Keeping Your Horse Comfortable During Laminitis

Key Message

Keeping a laminitic horse comfortable is important, but comfort is about more than simply relieving pain.

During the acute stage, the aim is to reduce unnecessary stress on the damaged laminae, give the horse comfortable footing, support the feet appropriately and allow the horse to rest.

Boots and conformable pads can be extremely useful both during the acute phase and throughout rehabilitation, but they work alongside correct hoof care, not instead of it.

Tools can include boots, pads, styrofoam, anti fatigue matting and other conformable support options as useful comfort measures.

At a Glance
• Provide a soft, supportive surface for standing and lying down.
• Keep unnecessary movement to a minimum while the horse is painful.
• Allow the horse to lie down and rest.
• Keep hay and water conveniently accessible.
• Hoof boots with conformable pads can provide immediate comfort and protection.
• Temporary foam pads can be useful if boots are not immediately available.
• Boots and pads support the foot, but they cannot compensate for an inappropriate trim.
• Pain relief may be necessary, but reduced pain does not mean the hoof is ready for increased movement.
• As recovery progresses, boots may continue to be useful for turnout and later exercise.
• Keep a calm companion nearby where possible to reduce stress and unnecessary movement.

The Full Lesson

Start with the environment

During acute laminitis, simply making the horse's environment more comfortable can make a significant difference.

A soft, supportive surface allows the horse to find the position that feels most comfortable and reduces the impact of standing and moving on hard ground. Moving the horse onto a comfortable surface and supporting the hooves with therapy boots and pads is part of the immediate action plan.

A sand yard or deeply bedded area can work well because the surface conforms to the bottom of the foot. The horse should also have somewhere comfortable to lie down.

Keep hay and water within easy reach so the horse does not have to walk unnecessarily to meet its basic needs.

If bedding is used, remember that some horses will eat straw or other edible bedding, which may be inappropriate for a metabolic horse.

Let the horse rest

A painful laminitic horse should not be forced to walk.

During the acute stage, restricting unnecessary movement and allowing the horse to lie down helps reduce loading on painful and potentially unstable feet.

Lying down is not something we need to discourage. It is one of the horse's own ways of unloading painful feet.

Movement becomes important later, but that belongs to a different stage of recovery and is covered in Returning to Exercise After Laminitis.

Boots and pads

Hoof boots with conformable pads are one of the most practical ways of making many laminitic horses more comfortable.

Most horses are more comfortable with styrofoam or gel pads, either inside boots or temporarily taped onto the feet.

Pads can conform to the underside of the foot and allow the horse to load the areas it finds most comfortable.

Depending on the individual horse, options can include:
• Hoof boots with pads
• Gel or other conformable pads
• Construction grade styrofoam cut to the shape of the hoof
• Anti fatigue matting cut to fit the foot
• Pads temporarily taped onto the hoof

One advantage of removable boots and pads is that they also allow relatively easy access to the hoof for regular trimming and reassessment during rehabilitation.

One option is the Easycare therapy boot pictured below, these are roomy enough for pads and fairly easy to get on and off.

If you don't have boots immediately

You don't necessarily have to wait for a pair of therapy boots to arrive before providing some support.

It's possible to make pads by cutting suitable foam pads to the shape of the hoof and taping them into place as a temporary measure while waiting for boots.

See link here for how to make your own temporary boots.

Support does not replace the trim

Boots and pads can make a horse considerably more comfortable, but they cannot correct the mechanical forces created by an incorrectly aligned hoof.

Appropriate trimming is an integral part of acute care and should be seen too in the earliest stges. Long toes and other mechanical problems continue to place damaging forces on already vulnerable laminae.

So hoof protection and hoof alignment need to work together.

What about pain medication?

Pain relief may be necessary during acute laminitis and should be considered with the treating veterinarian.

However, theres an important distinction between controlling pain and resolving the cause of the pain. Analgesics can make the horse feel better, but they do not correct the underlying metabolic trigger or mechanical problems within the hoof.

A horse that feels better because of medication may still have vulnerable feet. For that reason, reduced pain should not automatically be interpreted as a signal that the horse is ready for more movement.

The goal is not simply to mask discomfort. It is to create the conditions that allow the source of that discomfort to resolve.

Don't forget the rest of the horse

A horse with painful feet often changes the way it stands and moves.

It may shift weight backwards, brace through the body or spend long periods standing in unusual positions. Over time this can create tightness and soreness through the shoulders, back and hindquarters.

Providing comfortable footing, allowing the horse to lie down and avoiding unnecessary forced movement can help reduce some of this secondary discomfort.

As the feet become more comfortable and normal movement returns, much of this compensatory tension may also improve.

Provide company

Restricted movement does not have to mean social isolation.

Your original immediate action plan specifically recommends providing a friend to help reduce stress and unnecessary movement.

Where possible, keep a calm companion nearby so the horse can see and interact with another horse without being chased, bullied or encouraged to run around.

A suitable companion can also reduce anxious fence walking, which is exactly the sort of unnecessary movement we are trying to avoid during the acute stage.

Longer term hoof protection

Boots are not only useful during the initial painful period.

As rehabilitation progresses, some horses continue to benefit from boots and pads while the damaged hoof grows out. ECIR notes that complete hoof capsule replacement can take up to a year, and supportive measures may remain useful during that process.

Boots may later be useful for turnout, hand walking or exercise, particularly if the horse remains sensitive on harder surfaces or still has limited sole protection.

This does not necessarily mean the horse will need boots forever. The need for protection can be reassessed as hoof alignment, sole depth, laminar connection and comfort improve.

Let the horse tell you what is comfortable

There isn't one boot, pad or surface that suits every laminitic horse.

The horse gives us useful information

Does it stand more comfortably?
Does it move more freely when it chooses to move?
Does it stop constantly shifting weight?
Is it happier to pick up another foot?
Does it lie down and get back up comfortably?

If a change in footing or hoof protection clearly improves comfort, that is useful information. If it makes the horse less comfortable, it needs to be reconsidered.

The Most Important Thing to Remember

Comfort should protect the damaged feet, not encourage the horse to use them before they are ready.

Give the horse a comfortable surface.

Allow it to rest.

Support the feet with appropriate boots and conformable pads where needed.

Keep food, water and companionship accessible without encouraging unnecessary movement

And remember that a horse feeling better does not necessarily mean the hoof has finished healing.

As recovery progresses, the amount of protection needed can gradually be reassessed according to the individual horse.