Laminitis in Horses: Symptoms, Causes, Risk Factors and Treatment

Laminitis
Symptoms
Causes
Risk Factors
Treatment
Diagnosis
Ferrier Care
Diet
Prevention

Equine laminitis is a painful inflammatory condition affecting the horse’s hooves. Cases of laminitis range in severity from mild foot tenderness to chronic founder, potentially impeding the horse’s ability to walk.

Laminitis is the bane of any horse owner’s existence. Horses affected by laminitis suffer excruciating pain as the soft hoof structures known as lamina become inflamed.

While laminitis does not usually kill horses, per se, owners may make the decision to euthanize if the prognosis is poor or treatments do not work. 7% of equine deaths are associated with laminitis. ^[2]

Fortunately, most horses will recover from laminitis to some degree, but it can take time. Once recovered, the horse is generally more short-strided than before laminitis struck.

Laminitis is always an equine emergency. Call your vet immediately if your horse develops symptoms of this potentially life-altering condition. Prompt treatment can often prevent further damage when caught at an early stage.

There are many ways to improve the quality of life of a horse with laminitis. Dietary changes are recommended to reduce inflammation, improve metabolic health and support healthy gut function.

What is Equine Laminitis?

The term laminitis derives from inflammation of the hoof’s lamina. The lamina within the hoof keeps the coffin bone adhered to the hoof wall.

The coffin bone, formally known as the distal phalanx or third phalanx, is totally encased within the hoof. Also known as the pedal bone, it provides attachment for the deep digital flexor tendon.

In laminitis, the inflamed laminae may start separating. Should separation occur, the coffin bone loses support and rotates downward. It begins pressing on the sole.

In the worst-case scenario, the coffin bone loses all laminar support and is completely free within the hoof. This is known as a sinker.

Although laminitis is a disease of the hoof, the events leading to laminal inflammation have their origins in the animal’s gastrointestinal tract or endocrine system. Diet and gut health play a major role in reducing risk factors for laminitis for your horse.

Once a horse develops laminitis, recurrence is likely. Careful management is key to preventing recurrence and keeping the horse as sound as possible.

Some horses will recover fully from a bout of laminitis, and others may prove serviceably sound for less demanding work. There are horses who never regain soundness after laminitis. In many equines, it becomes a chronic issue.

Signs and Symptoms of Laminitis

Laminitis is a painful condition. If your horse does not want to move, “walks on eggshells,” and is trying to keep weight off his forelegs, suspect laminitis.

Although all four hooves can be affected, laminitis is far more common in the front feet.

Symptoms of laminitis include:

Coronary softening
Heat in the hooves
Increased digital pulse
Reluctance to move
Reluctance to rise from a prone position
“Sawhorse” stance

In the most severe cases, a bloody exudate may seep from the coronary band. The prognosis for equines who reach this point is not good.

Chronic Laminitis

Horses with chronic laminitis sport telltale rings on the affected hooves. These rings correspond to prior laminitic episodes. They are usually wider at the heel than the toe.

Various stressors can cause hoof rings. There are horses who experience mild cases of laminitis that go undetected by caretakers, but the rings in the hoof will eventually appear.

With chronic laminitis, hoof walls become dish-shaped. Such equines are prone to dropped soles.

Hooves will display a separated white line, often referred to as seedy toe. If the pedal bone rotates, a bulge appears in the sole where the rotation occurred.

Horses with chronic laminitis are prone to frequent abscessing. If your laminitic horse becomes very lame suddenly, wanting to bear little weight on the foot, the odds are good that an abscess is brewing.

People with laminitic horses should keep materials on hand to treat hoof abscesses. These include:

Epsom salts
Poultice
Vet wrap
Duct tape

Although you should keep these items handy, always have your vet confirm the horse is indeed suffering from an abscess. Such severe lameness could also result from a bone fracture or other emergency.

It is wise to invest in a pair of hoof testers and have your vet or farrier show you how to use them properly. Using this tool to apply pressure to the sole and hoof can identify the location of the abscess.

Founder vs. Laminitis

Laypeople often use the terms “laminitis” and “founder” interchangeably, but they are not synonymous. Founder occurs when the horse’s coffin bone has sunk or rotated, indicating a more severe or chronic case of laminitis.

Causes of Laminitis

Grain overload or sudden access to lush pasture are common causes of laminitis. These are not the only culprits. There are three different types of laminitis.

Endocrinopathic laminitis, which includes pasture-associated laminitis (“grass laminitis”), includes the majority of cases.

Sepsis-associated laminitis is a secondary result of illness, such as colic.

Supporting limb laminitis (SLL), the least common, occurs in horses suffering a serious, septic or non-weight-bearing lameness. Laminitis develops in a supporting limb.

Kentucky Derby winner Barbaro did not die from his broken rear leg but was euthanized because he developed laminitis in the supporting hind.

Various diseases and conditions can trigger laminitis. These include:

High fever
Opposite limb lameness
Retained placenta
Road founder – excess concussion on the feet
Severe colic
Strenuous exercise when unfit
Toxins released in the system

If using shavings as bedding, always know the type of wood involved. Bedding with black walnut shavings can cause laminitis. As little as 10 percent of black walnut residues in the bedding can result in clinical signs of toxicity.

Long-term use of corticosteroids may also predispose horses to laminitis.

Risk Factors for Laminitis

While any equine may develop laminitis, some are more vulnerable than others. Risk factors for laminitis include:

Cresty neck
Cushing’s disease
Equine metabolic syndrome
Fat pads on withers
Insulin resistance
Obesity

Horses who have received high or long-term doses of corticosteroids are at increased risk of developing laminitis. Animals with poor hoof conformation also have a greater risk of this condition.

Certain breeds and types of horses are known to have a higher risk of laminitis. These include:

Draft horses
Miniature donkeys and horses
Morgans
Ponies

As a general rule, the types of horses known as “easy keepers” run a greater risk of laminitis. That is because these are the equines most prone to metabolic disorders.

Remember that any horse with free access to a grain bin who consumes a large amount of feed is a founder candidate. If you discover a horse who has gorged himself on feed, call your vet even if the horse does not show symptoms of laminitis.

How to Treat Laminitis

Laminitis treatment involves a holistic approach once the initial crisis has passed.

If your horse shows symptoms of laminitis, take the animal off pasture and stop feeding any grain at once. Call your vet immediately. Do not feed anything other than grass hay until cleared by your veterinarian.

Liz Leahy, DVM, of Foundation Equine Wellness and Performance, Crosswicks, New Jersey, says that while waiting for the vet, put the horse in a deeply bedded stall or small area with soft footing where movement can be restricted.

There are also things horse owners should not do before the vet arrives. Leahy says horse owners should not administer medications before consulting with their veterinarian. They should also not exercise their horse.

“Cooling the feet with ice can be beneficial for laminitis. However, intermittent icing, such as applying ice packs for 30 minutes twice daily, can actually have negative effects,” according to Dr. Leahy.

“Unless you are able to keep the feet submerged in ice continually around the clock, do not attempt to cool the feet.”

Diagnosis & Treatment Factors

Gather the following information for the vet:

Current diet, including any recent changes in diet
Whether this is the first incidence of laminitis or a chronic issue
Any current medical conditions, such as Pituitary Pars Intermedia Dysfunction (PPID), also known as Equine Cushing’s disease, Equine Metabolic Syndrome (EMS)
Current health status including if the horse is being treated for things like diarrhea, infection, or musculoskeletal injury.
All current medications

Treatment will depend on the cause of the laminitis. As noted, horses with food-related laminitis require immediate removal from that source, whether pasture or grain. A mare with a retained placenta must have the remaining placenta removed and her uterus flushed.

Non-steroidal anti-inflammatory drugs (NSAIDs) are an integral part of laminitis treatment. The vet will determine the proper dosage of anti-inflammatories for the horse.

Horses on NSAIDs are at risk of developing digestive complications, including gastric ulcers. Your veterinarian may recommend probiotics in addition to NSAID use.

Veterinarians will recommend strict stall rest for horses for a specified period.

Working With a Farrier

Good farrier care is essential for any horse. With a laminitic animal, it can mean the difference between life and the owner’s decision regarding putting the horse down.

The hoof of a laminitic horse ever rarely returns to the way it was before laminitis. However, good farrier work, performed in conjunction with veterinary recommendations, can bring many horses back to a useful life.

After the veterinarian treats the immediate laminitic episode, the next step is a consultation between the vet and the farrier.

X-rays are necessary to assess the extent of the damage. These imaging tests reveal the degree of hoof rotation, providing a baseline for therapeutic farriery. No coffin bone rotation means that founder did not occur.

It is best to take a regular series of X-rays as the horse recovers to view bone remodeling or rotation. Changes may continue for months. These radiographs provide a way for the farrier to determine the best treatment for the particular horse.

Therapeutic farriery for the laminitic horse may include the use of heart-bar shoes and other types of corrective shoeing. Some horses may recuperate via barefoot trimming performed by a farrier well-versed in caring for the laminitic horse.

Every animal is different, and the farrier may have to try a few methods before finding out what works best for that particular equine.

Dietary Management for Laminitic Horses

Laminitic horses will need careful, lifelong dietary management.

Sarah Ralston, VMD, Ph.D., Dipl. ACVN is a retired professor of equine science in the Department of Animal Sciences at Rutgers’ School of Environmental and Biological Sciences, specializing in equine nutrition.

Ralston advises keeping high sugar and starch feeds away from the easy keepers. Such horses are also at increased risk of laminitis should they receive sudden access to grasses with high sugar content.

Instead, feed these equines hay. If they do require concentrates based on workload or other needs, feed high fiber, low starch, low sugar feeds.

If a horse owner knows their hay is high in fructans, they can soak it in warm water for one hour prior to feeding. Doing so should cause between 15 and 25 percent of the sugars to leach out.

Because there is always the risk of mold, she recommends soaking only if the horse is very laminitic.

She recommends restricting the grazing of laminitic equines to the morning, and not allowing access to pasture after a frost or after the first rains post-drought.

Laminitis Prevention

Good management practices can prevent many cases of laminitis. All horses should have regular farrier care.

The bulk of laminitis cases occur in the spring when horses consume too much new grass. Introduce your horses to spring pastures gradually, rather than allowing them to gorge themselves.

Ask your veterinarian about the recommended amount of grain for your horse, or whether your horse needs grain at all. Many horses in light to moderate work, and most ponies, need little or no grain in the diet.

If you breed horses, keep careful track of the placenta after foaling. Contact the vet immediately if you suspect the mare has retained part of the afterbirth. Retained placentas are always a veterinary emergency.

Finally, keep grain bins in a location where horses cannot get access. Should a horse escape the stall in the middle of the night, odds are he will head for the feed storage area.

The same holds true if the horses live out. If they get loose, the grain bin is a big attraction. This simple act of prevention can save you enormous heartache.

Meeting the Mineral and Vitamin Needs of the Laminitic Horse

Meeting your horse’s mineral and vitamin needs is critical when it comes to supporting laminitis recovery. Deficiencies in the diet can hinder hoof growth and exacerbate metabolic dysfunction.

Consider the mineral and vitamin supplement AminoTrace+, formulated to meet the needs of laminitic horses. It was designed specifically to support horses with insulin resistance, PPID, and EMS, conditions putting your horse at greater risk for laminitis.

AminoTrace+ contains higher levels of antioxidants, organic trace minerals, and other nutrients required to support hoof health and insulin sensitivity.

In particular, high levels of chelated copper and zinc in AminoTrace+ help to form the structural tissue that makes up the hoof. These essential microminerals work within the enzymes that crosslink collagen and elastin together.

Amino acids are the building blocks of protein required to build strong hooves. AminoTrace+ contains the three most limiting amino acids in the horse’s diet, lysine, methionine and threonine, helping to ensure protein synthesis keeps up with your horse’s demands.

AminoTrace+ also provides 20 mg of the B-vitamin biotin, an amount which is clinically proven to improve hoof quality in horses.

Formulated in a low-NSC pellet with no added sugars, AminoTrace+ supplies nutrients necessary for your horse to fight inflammation and boost digestive health. AminoTrace+ is a complete ration balancer meaning there is no need to feed additional supplements with this product.

Wondering if this supplement is appropriate for your horse? Submit your horse’s diet for analysis online and Mad Barn’s nutritionists can provide personalized recommendations.