Laminitis Prevention in Horses: A Comprehensive Welfare Approach
Risk Factor Assessment
Laminitis prevention begins with identifying individual risk. Key risk factors: obesity (BCS >3.5); equine metabolic syndrome (EMS/insulin dysregulation); pituitary pars intermedia dysfunction (PPID/Cushing's disease); spring/autumn grass flush access; dietary non-structural carbohydrate (NSC) overload; breed (native breeds, donkeys, Andalucians, warmbloods at higher risk); previous laminitis (major recurrence risk factor); and concurrent illness (systemic inflammation, grain overload).
Dietary Management for Prevention
Dietary management is the cornerstone of prevention in EMS/insulin-dysregulated horses. Key strategies: soaking hay (30-60 minutes cold water, 15 minutes warm) reduces NSC content; analyzing hay NSC levels (target <10-12% NSC for at-risk horses); limiting or eliminating lush grass access (particularly spring, autumn, and after rain); using grazing muzzles to reduce grass intake (30-70% reduction) while maintaining turnout welfare benefits; avoiding high-sugar feeds; and maintaining body weight in healthy range.
Pasture Management
Pasture management reduces the risk from grass sugars (fructans and simple sugars). High-risk periods: spring grass flush (rapidly growing grass after winter); autumn flush; post-frost thaw (freeze concentrates sugars in grass blades); sunny afternoons (peak photosynthesis); and drought stress. Strategies: strip grazing to limit intake; sacrifice paddocks with limited/no grass; track systems (paddock tracks allowing movement without grass access); and pasture selection (older, slower-growing swards).
PPID/Cushing's Management
PPID is a common cause of laminitis in older horses. Screening for PPID (ACTH measurement, particularly November-December when seasonal PPID-related ACTH rise is present) in any horse with laminitis over 15 years. Treating PPID with pergolide (Prascend) dramatically reduces laminitis recurrence and significantly improves welfare. Regular monitoring of ACTH levels guides dose adjustment. PPID management is one of the highest-impact welfare interventions in senior equine medicine.
Early Warning Signs and Monitoring
Owners should monitor for early laminitis warning signs: increased digital pulse; warm hooves; reluctance to move or turn; shifting weight; and reluctance to pick up feet. In EMS horses, regular insulin testing (resting insulin, or ideally oral sugar test/OST) identifies dangerous insulin peaks before laminitis occurs. BCS scoring every 2 weeks ensures early detection of weight gain. A pre-emptive laminitis management plan, agreed with the vet before the spring grass flush, is the most effective welfare intervention.