Horses

Laminitis in spring: what every horse owner should know

Lush spring grass is a recognised trigger for laminitis in at-risk horses and ponies. How to spot it early, lower the risk, and support a safe recovery.

By The Animal Physio Co 6 min read

A grey horse beside the words "Laminitis: a spring risk"

Spring in the Western Cape brings fresh, fast-growing grass. For most horses that's a welcome change, but for horses and ponies prone to laminitis it's a recognised trigger. The good news is that laminitis is often predictable, and with the right team around your horse, many of the risks can be managed.

Laminitis is an emergency. If you think your horse has it, call your vet and farrier straight away and don't exercise the horse until your vet says it's safe.

Key points

  • Most laminitis is linked to hormonal conditions, particularly insulin dysregulation (equine metabolic syndrome) and PPID (Cushing's disease), which your vet can test for and help you manage.1,2
  • Recent weight gain, a previous episode, new access to grass and soreness after trimming are well-documented warning flags.3,4
  • The early signs are easy to miss: in one study, owners didn't recognise nearly half of the cases their vet confirmed.5
  • Once your vet confirms the feet are stable, regular exercise is a cornerstone of keeping at-risk horses healthy, and physiotherapy helps get them back to it safely.6

What laminitis is

Laminitis affects the lamellae, the delicate tissue that bonds the hoof wall to the pedal bone inside the hoof. When the lamellae are damaged, the hoof becomes very painful and, in severe cases, the bone can shift within the hoof. Laminitis is now understood as a consequence of a wider problem in the body, most often a hormonal one.7

Why spring matters

Cool-season grasses build up sugars and starches (non-structural carbohydrates) in cool, sunny weather, especially in early spring and late autumn, when cold nights hold back growth. That's why limiting grazing on lush pasture in early spring is often recommended for at-risk horses.8,9 Sugar levels are usually lowest in the morning, though not after a cold or frosty night, and you can't reliably judge them by eye, so testing your grass or hay is the only accurate guide.8

In a large study of horses with hormone-related laminitis, mostly from Australia, more cases came in during spring than in any other season.10 Laminitis can strike at any time of year, though,11 so the steps below are worth keeping up all year round.

Which horses are most at risk

  • Horses and ponies with insulin dysregulation (equine metabolic syndrome). In a hospital study, 89% of horses with laminitis had an underlying hormonal disorder.1 High insulin levels predicted which ponies went on to develop laminitis in two studies that followed them over time.12,13
  • Overweight horses, especially those with a cresty neck.12 In one UK study of 446 ponies, almost three-quarters were overweight or obese.13
  • Older horses with PPID (Cushing's). PPID affects about a quarter of horses aged 15 and over, and those that also have high insulin appear to be at greater risk of laminitis.2
  • Horses that have had laminitis before, and those that have recently gained weight, moved onto new grass or been sore after trimming or shoeing.3,4

Warning signs

Watch for:14,15,16

  • Shifting weight from foot to foot
  • A short, stilted walk
  • Difficulty turning, or reluctance to walk
  • Standing "rocked back", with the front feet stretched forward to take weight off them
  • A stronger, bounding pulse at the back of the fetlock
  • Warm hooves

Laminitis usually affects both front feet. In a study comparing laminitis with other causes of lameness, lameness in both front legs was the clearest clue: 92% of these horses had laminitis, rising to 99% when the digital pulse was also raised.14 Because the early signs can be subtle, owners in one study didn't recognise 45% of vet-confirmed cases,5 so if in doubt, call your vet.

What to do if you suspect laminitis

Call your vet and farrier immediately. Treatment is vet-led, and typically includes restricting movement and changing the diet, alongside pain relief and foot support as your vet and farrier advise. With prompt care, most horses improve within weeks. In one clinical study of 80 horses, the typical laminitis score had fallen from 8 out of 12 to 0 within 25 days.17,18

Lowering the risk

The European consensus on equine metabolic syndrome recommends managing at-risk horses mainly through diet and exercise:6

  • Weight loss for overweight horses, aiming for 0.5–1% of body weight a week
  • Low-sugar forage, with less than 10% non-structural carbohydrate, soaking hay if needed
  • Controlled grazing. Grazing muzzles reduce intake to about 77–83% of normal, and horses with insulin dysregulation may need to come off grass entirely for the first 6 to 12 weeks of a diet
  • Regular exercise for horses that are sound and have no current laminitis
  • Good farriery, coordinated with your vet's care

Exercise brings benefits beyond weight loss. In obese horses and ponies, adding low-intensity exercise to a diet improved insulin sensitivity and lowered a marker of inflammation compared with diet alone.19 In a second study, only the exercised horses improved their insulin response, and they lost more around the neck.20 Even short daily walking and trotting lowered inflammation markers in ponies, including ponies that had had laminitis before.21

Recovery and getting back to work

Once your vet confirms the hooves are stable, the European consensus recommends a gradual, carefully monitored return to exercise: low-intensity work on a soft surface for more than 30 minutes, more than three times a week, watching closely for any sign of lameness.6 A gradual approach matters, because the way a horse loads its hooves can stay altered for 6 to 12 weeks after the obvious signs have settled.22

A long-term plan pays off too. Laminitis returned within two years in about a third of horses with hormone-related laminitis,23 so the diet, weight and exercise routine you build during recovery is your best protection.

How physiotherapy helps

When a horse is sore in its feet, it changes the way it moves, and that affects the whole body. Forelimb lameness alters how a horse moves its back,24 and back problems are found far more often in lame horses: in one study, 32% of lame horses had back problems, compared with 12% of a comparison group.25

Working alongside your vet and farrier, a physiotherapist can:

  • Assess your horse's posture, back and muscles for tension and soreness from its altered stance
  • Ease compensatory stiffness with hands-on manual therapy
  • Build a progressive, carefully monitored exercise programme once your vet confirms the feet are stable
  • Add in-hand groundwork and polework as your horse gets stronger
  • Help you structure regular exercise for weight and insulin management

If your horse is recovering from laminitis or is at risk this spring, book an assessment. We'll come to your yard anywhere in the Overberg, Somerset West and Stellenbosch, and work with your vet and farrier.

References

  1. Karikoski NP, Horn I, McGowan TW, McGowan CM. The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion/referral equine hospital. Domestic Animal Endocrinology. 2011;41(3):111–117.
  2. Menzies-Gow NJ, Banse HE, Duff A, et al. BEVA primary care clinical guidelines: diagnosis and management of equine pituitary pars intermedia dysfunction. Equine Veterinary Journal. 2024;56(2):220–242.
  3. Wylie CE, Collins SN, Verheyen KL, Newton JR. Risk factors for equine laminitis: a case-control study conducted in veterinary-registered horses and ponies in Great Britain between 2009 and 2011. The Veterinary Journal. 2013;198(1):57–69.
  4. Pollard D, Wylie CE, Verheyen KLP, et al. Identification of modifiable factors associated with owner-reported equine laminitis in Britain using a web-based cohort study approach. BMC Veterinary Research. 2019;15(1):59.
  5. Pollard D, Wylie CE, Verheyen KLP, et al. Assessment of horse owners' ability to recognise equine laminitis: a cross-sectional study of 93 veterinary diagnosed cases in Great Britain. Equine Veterinary Journal. 2017;49(6):759–766.
  6. Durham AE, Frank N, McGowan CM, et al. ECEIM consensus statement on equine metabolic syndrome. Journal of Veterinary Internal Medicine. 2019;33(2):335–349.
  7. Patterson-Kane JC, Karikoski NP, McGowan CM. Paradigm shifts in understanding equine laminitis. The Veterinary Journal. 2018;231:33–40.
  8. Jones GB, Ghajar SM, Duggan S, Fery M. Understanding sugar and nonstructural carbohydrates in equine pasture and hay (EM 9415). Oregon State University Extension Service. 2023.
  9. Kagan IA. Water- and ethanol-soluble carbohydrates of temperate grass pastures: a review of factors affecting concentration and composition. Journal of Equine Veterinary Science. 2022;110:103866.
  10. de Laat MA, Sillence MN, Reiche DB. Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis. Journal of Veterinary Internal Medicine. 2019;33(3):1456–1463.
  11. Pollard D, Wylie CE, Newton JR, Verheyen KLP. Incidence and clinical signs of owner-reported equine laminitis in a cohort of horses and ponies in Great Britain. Equine Veterinary Journal. 2019;51(5):587–594.
  12. Carter RA, Treiber KH, Geor RJ, et al. Prediction of incipient pasture-associated laminitis from hyperinsulinaemia, hyperleptinaemia and generalised and localised obesity in a cohort of ponies. Equine Veterinary Journal. 2009;41(2):171–178.
  13. Menzies-Gow NJ, Harris PA, Elliott J. Prospective cohort study evaluating risk factors for the development of pasture-associated laminitis in the United Kingdom. Equine Veterinary Journal. 2017;49(3):300–306.
  14. Wylie CE, Shaw DJ, Verheyen KL, Newton JR. Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study. Veterinary Record. 2016;178(17):420.
  15. Wylie CE, Collins SN, Verheyen KL, Newton JR. A cohort study of equine laminitis in Great Britain 2009–2011: estimation of disease frequency and description of clinical signs in 577 cases. Equine Veterinary Journal. 2013;45(6):681–687.
  16. Meier A, de Laat M, Pollitt C, et al. A "modified Obel" method for the severity scoring of (endocrinopathic) equine laminitis. PeerJ. 2019;7:e7084.
  17. Sillence M, Meier A, de Laat M, et al. Demographic, morphologic, hormonal and metabolic factors associated with the rate of improvement from equine hyperinsulinaemia-associated laminitis. BMC Veterinary Research. 2022;18(1):49.
  18. Meier A, McGree J, Klee R, et al. The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting. BMC Veterinary Research. 2021;17(1):16.
  19. Bamford NJ, Potter SJ, Baskerville CL, et al. Influence of dietary restriction and low-intensity exercise on weight loss and insulin sensitivity in obese equids. Journal of Veterinary Internal Medicine. 2019;33(1):280–286.
  20. Moore JL, Siciliano PD, Pratt-Phillips SE. Effects of diet versus exercise on morphometric measurements, blood hormone concentrations, and oral sugar test response in obese horses. Journal of Equine Veterinary Science. 2019;78:38–45.
  21. Menzies-Gow NJ, Wray H, Bailey SR, et al. The effect of exercise on plasma concentrations of inflammatory markers in normal and previously laminitic ponies. Equine Veterinary Journal. 2014;46(3):317–321.
  22. Al Naem M, Litzke LF, Failing K, et al. Hoof kinetic patterns differ between sound and laminitic horses. Equine Veterinary Journal. 2021;53(3):503–509.
  23. de Laat MA, Reiche DB, Sillence MN, et al. Incidence and risk factors for recurrence of endocrinopathic laminitis in horses. Journal of Veterinary Internal Medicine. 2019;33(3):1473–1482.
  24. Gómez Alvarez CB, Wennerstrand J, Bobbert MF, et al. The effect of induced forelimb lameness on thoracolumbar kinematics during treadmill locomotion. Equine Veterinary Journal. 2007;39(3):197–201.
  25. Landman MA, de Blaauw JA, van Weeren PR, Hofland LJ. Field study of the prevalence of lameness in horses with back problems. Veterinary Record. 2004;155(6):165–168.

This article is general information, not veterinary advice. Speak to your vet before starting any supplement or treatment, and ask a qualified animal physiotherapist to assess your animal individually.