Laminitis is not just hoof pain. It is a disease that damages the structures attaching the hoof wall to the pedal bone. If that attachment weakens enough, the pedal bone can move within the hoof capsule. Early recognition and appropriate management give the best chance of recovery.

The word laminitis simply means inflammation of the laminae, the interlocking tissues that suspend the pedal bone inside the hoof capsule. These laminae work much like two pieces of Velcro, holding the hoof wall firmly attached to the bone while allowing the hoof to support the horse's weight.

When these tissues become damaged, the attachment between the hoof wall and the pedal bone weakens. As that support fails, the pedal bone is no longer held securely in place and can move within the hoof capsule.

Although inflammation occurs during the acute stage, our understanding of laminitis has advanced considerably over recent years. We now know that most pasture-associated laminitis is driven by underlying metabolic disease and abnormally high insulin levels, rather than inflammation alone. Inflammation is part of the picture, but it is not the primary cause in most horses with Equine Metabolic Syndrome or PPID. This understanding has changed how we approach diagnosis, treatment and prevention.

These two terms are often used interchangeably, but they do not mean exactly the same thing.

Laminitis describes the disease affecting the laminae.

Founder describes the structural damage that can occur when the weakened laminae can no longer support the pedal bone.

In founder, the pedal bone may rotate, sink, or both. A horse can develop laminitis without progressing to founder, but a foundered horse has always experienced laminitis.

Understanding this difference is important because early intervention aims to prevent laminitis progressing to permanent structural damage.

The hoof is much more than a hard shell.

Inside the hoof capsule sits the pedal bone, suspended by thousands of tiny interlocking laminae. These tissues distribute the horse's weight and allow the hoof to function as an efficient shock absorber.

When the laminae fail, the forces acting on the hoof change dramatically. The weight of the horse, together with the pull of the deep digital flexor tendon, can allow the pedal bone to shift within the hoof capsule.

This movement may occur gradually or quite rapidly, depending on the severity of the damage.

The laminae contain an extensive nerve and blood supply.

As these tissues become damaged, the horse experiences significant pain. At the same time, the supporting structures of the hoof become mechanically unstable.

If the pedal bone begins to move, additional stress is placed on already damaged tissues, increasing pain and further weakening the attachment.

This is why reducing the trigger, supporting the hoof and restoring correct hoof mechanics are all essential parts of rehabilitation.

Many owners think founder simply means "rotation."

In reality, the pedal bone can move in several different ways.

It may rotate.

It may sink deeper within the hoof capsule.

Often, both occur together.

The hoof capsule itself may also distort over time as new hoof grows around the displaced bone. Changes such as a stretched white line, flared toe and altered hoof proportions may develop during chronic cases.

Understanding exactly what has happened inside the hoof is essential because every case is different.

Radiographs are one of the most valuable tools in laminitis rehabilitation.

They do much more than confirm whether rotation has occurred.

Radiographs show the position of the pedal bone relative to the hoof capsule, allowing the veterinarian and hoof care professional to determine how much movement has occurred and how the hoof should be trimmed and supported. It's recommended to request external markers on the hoof so the dorsal hoof wall, coronary band and frog can be accurately identified on the radiographs.

Trimming should be guided by the position of the bone inside the hoof, rather than the external appearance of the hoof capsule alone.

Laminitis should always be treated as an emergency.

The earlier the trigger is identified and removed, the greater the chance of preventing permanent structural damage.

Prompt implementation of the Emergency Diet, appropriate diagnosis, supportive hoof care and careful rehabilitation can dramatically improve the long-term outlook.

Even horses with significant hoof changes can often return to comfortable, useful lives when managed appropriately. The earlier treatment begins, the better the opportunity to preserve the structures inside the hoof before irreversible damage occurs.

If you'd like to explore these topics in more detail, the following lessons build on the information in this guide.