Farrier John O'Connell, thinks that a farrier should not touch a laminitic horse without a vet's assistance. "These horses are in so much pain that I can't touch them without the horses being sedated. Also, to properly fit a heart-bar shoe, I'll need radiographs. I've found that the partnership between vets and horseshoers are essential for successful treatment."

The heart-bar shoe is the most common type of shoe used on laminitic horses. It looks like a traditional shoe with a triangular steel insert in the frog area of the horse's foot. The insert is made to exert pressure to the frog, assist with circulation, and remove pressure from the wall transferring the horse's weight to the bony column of the leg. Some vets will instruct farriers to remove part of the hoof wall when the heart-bar is placed on the foot. Removing sections of the wall is another way to relieve the pressure inside, and the wall will grow back eventually. Sometimes this shoe works, sometimes it doesn't. If the bone is destined to rotate, the heart bar won't prevent that. In any case, fitting the shoe to the foot is crucial to the horse's recovery, and x-rays show the farrier exactly where the tip of the steel insert needs to be placed. But a bit of finesse is involved as well-it's a judgement call. Too much pressure against the frog and the shoe hurts the horse. Too little pressure and the shoe does nothing to help. This fine line is the reason not all farriers work on these horses.

For most horses, then, owners may never have to worry about the risk factors that can trigger laminitis; these horses will remain healthy their whole lives. Then there are those few...

Spring seems to be abundant in risks for laminitis. Spring is the season for mares to foal. Foaling brings its own set of risks.

"Mares who retain placental tissue are at an increased risk of infection that can be complicated with laminitis," says Johnston. "Careful monitoring of mares, making sure they clean completely, can prevent this."

Spring also brings the green grass. This change in diet can trigger laminitis in some horses. The only prevention is to remove the horse from pasture at that time of year. Another way to be a little more careful is to dry lot the horses for extended periods of the day, feed small amounts of grass hay (no alfalfa or high protein forage), and only allow an hour or two a day of grass for the horse. Once the grass matures, the risk seems to diminish. These might be appropriate measures to take for those obese horses who seem to be more prone to the condition to start with.

Another problem that can be avoided is bringing ranch horses down from higher elevations at branding time to graze on lush pasture. This change in diet can be enough in some horses to cause laminitis. Preventing free choice grazing is usually all that is called for. An hour or two a day of grazing, increasing by about this same amount every week should introduce a horse slowly enough to changes in pasture without creating illness.

Overeating on grain is a different problem. Prevention is easy if there is a way to keep the grain in a secure area where the horse can't get it. But if it's too late for that, and the horse has devised a way to devour large amounts of grain, the vet needs to be called immediately. Mineral oil, administered through a stomach tube, helps speed up the passage of grain through the horse's gut, while at the same time making it more difficult for the intestines to absorb nutrients and toxins. If caught soon enough, the horse may recover without any severe effects.

When spring fever hits, some riders may be tempted to go for a nice long gallop. But poorly conditioned horses, especially those overweight from a long winter of no work and plenty of feed, are sometimes at risk for two reasons. Obesity has been discussed above. Hooves grown long over the winter can create a second risk, as the leverage of the long foot can aggravate sensitive tissue inside. These two factors can be removed by planning a spring conditioning program for horses that includes reducing feed to help shed some extra winter pounds, and maintaining hooves on a regular basis removes the last risk factor.

If owners consider prevention the only treatment, that would be ideal. Seeing just one horse in the kind of pain that goes along with laminitis is enough to last a lifetime. But in those cases where horses exhibit lameness in both front feet, don't want to move, and more warmth can be felt in the front than hind feet, the vet may be that horse's only hope. There's always a chance the horse will get better without treatment. There's a chance the laminitis will respond quickly to treatment and the horse will recover fully. There's a chance it won't recover at all. No way to predict what will happen. The only defense is to be aware, know the signs, and call the vet early.