First Aid for Laminitis in Horses


There are two truly important things to do if you even remotely suspect laminitis – call your vet immediately and ice your horse’s hooves. Then you can worry about some other things to help your horse be more comfortable.


But first… how do you recognize laminitis? It’s important to know that the “classic” sign of laminitis when a horse rocks back and extends his front legs is not as common as we may think. In one giant study in the UK (link below), it was found that less than 25% of horses with laminitis displayed this behavior.


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Signs of laminitis in horses


  • A reluctance to walk or a reluctance to change footing. As a horse moves from stall to aisle, grass to path, a change of footing might make him pause, especially if going from a squishy or soft footing to a harder footing.


  • Different and/or stronger digital pulses. The increased feel of a digital pulse, often called strong or bounding, is an indication that something is going on inside the hoof. And not in a good way. It’s also an indicator of other hoof issues, such as abscesses and hoof bruises. In the most simple of terms, your horse’s hoof is painful. Learn how to check your horse’s digital pulse here.


digital pulse location

It’s easy to check your horse’s digital pulses as you are picking hooves.


  • Heat in the hooves. This usually goes hand in hand with stronger digital pulses, and is easy to check. Do not panic, however, if you feel hot hooves and your horse has been lounging in the sun. Go back to the big picture and check vitals, notice if your horse is “off”, etc.


  • Changes in your horse’s other vital signs. With anything that causes your horse discomfort and pain, his vital signs will reflect that. An increased heart rate is your first clue. Some horses also show an increase in respiration.


  • Just a reminder, normal vital signs in horses are:


    • Temperature – 99.5 to 101.5
    • Pulse (Heart Rate) – 24 to 40 beats per minute, although most horses are between 32 and 36
    • Respiration – 8 to 12 breaths per minute
    • Capillary Refill – approximately 2 seconds
    • This article has more on vital signs and TPR


  • Awkward turning. This can usually be seen as the horse that needs to rock back a bit and slowly pivot, instead of a usual turn. You will see it more in smaller spaces, and it’s helpful to know how your horse usually navigates swiveling around.


  • Change in stride. While I’m all about hand walking safely and looking ahead when you are doing so, you still need to know how your horse’s footfalls look and sound. Does he track up or overtrack the hind legs? How’s his normal walking rhythm? How long are his strides? Subtle laminitis will change these things, and you might end up noticing a different sound.


  • Foot lifting, or none at all. Most horses have fairly predictable ways of resting their hind legs. Some will even shift their front legs, but this is seen less often.


  • Lameness. Sometimes, a horse will just show up lame one day. For laminitis issues, there are usually more things going on that you can find under closer inspection. Horses that live outside and handled less may have lameness as the first thing you see, before you can get your hands on your horse.


stethoscope for pulse and gut sounds

This is your friend.


First aid steps if you suspect a hoof problem or laminitis.


  • Call your vet immediately. Even if it’s past office hours.

Make your horse comfortable as you wait for the vet.


  • Get him situated with some soft bedding, without walking him too far. Consider using a trailer if you need to move him across a farm.


  • Let him have his water source as close to him as possible so he doesn’t have to move around a lot.


  • Remove any food, especially grains, fortified feeds, and take him off pasture.


  • Don’t medicate your horse before talking to your vet. This interferes with the diagnostic process and makes your vet’s job even harder. This also applies to colics!


horse in buckets of ice


  • Get his hooves and legs into ice. PRONTO. There’s overwhelming evidence that continuous ice on your horse’s hooves can alleviate pain and improve outcomes. How long is continuous? At least 48 hours, even longer in some cases. It’s also a good idea to ice the lower legs, so that blood going into the hoof is cooled. Make sure you are not using ice water directly on skin for extended periods of time. The hoof is fine for this, but not skin.


  • There are lots of ways to do this. Ideas:


    • Laminitis boots if you have them.
    • Buckets of ice.
    • Eventing style ice boots that loop over your horse’s shoulders.
    • Certain styles of feed bags may work for holding ice.
    • Ice packs.
    • Do what you can to make this happen. It’s pain relief.


  • Give your horse some company. Laminitis often isolates horses from their usual routines and herds. Perhaps your horse could have some friends switch around so he has company at all times.


Some things to do as you care for the horse with laminitis, long term.


  • Dig deep with your vet to uncover the root cause of your horse’s laminitis and make some lifestyle changes if warranted. It might be an underlying metabolic disorder, an injury to another limb, a case of road founder, or a fever or colic-induced episode. More on the causes of laminitis here.


  • Work with your vet on these steps. There are several different causes of laminitis, which means that your horse’s plan may vary.


  • Make the necessary changes to your horse’s diet.


    • He still needs calories, just smarter calories in some cases. NSC values, an indication of how sugary a food is, need to be lowered if your horse has metabolic issues, like PPID (Cushing’s) or IR (insulin resistance).
    • There are some feeds that have NSC values around 4-6%.
    • Eliminate pasture from your horse’s diet.
    • Soaking your horse’s hay can lower the NSC value of his forage.


  • Give your horse the most amazing soft footing to rest and recover on. Keep it clean.


  • Get your farrier and vet on the same team, and use x-rays to help your farrier create the best possible mechanical support for your horse.


screen with many angles of hoof x-rays


  • Work with your vet on appropriate exercise and turnout for the horse recovering for laminitis. This may be a few days later, or months later, or years. Laminitis literally destroys the attachments between your horse’s bones and the outer hoof wall. You may be tempted to let your horse have more space if he’s feeling better, which may backfire on you.


  • Support the rest of your horse’s body with therapeutic treatments. Massage, grooming, chiropractics, whatever he likes.


  • Keep him busy with stall toys and activities!


  • Get regular check-ups and x-rays with your vet. You need a way to monitor progress.


  • Keep taking care of you, too! Laminitis is a marathon, and you will need a break and some support along the way.


For more reading, you may enjoy some of these reads:


One study of icing:

More science about icing for laminitis:

Laminitis is as common as colic:


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03/11/2024 02:59 pm GMT

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