Laminitis in Horses – Causes, Symptoms & Treatment

What is laminitis in horses?

Laminitis (also known as pododermatitis aseptica diffusa) is a non-infectious inflammation of the sensitive laminae inside a horse's hoof, which can cause severe damage. The disease results from the separation of the hoof wall from the underlying laminae. Without prompt treatment, laminitis can progress dramatically and lead to life-threatening complications.

One of the dangers of laminitis in horses is that it is an aseptic inflammation – it is not caused by germs. All hooves can be affected, although the front hooves are most commonly involved. Triggers are varied and include excess weight and metabolic disturbances.

An acute laminitis episode can develop into chronic laminitis, often resulting in recurring flare-ups. However, early detection and immediate treatment greatly improve the horse's chances of recovery.

To help you better understand laminitis in horses, we have prepared a short video that clearly explains the causes, symptoms, and treatment options for this serious disease. Watch it to gain valuable insights and learn how best to protect your horse.

Laminitis vs Founder

Many horse owners are confused about the terms laminitis and founder in horses. While they are often used interchangeably in everyday conversation, they actually describe different stages of the same serious condition.

Laminitis is the acute inflammatory process affecting the sensitive laminae inside the hoof. In this early stage, the connection between the hoof wall and the pedal bone becomes inflamed and weakened.
If the inflammation is not treated quickly and effectively, laminitis can progress to founder.

Founder in horses refers to the chronic mechanical failure resulting from laminitis. In a foundering horse, the pedal bone (also called the coffin bone) rotates downward or sinks inside the hoof capsule. In severe cases, the bone may even penetrate the sole.

The clear difference between laminitis vs founder:

• Laminitis = Inflammation of the laminae (early disease stage)
• Founder = Structural damage and pedal bone displacement (chronic, advanced stage)

Recognizing the symptoms of founder in horses is crucial for preventing further damage. Signs may include:

• Severe lameness
• A "sawhorse" stance (where the horse leans backward to relieve hoof pressure)
• Increased digital pulse
• Warm, painful hooves
• Abnormal hoof growth or changes in the laminitis hoof sole

The foundering horse definition always involves mechanical changes within the hoof — not just pain or inflammation, but actual displacement of internal structures.

Early recognition and treatment of laminitis can prevent the devastating consequences of founder in horses. Always seek immediate veterinary attention if your horse shows any signs of hoof discomfort, lameness, or behavioral changes that could signal the onset of this life-threatening condition.

First Aid for Laminitis

If you suspect your horse may be suffering from laminitis, there are several immediate actions you can take to help your horse.

What Happens to the Hoof During Laminitis?

During laminitis in horses, an inflammatory process damages the sensitive laminae inside the hoof, which normally create strong bonds between the hoof wall and the pedal bone. These laminae are delicate structures that, once compromised, cause the pedal bone to lose its attachment within the hoof capsule. As a result, the pedal bone can start to shift or sink.

Laminitis hoof rotation is a common consequence of this process, where the pedal bone either rotates downward or sinks toward the sole. In severe cases, the pedal bone may penetrate through the sole, a critical complication known as "hoof sloughing."

Additionally, inflammation and swelling of the laminae severely impair blood circulation within the hoof. This leads to nutrient deprivation and tissue death, which can cause long-term damage to hoof structures if laminitis is not treated promptly.

Laminitis symptoms in horses

Early detection of laminitis symptoms in horses is critical to prevent irreversible damage. Laminitis usually manifests with intense pain and noticeable changes in posture and movement. Some horses may even display symptoms similar to colic because of the severe discomfort.

The most common signs of laminitis in horses include:

• Lameness, especially in the front feet
• Warm or hot hooves
• Sawhorse stance (leaning back onto the hind legs)
• Increased pulsation in the digital arteries
• Reluctance to move or pick up the hooves
• Tiptoeing or short, careful steps
• Stiffness when walking or turning
• Pain upon turning or hoof lifting
• Landing heel first instead of toe first
• Swelling around the coronary band
• Sensitivity to pressure in the hoof sole or wall
• Elevated temperature of the hoof wall and coronary band

If you observe one or more of these laminitis symptoms in horses, it’s essential to act quickly and seek veterinary advice.

Stages and Symptoms of Laminitis in Horses

Laminitis in horses is a serious condition that often develops gradually and progresses through several stages. From the early, almost imperceptible signs to acute and chronic forms that can permanently impact the horse’s health, it is crucial to recognize the typical symptoms early. Timely treatment can prevent severe consequences.

The following table provides an overview of the different stages of laminitis and their characteristic symptoms.

Diagnosing Laminitis in Horses

Diagnosing laminitis in horses involves several important steps. The veterinarian will first look for obvious clinical signs, such as lameness, warm hooves, or increased pulsation in the digital arteries. Using hoof testers, they will localize the area of pain. To accurately assess the severity of the condition, x-rays are taken to determine the position of the pedal bone and to detect any signs of rotation or sinking.

To better understand the extent of laminitis, a venogram can be performed. In this procedure, a contrast agent is injected into the hoof’s blood vessels, making them visible on x-ray images. This method allows veterinarians to evaluate the severity and progression of the disease more precisely. Venograms can be repeated during an active laminitis flare-up to monitor changes and refine the treatment plan. However, because the procedure is time-consuming and costly, not all vets offer it.

X-rays comparing a horse’s hoof before and after treatment for laminitis clearly show the changes:

• On the left, before treatment: noticeable rotation and sinking of the pedal bone.
• On the right, after treatment: improved alignment of the pedal bone achieved through therapeutic measures.
  Yellow lines highlight the structural and angular changes in the bones.

What Causes Laminitis in Horses

Understanding what causes laminitis in horses is essential for both prevention and treatment. Laminitis often results from multiple overlapping factors, and identifying the specific triggers for each horse is crucial.

One of the most common causes is an overload of sugar and starch. When a horse consumes more carbohydrates than its system can handle, undigested starch reaches the large intestine. There, it ferments, producing lactic acid and killing beneficial bacteria. The release of toxins into the bloodstream triggers systemic inflammation, ultimately leading to damage of the sensitive laminae within the hoof.

Here’s an overview of the most common causes of laminitis in horses:

Treatment for Laminitis in Horses

When a diagnosis of laminitis in horses is made, it is crucial to act quickly to prevent the pedal bone from rotating or sinking.

Key emergency measures include:

• Strict stall rest: The horse should stand on soft bedding to relieve pressure on the hooves.
• Cooling the hooves: Applying ice water or cooling boots helps to reduce inflammation.
  Pain relief and anti-inflammatory medications: Medications must be administered carefully to avoid encouraging excessive movement that could worsen hoof damage.
• Laminitis bandages: Special bandages can help to reduce pressure and prevent secondary infections.

Individualized treatment plans are essential and must be developed in consultation with the veterinarian. Important steps often include:

• Dietary changes: Reducing sugar and starch intake to minimize metabolic stress.
• Eliminating underlying causes: Addressing factors like metabolic disorders (e.g., Equine Metabolic Syndrome, Cushing’s Disease) or obesity.

Chronic Laminitis:

In cases of chronic laminitis, special therapeutic shoeing, such as heart bar shoes or modified laminitis shoes, is highly recommended. These designs help shift the weight away from the damaged toe and distribute it toward the frog.

Regular x-rays are critical to monitor the position and alignment of the pedal bone over time.

Long-term therapy goals:

Most treatment strategies aim to slow the progression of the disease. In some cases, if the underlying causes are successfully addressed, laminitis in horses can be cured over time.

Preventing Laminitis in Horses: Essential Tips

How to Prevent Laminitis in Horses

Since the causes of laminitis in horses are diverse, laminitis prevention must also be approached individually. Each horse's age, breed, management, previous illnesses, and usage must be taken into account.
Although not all triggers can be completely eliminated, the risk of laminitis can be significantly reduced with the right management strategies.

General Management Tips for Preventing Laminitis in Horses

• Maintain optimal weight – avoid obesity through careful diet management.
• Provide regular exercise to promote healthy circulation.
• Avoid working horses on hard surfaces whenever possible.
• If the horse is lame, support the healthy limb with a laminitis support bandage.
• Regularly check pastures for toxic plants.
• Ensure professional hoof trimming and shoeing on a consistent schedule.
• Implement strict hygiene during and after foaling.
• Ensure the placenta is completely expelled after birth to prevent infection-related laminitis.

Feeding Tips for Laminitis Prevention

• Always transition feed gradually to prevent digestive disturbances.
• Adjust feed amounts to match your horse’s energy needs.
• Use clean, contaminant-free feed.
• Pay close attention to the sugar and starch content, especially in fresh grass and grains.
• Seed pastures with low-fructan grass varieties whenever possible.

Feeding Management for Horses Prone to Laminitis

How to Manage Grazing for Horses at Risk of Laminitis

• Avoid fructan overload:
  Fructan levels in grass spike during cold nights and sunny days. Laminitis-prone horses should avoid grazing during these times.
• Avoid freshly mown or overgrazed fields:
  Short grass contains a high concentration of sugars and should be avoided.
• Use carefully managed pastures:
  Ideally, pastures should have moderate grass height and a high leaf-to-stem ratio.
• Limit grazing time:
  Regulate time spent on pasture to reduce sugar intake. Supplement with low-sugar forage like late-cut hay.
• Use grazing muzzles:
  Grazing muzzles can effectively limit grass intake while still allowing turnout time.
• Feed late-cut hay:
  Later harvested hay contains less fructan. If unavailable, soaking hay in warm water for 30 minutes can reduce sugar content.

Monitoring and Planning the Diet to Prevent Laminitis

• Create a detailed feeding plan that includes pasture time and additional forage.
• Perform blood tests if necessary to fine-tune your horse's diet and detect metabolic risks early.
• Ensure slow, steady weight loss if dieting is needed — rapid weight loss can actually trigger laminitis.
• Choose supplements carefully: prioritize low-sugar and low-starch products, such as beet pulp or specialized low-carb feeds.

➡️ Must-Watch: Managing Metabolic Problems in Horses
Discover how optimal nutrition can help prevent obesity, insulin resistance, laminitis, Equine Metabolic Syndrome (EMS), and Cushing’s Disease, promoting better overall health and well-being!

Recovery Chances for Laminitis in Horses

Is Laminitis in Horses Curable?

When it comes to laminitis in horses, it is impossible to guarantee full recovery in every case. The chances of healing — and the horse’s future quality of life — largely depend on the severity of the condition and the stage at which it is diagnosed.
A key indicator is the degree of pedal bone rotation.

• If there is no rotation, the horse often returns to full performance after recovery.
• If rotation is limited to up to seven degrees, the prognosis is still quite good.
• Greater rotation significantly reduces the likelihood of returning to previous athletic performance.
  In severe cases, euthanasia may be necessary — but this outcome is not inevitable.

Early diagnosis and prompt treatment are essential for improving the chances of recovery. If laminitis is not treated quickly, it can progress to chronic stages within two to three days, potentially leading to lifelong impairment.

Does Hoof Sloughing Mean the Horse Has to Be Euthanized?

In severe cases of laminitis, the horse’s hoof capsule can completely detach from the underlying structures — a condition known as hoof sloughing.
This occurs when the inflammation destroys the connection between the hoof wall and the pedal bone, leading to extreme pain and instability.

Fortunately, hoof sloughing is rare thanks to modern veterinary care. Even if it does occur, it is not necessarily a death sentence. A new hoof capsule can regrow over several months to a year, provided the horse receives intensive care, pain management, and close veterinary monitoring during the healing process.

When Is It Time to Put a Laminitis Horse Down?

Deciding to euthanize a horse with laminitis is one of the hardest choices you may ever face. It depends on several factors, especially the horse’s level of pain, the degree of structural damage within the hoof, and the response to treatment.

You should start considering euthanasia if:

• The horse is experiencing uncontrollable pain despite aggressive treatment and pain management.
• There is severe rotation or sinking of the pedal bone that compromises the horse’s ability to stand or move without agony.
• The hoof capsule has detached (hoof sloughing), and the horse cannot regrow a new hoof without prolonged suffering.
• Chronic laminitis has caused irreversible structural damage that severely impacts the horse's quality of life.

Early veterinary consultation is crucial. Your vet can help assess whether further treatment offers a realistic chance of recovery or if continued efforts would only prolong the horse’s suffering.
The decision should always prioritize the horse’s well-being, focusing on whether a pain-free and dignified life is still possible.

How Long Does It Take for Laminitis in Horses to Heal?

Healing from laminitis is a long process.
Even in mild cases, recovery can take several months. In severe cases involving pedal bone rotation or sinking, it can take up to a year for the hoof to stabilize and regain full function.

Throughout recovery, it is crucial to monitor hoof health closely and maintain careful management to prevent setbacks or complications.

Can Laminitis Recur After Recovery?

Yes — a horse that has suffered from laminitis will always remain at risk for future flare-ups.
Seasonal changes, pasture conditions, feed management, and stress levels must be closely monitored year-round to minimize this risk.

Because laminitis is associated with intense pain, prevention is key to ensuring your horse’s long-term well-being. A careful management plan, including proper nutrition and exercise, is essential to reduce the likelihood of recurrence.

Is Exercise Good for Horses with Laminitis?

The answer depends on the stage and severity of the disease.

• Acute phase:
  During the acute stage, the horse must be kept on strict stall rest, ideally on soft footing. Movement can worsen the damage to the sensitive laminae and increase pain.
• Post-acute phase:
  Once the acute inflammation subsides, light, controlled exercise under veterinary supervision can be beneficial. It promotes blood circulation and prevents stiffness.
  Horses should be allowed to move only as much as they are willing, and only on soft ground to minimize concussion.
• Chronic laminitis:
  In cases of chronic laminitis, light and regular exercise on soft surfaces can help maintain blood flow and muscle tone. However, any exercise plan must be approved and supervised by your veterinarian.

In all stages, the key is individualized management, based on veterinary advice and the horse’s physical condition.

How to Safely Exercise a Horse Recovering from Laminitis

• Avoid complete immobilization:
  Prolonged stall rest can exacerbate laminitis in some cases.
  Allow gentle movement if the horse is willing — never force exercise.
• Prefer soft ground:
  Use soft surfaces for turnout and walking exercises. Hard or uneven surfaces should be avoided.
• Use hoof boots or therapeutic shoes if needed:
  These can provide additional support and protection during movement.
• Reduce stress:
  Social contact with other horses is important for mental health. If necessary, create a separate paddock with visual access to other horses to reduce stress without risking injury.

When Can You Ride a Horse Again After Laminitis?

Before resuming riding, the horse should:

• Show clear signs of comfort and willingness to move.
• Be cleared by your veterinarian through clinical examination and x-rays confirming no further hoof damage.

It is always better to wait longer than to risk a relapse.
A cautious, gradual return to work is essential to protect the newly healed hoof structures.

Laminitis in Horses: Key Takeaways

Laminitis is a serious, non-infectious inflammation of the sensitive laminae in the hoof that can cause severe pain and long-term damage in horses.
The causes are diverse and include overfeeding, metabolic diseases like Cushing’s and EMS, mechanical overload, and toxins.

Early diagnosis and immediate treatment are critical for the best outcome.
While acute laminitis in horses can often be successfully treated with prompt intervention, the risk of relapse remains. In more severe cases, chronic laminitis can develop, requiring lifelong management.

Key measures for preventing laminitis include:

• Regular veterinary check-ups
• Carefully managed feeding programs
• Avoiding excess sugar and starch intake
• Providing soft, supportive footing
• Stress reduction and careful pasture management

With the right treatment for laminitis in horses, such as stall rest, hoof cooling, specialized therapeutic shoeing, and intensive care during critical phases, many horses can recover well.
Preventive strategies, particularly in feeding and hoof care, play a central role in ensuring long-term soundness and well-being.

A holistic management approach that addresses both physical and environmental factors gives horses the best chance of recovery and helps to prevent future episodes of laminitis.

Laminitis in Horses: Frequently Asked Questions

What is laminitis in horses?

Laminitis in horses is an inflammatory condition affecting the sensitive laminae inside the hoof. It can lead to extreme pain, structural failure, and, if untreated, to founder – a permanent displacement of the pedal bone.

What are the symptoms of laminitis in horses?

Typical signs include lameness, reluctance to move, warm or hot hooves, a strong digital pulse, and a "sawhorse stance," where the horse leans back to relieve pressure on the hooves.

What causes laminitis in horses?

There are multiple causes, including overeating sugary feeds, hormonal disorders like Cushing’s disease or Equine Metabolic Syndrome (EMS), excessive weight-bearing on one limb, and systemic infections. Understanding what is the main cause of laminitis in horses often requires veterinary diagnostics.

What is the difference between laminitis and founder in horses?

The term laminitis refers to the acute inflammation phase, while founder describes the chronic mechanical failure where the pedal bone rotates or sinks. Recognizing the difference between laminitis vs founder is crucial for timely treatment.

What are the symptoms of founder in horses?

The symptoms of founder in horses include severe lameness, abnormal hoof growth, widened white lines, chronic hoof pain, and sometimes penetration of the sole by the pedal bone.

How do you treat laminitis in horses?

Treatment for laminitis in horses includes stall rest, cooling the hooves, anti-inflammatory medication, dietary changes, corrective trimming, and possibly therapeutic shoeing. Every case is different and should be handled by a veterinarian.

What is the new treatment for laminitis in horses?

Emerging treatments include regenerative therapies like stem cell injections, platelet-rich plasma (PRP) therapy, and innovative supportive shoeing techniques designed to stabilize the laminitis hoof sole and prevent further damage.

Can you reverse laminitis in horses?

With early detection and aggressive management, it is possible to reverse mild cases of laminitis in horses. Chronic cases, especially those with significant bone displacement, often require long-term management.

Can laminitis in horses be prevented?

Yes. Preventive measures include controlled feeding, regular exercise, weight management, careful pasture access, and close monitoring of metabolic health to minimize the risk of developing founder in horses.

What does laminitis in horses look like?

In the early stages, you may notice shifting weight, stiffness, or an unusual stance. In advanced stages, deformation of the hoof wall, a dropped sole, and signs of severe pain may appear.

Can horses get laminitis in just one foot?

While rare, a horse can develop laminitis in a single hoof, often secondary to bearing excess weight on a healthy limb due to lameness in the opposite leg.

Are hoof boots good for laminitis?

Yes, hoof boots can be very helpful for laminitis by cushioning the hooves, reducing pain, and offering additional support during recovery.

Does biotin help with laminitis in horses?

Biotin can support overall hoof health, but it does not cure laminitis. It may be part of a long-term management plan to strengthen new hoof growth after a laminitic episode.

Can glucosamine cause laminitis in horses?

Currently, there is no strong evidence that glucosamine directly causes laminitis in horses, but any supplements should be used cautiously, especially if the horse has metabolic issues.

What food causes laminitis in horses?

Feeds high in sugars and starches, such as rich spring grass, grains, and sweet treats, can trigger laminitis in susceptible horses.

How do you get rid of laminitis in horses?

You cannot simply "get rid" of laminitis overnight. It requires intensive veterinary care, environmental management, dietary adjustments, and sometimes months of rehabilitation.

What can be mistaken for laminitis in horses?

Conditions like abscesses, sole bruising, or severe arthritis can mimic the early laminitis symptoms in horses. Accurate diagnosis by a veterinarian is critical.