Laminitis in horses: Understanding causes and recognizing symptoms with the symptom test

What is laminitis?

Laminitis (pododermatitis aseptica diffusa), also known as laminitis, is a non-infectious inflammation of the hoof corium in horses that can lead to severe damage. It is caused by the detachment of the hoof's horn capsule from the underlying hoof corium. Without timely treatment, this disease can take a dramatic course.

Laminitis is particularly dangerous because it is not caused by germs but is an aseptic inflammation. All of the horse's hooves can be affected, although the front hooves are most frequently affected. The triggers of laminitis are varied, including obesity and metabolic imbalances.

Acute laminitis can develop into chronic laminitis and lead to relapses. However, if laminitis is detected and treated at an early stage, the chances of recovery increase considerably.

To further deepen your understanding of laminitis, we have prepared a short video that clearly explains the causes, symptoms and treatment options for this serious condition. Watch the video to get a comprehensive insight into the subject and learn how you can best protect your horse.

First aid for laminitis

If laminitis is suspected , there are some immediate measures that can be taken to help the affected four-legged friend!

What happens in the hoof in the event of laminitis?

Laminitis is an inflammatory process in the hoof corium that destroys the stable connections between the horn capsule and the coffin bone. These two structures are normally connected by fine lamellae, which are damaged during laminitis. As a result, the coffin bone loses its hold in the horn capsule and begins to shift or sink.

Rotation of the coffin bone is a common result of this process, where the coffin bone either rotates downwards or sinks towards the sole. In more severe cases, the coffin bone may even break through the sole. This severe complication causes the horse to lose the horn capsule, a condition known as "shoeing out".

In addition, the inflammation and swelling of the hoof corium severely impairs blood circulation in the hoof, which leads to circulatory problems and an undersupply of nutrients. This can cause long-term damage to the hoof structures if the laminitis is not treated in time.

Recognizing laminitis: Symptoms & stages

Laminitis symptoms

How is laminitis recognized? The symptoms of laminitis usually manifest themselves in severe pain. Colic-like symptoms can also occur due to severe pain.

Signs of laminitis often include:

• Lameness
• Warm or hot hooves
• Changed posture
• Sawhorse position (front limbs are outside the center of gravity/ hind limbs are pushed under)
• Increased pulsation in the main metatarsal arteries
• Pain when moving or lifting the hooves
• Tripping (relieving the front hooves)
• Changes in movement/gait at the walk and trot
• Stiff motion sequence
• Turning pain
• Trachtenfußung (relief of the front hoof parts)
• Crown swelling
• Pressure sensitivity in the sole and wall area
• Increased temperature of the horn capsule & at the coronal edge

If you suspect that your horse may have laminitis , you can use our symptom test below to get an initial assessment.

Laminitis stages and symptoms

Laminitis, a serious disease in horses, often develops gradually and progresses in several stages. From early, barely recognizable symptoms to acute and chronic forms that can permanently affect the horse, it is important to recognize the typical signs early on. Timely treatment can prevent serious consequences. The following table provides an overview of the different stages of laminitis and their characteristic symptoms.

Laminitis diagnosis

Diagnosis of laminitis: Important measures
The diagnosis of laminitis involves various steps. The vet first checks for signs such as lameness, warm hooves or increased pulsation of the arteries. The area of pain is localized using hoof tongs. For a precise assessment, an X-ray is taken, which provides information about the position of the coffin bone and possible changes.

Diagnosis process for laminitis: Video insight

This video gives you a comprehensive overview of the entire diagnosis of laminitis. It will help you to better understand how the various tests are carried out and how the results are used to choose the best treatment strategy.

Venography can be used to better understand the extent of laminitis. A contrast agent is injected into the blood vessels in the hoof, which becomes visible on the X-ray image. This allows the severity and progression of the disease to be assessed. This can be repeated several times during a relapse in order to make a precise prognosis and optimize the treatment plan. However, as the method is time-consuming and expensive, not all vets offer it.

Laminitis: treatment and therapy

How is laminitis treated?
If laminitis is diagnosed during the examination, it is important to act as quickly as possible to prevent the coffin bone from turning or sinking.

Important immediate measures:

• Stall rest: The horse should stand on soft ground to relieve the hooves.
• Cool hooves: Cooling the hooves helps to reduce inflammation.
• Painkillers and anti-inflammatories: Medication to relieve pain should only be used carefully to avoid overloading the hooves.
• Deer bandage: A deer bandage can help to relieve pressure and prevent infections.

Individual treatment: Which treatment is suitable must be clarified individually with the vet. Important steps include:

• Change of diet: reduction of sugar and starch in the feed.
• Elimination of causes: treatment of the triggers, such as metabolic problems or obesity.

Chronic laminitis:

• In the case of chronic laminitis, a special shoe, such as a laminitis shoe, is recommended. This relieves the front toe wall and transfers the load to the frog.
• X-rays should be used to check the rotation of the coffin bone.

Long-term therapeutic goals: Many of the therapeutic approaches are aimed at slowing down the progression of the disease. In some cases, the disease can be cured in the long term by eliminating the causes.

Causes of laminitis

There are several causes of laminitis, some of which can occur simultaneously. Recognizing the causes is crucial for the treatment and prevention of further attacks.

Basically, laminitis often occurs when the horse ingests more sugar and/or starch over a longer period of time than its body can process. Starch that has not been fully broken down reaches the large intestine, where bacteria break it down and produce lactic acid. This process kills beneficial bacteria and releases endotoxins that enter the bloodstream and acidify the body, ultimately causing inflammation of the hoof corium.

Below you will find a detailed table of the most common causes of laminitis:

Preventing laminitis: anti-lameness rules

How can I avoid laminitis?

The causes of laminitis are very diverse. It is therefore only logical that the disease can be prevented in different ways. In addition, there are the individual characteristics of the horse, for example its age and breed, but also the way it is kept, past or current illnesses and how it is used. It is also important to know that not all triggers can be eliminated by prevention; however, the risk of laminitis can be reduced by taking appropriate measures.
The following are general tips for preventing laminitis, which are then supplemented by specific tips on feeding.

General tips for handling and keeping

1. Avoid overweight / diet
2. Move horse regularly
3. No work on hard ground
4. In case of lameness: support healthy leg with laminitis bandage
5. Check paddocks, for example for poisonous plants
6. Regular, professional hoof care and shoeing
7. Take hygiene measures at birth
8. Ensure that the afterbirth is complete

General feeding tips

1. Change food (slowly)
2. Adjust the feed dosage for the horse
3. Fodder without impurities
4. Pay attention to sugar and starch concentration in the feed (especially in grass and grain!)
5. Use fructan-reduced grass seed for paddocks

Feed tips for marriage-prone horses

Can my horse with laminitis go out into the paddock? These and similar questions arise if your horse is already suffering from laminitis. You should then be especially careful with possible triggers and prevent a recurrence of the disease:

1. Avoid excess fructan
   The fructan content in grass depends on the time of day, weather, and temperature, among other factors.
   If the sun is shining, but it is cold overall and the ground may even be frozen, a lot of fructan is stored and thus absorbed by a grazing horse. For horses that are susceptible to deer, this combination should therefore be avoided. Also, an excessively dry soil and strong sunlight or heavy rain on extremely dry soil do not provide the optimal conditions.
2. Avoid freshly mown and eroded meadows
   Short blades of grass, such as those found after mowing, contain high amounts of fructan. Logically, however, the horse cannot eat as much grass as on an unmown pasture. Ideally, a well-kept meadow should be used, which is neither too high nor too low and has as much leaf content as possible.
   If you sow a meadow that you want to use as a paddock later, you can already use seeds there that are specially designated for this purpose.
3. Limit grazing time
   Regulate your horse's grazing time and make sure that he is in the paddock regularly and not for too long. When feeding, you should still provide him with enough roughage in the form of hay or roughage substitute products, for example. You should make sure that these foods are low in sugar and starch.
4. Use scuff brakes
   Feed intake on pasture can be reduced by feeding brakes. Especially for horses whose paddock is very extensive, this can be an alternative and allow sufficient time in the pasture.
5. Cutting hay late
   For horses that are prone to deer, late hay pruning is recommended in order to have as little fructan as possible in the hay. Since not every horse owner can influence the hay cut, the hay can alternatively be soaked in warm water for at least half an hour. This also reduces the fructan content, but also reduces the vitamins it contains.
6. Creating a feeding plan
   In order to keep track of the feed, and thus the sugar and starch that your horse eats, you should create a feeding plan. In it, you take into account both the times in the paddock and the additional roughage given during the grazing season.
   A blood count can answer the question of what nutrients your horse needs. It also provides information on how to avoid an excess of some substances.
   If a horse is put on a diet, weight loss should proceed slowly. Losing weight too quickly can again favor deer.
7. Additional lining
   If your horse is given additional food, you should also pay attention to a low sugar and starch content. That's why many mueslis and beet pulp, for example, are suitable as supplementary feed.

Chances of recovery from laminitis

Can laminitis be cured?

It cannot be said with certainty whether laminitis is curable or not . Healing and life expectancy depend on the horse and the stage of laminitis and is therefore not a direct death sentence. One point of reference is the rotation of the coffin bone: no change means that the horse can be ridden as it was before it became ill. If there is a rotation of up to seven degrees, the probability of healing is still high. If the rotation is even more advanced, the horse is unlikely to return to sport. However, this scale is not universally valid and can be different for different horses. The worst outcome is that the horse is euthanized.

In order to keep the chance of recovery as high as possible, early detection and proper treatment of acute laminitis is important. If this does not happen, chronic laminitis can occur after two to three days, which lasts several weeks and, in case of doubt, can affect the horse for life.

Does shoelessness mean the death of the horse?

Shoeing out in a horse with laminitis is a very serious condition in which the horn capsule of the hoof becomes completely detached from the coffin bone and falls off. This happens when the connection between the hoof corium and the coffin bone is destroyed by the inflammation of laminitis. The coffin bone loses its support, which leads to extreme pain.

As a rule, shoing does not occur at all, as most horses are either treated early or have to be euthanized if the pain is too great. However, if shoeing does occur, this is not automatically a death sentence: a new horn can be formed, resulting in a new hoof capsule.

Healing after a horse with laminitis has been shod can take a long time. As a rule, the process in which a new hoof capsule forms takes several months to a year. This process is highly dependent on the severity of the shoeing and the individual healing factors of the horse. During this time, intensive care and monitoring by a vet is crucial to support the healing process and avoid complications.

My horse has laminitis, do I have to put it to sleep?

The question of whether a horse with laminitis needs to be euthanized cannot be answered in general terms, as this depends on the severity of the disease and the associated pain. Early diagnosis plays a crucial role in taking timely measures to alleviate the horse's suffering and improve the chances of recovery.

Whether euthanasia is necessary or the horse has a chance of recovery should always be decided together with the vet. The vet can accurately assess the horse's condition and draw up a treatment plan that is tailored to the individual circumstances.

When is laminitis cured?

The healing of laminitis is a long process, especially if the disease has severely damaged the hoof through rotation or depression of the coffin bone. On average, the recovery phase takes about a year, even if there are no visible external impairments.

It is important that the healing of the hoof is thoroughly monitored and that care remains intensive during this time in order to prevent relapses and fully restore the functionality of the hoof.

Once laminitis, always laminitis?

Yes, once a horse has had laminitis, it has a lifelong tendency to relapse. This means that there is always a risk of the disease returning.

The risk of laminitis does not depend on the season, but is strongly influenced by the weather. As the disease is associated with great pain for the horse, owners should pay particular attention to feeding and husbandry. It is also important to consistently take preventative measures to minimize the risk of a relapse.

Is exercise good for laminitis?

Whether exercise is good for laminitis depends very much on the stage of the disease and the severity of the symptoms. Here are some important points:

1. Acute stage:
   • In the acute phase of laminitis, the horse should be given absolute rest. Movement in this condition can aggravate pain and exacerbate the damage to the hoof structures. In this phase, strict stall rest is required, preferably on a soft surface.
2. After the acute phase:
   • Once the acute symptoms have subsided, controlled exercise under veterinary supervision can be helpful to promote blood circulation and prevent stiffness. It is important to only allow the horse to move as much as it is willing to on its own.
   • Soft surfaces are preferable as they reduce the strain on the hooves.
3. Chronic laminitis:
   • In the case of chronic laminitis, light, regular exercise on soft ground can be useful to improve circulation and maintain muscle strength. Here, exercise is generally better than complete immobilization.

In any case, exercising a horse with laminitis should always be done in consultation with the vet to ensure the best treatment plan and avoid relapses.

How do I move a horse with laminitis?

‍Thereis no universal recommendation for keeping and exercising a horse suffering from or susceptible to laminitis. The following points are possible approaches, but they should always be based on the individual case, the severity and the current stage of the disease. It is important to make all decisions in consultation with a vet.

• Avoid lack of exercise: Complete immobilization in a stall is often not ideal, as lack of exercise can make laminitis worse. However, the horse should also not be forced to move if it does not want to in its condition.
• Soft ground: If the horse wants to move, it should do so on soft ground. Hard ground should be avoided as it can increase the strain. This also applies to the ground in the paddock or box.
• Hoof boots or shoeing: In the event that a hard surface cannot be avoided, hoof boots or special shoeing can be used to protect the hoof.
• Avoiding stress: It is also important that the horse has contact with its conspecifics to minimize stress. If stress is caused by the herd, a paddock with visual contact to other horses can be a temporary solution.

When can I ride and exercise again after laminitis?

‍Beforea horse can be ridden again after laminitis, it should make a motivated impression in everyday life and be happy to move. It is also important to get the vet's opinion and make sure that the x-rays no longer show any injuries. Only then can the horse be trained or ridden as usual.

It is better to wait longer and make sure the horse is fully recovered rather than rushing recovery and making laminitis worse again.

Laminitis: Summarized

Laminitis is a serious, non-infectious inflammation of the hoof corium that can cause considerable pain and long-term damage in horses. There are many causes, ranging from overfeeding and metabolic diseases such as Cushing's or EMS to overloading or poisoning. Early detection and treatment are crucial for successful healing.

While acute laminitis can often be cured with the right measures, the risk of relapse remains and, in severe cases, chronic laminitis can develop, requiring lifelong care. Regular veterinary examinations, appropriate feeding and stress-free management are essential to provide the best possible support for affected horses and prevent future relapses.

With the right treatment, such as stall rest, hoof cooling, individual shoeing and in some cases even shoeing, the disease can often be controlled. Preventative measures, such as avoiding excessive sugar consumption and managing the hooves, are also key to ensuring the horse's long-term welfare.

A holistic approach that takes into account both the horse's physical and environmental conditions can help to minimize the risk of laminitis and restore the horse to health and freedom from pain.

Laminitis: The most important questions and answers

How does laminitis announce itself?

Laminitis often announces itself through subtle signs such as irregularities in rhythm, changes in posture (horse relieves pressure on the front hooves), warm or hot hooves, increased pulsation in the metatarsal arteries and lameness. In acute laminitis, severe lameness often occurs and the horse tries to relieve pressure on the hooves.

What is the best remedy for laminitis?

Immediate rest in the stall, cooling the hooves and calling the vet are the first measures to take if laminitis is suspected. Treatment should be individually tailored to the horse and the trigger and may include anti-inflammatory medication, special shoes or bandages.

What are horses with laminitis not allowed to eat?

Horses with laminitis should not eat sugary or starchy feed such as cereals, bread, fruit or fresh grass with a high fructan content. Diets containing concentrated feed or grazing on grass with a high fructan content should be avoided in particular.

What triggers laminitis?

There are many triggers for laminitis, including overfeeding, especially with sugary and starchy foods, overloading the hooves, metabolic diseases such as Equine Metabolic Syndrome (EMS) or the Cushing's syndromeand poisoning caused by toxins or poisonous plants.

Can laminitis be cured?

Acute laminitis can be cured with early diagnosis and consistent treatment. Chronic laminitis is often a lifelong challenge, but can be controlled with the right management to keep the horse pain-free.

Which hoof boot for laminitis?

We recommend deepening shoes or special hoof boots that reduce the pressure on the toe and shift the weight onto the heels. There are various models, such as soft-ride hoof boots, which can be used for laminitis.

Which shoeing for laminitis?

A special lifting shoe is often used to relieve pressure on the hoof. This shoe is open at the front to relieve pressure on the toe and often has a bar shape that redirects the pressure onto the frog and heels.

What should I not feed if I have laminitis?

Horses with laminitis should not be given cereals, bread, fruit, fresh grass or other carbohydrate-rich feeds, as these can stress the metabolism and exacerbate the symptoms.

Can you still ride a horse with laminitis?

A horse with acute laminitis should not be ridden under any circumstances. As soon as the acute symptoms have subsided and the vet has given the go-ahead, the horse can be gently moved again in consultation with the vet.

How long does it take for laminitis to heal?

The healing time varies depending on the severity of the laminitis. In mild cases, healing can be completed after a few weeks, while severe cases, especially with rotation of the coffin bone, can take several months to a year or longer.

How long does laminitis take to heal?

With a full recovery, it can take up to a year for the hoof to heal completely. This is particularly true in the case of coffin bone rotation or depression, as the hoof grows back slowly and the hoof capsule stabilizes.

What does the vet do for laminitis?

The vet will first carry out a clinical examination, which often includes a hoof calliper examination and, if necessary, x-rays to assess the degree of coffin bone damage. He may then recommend anti-inflammatory medication, painkillers and special measures such as re-shoeing or cooling.

How do I keep a horse with laminitis?

A horse with laminitis should be kept on soft ground and protected from excessive exercise. An appropriate diet, avoiding stress and avoiding carbohydrate-rich feed are essential. Regular hoof care and monitoring by a vet are also important.