September 01, 2016 4 min read

What is Laminitis exactly and what’s the difference between Laminitis and Founder?

Due to the popularity of our last Blog on Laminitis and the fact that we’re coming into Laminitis season, we’ve decided to release the first few chapters of our book as a series of Blog articles. We’ll discuss what Laminitis is exactly, the causes, signs and symptoms as well as steps to prevention, treatment and rehab. We hope you enjoy the series and please share in the interest of the horse!

Image: A pony showing the classic founder stance – rocked back on the haunches to relieve the pressure on the sore front hooves

‘Laminitis’ simply means inflammation in the lamina. ‘Founder’ is the term used to describe a horse where the condition has caused the pedal bone to rotate and/or sink in the hoof capsule. The founder is the catastrophic and most severe result of laminitis. When the lamina become inflamed they ‘let go’ and the velcro-like connection of the laminae within the hoof breaks down to the point where the pedal bone loses its support structures. This bone then virtually ‘rotates’ away from the hoof wall and/or and drops lower in the hoof capsule. In the most severe cases of rotation and/or sinking, it is too painful for the horse to walk.

A laminitic horse does not necessarily founder. But a foundered horse is always laminitic. A foundered horse is unable to walk properly due to the collapse taking place in its hooves.  Inflammation is present in the hoof in the acute stage of the illness.  Horses which suffer chronic, ongoing or repeated episodes of laminitis will generally suffer the loss of some of their pedal bone – both a reduction in bone density and the loss of the tip of the bone. This is often referred to as chronic founder and once this happens the horse can become difficult or impossible to completely rehabilitate. Complete soundness may never be possible for these horses.


There are several main causes of laminitis, however, the most common cause is metabolic or endocrine in nature. This includes insulin resistance (IR) and Cushing’s disease (PPID). These two causes of laminitis are referred to as being metabolic or endocrine induced and are often referred to as an equine metabolic syndrome, pasture laminitis, grass founder, equine syndrome X or endocrinopathic laminitis.

Because IR is such a common cause of laminitis, it is wise to assume and treat a laminitic horse as if it were IR. Unless there is another obvious cause – such as a feed room break-in, retained placenta or supporting limb laminitis – an immediate action plan and diet management must be implemented. This is always the safest initial action to be taken with any laminitic horse. This approach can always be modified down the track if the IR diagnosis proves otherwise.


Image: Pony showing classic long wiry coat and overgrown dished shaped hooves. Photo by GoBarefoot trimmer Sandi Chiswell

Cushing’s disease is a common cause of laminitis in horses and is caused by an enlargement or adenoma (benign tumour) in the portion of the pituitary gland called the pars intermedia. The more accurate term is pituitary pars intermedia dysfunction (PPID). It is estimated that over 20% of horses aged 15 or over have PPID. The symptoms of Cushing’s disease are due to an excess of the stress hormone, cortisol. A horse with Cushing’s disease will need to be medicated with Pergolide to control the disease. Please discuss this with your vet.

Missy’s Bucket – the best option to balance Minerals when testing the pasture and hay is not a practical option.

Insulin resistance (IR) is also a common cause of laminitis and founder in horses. IR in the horse is caused by elevated circulating levels of insulin which in turn is mainly the result of an inappropriate diet. However, it can be caused by pregnancy and other disease states. IR is characterised by a loss of insulin sensitivity at the cellular level. It is estimated that IR effects 10 to 15% of the equine population.

Image: Obese horse showing classic fat pads on crest, shoulders and tailhead

How is IR different to Cushing’s disease?

Cushing’s disease and IR are distinctly separate conditions. Diagnosis can be difficult, however. Often there are overlapping signs and symptoms and to confuse things further… many of Cushing’s horses can also have IR.


Serious systemic disease with septic or toxic focus can cause laminitis. The horse will show signs of systemic (whole system) illness and have a raised temperature and often have diarrhoea. Causes might include post-colic surgery, colitis, peritonitis, poisoning or retained placenta in a mare.

Carbohydrate overload is also included under the category of SID. Acute laminitis can be induced very quickly if a horse’s hindgut is exposed to a large volume of carbohydrates. This is commonly seen when a horse breaks into the feed room – for example – and gorges itself on grain.


Long, hard or prolonged work especially on the hard ground has been known to cause laminitis and is sometimes referred to as road founder. Damage and inflammation can occur in the hoof lamina from a repeated and ongoing concussion on hard surfaces. This occurs particularly where the hoof walls are too long, effectively putting pressure on the laminar connection. See pic below.

Image: Long toes cause lever forces on the hoof wall

Laminitis can also occur due to poor trimming or lack of trimming. When the hooves are allowed to grossly overgrow, the lever forces from the long hoof wall can pull, stressing the laminae and other tissues of the hoof.

For more info on Laminitis including treatment, rehab and prevention, have a look at the book ‘What is Laminitis? – A Practical, Step by Step Guide to Recovery’ written by Rebecca Scott and Zoe Messina. Available as an EBOOK

‘If your horse has laminitis, this is the FIRST book you should read! 

A review by Linda Whitfield Cowles – Equine rehab specialist.

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