Horse health guide
Horse laminitis
Signs, causes, treatment, recovery and prevention
Horse laminitis is an extremely painful condition affecting the sensitive laminae that support the pedal bone inside the hoof. Without prompt treatment, these attachments can weaken and allow the pedal bone to rotate or sink within the hoof capsule.
Treat it as a veterinary emergency. Call your vet immediately and do not force your horse to walk.
Horse laminitis at a glance
The essential information
What is it?
Damage and inflammation affecting the laminae that attach the hoof wall to the pedal bone.
Is it an emergency?
Yes. New or worsening signs of laminitis require immediate veterinary advice.
What commonly causes it?
Insulin dysregulation associated with EMS or PPID is a major cause, but severe illness and supporting-limb overload can also trigger it.
Can a horse recover?
Many horses recover, particularly when treatment begins early and there is little or no displacement of the pedal bone.
Act immediately
What to do if you suspect horse laminitis
Laminitis can deteriorate rapidly. Early veterinary assessment, pain relief, hoof support and treatment of the underlying cause can make a significant difference to the outcome.
Call your vet immediately
Describe the horse’s stance, movement, digital pulses, hoof temperature and any recent illness, dietary change or access to grain.
Do not force the horse to walk
Turning, trotting or repeatedly walking a painful horse can place additional strain on already weakened laminae.
Restrict movement and grass access
If the horse can move comfortably, place them in a stable or small sheltered area with deep, supportive bedding. If they cannot move, make them comfortable where they are.
Do not starve the horse
Remove access to grass, grain and high-starch feeds, but do not withhold all forage. Your vet or equine nutritionist should advise on suitable forage and quantities.
Ask about cooling and hoof support
Your vet may recommend continuous cooling of the lower limbs and immediate sole or frog support, depending on the cause and stage of the condition.
Give medication only as directed
Do not administer leftover painkillers or alter prescribed medication without speaking to your veterinary surgeon.
Understanding the hoof
What is laminitis in horses?
Laminitis is a painful disease of the laminae, the interlocking tissues that suspend and support the pedal bone inside the hoof capsule.
Healthy laminae form a strong connection between the inner surface of the hoof wall and the pedal bone, also called the coffin bone or distal phalanx. When these tissues become damaged, that connection can weaken.
In more serious cases, the pull of the deep digital flexor tendon and the horse’s weight can contribute to rotation or downward displacement of the pedal bone.
Severe displacement may compress the sensitive structures beneath the bone and, in extreme cases, the tip of the pedal bone can threaten or penetrate the sole.
Laminitis and founder
The word founder is often used interchangeably with laminitis, particularly in the United States. More precisely, founder usually describes a severe or chronic consequence of laminitis in which the pedal bone has rotated or sunk.
Early recognition matters
Signs and symptoms of laminitis in horses
Laminitis does not always begin with the dramatic rocked-back stance commonly shown in photographs. Early cases can be subtle and may first appear as stiffness, shortened steps or reluctance to turn.
Changes you may notice now
Changes that can develop over time
Why laminitis develops
What causes laminitis in horses?
Laminitis is a syndrome rather than a single disease. The damage occurs in the feet, but the trigger often begins elsewhere in the horse’s body.
Endocrinopathic laminitis
This is the most common form and is associated with abnormal insulin regulation. It commonly occurs in horses and ponies with equine metabolic syndrome, PPID or both.
- Equine metabolic syndrome
- Insulin dysregulation
- PPID, also known as equine Cushing’s disease
- Obesity or regional fat deposits
- Pasture or feed high in sugar and starch
Sepsis-associated laminitis
Severe inflammatory illness can release mediators and toxins that damage the laminae. These horses are often already seriously unwell.
- Severe colitis or diarrhoea
- Serious colic or intestinal disease
- Retained placenta after foaling
- Severe pneumonia or systemic infection
- Endotoxaemia
Supporting-limb laminitis
A horse with severe pain or injury in one limb may overload the opposite limb for a prolonged period. This excessive weight bearing can damage the supporting foot.
- Fracture or major limb injury
- Severe joint or tendon damage
- Persistent non-weight-bearing lameness
- Inadequate support of the opposite limb
Carbohydrate overload
Sudden access to large quantities of grain or concentrate can disrupt the hindgut and trigger severe systemic inflammation and laminitis.
- Breaking into a feed room
- Rapid dietary changes
- Large quantities of cereal-based feed
- Unaccustomed access to rich grazing
What about corticosteroids?
Corticosteroid treatment may increase laminitis risk in some predisposed horses, particularly those with insulin dysregulation. This does not mean prescribed steroids should be stopped independently. Discuss the individual risks and benefits with your vet.
The metabolic connection
EMS, PPID and insulin dysregulation
Many cases of horse laminitis are linked to an exaggerated insulin response rather than grass acting as a direct poison.
Equine metabolic syndrome is characterised by insulin dysregulation, an increased risk of laminitis and often, although not always, excess body fat or regional fatty deposits.
PPID is a progressive hormonal disorder that is more common in older horses and ponies. Possible signs include delayed coat shedding, a long or curly coat, muscle loss, increased drinking and urination, recurrent infections and laminitis.
Some horses have both PPID and insulin dysregulation. Blood testing may therefore include an assessment of insulin regulation and tests for PPID.
Veterinary assessment
How horse laminitis is diagnosed
Diagnosis combines the horse’s history, physical examination, assessment of the feet and, where appropriate, diagnostic imaging and blood testing.
Clinical examination
Your vet may assess stance, gait, turning, digital pulses, hoof temperature, pain response and willingness to lift each foot.
History and risk factors
Recent grazing, feed-room access, weight gain, illness, foaling, medication, previous laminitis and existing lameness are relevant.
Radiographs
X-rays show the position of the pedal bone, sole depth and hoof capsule alignment. Repeat images can help guide farriery.
Blood tests
Testing may investigate insulin dysregulation, equine metabolic syndrome, PPID or an underlying inflammatory illness.
A coordinated treatment plan
How laminitis in horses is treated
There is no single treatment suitable for every laminitic horse. Management must address pain, protect the damaged laminae and treat the original cause.
Pain relief and inflammation control
Veterinary-prescribed analgesic and anti-inflammatory medication is commonly required. The drug, dose and duration must be selected for the individual horse.
Cryotherapy
Continuous cooling of the feet and lower limbs can reduce lamellar damage, particularly when started early.
Mechanical hoof support
Deep conforming bedding, pads, impression material, hoof boots, casts, trimming or therapeutic shoeing may be considered.
Treatment of the trigger
This may involve managing insulin dysregulation, treating PPID, controlling sepsis or protecting a supporting limb.
Dietary management
Grazing, forage and concentrate intake may need to be changed while maintaining adequate fibre and balanced nutrition.
Ongoing monitoring
Digital pulses, comfort, weight, hoof growth, sole depth and pedal bone position may require repeated assessment.
Understanding progression
Developmental, acute and chronic laminitis
The terminology describes how the condition develops and whether longer-term structural changes have occurred within the hoof.
| Stage | What it means | What an owner may notice | Required action |
|---|---|---|---|
| Early stageDevelopmental phase | Lamellar damage may be developing before obvious foot pain or lameness appears. | The horse may instead be showing signs of severe illness, grain overload or another recognised trigger. | Veterinary treatment of the trigger and preventive hoof protection may begin before lameness develops. |
| Emergency stageAcute laminitis | Clinical foot pain and lameness are present. Structural displacement may or may not have occurred. | Reluctance to move, stronger digital pulses, weight shifting, hoof pain and a characteristic stance. | Emergency veterinary treatment, movement restriction, pain control and hoof support. |
| Long-term stageChronic laminitis | Long-term structural or hoof-capsule changes have developed, often following pedal bone displacement. | Altered hoof growth, widened white line, sole changes, recurrent abscesses or persistent lameness. | Long-term veterinary and farriery care alongside management of the underlying cause. |
Managing metabolic risk
Grass, forage and feeding a laminitis-prone horse
Dietary management should reduce excessive sugar, starch and calorie intake while protecting digestive health and supplying adequate fibre, protein, vitamins and minerals.
Assess the whole horse
Use body-condition scoring, neck-crest assessment, photographs and a weigh tape or weighbridge to identify gradual changes.
Analyse forage where possible
Forage analysis can help identify sugar, starch, protein and mineral content and allows a more informed ration to be created.
Control grazing safely
Options may include a correctly fitted grazing muzzle, strip grazing, a track system, restricted turnout or a suitable grass-free area.
Do not rely on the time of day
Grass sugar levels vary with sunlight, temperature, plant stress, species and season. No turnout time is guaranteed to be safe.
Make changes gradually
Abrupt changes to forage or concentrate feeding can disturb the hindgut. Introduce changes under professional guidance.
Exercise only when safe
Exercise can support weight and insulin management in a sound horse, but it must not be used during active laminitis.
Should hay be soaked?
Soaking can reduce some water-soluble carbohydrates, but the result varies between hay batches and soaking methods. Ask your vet or qualified equine nutritionist whether soaking is appropriate.
Reducing future risk
How to help prevent laminitis
Not every case can be prevented, but identifying susceptible horses and managing recognised triggers can substantially reduce risk.
Maintain a healthy condition
Monitor total body fat and regional fat deposits rather than judging weight by appearance alone.
Investigate previous episodes
Assess the horse for insulin dysregulation, EMS, PPID and other possible causes.
Control sugar and starch
Use a suitable forage-based ration and avoid unnecessary cereal-rich or high-sugar feeds.
Manage grazing year-round
Laminitis can occur during every season and is not only a spring problem.
Keep feed securely stored
Prevent access to feed rooms, grain bins and large quantities of concentrate.
Arrange regular farriery
Monitor hoof balance, growth rings, white-line changes and sole condition.
Monitor older horses
Discuss PPID testing with your vet when age or clinical signs raise concern.
Respond quickly to serious illness
Severe colic, infection, diarrhoea or retained placenta can increase the risk of laminitis.
Long-term outlook
Recovery and prognosis for a laminitic horse
Recovery can take weeks or months and depends on the cause, severity, degree of pedal bone displacement and response to treatment.
Horses with mild laminitis and no structural displacement may return to comfortable work. Horses with rotation, sinking, reduced sole depth or repeated episodes usually need longer rehabilitation.
Hoof horn grows slowly, so visible distortion can take many months to grow out. Repeat radiographs, adjusted hoof support, diet monitoring and treatment of EMS or PPID may be needed.
Exercise should not restart simply because the horse looks more comfortable while receiving pain relief. Your vet should decide when controlled movement is appropriate.
Common misunderstandings
Horse laminitis myths
“Only overweight ponies get laminitis.”
Lean horses, performance horses, donkeys and animals with severe systemic illness can also develop laminitis.
“Laminitis only happens in spring.”
Laminitis occurs throughout the year. Autumn grass, winter weight gain, PPID and illness can all contribute.
“A hot hoof proves the horse has laminitis.”
Hoof heat fluctuates naturally and must be considered alongside pain, digital pulses and movement.
“Walking the horse improves circulation.”
A horse with suspected laminitis should not be forced to walk. Unnecessary movement can increase damage.
“Once sound, the problem has gone.”
Pain can improve before the hoof has stabilised. The underlying risk may still require long-term management.
“A supplement can cure laminitis.”
No supplement replaces veterinary diagnosis, pain relief, radiographs, hoof support or treatment of underlying disease.
Complementary nutritional support
Where Trinity Consultants and L94 may fit
Trinity Consultants can provide individual nutritional support alongside the management plan agreed with your veterinary surgeon and farrier.
L94 is sold as a complementary feed supplement used to support liver function and general nutritional wellbeing.
It is not a veterinary medicine and should not replace immediate veterinary diagnosis, prescription pain relief, radiographs, cryotherapy, hoof support or appropriate management of insulin dysregulation, EMS or PPID.
Horse laminitis questions
Frequently asked questions
Straightforward answers to common questions about laminitis signs, treatment, feeding and recovery.
Can laminitis be cured?
There is no single cure that reverses every case. Some acute episodes resolve completely, particularly when treatment starts early and the pedal bone remains stable. Structural damage or conditions such as EMS or PPID may require lifelong management.
How quickly does laminitis develop?
Lamellar damage may begin before obvious lameness appears, and clinical signs can develop rapidly. A horse may become visibly painful within hours of a serious trigger.
What should I do if my horse shows signs of laminitis?
Call your vet immediately, restrict movement, remove access to grass and concentrate feed and do not force the horse to walk.
What should I do if my horse has acute laminitis?
Acute laminitis requires urgent veterinary treatment. Your vet may prescribe pain relief, recommend cooling, arrange hoof support, investigate the cause and take radiographs.
Are there specific treatments for acute laminitis?
Treatment commonly combines veterinary pain relief, cryotherapy where appropriate, deep bedding, mechanical hoof support and treatment of the original trigger.
Can grass cause laminitis in horses?
Pasture can trigger laminitis in susceptible horses, particularly those with insulin dysregulation. Grass-associated laminitis can occur at different times of year.
Should a horse with laminitis be exercised?
No. A horse with active or suspected laminitis should not be forced to exercise. Movement can place additional strain on damaged laminae.
How long does laminitis recovery take?
Recovery may take several weeks in a mild case and many months where structural damage has occurred.
Is founder the same as laminitis?
The terms are often used interchangeably. Laminitis describes damage affecting the laminae, while founder commonly refers to pedal bone rotation or sinking.
Can a horse return to work after laminitis?
Many horses can return to work after a mild, successfully managed episode. Return to exercise must be gradual and approved by the veterinary surgeon.
Evidence and further reading
Veterinary information sources
This guide has been structured around established equine veterinary and welfare guidance. It does not replace an examination or treatment plan from your veterinary surgeon.
Information on this page is for general education only. Laminitis is a potentially life-threatening and welfare-critical condition. Contact your veterinary surgeon immediately if you suspect your horse or pony may be affected.