Endocrine laminitis — triggered by hormonal imbalances in conditions like PPID (Cushing's disease) and Equine Metabolic Syndrome — is one of the most common and preventable causes of severe hoof pain in horses and ponies worldwide.
Endocrine laminitis is tragic precisely because it is so preventable. The horse or pony who develops acute-on-chronic laminitis due to unmanaged EMS or untreated PPID has usually been showing early warning signs — weight gain, cresty neck, slow shedding of winter coat, subtle gait changes — for months or years before the acute crisis. Pain during a laminitic episode is severe and constant; affected animals cannot escape it because they must bear weight on painful feet to survive. Pedal bone rotation causes irreversible structural damage that leaves horses vulnerable to repeated and increasingly severe episodes. The welfare burden extends beyond the acute episode: horses managed on restricted grazing programmes experience chronic frustration of foraging motivation — they want to eat constantly and are prevented from doing so. Balancing this necessary restriction against normal behavioural needs (turnout in company, freedom to move) requires creative management solutions such as track systems, grazing muzzles, and hay nets that allow movement while limiting caloric intake.