Early signs of laminitis in horses

What it looks like

• •Lameness that is worse when the horse turns in a circle, and shifting lameness when standing
• •Constant weight shifting from one front foot to the other
• •Heat in the feet that does not settle
• •An increased digital pulse, most easily felt over either sesamoid bone at the level of the fetlock
• •A reluctant, hesitant gait, as if the horse is walking on eggshells
• •Pain in the toe region when a vet applies hoof testers
• •A sawhorse stance, front feet stretched out in front and hind feet camped out behind, which is a late and serious sign
• •In a chronic case: rings in the hoof wall that widen from toe to heel, bruised or dropped soles, a widened white line, and a thick cresty neck

Likely causes, ranked

A tag marks the causes that are pain wearing a behavior label. Those are the ones to rule out first.

1. 01Endocrine disease: equine metabolic syndrome or PPIDcommonpossible painThe Merck Veterinary Manual describes endocrine dysfunction as probably the most common underlying cause of laminitis in horses today, with hyperinsulinemia thought to be the predisposing condition in horses with equine metabolic syndrome and PPID. This is why a laminitis episode in a horse with no obvious diet accident is a reason to test for insulin dysregulation and PPID, not just to trim the feet.
2. 02Grain overload or a sudden change of dietcommonpossible painThe AAEP lists digestive upset from grain overload, including a horse that breaks into the feed room, and abrupt diet changes among the events that produce laminitis. Its advice for a grain binge is not to wait for signs: call the vet immediately so corrective action can be taken before tissue damage progresses.
3. 03Sudden access to lush grasscommonpossible painThe AAEP describes sudden access to excessive amounts of lush forage before the horse's system has adapted, the pattern owners call grass founder. It also advises horses that have foundered before to avoid lush pasture between late morning and late afternoon, when plant sugars are highest, and to restrict pasture in spring.
4. 04Illness, sepsis, or a retained placentapossiblepossible painMerck lists sepsis-associated laminitis after conditions such as metritis, pleuritis, enteritis, and colitis, and the AAEP lists high fever, severe colic, and a retained placenta after foaling among the triggers. A horse that is systemically ill is a horse whose feet need watching.
5. 05Excessive weight on one limbpossiblepossible painMerck describes mechanical or support-limb laminitis, which results from a single limb being forced to bear excessive weight because of an injury to the opposite leg. The AAEP lists the same risk under excessive weight-bearing on one leg or any other alteration of the normal gait. A horse laid up with a limb injury needs the sound foot monitored.
6. 06Concussion, black walnut bedding, or corticosteroidsless commonpossible painThe AAEP lists excessive concussion to the feet, sometimes called road founder, and bedding that contains black walnut shavings, and notes that prolonged use or high doses of corticosteroids may contribute in some horses, though that link is controversial. These are less common than diet and endocrine causes but worth ruling out when nothing else fits.

What to try

1. 1Call the vet before you do anything elseThe AAEP is explicit: if you suspect laminitis, consider it a medical emergency and notify your veterinarian immediately, because the sooner treatment begins the better the chance of recovery. This is not a wait-and-see problem. Nothing on this page replaces that call.
2. 2Stop the horse moving and take it off grain and grassThe AAEP's treatment guidance includes dietary restriction, stopping all grain-based feeds and pasture and feeding only grass hay until the vet advises otherwise, and stabling the horse on soft ground such as sand or shavings, not black walnut, so it can lie down and take pressure off the weakened laminae.
3. 3Learn where the digital pulse is before you need itThe AAEP places the digital pulse over either sesamoid bone at the level of the fetlock, and an increased pulse there is one of the earliest signs. Find and feel it on a sound horse regularly so you know what normal feels like on your own horse, because a bounding pulse only means something if you know the baseline.
4. 4Ask the vet to look for the underlying causeSince Merck names endocrine dysfunction as probably the most common underlying cause today, a laminitis episode is a reason to ask about insulin and ACTH testing, especially in an older horse or an easy keeper. Treating the foot without finding the driver means waiting for the next episode.
5. 5Plan the long-term management with your vet and farrierThe AAEP notes that once a horse has had laminitis it may be likely to recur, and recommends a modified diet built on high-quality forage and digestible fiber rather than excess carbohydrate, routine trimming and in some cases therapeutic shoeing, and a proper health-maintenance schedule. The ACVS adds cryotherapy with ice boots, deep bedding, sole pads and corrective shoeing to the treatment picture.

Questions people ask

Keep reading

Sources

Every figure on this page traces to one of these. We cite registries, associations, government and veterinary bodies, and published cost surveys - not other blogs.

1. [1]Learn to Recognize the Signs of Laminitis- American Association of Equine PractitionersassociationThe listed signs of acute laminitis (lameness worst turning, shifting lameness, heat in the feet, increased digital pulse, toe pain on hoof testers, walking on eggshells, sawhorse stance), the chronic signs (hoof rings, bruised and dropped soles, seedy toe, cresty neck, dished hooves), and the instruction to consider suspected laminitis a medical emergency and notify a veterinarian immediately.
2. [2]Laminitis: Prevention and Treatment (AAEP document, hosted by the American Association of Professional Farriers)- American Association of Equine Practitioners / American Association of Professional FarriersassociationThe causes and risk factors (grain overload, lush forage, high fever, severe colic, retained placenta, road founder, weight-bearing on one leg, black walnut bedding, corticosteroids, ponies and drafts, previous episodes, older horses with Cushing's), the digital pulse location over either sesamoid bone at the fetlock, the treatment and management guidance, and the advice to call immediately after a grain binge rather than waiting for signs.
3. [3]Laminitis in Horses- Merck Veterinary ManualeditorialThat endocrine dysfunction is probably the most common underlying cause of laminitis in horses today, that hyperinsulinemia is thought to be the predisposing condition in equine metabolic syndrome and PPID, the sepsis-associated and support-limb categories, and that the prognosis is guarded to poor for horses with severe acute laminitis.
4. [4]Laminitis in Horses- American College of Veterinary SurgeonsassociationThe range of lameness from a minor head nod to non-weight bearing, the walking-on-eggshells and sawhorse descriptions, bounding digital pulses and warm hooves, diagnosis by radiographs showing rotation or sinking of the coffin bone, treatment including cryotherapy with ice boots and corrective shoeing, and that prognosis is directly related to the underlying primary cause.