Early signs of laminitis in horses (and why the classic stance comes too late)

Almost everyone can describe a laminitic horse. Rocked back on its heels, front feet stretched out, refusing to move. It is the picture in every textbook and the one that comes to mind when someone says the word.

The trouble is that the stance shows up in fewer than half of diagnosed cases. If that is what you are waiting for, you will miss more than half of them, and you will miss the half where catching it early would have made the most difference.

Laminitis affects roughly one horse or pony in ten every year in Great Britain. It is not rare, it is not confined to fat ponies on spring grass, and there is no safe season. This is a post about what it actually looks like in the first day or two.

What is laminitis in a horse?

Inside the hoof, the pedal bone is bonded to the hoof wall by tissues called the laminae. The British Horse Society’s laminitis guidance puts it in the way worth remembering: they work like Velcro, gripping the bone in place inside a rigid capsule. Every figure in this post comes from there or from the papers it cites.

Laminitis is those tissues becoming inflamed and damaged. They stretch and weaken, and the bond starts to fail. In bad cases the pedal bone rotates, or sinks, and in the worst cases it comes through the sole. That is why this is treated as an emergency rather than something to watch for a few days: the damage is structural and it does not undo.

It is also why the pain is so severe. A swollen, inflamed tissue inside a rigid box has nowhere to go.

What causes laminitis in horses?

Here is the thing most people have backwards. The grass is not usually the culprit.

Up to 90% of cases are linked to an underlying hormonal disorder, principally Equine Cushing’s disease (PPID) and Equine Metabolic Syndrome. Both drive high insulin levels, and high insulin is what damages the laminae. The grass is often the trigger that tips over a horse who was already at risk, rather than the cause in its own right.

That single fact should change what you do. If your horse has had laminitis, the question for your vet is not only “how do we treat the foot” but “why did this horse get it”, because in nine cases out of ten there is something underneath to test for and manage.

The other routes in:

• Weight. Excess weight gain more than doubles the risk. It is the most modifiable factor on this list by some distance.
• A gut overload. A large feed of concentrates in one go can push undigested sugar and starch into the hindgut, which damages it and releases toxins into the bloodstream. Severe colic, lung inflammation and a retained placenta after foaling can do the same thing.
• Weight-bearing on the other leg. A horse resting one limb because of an injury loads the opposite one far beyond what it is built for, and that limb can founder on its own.
• Concussion. Fast or prolonged work on hard ground.
• The feet themselves. Long toes and irregular trimming or shoeing contribute, and the BHS cites evidence that leaving more than eight weeks between visits may play a part. Worth knowing your horse’s interval and holding to it, which is the subject of how often a horse should see the farrier.

What are the early signs of laminitis?

These are the ones that come before anything dramatic, and they are easy to explain away individually. Any of them in a horse that isn’t right is worth a phone call.

• A strong, bounding digital pulse, most often in both front feet
• Shifting weight from one foot to the other while standing
• Reluctance to turn. Tight turns hurt first, so a horse that swings wide or hesitates on a turn is telling you something
• Reluctance to pick a foot up, because that puts all the weight on the other one
• Heat in the hoof wall or coronet, compared with what is normal for that horse
• Being careful on stony ground when it was never careful before
• A shortened, pottery stride, often described as walking on eggshells
• A change in behaviour. Duller, standing more, lying down more than usual

The digital pulse is the most useful of these because you can learn to read it in about ten minutes and it costs nothing to check daily. It is worth practising on a sound horse now so you know what that horse’s normal feels like: a horse’s digital pulse covers where to feel and what you are feeling for.

There are slower changes visible in the hoof itself, which point at episodes that have already happened: rings on the hoof wall that are wider at the heel than the toe, a groove just above the coronet band, a change in the shape or angle of the hoof, and bruising on the sole just in front of the frog.

Why isn’t the classic stance an early sign?

Because it is a late one. The laminitic stance, rocked back onto the hind legs to unload the front feet, appears in less than half of diagnosed cases, and when it does appear the horse is already in significant pain.

Treat it as confirmation, not as the thing you are screening for. The signs in the list above are what you are actually looking for on a normal morning, and they are the ones that get dismissed as the horse being lazy, or footy after the farrier, or a bit stiff because it is cold.

What should you do if you suspect laminitis?

Ring your vet immediately. Laminitis is an emergency, and this is the one health post on this site where the advice is genuinely that simple. Early treatment changes the outcome, and there is nothing you gain by waiting until tomorrow to see how it looks.

While you wait:

• Do not make the horse walk if it is reluctant. Movement on damaged laminae causes more damage. This is the instinct to fight: the urge to trot it up to see how bad it is can make it worse.
• If it can walk comfortably, move it to a stable or shelter. If it cannot, make it comfortable where it is and restrict its movement.
• Get it off grass.
• Deep bed, ideally shavings, which supports the foot.
• Then wait for your vet rather than starting anything yourself.

Your vet will assess posture, gait and the response to hoof testers, and will often X-ray to see whether the pedal bone has moved. The Royal Veterinary College’s laminitis fact file is a good thing to have read before you need it.

How do you prevent laminitis?

Prevention is mostly two unglamorous habits and one conversation.

Manage weight, and measure it rather than eyeballing it. A weigh tape and hands-on fat scoring will tell you what your eye will not, because a horse you see daily changes too slowly for you to notice. This is the single highest-value thing on the list, given that excess weight more than doubles the risk.

Pick the feet out daily and check for heat and a digital pulse while you are down there. It takes twenty seconds a foot and it is the only way you will catch the subclinical stage.

Have the hormonal conversation with your vet, particularly for a horse that has had an episode, is over about fifteen, is a good doer, or has a cresty neck or fat pads. PPID and EMS are testable and manageable, and given they sit behind up to nine in ten cases, testing is rarely wasted.

Keep the farrier or trimmer on a regular cycle, and don’t let it drift past eight weeks.

Where the technology fits

Nothing here is replaced by an app. Laminitis is caught by hands on feet every morning and prevented by a weigh tape and a vet who knows the horse.

The one place Stride does something directly relevant is the feed. It adds sugar and starch together into a non-structural carbohydrate figure and flags any feed over 12%, which is a widely used guideline rather than veterinary advice, with a plain warning that it is worth watching for laminitis-prone horses. If you photograph a feed bag it reads the sugar and starch off the label for you. Given that a gut overload is one of the routes into laminitis and that high insulin is behind most of the rest, the sugar and starch content of what you are actually feeding is a reasonable thing for software to keep an eye on.

The rest is record-keeping, which matters here because laminitis is a trend problem disguised as an event. The subclinical stage produces changes too small to see day to day, and the question your vet will ask, which is “when did this start and what changed”, is the one nobody answers well from memory. The morning check is a dated observation from a fixed list that includes heat in hoof, lame and filled legs, each with a mild, moderate or marked severity and a note, and it lands on the horse’s health timeline next to farrier visits, vet records and feed changes. Two of the biggest risk factors above are exactly those last two, and a shoeing interval that quietly stretched to nine weeks, or a feed change three days before the episode, is obvious in hindsight and invisible without the dates.

Now the limits, which on this topic are worth stating plainly.

There is no laminitis detection and no risk score. Nothing combines heat, lameness and a reluctant horse into a verdict, and there could not honestly be one from a phone when diagnosis needs hoof testers and usually an X-ray to see whether the pedal bone has moved.

There is no weight field at all. You cannot record a weigh-tape reading or track weight over time, which is a real gap given weight is the most modifiable risk factor on the list. A body condition score exists, but only as a number estimated from a photo in a whole-horse scan, compared against the previous scan. Use a weigh tape and write the number somewhere, even if that somewhere is a note.

An observation has no foot on it. You can log heat in hoof; you cannot log heat in the near fore. Put that in the note.

What the app holds is what you observed, dated, so the phone call you make is a better one.

If you take one thing from this: stop waiting for the stance. Learn the digital pulse, check it while you pick the feet out, and ring on the strong pulse rather than on the rocked-back horse.