Rehabilitating the Laminitic Horse

Heather U
Jan 15
5 min read

Updated: Jan 16

If you’ve just learned that your horse has laminitis, you might be feeling overwhelmed — but don’t worry, you're not alone. Laminitis is a serious hoof condition but with the right care, many horses recover and live comfortably. Many even return to light work.

This article will help you better understand what laminitis is, how it differs from founder, how to care for a horse dealing with it, and how to prevent it in the first place. Whether you're new to horses or learning to manage your first laminitic case, this article is for you.

What Is Laminitis (and How Is It Different from Founder)?

Laminitis refers to inflammation in the sensitive laminae — the tissue structures inside the horse’s hoof that connect the coffin bone to the inner wall of the hoof. When these tissues become inflamed, painful damage occurs.

Founder is a term often used interchangeably with laminitis, but technically, it's a more advanced stage. Founder occurs when the coffin bone inside the hoof rotates or sinks due to laminar failure. So, laminitis is the disease process, and founder is a result of severe or chronic laminitis.

Additionally, there are multiple types of laminitis, with the most common type often referred to as "grass founder" or SIRS-related, to be more technical.

Endocrinopathic (hormonal) laminitis is hormone-related like what we see in EMS/PPID. It is caused by insulin resistance linked to Equine Metabolic Syndrome (EMS) or Pituitary Pars Intermedia Dysfunction (PPID/Cushing's). Hormonal imbalances affect hoof health, leading to inflammation, which ultimately can lead to hormonal laminitis.

SIRS-Related laminitis often stems from severe illness/inflammation like colic, pneumonia, retained placenta, or grain overload. Systemic inflammation triggers laminitis as a secondary problem, often involving toxins (endotoxins) from a gut imbalance. "Grass founder" or "grain founder" from gorging on rich feed can lead to this condition and creates imbalance in the hindgut.

"Road founder", also called is also often referred to as "supporting-limb laminitis" or "stress laminitis" and this is caused by overcompensation of weight-bearing on an injured leg or overworking on hard surfaces such as concrete or gravel. With nutritional triggers, (grain/grass overload) this type often leads to the SIRS type.

Think of laminitis as the cause — the inflammation — and founder as the serious consequence if that inflammation leads to structural collapse.

📘 Morrison, S. (2010). Chronic laminitis: foot management. Vet Clinics of North America: Equine Practice explains how repeated metabolic or mechanical stress leads to laminar breakdown.

🔍 Signs Your Horse May Have Laminitis

Refuses to walk or moves stiffly
Rocked-back stance to take pressure off front feet
Heat in the hooves
Strong digital pulses in the pastern area
Lameness, especially after grain or lush grass
Rings on the hoof wall or dished hooves

Additionally, certain characteristics are often early warning signs and can be useful to a horse owner who can then take some precautions and preventative measures. For example, horses that have a "cresty neck", more rock to the back, hay belly even with exercise, or occasionally sore footed after grazing may be high risk for laminitis or metabolic disorders like Cushing's disease.

Photo credit: OKSNHC

Rehabilitating the Laminitic Horse

Laminitis is a condition that requires time, consistency, and careful planning. The goal of rehabilitation is to control pain, halt further damage, and support the hoof as it heals — which can take months.

1. Rest and Stall Confinement

Horses with acute laminitis must rest in deeply bedded stalls. (For horses that do not stall well, create a safe enclosure in a dry lot or if possible a round pen that has soft footing or hoof packing).
Movement can worsen damage in the early stages.
Use sand or shavings to provide support and cushion.
Consider topical products such as Magic Cushion hoof pack to offer the horse more relief.

2. Supportive Hoof Care

A skilled farrier experienced in laminitic cases is essential.
Heart bar shoes, padded boots, or foam support may be used.
Regular trimming helps realign the coffin bone and hoof capsule.

📗 Rendle, D. (2006). Equine Laminitis 2: Management and prognosis. recommends corrective trimming to restore proper angles and reduce pressure on damaged laminae.

3. Veterinary Management

Anti-inflammatory drugs (e.g., bute) for pain and inflammation.
Ice therapy in the early stages reduces inflammation.
Test and treat underlying issues like insulin resistance (EMS) or PPID (equine Cushing’s disease).
Massage and bodywork from a professional can significantly help a laminitic horse's recovery during the rehabilitation phase once hooves and inflammation have been addressed.

4. Gradual Reintroduction to Exercise

Once the horse is stable and the hoof is structurally safe, light movement can be beneficial.

Begin with short hand walks on soft footing.
Slowly increase turnout duration.
Avoid forced exercise or hard surfaces.

Taylor et al. (2014) found that obese laminitic horses improved after 6 months of diet control, slow reintroduction of movement, and regular hoof care.

Gentle Exercises and Stretches for Recovery

Only do these with your vet’s approval:

Front Leg Stretches: Gently stretch the leg forward to reduce joint stiffness.
Neck Carrot Stretches: Encourage the horse to reach left and right to improve flexibility and core strength.
Balance Pads: Let the horse stand on soft pads to encourage better proprioception and hoof use.

📄 Schumacher, J. et al. (2014). highlighted that these methods improve posture and soft tissue function during the chronic recovery stage.

Diet: The Primary Factor in Laminitis Prevention

Diet plays a critical role in both preventing and managing laminitis. Many cases are linked to high sugar intake or metabolic disorders.

Avoid:

🚫 Grains, sweet feeds, and molasses

🚫 Access to lush spring or fall grass

🚫 Excessive treats high in starch or sugar

Do:

✅ Feed low-sugar hay (NSC <10%)

✅ Soak hay for 30 minutes to reduce sugar content

✅ Use slow feeders or hay nets

✅ Provide minerals to balance the diet

🧾 Belknap & Geor (2017). Equine Laminitis stress that dietary changes alone often reverse insulin-related laminitis.

How to Prevent Laminitis Before It Starts

Use a grazing muzzle on prone horses during grass flushes.
Keep your horse at a healthy weight.
Avoid overfeeding concentrates or grain.
Have your horse’s feet trimmed every 4–6 weeks.
Test for metabolic issues in overweight or older horses.

📘 Orsini & Wrigley (2010). Home care for horses with chronic laminitis recommend body condition scoring and seasonal blood testing to identify risk early.

Recovery Expectations

Laminitis recovery can be long and emotionally draining — but it’s possible.

Some horses recover in 3–6 months.
Others take a year or more to regrow a healthy hoof capsule.
Communication with your vet and farrier is key and if possible, collaboration between veterinarians and farriers is ideal. Work with a farrier who is experienced with corrective issues involved with laminitic horses.

Real Example: My haflinger-cross "Tony Bananas", developed laminitis from overgrazing. With diet change, stall rest, and appropriate rehab, he was comfortable again in about four months and returned to light riding by the end of the year. Tony went on to be a kids and driving horse for many years and lived into his 30s.