In my years treating horses, few conditions are as painful for the patient and as frustrating for the owner as laminitis. It strikes quietly, often in a fat pony turned out on spring grass, and by the time the horse is visibly hobbling, real damage may already be happening inside the foot. The hoof looks normal from the outside, which is exactly why so many owners underestimate it.

I want owners to understand that laminitis is not a foot bruise or a passing soreness. It is inflammation of the delicate tissues that suspend the pedal bone inside the hoof capsule, and when those tissues fail, the bone can move. The earlier we intervene, the more of that internal structure we can save. That is why I treat every suspected case as urgent, and why you should too.

A horse (illustrative).

What Is Laminitis in Horses?

Inside the hoof, thousands of interlocking leaves of tissue called laminae bond the hoof wall to the pedal bone (the coffin bone). They act like a biological velcro that holds the bone in place and carries the horse’s considerable weight. In laminitis, these laminae become inflamed and weakened. As the bond fails, the pull of the deep flexor tendon and the horse’s body weight can cause the pedal bone to rotate downward or sink within the hoof.

🔵 Why it hurts so much
The foot is a rigid capsule with no room to swell. When the sensitive laminae inflame inside that fixed space, the pressure is intense, which is why laminitic horses are often acutely and obviously lame. The front feet bear more weight, so they are affected most often, but all four feet can be involved.

Laminitis is usually a sign of a problem elsewhere in the body, most commonly a metabolic or hormonal disturbance. That is why managing the foot alone is never enough. We have to find and address the underlying cause to stop it returning.

Symptoms to Watch For

Signs range from subtle and intermittent to dramatic. Catching the early ones can make the difference between a manageable case and a severe one.

🦵
Rocked-back stance
Front legs stretched forward and weight shifted onto the heels.
🐢
Reluctance to move
Short, pottery steps and great difficulty turning in tight circles.
🔥
Heat in the hooves
One or more feet feel warm to the touch compared with normal.
💓
Bounding digital pulse
A strong, easily felt pulse at the back of the fetlock or pastern.
😣
Pain on the toe
Flinching when pressure is applied over the front of the sole.
🛌
Lying down more
Spending unusually long periods lying down to relieve the feet.
🟠 Do not wait it out
If your horse is shifting weight constantly, refusing to walk, or showing a strong bounding pulse in the feet, do not assume it will settle overnight. These are signs of active laminitis and the internal damage may be progressing. Get the horse onto a soft, deep surface, stop all exercise and call your vet immediately.

What Causes It

Laminitis has several recognised triggers, and many horses have more than one risk factor working together. Grouping them helps you see where your own horse may be vulnerable.

Hormonal and metabolic

  • PPID (Cushing's disease)
  • Equine metabolic syndrome
  • Insulin dysregulation
  • Obesity and a cresty neck

Diet and grazing

  • Rich, sugary spring or autumn grass
  • Sudden access to large amounts of grain
  • High-starch concentrate feeds
  • Abrupt diet changes

Illness and inflammation

  • Severe colic or diarrhoea
  • Retained placenta after foaling
  • Serious infection or toxaemia
  • High fever

Mechanical overload

  • Excessive weight on one leg due to injury
  • Hard, concussive ground work
  • Long, unbalanced or overdue hoof trimming
  • Obese animals on hard standing

Treatment and Recovery

Laminitis treatment focuses on relieving pain, supporting the foot, and tackling the underlying cause. The steps below are veterinary-led, and no medication should be given without your vet’s direction.

1

Immediate box rest

Confine the horse to a stable with a deep, soft bed right up to the door. Movement increases damage, so restrict it completely until the vet advises otherwise.

2

Pain relief and diagnosis

Your vet provides anti-inflammatory pain relief and examines the feet, often using hoof testers and X-rays to assess any rotation or sinking of the pedal bone.

3

Foot support

Frog and sole support, special pads, or therapeutic shoeing help redistribute load away from the painful laminae and stabilise the bone.

4

Treat the cause

Blood tests may check for PPID or insulin problems so the trigger can be managed long term, alongside a strict low-sugar diet.

5

Gradual rehabilitation

Return to movement is slow and guided by repeat X-rays and your farrier, with controlled exercise only reintroduced once the foot is stable and comfortable.

If you suspect your horse has eaten a toxic plant or feed and laminitis or colic follows, you can call the ASPCA Animal Poison Control Center at 888-426-4435, but your equine vet remains the first and most important call for an actively laminitic horse.

Prevention and Home Care

Prevention is far easier than treatment, and most cases are linked to weight and diet you can control. Use this checklist year round, with extra vigilance in spring and autumn.

  • ✅ Keep your horse or pony at a healthy body condition
  • ✅ Restrict grazing on lush grass, especially after rain and sun
  • ✅ Use a grazing muzzle or track system for at-risk animals
  • ✅ Feed a low-sugar, forage-based diet and avoid grain meals
  • ✅ Introduce any feed or pasture changes gradually
  • ✅ Maintain a regular farrier schedule for balanced feet
  • ✅ Test older horses for PPID and metabolic disease as advised
  • ✅ Learn to feel a normal digital pulse so you notice changes

When to Call Your Vet

Call your veterinarian the moment you suspect laminitis, not after a day of watching. Even a horse that looks only slightly footy can be in the early stages of significant internal change, and the feet rarely give you a second chance. Treat strong digital pulses, the rocked-back stance, heat in the feet, or a horse that simply will not walk as emergencies. While you wait, move the horse as little as possible onto a soft surface and remove any rich feed or grass. The sooner the vet starts treatment and identifies the cause, the better your horse’s long term outlook.

Safety note: Never delay calling your vet for a suspected laminitis case, because the hoof can look normal from the outside while the pedal bone is already moving inside it.