with it. A little sore today, better next week, dead in a month or two. It takes monumental perseverance to specialize in this malady.

The Laminitis Symposium, established by Dr. Ric Redden in 1987, took Burney Chapman's groundbreaking leap one step forward. Instead of one man burning up a lot of jet fuel sharing his ideas with others, the Symposium brought everybody together at the Galt House in Louisville, Kentucky. To complete the analogy, the hotel became Command Central for the duration of the war. And like Burney's tireless approach, Redden considered every opinion priceless-scientific or layman's, or somewhere in between. This disease lives under a microscope, but it also roams the pastures and paddocks of the world, profiting from the same immunity once granted to polio, a disease that has virtually disappeared.

One of the most potentially important lectures delivered at the Symposium was by Napa, California, farrier Matt Frederick. Frederick noted a connection between "unresponsive (refractory) laminiti[ic] cases" and Cushing's Syndrome, technically known as hyperadrenocorticism, taking note of the relationship to diabetes mellitus, or Type I diabetes, as well. Endocrinology is a tough science on a good day. Yet we know that carbohydrate loading plays a role, that corticosteroids have been implicated, and that a vast majority of the cases probably have a glucose or insulin sensitivity-perhaps unknown prior to the onset, but an undeniable element in both the acute and post-acute stages. Cushing's Syndrome has been studied extensively in dogs, implicating pituitary tumors as one of the leading factors. Diabetes mellitus involves the pancreas, thyroid and pituitary glands. Both diseases involve insulin assimilation or the ability to process carbohydrates (or sugars) properly.

What does all this mean? It goes to the core definition of laminitis: a systemic disease, minus the wiring diagram. While a great deal of focus must be on the tertiary aspect- after the catastrophe-prevention is the ultimate goal. Somewhere in this large, complex organism, some molecular inconsistency sets the ball in motion. Most diseases, like cancer, are cellular in origin, too small to be seen until the host is already sick. In the search for the laminitic `trigger,' no discipline should be overlooked, no opinion discarded. Thanks to the efforts of Dr. Ric Redden, Burney Chapman and many others, this monster will someday be conquered.

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