14/08/2025
NOTE: The photo is merely an example of a laminitic foot! It is *not* an animal under my care, and, thanks, but I’m not asking for advice about how it should be trimmed. It’s just a photo I had handy for my “Trimming the Laminitic Horse” class we offer in our Comprehensive Hoof Care Workshops. Please READ THE POST. Again - it’s *not* about the photo!
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I usually avoid commenting on the plethora of incorrect hoof care information posted on FB simply because I’d have no time left in my day for doing what’s truly important to me: ensuring the horses in our care, their owners & caregivers, and the students & professionals who study/consult with us, receive the majority of my time.
But, occasionally, I read something I believe to have the potential to cause a great deal of needless harm to horses and, potentially, a consequent and considerable emotional and financial burden to their owners. And in those cases, I feel compelled to speak out.
Such is the case now, because I’ve just read a post from one of the trimming training groups stating that laminitis isn’t caused by excessive sugar/grass, but is instead caused by chronic incorrect trimming. Both pieces of that assertion are incorrect: the most common cause of laminitis has, in a large number of studies, been shown to be excess dietary sugars/starches; and laminitis has *not* been shown to be linked to chronically incorrect trimming. But first, a brief bit of background on what laminitis actually is.
In the healthy equine foot, the natural breakdown of the connection between the sensitive laminae (on the outside of the coffin bone) and the insensitive laminae (on the inside of the hoof capsule) is controlled by the balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), and happens as the hoof wall grows past the sole. In the laminitic horse, however, an overproduction of the MMP enzymes and/or an underproduction of the TIMP enzymes causes the lamellar connections to break down, or “let go,” prematurely, and the weight of the horse on these compromised connections then causes the hoof wall to separate (not tear) from the coffin bone. The hoof literally “comes apart,” evidenced by the “stretching” at the white line. Laminitis can be consistently induced in the horse in the laboratory by either excessive sugar ingestion (see, for example, “Methylated tirilazad may mitigate oligofructose-induced laminitis in horses”) or hyperinsulinaemia (excessive insulin levels – see, for example, “Equine laminitis: Induced by 48h hyperinsulinaemia in Standardbred horses”). There are many other references in the literature. It is also important to note that stress, and the subsequent release of stress hormones – specifically, eACTH and histamine – has also been implicated as a causative factor in laminitis (see “Stress response as a contributing factor in horses with laminitis”).
If one doesn’t truly understand what laminitis is and what causes it, how can one possibly be in a position to determine cause & effect by looking at *any* number of radiographs of the laminitic foot? In other words, while the coffin bone is nearly always out of position in the laminitic foot, the laminitis is not *caused* by the coffin bone being out of position; it is a *consequence* of the laminitis, and not the cause. And yes, of course, proper trimming is absolutely essential to ensure proper alignment of bones/joints in *every* horse, but is especially important in the laminitic horse to minimize the mechanical forces causing the separation and provide maximal comfort for the horse. But unless the underlying *cause* of the laminitis is identified and resolved, the horse will remain in a laminitic state.
Anecdotally speaking, I have personally provided hoof care to *many* laminitic horses over the past 20 years, and have made several observations about laminitis and its management/treatment. First of all, and most important to the horse owner (and the horse!) is that *if* the feet are trimmed correctly i.e. for proper bone/joint alignment, the horse will readily recover as long as the underlying cause of the laminitis has been identified and addressed. If, however, the cause is *not* addressed, no amount of proper trimming will take away the laminitis. I’ve also had horses who have been under my care and completely sound for many years develop laminitis because they’ve gradually gained too much weight despite my warnings to the owners. And I’ve also seen laminitis appear in horses who have had consistently good hoof care but have developed metabolic conditions such as Equine Metabolic Syndrome and Cushing’s Disease (PPID).
What I have *never* seen is laminitis in a horse who’s had *only* consistently crappy hoof care; there’s always been some other identifiable factor causing the problem. I've cared for many horses from rescues that are flat-out neglect cases and have been stuck in stalls with *no* hoof care for years – they don't have laminitis. But I’ve definitely seen laminitic horses that have been improperly trimmed – always with too-long heels and/or wedge shoes/pads, which can *never* help a laminitic horse – suffer needlessly for months because the increased heel height kept the bones/joints out of proper alignment and increased the mechanical forces responsible for the white line separation. As a side note, it’s always *very* rewarding to have one of these horses come under my care and see them go from completely unwilling to move, or even constantly lying down, to up and moving, often within a matter of minutes!
I remember circa 2008 when I was teaching the class called "Farriering" at The Ohio State University ATI (which I did for many years, although I always taught it from a natural hoof care perspective - never any shoes!) and one of the students told me she believed the proper way to care for the laminitic horse was with bar shoes and wedge pads. My response was: Just because you believe it doesn't make it true. Same thing here.
And that’s my public service announcement for the day!
