Stabled Shetland pony with owner

Laminitis in horses

Laminitis results in inflammation of the sensitive tissue – laminae – in a horse's hoof.

In severe cases, laminitis causes permanent damage to the foot. It's a very painful condition affecting one in ten horses ever year and, in some cases, can be fatal. Understanding and tackling the cause is key to a good recovery.

What is laminitis?

When blood flow in the hoof is affected, inner sensitive tissues – laminae – are starved of oxygen and nutrients. Over time this leads to inflammation and swelling and, unless the cause is quickly treated, the tissue begins to die.

When the laminae is particularly damaged, the pedal bone begins to rotate. Laminitis can affect any of the feet but is more common in the front feet. Any horse can be affected by laminitis at any time of the year.

Signs of laminitis

There are three stages of laminitis:

  1. Subclinical laminitis
  2. Acute laminitis
  3. Chronic laminitis

Subclinical laminitis

Early signs of laminitis can be difficult to spot in subclinical cases. Changes within the hoof are beginning to take place, but may not cause visible pain. A subtle sign of subclinical laminitis is a stretched white line on the sole of the hoof.

Acute laminitis

Symptoms of acute laminitis come on very suddenly and severely. Signs include:

  • an inability or reluctance to walk
  • reluctance to get up after lying down
  • a hoof that is hot to the touch for more than two hours
  • visible lameness on a hard surface or when turning a circle
  • leaning back onto the hind feet (also known as laminitic stance)
  • an increased digital pulse in the foot
  • an increased heart rate

Horses with acute laminitis can also show symptoms similar to colic. Spotting signs of acute laminitis early is vital for preventing permanent damage to the hoof.

Horse with laminitis
A pony with acute laminitis leaning back onto their hind feet (laminitic stance).

Chronic laminitis

Chronic laminitis usually follows cases of acute laminitis where the hoof has been damaged. Symptoms of chronic laminitis are often a sign of relapse. Signs include:

  • a cresty neck
  • lameness
  • abnormal hoof growth creating a longer toe
  • growth rings around the hoof wall
  • a bulge in the sole where the pedal bone has rotated

What causes laminitis?

A number of different factors can cause laminitis or put your horse at higher risk of developing laminitis. Horses who are overweight or have suffered previously from laminitis are particularly in danger.

Inflammatory laminitis

Diseases linked to inflammation can trigger laminitis. These diseases include types of colic, diarrhoea, severe pneumonia, or a retained placenta in mares.

Hormonal laminitis

There are two hormonal diseases linked to laminitis – equine Cushing’s disease and equine metabolic syndrome. These diseases should be quickly and carefully treated to prevent laminitis from developing:

Equine Cushing’s disease

Often found in older horses, equine Cushing’s disease affects the pituitary gland, causing an overproduction of hormones. This can affect the whole body in various ways, including excessive hair growth, abnormal fat deposits, lethargy and laminitis. There is no cure for Cushing’s, but it can be managed with medication and supportive care.

Equine metabolic syndrome (EMS)

Horses affected by EMS have a resistance to insulin. They have difficulty losing weight, abnormal fat deposits and an increased risk of laminitis. Losing weight, increasing exercise and appropriate medication can help to control EMS.

High intake of soluble carbohydrates

Too much carbohydrates – sugar and starch – can overload the digestive system. Undigested sugar and starch is then pushed through to the hindgut. When this is broken down, acidity is released and kills useful bacteria. This produces toxins that can disrupt blood flow to the feet, resulting in laminitis.

Mechanical problems

Laminitis can be caused by mechanical problems, such as:

  • excessive foot trimming
  • improper shoeing
  • fast or intense work on hard surfaces
  • too much length of toe
  • a fracture or infected joint forcing one leg to carry more weight


There are a number of reasons a horse can become stressed. Sudden changes in environment, diet or routine, frequent travelling and overworking can trigger laminitis. Overweight horses and mares who have recently given birth are particularly at risk.


Too much weight can add strain on a horse’s vital organs and limbs. The risk of laminitis more than doubles in overweight horses.

Treating laminitis in horses

If you suspect your horse has laminitis, call your vet immediately and restrict your horse's movement. They will be in a lot of pain and will need to be kept comfortable. If they are usually stabled, provide a deep bed of clean shavings for extra support under the hoof. Alternatively, a small pen with the same soft bedding may suit horses who live out.


To reduce stress during box rest, make sure your horse has a familiar companion nearby.

Your vet will advise you on the best treatment for your horse. This can include:

  • painkillers
  • extended box rest on a deep bed of shavings
  • therapeutic trimming and shoeing
  • dietary changes

X-rays may be necessary to assess how much the pedal bone has rotated, if at all. In cases where the bone has dropped through the sole, euthanasia may be the only option to prevent the horse from suffering.

Can laminitis in horses be cured?

With early diagnosis and careful management, horses with laminitis can make a good recovery. But in many cases damage to the hoof cannot be reversed. Prevention is always better than the cure.

How to prevent laminitis


A good, low calorie diet is essential to preventing laminitis. This should be fed little and often – in line with a horse’s natural diet pattern – to keep the digestive system working properly.

Grass should be restricted during spring and summer when their sugar content is highest. You can strip graze or turn out your horse at night when there are less carbohydrates in the grass. Horses prone to laminitis can also be given a muzzle.

You should only give your horse supplementary feed if absolutely necessary. Speak to your vet or an equine nutritionist to make sure your horse is on the correct diet for their weight, age and exercise levels.


Weighing your horse regularly can highlight problems before they lead to laminitis. Body scoring can help also you to identify abnormal fat deposits, and develop a weight loss plan if necessary.

Preventing your horse from becoming overweight will also reduce the mechanical strain on their feet.


Pick out and check your horse's feet daily for heat or an increased digital pulse. Checking the digital pulse is easy to do:

  1. Place your first two fingers on the fetlock joint
  2. Gently press and move your fingers from side to side. You should feel a soft bundle of strings (the digital arteries).
  3. Continue to gently press until you feel a pulse. Pressing too hard will cut off the pulse, but pressing too lightly will make it hard to find. Most horses should have a faint digital pulse.
  4. Staying on top of trimming and shoeing will also keep your horse’s feet in the best possible condition. Neglecting foot care for over eight weeks can put your horse at higher risk of developing laminitis.


To prevent mechanical problems, monitor the ground before working your horse. Hard surfaces – such as roads or rocky ground – can damage the feet. If you come across these surfaces, stick to a steady walk.

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• 30 June 2023

Next review

• 30 June 2026

Approved by
Ruth Court

Horse Welfare Manager