Laminitis in horses – symptoms, causes and treatment

Laminitis is a dreaded disease in horses. It is very painful for horses that suffer from it, and can even become chronic. If you suspect that your horse has laminitis, you should take important measures immediately. But what is laminitis anyway? How can you tell when a horse is suffering from laminitis? What causes laminitis? And how can laminitis be treated?

Laminitis is an inflammation of the laminae that causes a blood microcirculation disorder in the laminae area.

Laminitis is an aseptic inflammation of the laminae. The inflammation isn’t caused by germs; there are other reasons it will affect a horse. The exact causes of laminitis are very diverse, and are not yet clearly understood. We have provided an explanation of some potential causes of laminitis below.

Feeding laminitis

The most common form of laminitis is what is known as ‘feeding laminitis’. It is caused by incorrect feeding. A high-carb diet involving too much concentrated feed, bread, carrots and fruit can lead to hyperacidity in the horse’s body and thus reduce blood circulation in the hooves. The starch contained in the feed and the fructan contained in the grass and hay can also be problematic. Especially in spring, grass has a high fructan content. Increased fructan intake causes hyperacidity of contents in the digestive tract, and therefore kills off beneficial microbes. This can cause toxins produced naturally in the body to form. They enter the bloodstream and trigger inflammation of the laminae.

Stress laminitis

Overloading the hooves leads to disruption in the blood supply, and the laminae can become inflamed. Running for long periods of time, or constantly standing on hard surfaces, can be triggers for this. Additionally, resting one leg by lifting it up can also lead to the others becoming overloaded.

Toxic laminitis

In toxic laminitis, poisonous plants and medication can cause laminitis to occur. The toxins enter the laminae through the bloodstream.

Natal laminitis

If the placenta does not come away completely when a foal is born, bacterial decomposition of the placenta occurs in the uterus. This leads to the uptake of endotoxins into the bloodstream.

Lyme disease

Lyme disease is transmitted through tick bites. An accompanying symptom of the tick-borne disease can be inflammation of the laminae.

Cushing’s disease

Cushing’s disease is caused by a slow-growing, benign tumour at the pituitary gland. The tumour causes the horse’s body to produce more cortisol. This affects the metabolism, cardiovascular system, immune system, protein metabolism and blood sugar levels. If the blood sugar level is too high, this constricts the blood vessels and the horse’s body becomes superacid, thus reducing the blood flow to the hoof.

Equine metabolic syndrome (EMS)

Equine metabolic syndrome is a metabolic disorder that leads to increased insulin production. Where insulin resistance is pathological (EMS), the cells react less and less to insulin secretion. This keeps the blood sugar level at a pathologically high level. Again, too much sugar in the blood leads to hyperacidity and blood flow to the hoof is reduced.

Obesity

Extra weight puts stress on the hooves. Additionally, fat is more than just storage tissue. It also produces hormones, upsetting sugar and insulin metabolism.

Laminitis can cause severe pain depending on its severity. The disease is split into three different degrees of severity. Laminitis can be recognised by the following symptoms:

Stage 1: Preliminary stage

In the preliminary stage, the symptoms of laminitis are often difficult to identify. If the laminae is mildly inflamed, the horse will lift and take the pressure off the affected hooves more often, become uncooperative with the farrier and reluctant about having someone pick up its feet. Additionally, the horse may become slightly lame when walking and trotting. Affected hooves are more often slightly warmer than normal, and slight pulsation may be palpable at the toe artery.

To summarise, the most common symptoms in the early stages of laminitis are:

• Taking the pressure off the affected hooves
• Slightly warmer hooves
• Pain response during tests with hoof testers
• Slight lameness (often perceived as a stiff gait)

Stage 2: Acute stage

In the second stage of laminitis, the horse is in severe pain and wants to move as little as possible. The horse is lame and is also often in pain when standing because the pressure on the hoof walls is relieved, but the heels are overloaded. So the horse often moves into what is known as the ‘sawhorse stance’, where the front legs are stretched far forward and the hind legs are placed far under the body. Some horses even lie down. The hooves are clearly warm, and pulsation of the arteries is clearly palpable too.

To summarise, the most common symptoms in the acute stage are:

• The horse does not want to move
• The hooves are hot
• There is noticeable pulsation of the arteries in the toe area
• The horse develops a lame gait (especially on hard ground and on turns)
• Hoof flight pattern: Heel bulb-first landing
• Typical stance in a horse suffering from laminitis: Sawhorse stance

Stage 3: Chronic stage

In the chronic stage of laminitis (48 – 72 hours after the acute stage), horses are lame and apathetic, and eat little. Their hooves are cold at this stage because blood circulation is decreasing and there is no longer acute inflammation. The white line on the sole of the hoof has widened, since scar tissue forms in the laminae as a result of the inflammation. The toe wall is often curved, and the typical ‘growth rings’ can form.

To summarise, the symptoms of a chronic stage of laminitis are:

• The white line on the hoof has widened; hoof abscesses often form too
• The shape of the hooves changes; a kink develops in the toe wall
• The hoof wall has transverse grooves that are further apart at the ball than at the tip of the hoof
• Symptoms may occur, but do not have to
• The horse is lame and apathetic, and has no appetite

The treatment depends on the stage of laminitis and the extent of the pain. It is important to find the actual cause of laminitis and treat it. Additionally, the inflammation of the laminae must be treated as quickly as possible. In the acute stage, painkillers and anti-inflammatories are often administered to contain the oedema of the laminae and thus reduce the pressure. Blood-thinning medication (such as heparin) is also used to promote blood flow. Hooves are cooled as an immediate measure in acute laminitis. The pressure on the hooves can be relieved by applying padded laminitis bandages and placing the horse on a soft surface.

If laminitis is chronic, the hooves are often specially rehabbed.

In addition to treating the symptoms of laminitis, the cause should be identified so that it can be treated too (e.g. adjusting feeding if a horse has laminitis).

How well a horse survives laminitis depends on the horse itself and what stage laminitis is at. Here, it depends on how far the coffin bone has rotated or even sunk. If the coffin bone has not moved, often it will be possible to ride the horse just like before it contracted the disease. If the rotation is severe, the horse should be rested in future, and cannot be ridden or used in sport as it was before getting the condition. Once a horse has had laminitis, it will always be susceptible to it due to damage to the suspensory apparatus of the hoof. It is therefore important to prevent laminitis, or at least treat it as soon as possible.

Laminitis is painful and can cause chronic damage, so preventing it is important. To prevent laminitis from occurring, it is important to exercise the horse appropriately. Both overloading and underloading should be avoided. The right feed is enormously important too. Feeding should be adapted to the horse’s needs. Concentrated feed in particular should be adapted to the horse’s workload. Feed stores and feed bins should be tightly closed, and unlimited grazing should not be allowed if horses are overweight. Additionally, regular weight control is recommended to prevent overfeeding and obesity from occurring in the first place. If a horse is overweight, it should be kept on a strict diet. However, feeding habits should be changed slowly and in a controlled manner.

The fructan content in hay and grass should be monitored too, and the pasture checked for poisonous plants.

Diseases such as Cushing’s disease and EMS should be tested for at an early stage, and treated if necessary.

Of course, regular hoof care with correct shoeing is a must too.

Laminitis is a dreaded disease that horse owners should always keep an eye out for so they can protect their horse from it as much as possible. If laminitis is detected early, the possibilities of it being cured are good.

If laminitis is not detected and treated at an early stage, in the worst-case scenario it can lead to hoof loss, where the hoof capsule detaches entirely. This causes extreme pain. In these cases, vets often advise that the horse be put down. Laminitis is the second most common cause of death in horses and ponies after colic.

While coming to terms with your own pet’s death is difficult, it is important. A cremation plan allows you to make all the important decisions regarding saying goodbye to your horse when you have enough peace and strength to do so. You have financial and organisational security in an emergency, can contact the ROSENGARTEN Pet Crematorium team, and can say goodbye to your beloved horse in a dignified manner.