Laminitis cases
These show a lameness by being reluctant to move, taking the weight on their heels and shifting their weight from one foot to another, constantly. They also have bounding digital pulses. Laminitis cases uncomplicated by an underlying medical problem should be much better within a few days if given the treatments which we recommend. Nevertheless I strongly suggest that they remain confined to their stables for at least a month after they appear sound without painkillers. The reason for this is that the laminae are still inflamed and have lost some of their strength. Premature exercise can induce these cases to founder. Even mild exercise can do this; such as allowing the horse to mooch around a barn or menage.However cases which do have an underlying problem such as Cushing's disease, metabolic syndrome or those which have been given corticosteroids have a much more guarded prognosis. Some of these do not respond to treatments, continue to be lame or become more lame and have to be put down.

Acute founder cases
These show the same symptoms as laminitis cases but also have palpable depressions above their coronary bands on the affected feet. These depressions usually, but not always, first appear at the front of the coronary band. The deeper and wider the depression the worse the founder i.e. the more the pedal bone has dropped within the hoof. Accurately measuring the founder distance from X-rays gives an accurate prognosis. For example a true founder distance of 15 mm or more is bad news and I rarely attempt treatment of such cases. The depth of the supra-coronary depressions is highly correlated with the founder distance so that regular monitoring of the depressions gives an excellent idea of whether the horse is continuing to founder. All acute founder cases should be given a year's rest if they are to be achieve optimal soundness. This means at least four months box rest. Thereafter confinment to a yard or barn may be appropriate. Acute founder cases need corrective shoeing, sympathetically and regularly applied every five weeks. They may well need dorsal wall resections, specific treatments of tubbing should the develop foot abscesses and may need surgical treatments should they develop deep digital muscle contracture.

Sinkers
Sinkers do not show the same type of lameness as laminitis or acute founder cases. Sinkers are very reluctant to move. They have bounding digital pulses and sometimes stone cold feet. They do not try and stand on their heels; they stand flat footed. Sinkers have supra-coronary depressions which extend the full length of the coronary band on the affected feet. That is, from one heel all the way around the front of the coronary band and back to the other heel. Remember only 20% of sinkers can be expected to recover, again the founder distance is a significant prognostic indicator. If you are successful at treating a sinker it should be given one year of rest just like an acute founder case.

Chronic founder cases
We need to distinguish here between chronic founder cases which are lame because they have distorted feet and those which also have laminitis. The former can usually be treated successfully, at least to greatly improve their lameness by corrective foot dressing and shoeing. This involves using the principles of rasping off any long toes to restore the parallel relationship between the front of the hoof wall (or what is left of it) and the front of the pedal bone [This can be checked by taking X-rays if necessary]; and lowering the heels to restore a straight phalangeal axis. Most chronic founder cases are more comfortable if they are shod (to lift their soles off the ground) with well seated out shoes with sufficient length and width at the heels. However, be aware of the possibility of deep digital flexor contracture in chronic founder cases and emply of toe-wedge test before starting any foot dressing if there is any doubt. Additionally chronic founder cases which have lost large amounts of pedal bone mass will never be sound; there is not sufficient laminal surface area left to support the horse within its hooves. Without these two complications these cases can be improved within one or two shoeings so that they may return to ridden work. Many go into the forge lame and come out pretty sound. Chronic founder cases which are also suffering laminitis may be more complicated and have an unpredictable timescale of treatment. This is because many chronic founder cases do have underlying medical problems. If or until these can be treated little or no improvement in lameness can be expected. In addition to the usual laminitis treatments chronic founder cases need corrective foot dressing and shoeing to be done whilst the medical treatments are starting to work.