Hoof Pain and Laminitis Relief in Horses – 2025 Vet-Recommended Treatments for Founder 🐴🦶🩹

By Dr Duncan Houston, BVSc

Understanding Hoof Pain in Horses 🐎

Horses are highly susceptible to foot pain due to the anatomical design of their hooves and the tremendous weight they carry. From hoof abscesses and sole bruises to severe inflammatory conditions like laminitis and founder, managing hoof pain is a cornerstone of equine veterinary care.

Laminitis and Founder: What's the Difference? ❓

Laminitis is an inflammation of the laminae—the soft tissue that connects the hoof wall to the coffin bone. Founder occurs when the condition progresses to rotation or sinking of the coffin bone. In either case, affected horses are in severe pain and often unwilling to walk or even stand. 🚫🦶

The Role of the Coffin Bone 🦴

The coffin bone (also called the third phalanx or P3) is the critical bone inside the hoof capsule. If inflammation from laminitis causes rotation or sinking of the coffin bone, the damage can be permanent and potentially career-ending. In severe cases, humane euthanasia is considered. 😢

Why Sole Support Is Crucial 🧼

During a laminitic episode, relieving pressure on the damaged laminae and protecting the sole helps:

• Reduce pain and inflammation
• Prevent further rotation of the coffin bone
• Stabilize the hoof and allow healing

Top 2025 Supportive Therapies for Hoof Pain ✅

1. Styrofoam Pads 📦

Veterinarians have long used high-density Styrofoam pads to provide immediate sole support. These are cut to fit the hoof, taped in place, and allow for easy compression under pressure—relieving weight on the damaged hoof structures.

Pros: Inexpensive, effective for short-term relief.
Cons: Must be replaced every 24–48 hours as they compress and lose form.

2. Deep Sand Bedding 🏖️

Placing a horse in a stall with 6–8 inches of soft, deep sand can help redistribute pressure away from the hooves. Horses often naturally find the most comfortable position in the sand.

Challenges: Hard to find truly soft sand that doesn’t compact. A full stall may require a truckload of sand, which limits practicality for many facilities.

3. EVA Pads – The 2025 Gold Standard 🩹

Ethylene vinyl acetate (EVA) pads offer long-lasting, customizable sole support. These lightweight, moldable pads retain their shape over time and can be trimmed based on radiographic evidence of the horse's individual hoof structure. 🔬📐

Dr. Mike Steward has pioneered the use of EVA pads in laminitic horses. They’re now widely considered the standard for long-term supportive care in laminitis cases.

How EVA Pads Work 👣

• Provide uniform pressure across the sole
• Conform to hoof shape, offering stability and comfort
• Durable for weeks of use without needing frequent replacement
• Can be used alone or with therapeutic shoes

When to Use These Pads 🧭

Best used immediately after diagnosis of laminitis or in any case where there is sole sensitivity or suspicion of coffin bone movement. X-rays should be performed to determine rotation or sinking of P3. Pads should then be trimmed and adjusted accordingly.

Veterinary-Guided Laminitis Support Program 📋

Initial Management:

• Stall rest with deep bedding
• NSAIDs for pain (e.g., phenylbutazone or firocoxib)
• EVA pad or foam sole support

Advanced Measures:

• Radiographs to assess P3 alignment
• Specialized shoeing (heart bar, reverse shoe, etc.)
• Ice therapy in acute stages to reduce inflammation

Dietary Management 🍽️

• Remove all grain and high-sugar feeds
• Feed low-starch hay (soaked if needed)
• Evaluate for underlying metabolic disease (e.g., EMS or PPID)

Case Study 🐎

Horse: 12-year-old draft-cross gelding
Problem: Sudden lameness, unwilling to walk
Diagnosis: Radiographs showed mild coffin bone rotation (P3)
Treatment: EVA pads applied immediately; NSAIDs administered; horse moved to deep-stall bedding

Outcome: With proper pad support, diet change, and vet-directed rehab, horse made a full recovery and returned to trail riding 6 months later.

When to Call Your Vet 📞

• If your horse is shifting weight constantly or refuses to move
• If there's visible heat or bounding digital pulse in the hoof
• If your horse is lying down frequently or appears distressed
• If you suspect laminitis or see changes in hoof shape

FAQs About Laminitis Support 🧐

Q: Are foam or EVA pads a permanent solution?

A: No. They are temporary therapeutic aids used during active laminitis flare-ups or founder recovery. Once the hoof stabilizes, therapeutic shoeing or barefoot rehab may follow.

Q: Can I make a DIY EVA pad?

A: EVA foam can be cut from industrial sheets or purchased as veterinary-grade pads. Consult your vet before applying, as trimming and positioning should be based on radiographs.

Q: Can I turn a laminitic horse out on pasture?

A: No. Especially in acute stages, full stall rest is required. Pasture turnout may exacerbate coffin bone rotation due to added movement and grass sugar content.

Conclusion

Laminitis and hoof pain require urgent and thoughtful intervention. Whether it’s a Styrofoam pad, EVA support, or deep sand bedding, the key is prompt, effective sole support and minimizing damage to the internal structures of the hoof. 🩹

For a customized hoof pain management plan, consult Dr Duncan Houston directly via the AskAVet.com app 📲. You’ll get personalized guidance and support from diagnosis through recovery. 🐴💪