06/08/2026
This one is appropriate for some many , thanks John
Lower Limb and Hoof Neuropathy in Laminitic Horses and Ponies
By Dr John Kohnke BVSc RDA
Following an acute episode of laminitis in a horse or pony, or well after the recovery phase, many horses develop apparent increased hoof sole sensitivity and symptoms of reduced stride length, a shuffling, gait with signs of hoof discomfort by frequently lifting a front hoof off the ground, or shifting weight from one front limb to the other when standing at a feed bin or when standing as they are being saddled up to ride.
Although dosing with anti-inflammatory medications, such as ‘bute’, can relieve the lameness and ‘sore feet syndrome’ during the laminitic episode, they have little benefit for helping horse or pony with post-laminitis hoof pain and a shortened stride. This is because these preparations mainly have benefit in reducing inflammatory pain and ‘sore feet syndrome’ during inflammation of the lamellae or ‘laminitis’ in the hooves, rather than lower limb and hoof nerve pain or neuropathy
However, in many horses, especially older horses with a recurring history of endocrine elevated insulin induced laminitis related to Insulin dysfunction, also referred to as insulin resistance, associated with Equine Metabolic Syndrome or EMS, they still remain ‘sore in the hooves ‘ and shuffling lameness, even when medicated with ‘bute’ and other anti-inflammatory drugs.
The same neuropathy symptoms develop in humans with insulin induced Type 2 diabetes in older adults, as it is a similar elevated blood sugar-induced high circulating insulin condition as EMS in horses and ponies. Human sufferers develop a ‘burning’ pain on their soles and tops of their feet, especially at night, with a shortened stride when walking, and a risk of falling, due to neuropathy to sensory nerves in their feet, associated with poor oxygen supply to the long nerve cells of the lower limbs.
In horse and ponies, laminitic inflammation may no longer be the underlying the cause of the apparent hoof pain around the toes and soles, the shifting weight lameness or the shuffling, uneven front limb stride.
Studies in 2007 found that the response to pain was due to neuropathy of the lower limb and hoof sensory nerves. It was found that the intense inflammation of laminitis and vascular damage, reduced blood perfusion within the hooves, causing damage, death and reduced numbers of neurons supplying sensory innervation to the hooves, which in chronic cases, the cervical spinal cord nerve trunks expressed neuron injury markers as well.
The 2007 study that the neuropathy component was highlighted following episodes of laminitis resulted in a 43.2 % loss of unmyelinated nerve neurons and 34.6 % reduction in myelinated or myelin coated nerve fibres, as compared to normal non-laminitic horses.
In severe cases of laminitis resulting in ‘founder’ with the pedal bone tearing away from the hoof wall lamellae, the sinking of the pedal bone within the hoof capsule, causes tearing of the sensory nerves as well and neuropathy changes.
At this stage, as in human neuropathy sufferers, treatment and management options are limited.
Drug medications to help relieve neuropathy pain in horses are limed, expensive and not well-documented to manage chronic laminitic neuropathy. Consult your vet for advice. Supplementation with bioavailable magnesium and Vitamin E, such as in Kohnke’s Own Mag-E®, is recommended as nutritional support for horses with sciatic nerve damage due to ingestion of neurotoxins from flat w**d, dandelion and capew**d ingestion and symptoms of Pasture-Associated Stringhalt, may be of benefit in cases of hoof neuropathy.
Providing a thick covering of bedding in stables and working horses on softer ground to reduce concussion, is also recommended to reduce post laminitic neuropathy discomfort in the hooves. Research to improve the relief from neuropathy in horses and ponies in continuing.
