Risk factors
Whilst diet has long been known to be linked to laminitis, there is emerging evidence that breed and body condition also play a role. Levels of hormones, particularly adiponectin, and serum insulin are also implicated, opening up new possibilities for developing early prognostic tests and risk assessments. Diagnosis
Early diagnosis is essential to effective treatment. However, early outward signs may be fairly nonspecific. Careful physical examination typically is diagnostic, but radiographs are also very useful. Clinical signs
Increased temperature of the wall, sole and/or coronary band of the foot
A pounding pulse in the digital palmar artery
Anxiety and visible trembling
Increased vital signs and body temperature
Sweating
Flared nostrils
Walking very tenderly, as if walking on egg shells
Repeated "easing" of affected feet, i.e. constant shifting of weight
Lameness with a positive response to hoof testers at the toe
The horse stands in a "founder stance" in attempt to decrease the load on the affected feet. If it has laminitis in the front hooves, it will bring its hind legs underneath its body and put its fore legs out in front. In cases of sinking, the horse stands with all four feet close together, like a circus elephant.
Mechanical separation
Commonly known as road founder, mechanical separation occurs when horses with long toes are worked extensively on hard ground. The long toes and hard ground together contribute to delayed breakover, hence mechanical separation of the laminae at the toe. Historically, this was seen in carriage horses bred for heavy bodies and long, slim legs with relatively small hooves; their hooves were trimmed for long toes (to make them lift their feet higher, enhancing their stylish "action"), and they were worked at speed on hard roads. Road founder is also seen in overweight animals, particularly when hooves are allowed to grow long; classic examples are ponies on pasture board in spring, and pregnant mares. Poor blood circulation
Normal blood circulation in the lower limbs of a horse depends in part on the horse moving about. Lack of sufficient movement, alone or in combination with other factors, can cause stagnant anoxia, which in turn can cause laminitis.A horse favoring an injured leg will both severely limit its movement and place greater weight on the other legs. This sometimes leads to static laminitis, particularly if the animal is confined in a stall. A notable example is the 2006 Kentucky Derby winner Barbaro.Transport laminitis sometimes occurs in horses confined in a trailer or other  transportation for long periods of time. Historically, the most extreme instances were of horses shipped overseas on sailing ships.