Coming into spring with the grass starting to come through – and likely some warmer weather coming soon here is a reminder of what laminitis is and what we can do with laminitis.

We have already given a brief summary on facebook (click here) and Holly has written about feeding for a laminitis prone horse / pony – click here for more details.

There is also a client evening coming up on 15th May 2024 covering more detail on laminitis - have a look on our facebook page for more details.

Why is laminitis such a concern?

Laminitis is a very painful condition of the hooves in horses, ponies and donkeys, which in some cases can start without any warning. It is common and unfortunately once you have laminitis it is much more likely to have another episode in the future. Laminitis can also lead uncontrolled pain or a poor prognosis and is one of the more common reasons horses are euthanased.

Even with milder cases horses can be on rest and out of work for long periods of time.

What causes Laminitis?

In the vast majority of cases laminitis is caused by one of two hormonal diseases (endocrine):
Cushings disease (mostly in older horses) or Equine metabolic Syndrome (EMS – similar to type II diabetes in people) which is usually seen in overweight horses.

Both of these conditions can be diagnosed by blood tests and are managed with medication, weight management, diet and exercise – details of which are coming in a blog in June, or click here for an older article.

Other causes include:

  • Diseases with severe inflammation – for example retained placenta after foaling, certain severe colics and bad diarrhoea.
  • Overloading the limb – if there is a severe lameness on the opposite limb overloading of the other leg can cause laminitis.
  • Severely overgrown hooves – a lot of pressure on the limb from overgrown hooves can also cause lamintis.


Acute sudden cases can show: severe pain, weight shifting, high heart rate, reluctant to move or recumbent (lying down) – and they can in some cases be difficult to distinguish from colic.

More chronic cases – often have more subtle signs, but have pain especially when walking on hard or uneven ground, difficulty turning and raised digital pulses.

Below is a short video of a horse with laminitis trying to move:

What to do if my horse has signs?

If out bring your horse in slowly and rest them in a box with a deep bed. Make sure there is fresh water available and keep them on a restricted diet – ideally on soaked hay, but making sure you avoid anything rich in carbohydrate or sugars – see Holly’s recent post for more details.

Most horses with laminitis will need a visit from your vet for a diagnosis, pain relief, blood tests and x-rays/treatment as recommended.


Rest on a deep bed is an important part of treatment – this should reduce further damage to the laminae in the hoof and allow the hoof to start to repair. Hoof support from pads and when more comfortable remedial farriery to fit support shoes like heartbars may also help.

A heart bar shoe in place

X-rays can be important as they allow us to see what is going on inside your horses hooves - and help assess severity and plan treatment / farriery. They can also help assess how long it will take for your horse to recover and make a plan going forward.

Rotated pedal bone in a pony with laminitis
An x-ray of a hoof showing marked pedal bone rotation - the front wall of the hoof should be parallel with the front of the pedal bone in the hoof.

Pain relief – as above horses can be in a lot of pain and need courses of pain relief including bute or other NSAID drugs and in more severe cases other types of pain relief are likely to be included as well.

Weight management – overweight horses are more likely to have equine metabolic syndrome (EMS) which is a common cause of lamintis, but losing weight reduces this risk and can control it well in many horses. In the shorter term medication can help control this condition.


Recovery can take weeks in milder cases and months in more severe cases – more than 60% of horses are back in work within 8 weeks.

How to prevent laminitis

Laminitis cannot be cured completely with many severe cases not returning to complete comfort, and recurrence being common. However steps to avoid recurrence and also the first episode of laminitis include:

  • Weight management – horses at the correct body condition are much less likely get an episode of laminitis.
  • Restrict access to very rich feeds – other than breaking into a feed room and eating a large quantity of rich food, avoid very rich pastures and feeding sugar rich foods – especially in EMS or horses with previous laminitis episodes.
  • Blood testing for Cushings disease – in older horses (teens or older) the risk of having Cushings disease increases. Monitor for signs of Cushings and consider testing every year to rule out the disease in older horses – especially if your horse has had previous laminitis.
  • Keep your horses feet well trimmed/shod – although farriery is unlikely to cause laminitis overgrown poor quality feet will not help, and severely overgrown feet may be a cause.
  • If your horse has severe lameness on another limb consider a deep bed and possibly support for the opposite weight bearing limb.
  • In severely ill horses prompt treatment and management may reduce the risk of laminitis.

If you have any concerns your horse may have laminitis please remember to speak to your vet - we can be contacted on 07747 717474, please note we can only give opinions on horses in our area who are registered clients.


What should I be feeding my EMS/laminitis prone pony?!


Forage is an essential part of all horses and ponies diets to maintain a healthy gastrointestinal system so we need to find a balance when dieting.

To assist weight loss and reduce risk of laminitis and equine metabolic syndrome diet should be low in non-structural carbohydrates (simple starches and sugars) –  ideally non-structural carbohydrate (NSC) content should be less than 10%.

Knowing the starch and sugar content of your hay can be tricky, generally later cut/coarser hay is lower in NSCs however it is not an exact science. There are now various companies offering forage analysis, these can be found easily with a google search.

As a general rule hay has a lower NSC content than haylage so is most often the forage of choice. Straw has the lowest NSC content - good quality straw can be used to replace a small percentage of the hay ration (no more than 30%) if needing to slow eating time.

How much?

1.5% bodyweight for weight loss – for a 500kg horse this equates to 7.5kg per 24 hour period, for a 250kg pony this equates to 3.75kg per 24 hour period

1.75%  bodyweight for maintenance – for a 500kg horse this equates to 8.75kg, for a 250kg pony this equates to 4.4kg per 24 hour period

Soaking hay

Soaking hay is a sustainable approach to weight loss – by removing carbohydrates from the hay it allows us to feed adequate quantities of fibre in order to maintain welfare and gut health while minimizing starch and sugar intake.

We recommend soaking hay for 10-12 hours for EMS and laminitis.

Soaking also removes minerals so horses need to be supplemented for these – the easiest way to do this is by feeding a balancer – most balancers are below 10% NSCs and there are lots of low calorie balancers available that are aimed at good doers.

Soaking reduces palatability so it can be necessary to increase soaking time gradually.

Soak in cold water and ideally out of direct sunlight - soaking at higher temperatures might encourage bacterial growth.

Haylage cannot be soaked due to fermentation and bacterial growth.

Supplementary feeding

As mentioned earlier it is often a good idea to supplement your horse or pony with a light/low calorie balancer to ensure they are getting the vitamins and minerals they require, especially when on soaked hay and/or a grass-free diet.

These can be safely accompanied by a molasses-free chaff or mash to increase fibre intake.

The 10% rule applies to feeds too! So look out for those little numbers on the back of the bag – less than 10% starch and sugar!


Time at grass needs to be managed carefully, consider one or more of the following options:

  • Turning out late at night (when grass sugar levels are at their lowest) and bringing in early morning
  • Track systems
  • Grazing muzzles
  • Strip grazing
  • Co-grazing with other species (sheep)
  • Yard or dust paddock turnout

Laminitis- What is it and how do I know if my horse has it?

This has been a very busy week for us at Ridings Equine, unfortunately the spring grass and relatively hard ground have been causing a lot of problems for our lovely patients!
As previously mentioned in our 'Spring Emergencies on the Rise!' blog by Jenny, the spring grass has continued to flourish with the spells of rain and warm weather we've been having making our once bare paddocks into large sweet shops for our horses and ponies!