Chronic laminitis — where coffin bone rotation or sinking has caused permanent structural change to the hoof — is one of the most challenging pain management situations in equine welfare. Corrective farriery and targeted analgesia can maintain reasonable quality of life even in severe cases.
Horses with chronic laminitis experience pain with every step — the degree depending on severity of rotation and adequacy of treatment. Horses that stand in deep bedding voluntarily are communicating pain relief from reduced mechanical loading. Farriery that raises the heels and rolls the toe reduces the mechanical moment pulling the coffin bone forward and downward, addressing the biomechanical cause of ongoing pain. Analgesia with NSAIDs must be dosed carefully — adequate pain relief is essential, but masking pain completely may allow horses to overexert and worsen damage. The welfare decision to euthanise a chronic laminitic depends on whether multi-modal management can maintain more good days than bad.