The Signs of Laminitis in Horses

X-rays can help diagnostics and monitoring of hoof health.

Laminitis in horses

• It’s quite common to use the words laminitis, laminitic, foundered, and foundering interchangeably, despite there being a distinction between laminitis (swelling of the laminae) and founder (displacement of the bones).

What is laminitis in horses?

• Inside the hoof are laminae. This tissue resembles folded fabric and contains blood vessels for nourishment. The laminar tissue holds the coffin bone (also known as the distal phalanx or the pedal bone) to the hoof wall. Laminitis is the inflammation of these tissues inside the hoof capsule.

• This process in horses can lead to founder. When the supporting laminae have a restricted blood supply and swelling, they lose their ability to support the bones of the hoof properly. This gives the coffin bone the chance to shift, rotate, or drop, creating equine founder.

Laminitis tidbits

• Laminitis is most common in both front feet, and current research tells us the hind feet are also affected. and can happen in the hind feet as well.

• Metabolic disease is the most common cause.

• Before your horse shows obvious signs of laminitis, damage has been done.

• In extreme cases of founder, the coffin bone will push through the sole of the hoof.

• The typical sawhorse stance, where the front feet extend and weight shifts back, is not that typical. Not all horses stand this way.

• Subclinical cases happen invisibly as the laminae change over time without presenting any outwards signs.

• Acute cases pop up suddenly and are new and fresh. Chronic laminitis can drag on for months and even years, with your horse’s hooves constantly changing.

• Chronic cases are susceptible to a lifetime of frequent hoof abscesses, obvious growth rings on the hoof, questionable soundness, and flares of laminitic episodes.

This article provides more information about the subclinical form of hoof disease.

Checking for heat and a strong digital pulse takes seconds a day to do.

Here are the Signs of Laminitis in Horses

• There is almost a sliding scale of what you will notice, from the near-invisible early signs of laminitis to the glaring red flag that founder is around the corner.

Early warning signs of laminitis

• Metabolic diseases like equine metabolic syndrome (EMS) and pituitary pars intermedia dysfunction (PPID, formerly called Cushing’s disease) that increase a horse’s insulin levels may trigger hoof changes.

• Seedy toe often goes hand-in-hand with major hoof problems, and some horses may show a widening or pinking of the white line as changes occur in the hoof.

• Your horse is tender or sore after being shod. They may need a few days to get back to normal, and this could result from a too-close trim or from a sub-clinical case.

• Sub-clinical conditions in horses may also include soreness after eating, especially on pasture. Sensitivity to grass may increase during the spring and fall as sugars rise in lush pasture. And while the pasture grass in fall may not look “lush,” the grass is actively hoarding sugars to prepare for winter. Cooler mornings can lead to more dangerous sugar levels, too.

• The hooves are warm or hot. Heat signals inflammation, and inflammation causes pain. The swelling in the rigid hoof wall is trapped, worsening the situation. This increase in hoof wall surface temperature (HWST) is a huge warning sign of an underlying condition, which may be laminitis or something else.

• An increased pulse rate. If your horse has a consistent resting heart rate, but you notice that it’s increased at rest, there’s likely some discomfort.

• Hoof rings. When injured, hoof growth may show up weeks later as a distinct ring around the hoof wall. This will grow out over time, but serves as a reminder that there was some event inside the hooves.

This article has more about the early signs.

More obvious signals of hoof trouble

• Walking is uncomfortable, and your horse may hesitate as if they’re walking on eggshells. Transitioning from a soft ground to a hard ground creates hesitation and painful steps.

• They may not want to turn in small spaces. Instead, they may pirouette or pivot by shifting weight onto the hind end. Shorter steps and limping during a turn can also be seen.

• Mild colic symptoms may also be an early indicator of laminitis. Sometimes the pain shows itself as a colic situation. You may see weight shifting to find comfort, which can look like digestive issues.

• Postural changes. Are they standing differently? Some horses look as if their front feet splay out in front of them. That typical stance of a horse leaning dramatically backward is actually not as common as once thought! A fascinating study revealed that about 10% of horses will develop laminitis, and only a few presented this way. Read the study here.

• Horses may stand with one front leg stretched outward, shift side to side more, or perhaps remain perfectly still.

• The digital pulse is strong or bounding. Typically, a non-existent or faint digital pulse indicates no major disturbances to the hoof. However, as swelling impairs blood flow, the pulse becomes stronger.

The most evident signs of laminitis

• Clearly lame horses that appear to hop along with great pain may be laminitic.

• You may also see the hair around the coronary band start to stand out or upwards. As the coffin bone sinks, the skin redirects upwards.

• There may be an outline of a half-moon on the sole, indicating the outline of the coffin bone as it presses into the sole.

• Increased sweating, respirations, and pulse. These are all signs of pain.

• Refusal to move. Sometimes, even softer ground offers no reprieve from this painful condition.

• Refusal to get up. Staying recumbent to avoid putting weight on the hooves.

Inspect and monitor the hooves 

• Checking for heat and a strong digital pulse takes only a few seconds a day.

Overlapping clinical signs of many hoof problems

• Do some of these signs look like bruising, severe abscesses, or injuries to the sole of the foot? YES! Hoof problems can also produce those colic-like signs that confuse everything.

• Sometimes, hoof issues like bruises and abscesses can progress to more serious problems, such as laminitis and founder.

• Any suspected hoof pain in a horse is a medical emergency. Your horse will thank you and your equine vet for quick action and pain relief.

What Causes Laminitis?

• There are plenty of reasons horses develop laminitis. Sometimes this is sudden, while in other cases it is a slow burn. Clinical signs may lie under the surface for weeks, months, or years. We also know that a horse’s metabolic health and laminitis risk are related.

Metabolic issues – equine metabolic syndrome

• Equine metabolic syndrome (EMS) is a condition characterized by Insulin Resistance (IR), obesity, and a history of laminitic episodes. Many overweight horses will develop IR, which interferes with insulin regulation. As a horse becomes less sensitive to insulin in their body, sugar levels creep up. More insulin is needed to regulate those sugars, and insulin levels rise accordingly.

• There is overwhelming evidence that too much insulin directly affects the laminae in your horse’s hooves. Insulin may alter blood flow to the foot, eventually leading to laminar swelling. More insulin is directly linked to a horse’s high risk of developing this disease. In research and clinical settings, insulin IV drips trigger this condition for study.

• Weight loss can often mitigate EMS and can reduce the associated higher risk of laminitis.

• It’s easy for your vet to monitor your horse’s insulin and sugar levels.

Cushing’s in horses

• Another metabolic disorder is equine Cushing’s disease, also known as Pituitary Pars Intermedia dysfunction (PPID). While this does not fall under the umbrella of equine metabolic syndrome, some horses will also develop insulin resistance.

• Equine Cushing’s disease stems from a pituitary gland issue in the brain, releasing hormones to create a cascade of chemical reactions in your horse. Eventually, a horse’s insulin levels rise, creating that risk factor for developing laminitis.

• Metabolic disorders are thought to be the most common cause of laminitis.

• There are blood tests to identify underlying endocrine diseases long before the cresty top of the neck or hair growth and shedding problems associated with Cushing’s.

A stronger digital pulse tells you there’s trouble inside the hoof. For details on finding and checking the digital pulse, this article has more info. 

Supporting limb laminitis

• When a horse has a painful, injured leg, they may shift weight to the partner leg. The excessive weight on the standing legs directly impacts hoof health and can not properly support your horse’s body for prolonged periods.

• Stress on the uninjured legs can cause supporting-limb laminitis.

• Fractures, street nails, and even cellulitis and lymphangitis are situations in which a horse is at high risk of inflammation. This process is usually a slowly developing situation.

Road founder and repetitive trauma

• Road founder occurs when a horse repeatedly pounds its legs on hard surfaces. This could be an isolated incident, such as the loose horse galloping on asphalt or packed earth. In other cases, long-term concussion on hard surfaces such as rock-solid arenas, roads, and tracks can also cause problems.

Disease, fever, and black walnut

• Systemic illness in your horse’s body can trigger laminitic damage. Colitis, colic, pneumonia, and retained placenta in mares can cause laminitis. Even fevers of known (or unknown) origin can trigger laminitis.

• A horse that gorges on grain also triggers an inflammatory disease process that can progress to colic and laminitis. Grains, concentrates, and feeds zip through the stomach and small intestine quickly! When they land in the hindgut, they are quickly gobbled up by sugar-loving microbes. Those microbes then produce by-products that change the gut’s pH. Large amounts of gas can develop, and other types of microbes die and poison the bloodstream. This lands in the hooves, creating swelling.

• Black walnut shavings create acute laminitis within hours of touching your horse’s body. Standing in shavings with even a small percentage of black walnut will cause damage. Interestingly enough, the lower legs typically swell too, something that’s not usually seen with other triggers.

Ice can help.

Treatment of Laminitis

• The most important thing when you suspect any hoof or colic issue is to talk to your vet. Farriers are well-versed and experts on hooves, but can’t diagnose, take X-rays, or prescribe medications. Farriers, however, can play a vital role in stabilizing, balancing, and protecting the hoof during and after this disease process. Call your vet first.

This article has more about the diagnostic process.

First steps

• Get those hooves into ice water or pack them with ice packs. For tips on icing hooves, read this! For a long time. Icing reduces inflammation and also provides some pain relief.

• Your vet will likely take radiographs to check the coffin bone. Periodic X-rays also track your horse’s progress and help your farrier provide support with corrective trimming, wedges, special shoes, or whatever your horse needs.

• Taking video and pictures of your horse’s hooves along the way also tracks progress and can record growth rings on the hoof wall.

• Your vet will likely prescribe anti-inflammatory medications like Bananime and give you a schedule for follow-up visits. There are many supplements and other medications to support the healing process.

Change your horse’s lifestyle

• Feeding the laminitic horse a low-sugar diet. Most grains, grasses, and feeds need to be eliminated, changed, or reduced. For chronic laminitis cases, long-term dietary changes can help your horse reduce their risk factors.

• Opt for hays and feeds with low NSC values. This number is a measure of the sugar and starch content of grass, grains, and other feed ingredients.

• There are many supplements available for the laminitic horse. Many support the treatment of metabolic disorders, and most are available over the counter. Your vet may have some specialized supplements, too. 

• Your vet and farrier may also suggest adding more shavings and using cushy stall mats.

• There are dozens of wonderful boots on the market for extended wear.

• Your job is to track your horse’s progress, monitor for increased digital pulses, and support your vet’s pain and inflammation management plan.

• If you are at all uncertain about anything – call your veterinarian. Better safe than sorry. Even a tiny delay in veterinary care can have staggering implications for the outcome of this disease. Do not delay! Any problems within the hoof can indicate different things. Laminitis may look like bruising, abscesses, or other lamenesses.

There are lots of ways to cool the hoof, providing relief! These laminitis boots keep the hooves icy cold for hours.

More resources for horse owners and caretakers

One of my favorite resources is Fran Jurga’s Hoof Blog. You can also read more about laminitis here:

First aid for laminitis

Laminitis myths

Acute and chronic laminitis

Help prevent laminitis

Risk factors for laminitis

Fall is risky for laminitis

Subtle signs your horse is lame