June 12, 2025, 1:54 pm | Read time: 5 minutes
Laminitis is a common and extremely painful condition in horses. It is not always recognized early enough or treated consistently. PETBOOK highlights what owners should watch for.
It is one of the most feared diseases in the equine world: laminitis. Anyone who has ever seen an animal with a pain-stricken look standing in a sawhorse-like stance in the stable knows how dramatic the course can be. But what exactly is behind this inflammation deep within the hoof—and what really helps when it breaks out?
Causes—Many Paths Lead to Laminitis
In laminitis, the so-called laminae—a sensitive network of fine blood vessels that connects the hoof to the coffin bone—becomes inflamed. This connection ensures that the coffin bone is “suspended” within the hoof capsule. When inflammation occurs, this suspension is weakened—with devastating consequences. “During inflammation, it swells and blood circulation in the hoof is further disrupted. The severe swelling under the hoof capsule cannot spread in the horse’s hoof, resulting in high, very painful pressure in the hoof,” writes the Aschheim Equine Clinic on its website.
In the worst case, the coffin bone sinks or even rotates—a condition that often leaves irreparable damage. However, laminitis is not an independent disease but primarily a symptom of underlying problems. It can be triggered by a variety of causes:
- Feeding errors: The most common cause of acute laminitis attacks. Too much fructan-rich grass—especially in spring, excessive grain feed, or sudden dietary changes disrupt the horse’s gut flora. Inflammation-inducing substances enter the bloodstream and reach the hooves.
- Metabolic disorders: Horses with Equine Metabolic Syndrome (EMS), Cushing’s syndrome (PPID), or insulin resistance are particularly susceptible. Their bodies react with inflammatory processes, becoming overly sensitive to sugar and starch.
- Mechanical overload: Excessive strain—such as long rides on hard ground—can also trigger so-called overload laminitis.
- Toxin-related causes: Infections, retained placenta in mares, or poisoning (e.g., mold in feed) also lead to inflammatory reactions in the body—with dramatic effects on the sensitive laminae.
Typical Symptoms Are Usually Visible Late
Typical symptoms of laminitis often appear late. The University of Zurich Veterinary Hospital notes that the condition progresses in several phases. The first, clinically almost symptomless phase often goes unnoticed. “Depending on the cause, it can last from a few hours to several days in systemic diseases, without any pain symptoms appearing.” Gradually, however, the general condition worsens, and increased pulsation in the limb arteries sets in.
As a result, laminitis is often recognized quite late—and can quickly become dramatic. An attack, especially due to mechanical overload, can also occur suddenly. In the inflammatory phase, the horse shows severe symptoms: The general condition is significantly reduced. Food intake is decreased or completely stopped.
Symptoms of Laminitis
- Sawhorse stance: The horse shifts its weight onto its heels to relieve the painful front of its hooves.
- Reluctance to move: Horses with laminitis are unwilling to walk and lift their hooves only in small steps.
- Heat in the hooves: The affected hooves feel noticeably hot.
- Increased pulse: There is often a noticeable increase in the pulsation of the digital arteries.
- Toe flicking: The horses try to relieve the pain by flicking their toes forward when stepping.
- Changes in the hooves: Laminitis that recurs or is prolonged can lead to visible changes in the hooves—such as ridges in the hoof horn, dropped soles, a loose white line, or coffin bone rotation. Even broken hoof walls can occur.
The sawhorse stance is a particularly acute, early warning sign that owners should always respond to. Often, especially in ponies or hardy breeds with high pain tolerance, laminitis initially goes unnoticed—with dire consequences.
Horses often show pain stoically—making it all the more important to pay close attention to body language, gait, and small behavioral changes. Early detection can often slow the course of laminitis. Especially in ponies or robust breeds with high pain tolerance, laminitis initially goes unnoticed—with fatal consequences.
Prognosis for Laminitis—From Full Recovery to Permanent Limitation
The chances of recovery from laminitis depend on how early it is detected and how consistently it is treated. Acute cases—where the coffin bone is not affected—can fully heal. However, cases with coffin bone rotation or sinking often lead to permanent damage. Some horses remain lame and struggle with limitations, and they should no longer be used for riding.
“With the right effort and patience, many horses can be restored to normal functionality,” Dr. Rödig reports on her website. “The basic requirement is that the owner adheres to the appropriate guidelines for feeding, exercise, and care for their horse.”
It is crucial to control and address the underlying issues to prevent recurrence. This is especially true if the horse has had laminitis before, as the tendency for inflammation can easily reoccur.
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Laminitis Is Not Fate
Laminitis is not a fate—it is usually the result of management issues or untreated underlying conditions. Those who know their horse and its signals well, pay close attention to the feed offered, and regularly check blood values can do much to prevent laminitis. Because it is clear: Every laminitis attack that is prevented is a victory.