Hoof Pain and Laminitis in Horses: What It Means and What To Do

By Dr Duncan Houston

If your horse is suddenly sore on its feet, reluctant to move, or shifting weight constantly, this is not something to wait on.

Hoof pain in horses can range from minor bruising to one of the most serious conditions in equine medicine, laminitis. The challenge is that early laminitis can look subtle, but once it progresses, the damage can become permanent.

This is one of those situations where early decisions directly determine outcome.

Quick Answer

Laminitis is inflammation of the structures that hold the hoof wall to the coffin bone. If severe, it progresses to founder, where the bone rotates or sinks. This is painful and potentially permanent. Immediate rest, removal of dietary triggers, and proper hoof support are critical to prevent worsening.

What Is Laminitis and Why It Matters

Inside the hoof, the coffin bone is suspended by microscopic structures called laminae.

When these fail:

• The bone loses support

• Weight begins to pull it downward

• Pain increases rapidly

This is why affected horses often:

• lean back onto their heels

• resist walking

• shift weight constantly

In practice, what matters most is not just the presence of laminitis, but how stable the hoof still is.

Laminitis vs Founder

• Laminitis is the inflammatory process

• Founder is structural failure, where the coffin bone rotates or sinks

Once rotation occurs, management becomes significantly more complex.

How Serious Is This?

Low Risk

• Mild stiffness

• Subtle changes in movement

• Eating normally

What this means: Early stage or mild inflammation
What to do: Restrict movement immediately and monitor closely over 12 to 24 hours

Moderate Risk

• Clear lameness

• Warm hooves

• Strong digital pulse

What this means: Active inflammation
What to do: Veterinary assessment recommended within 24 hours

High Risk

• Reluctance or refusal to walk

• Rocked-back stance

• Constant weight shifting

What this means: Significant pain and instability
What to do: Urgent veterinary care required

Critical

• Unable to stand

• Severe distress

• Lying down excessively

What this means: Severe laminar failure or systemic involvement
What to do: Emergency care immediately

What Causes Laminitis

Laminitis is usually triggered by something outside the hoof.

Most common causes:

• High sugar intake from pasture or grain

• Sudden dietary changes

• Equine metabolic syndrome

• PPID (Cushing’s disease)

• Severe illness or inflammation

• Overloading a limb due to injury

In practice, the mistake most people make is focusing only on the feet.
The underlying trigger is often the real problem.

Why Early Hoof Support Changes Outcomes

Once laminitis starts, the laminae cannot handle normal weight.

Without support:

• The coffin bone continues to move

• Damage progresses

• Pain worsens

With support:

• Pressure is redistributed

• Pain is reduced

• Progression can be slowed

This is one of the most important early interventions.

Best Support Options

Foam Pads

• Quick, simple support

• Good for immediate use

• Lose shape within 24 to 48 hours

Best used for: early stabilisation

Deep Bedding or Sand

• Allows natural weight redistribution

• Improves comfort

Limitation: consistency and practicality

EVA Pads

Currently one of the most effective options for ongoing support.

They:

• conform to the hoof

• distribute weight evenly

• maintain structure over time

What matters most is correct placement based on imaging.
Poorly applied support is often no better than none.

What To Do Right Now

If you suspect laminitis:

1. Stop movement immediately
No walking “to test it”

2. Remove dietary triggers
No grain, no pasture, only low-sugar hay

3. Apply temporary support
Foam pads or similar

4. Call your vet
Do not delay if signs are more than mild

5. Monitor closely over hours, not days
If worsening, escalate immediately

When Is This an Emergency?

Treat as urgent if you see:

• refusal to walk

• strong digital pulse

• heat in the hooves

• constant shifting of weight

Treat as an emergency if:

• your horse cannot stand

• shows severe distress

• is lying down repeatedly

Laminitis can progress quickly. Waiting is where things go wrong.

Common Mistakes

• Waiting too long to act

• Continuing pasture access

• Walking the horse unnecessarily

• Delaying hoof support

• Assuming it is just a bruise

In practice, these are the exact mistakes that turn manageable cases into severe ones.

Long-Term Prevention

Once stabilised, preventing recurrence is critical.

Focus on:

• controlling diet and sugar intake

• maintaining healthy weight

• managing metabolic disease

• consistent hoof care

Laminitis is rarely just a one-off event.
It is usually something that needs ongoing management.

Frequently Asked Questions

Can laminitis go away on its own?
Mild cases may stabilise, but relying on this is risky. Early intervention significantly improves outcomes.

How long does recovery take?
Mild cases may improve within weeks. Severe cases can take months and may not fully resolve.

Should I walk my horse to keep circulation going?
No. Movement increases mechanical damage during the acute phase.

Can a horse return to normal work?
Yes in mild cases. More severe cases may have long-term limitations.

Is laminitis always caused by diet?
No. Hormonal conditions and systemic illness are also common causes.

Final Thoughts

Laminitis is one of the most important conditions to recognise early in horses.

The key decisions are simple:

• stop movement

• remove triggers

• support the hoof

• involve a vet early

Handled early, many horses recover well.
Handled late, the consequences can be permanent.

If you are unsure how serious your horse’s signs are or need help managing recovery, ASK A VET™ can help guide you through what to do next with clear, practical support.