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How is Laminil Administered? Perfusion Protocol

Watch a video of the Laminil Perfusion Process

Laminil Perfusion is for veterinary use only and is administered by limb perfusion via injection into the cephalic vein at or above the knee with a tourniquet applied above the injection site. Laminil should be administered to one leg at a time. Apply the tourniquet just above the chestnut and insert the catheter just below the chestnut. Slowly infuse the entire contents of the 70ml vial. Leave tourniquet in place for 30 minutes. Remove tourniquet before removing catheter.

Withhold vasoconstrictors (cryotherapy or ice), anti-inflammatories (phenylbutazone or bute), and other vasodilators for 6 hours before and 6 hours after treatment.

MATERIALS CHECKLIST for two feet

  1. (2) 70 mL vials of Laminil (cromolyn injectable)
  2. (4) Sterile 35cc syringes (2 for each foot)
  3. Sedative to keep the horse calm and still during the perfusion
  4. Isopropyl alcohol to aseptically cleanse the injection area.
  5. (2) 22-23 gauge butterfly Surflo winged infusion sets (catheters)
  6. (2) 4×4 gauze rolls
  7. (1) Tourniquet (Esmach or Kerlix) that is at least 4-inches wide
  8. Tape to secure catheter.

PROCEDURE

  1. Fill and set aside four 35ml syringes with the contents of two 70ml vials of Laminil.
  2. Sedate the standing horse to remain calm and still during the perfusion (about an hour).
  3. Shave and aseptically prepare the injection area with isopropyl alcohol. Do not use iodine solution.
  4. Wrap leg with 4×4 rolled gauze above the chestnut and apply tourniquet over the gauze.
  5. Insert butterfly catheter into the cephalic vein below the chestnut and secure with tape.
  6. Insert syringe in catheter.
  7. Slowly infuse Laminil , taking at least 2 minutes to infuse each of two syringes.
  8. Keep both tourniquet and catheter in place for 30 minutes after infusion.
  9. Remove tourniquet before removing catheter to reduce swelling at the injection site.
  10. Complete the procedure on one leg before administration to second leg. Do not apply tourniquets to both legs at the same time.

After-care

After Laminil perfusion, apply a “standing wrap” or “track bandage”—not a polo wrap—to all four legs to support the suspensory apparatus and fetlock. Refresh and rewrap legs daily until horse can stand comfortably.

Begin daily application of Laminil Transdermal cream to the coronary band, heel, and bulb of the feet.

Apply podiatry to stabilize the hoof capsule and support the sole, which is critically important to the comfort and recovery of the horse with laminitis. Laminil Equimold Podiatry System offers a flexible mold that is easily fitted to the hoof, injected with polymer resin, and removed to leave a custom-made polymer shoe that provides proper support for the laminitic horse. Current radiographs are useful to ensure proper support is provided.

Wait 72 hours before expecting results from the Laminil perfusion, depending on timing. Early diagnosis and treatment improve results. After Laminil stops the inflammatory response, it takes time for the horse to heal, and appropriate shoeing is necessary to support the foot. In most cases, the horse shows signs of improvement 3 days after perfusion. After 7 days with prescribed after-care, the horse’s improvement should be apparent on the Obel Scale. If there’s no improvement after 14 days, re-examination by the attending Veterinarian may be necessary, and another Laminil Perfusion may be appropriate.