Chronic laminitis can be a very difficult disease to treat however by using natural treatments the success rate increases significantly. High levels of anti oxidants are needed until this process is reversed then lower maintenance levels can be used. In analgesic naive horses with chronic laminitis co administration of tramadol and ketamine resulted in significant improvement in off loading frequency forelimb load and plasma levels of a major pro inflammatory cytokine and a critical vasoconstrictor prostanoid 3it is possible that co administration of tramadol with nsaids could result in greater mod ulation of inflammatory responses and superior pain management than when each drug is used alone.
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