A horse can live with laminitis for many years, and although a single episode of laminitis predisposes to further episodes, with good management and prompt treatment it is by no means the catastrophe sometimes supposed: most horses suffering an acute episode without pedal bone displacement make a complete functional recovery. Some countermeasures can be adopted for pasture based animals. Discovery of laminitis, either active or relatively stabilized, on an equine prepurchase exam typically downgrades the horses value, as the possibility of recurrence is a significant risk factor for the future performance of the horse. Several radiographic abnormalities can be judged to correlate with a worsened prognosis:

Increased degree of rotation of P3 relative to the dorsal hoof wall (rotation greater than 11.5 degrees has a poorer prognosis)
Increased founder distance, the vertical distance from the coronary band (seen with a radio-opaque marker) to the dorsoproximal aspect of P3 (distance greater than 15.2mm has a poorer prognosis)
Decreased sole depth
Sole penetration by P3

Treatment
In laminitis cases, a clear distinction must be made between the acute onset of a laminitis attack and a chronic situation. A chronic situation can be either stable or unstable. The difference between acute, chronic, stable, and unstable is of vital importance when choosing a treatment protocol. There is no cure for a laminitic episode and many go undetected. Initial treatment with cryotherapy and anti-inflammatory drugs may prevent mechanical breakdown if instituted immediately, but many cases are only detected after the initial microscopic damage has been done.
Normal forces placed on the hoof are then strong enough to tear the remaining laminae, resulting in a failure of the interdigitation of the epidermal and dermal laminae between the hoof wall and the coffin bone. When severe enough, this results in displacement of the coffin bone within the hoof capsule. Most cases of laminitis occur in both front feet, but laminitis may be seen in all four feet, both hind feet, or in cases of support limb laminitis, in a single foot. Mechanism
The mechanism remains unclear and is the subject of much research. Three conditions are thought to cause secondary laminitis:

Sepsis/endotoxemia or generalized inflammation
Endocrinopathy
Trauma: concussion or excessive weight-bearingInflammationInflammatory events that are associated with laminitis include sepsis, endotoxemia, retained placenta, carbohydrate overload (excessive grain or pasture), enterocolitis, pleuropneumonia, and contact with black walnut shavings. In these cases, there is an increase in blood flow to the hoof, bringing in damaging substances and inflammatory cells into the hoof. EndocrinopathyEndocrinopathy is usually the result of improper insulin regulation, and is most commonly seen with pituitary pars intermedia dysfunction (also called equine Cushings syndrome) and equine metabolic syndrome (EMS), as well as obesity and glucocorticoid administration. In cases of EMS, most episodes occur in the spring when the grass is lush. TraumaMechanical laminitis starts when the hoof wall is pulled away from the bone or lost, as a result of external influences.