06/11/2025
Changing the mindset (and fear) of the world surrounding the word 'laminitis' will not be easy... but it will happen.
Great article Lindsay Setchell 💪
Please join HM's free rehab group The Phoenix Way: Path 2 Hoof Health and prevent your horse from Hoof Capsule Divergence (HCD).
The BHM Team ❤️
I make no apology for the length of this post. But if you don't wish to read it all, just look at the three horse cadaver feet in the photo. Only one was balanced. The other two had Hoof Capsule Divergence (HCD) - not 'laminitis'. That word is now not fit for purpose anymore.
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The word laminitis has scared owners for decades. And even though owners are far more health and diet savvy these days - still horses are going terribly lame, being diagnosed with laminitis, rotation, sinking and pe*******on of P3, put on months of box rest, fed high doses of metabolic ‘calming’ drugs - and yet even after all of this metabolism ‘control’, the awful pain of laminitis persists… in fact worse than ever before.
There is no downward tick of laminitis at all - even though everyone is perpetually told that laminitis is first and foremost a metabolic driven ‘disease’ - horse owners are still freaking out over ‘laminitis’. And their equines are being pts.
Every year you are told - get your horses off the grass, especially in the spring. Feed more appropriately - and if you can, put up tracks (still incidentally, the best and most optimum way of keeping horses).
And still - laminitis rises. There is no end in sight.
For decades now the word laminitis had been synonymous with:
>> inflammation of the laminae caused by high sugars, toxins, standing on one limb, endocrinopathic overload
>> leading to laminae failure
>> then P3 rotating inside the hoof capsule
>> sometimes aided and abetted by the DDFT (deep digital flexor tendon), which pulls P3 through the capsule.
And at this point, if that hasn't frightened you enough - if the inflammation and tearing of the laminae continue, P3 may sink and pe*****te the sole. Catastrophe and death, in most cases.
So, you can see why everyone has become horribly scared to death of 'laminitis' - and HM are usually hauled over the coals for speaking about it at all - we exist in the ‘dark side’ of the equine world.
Lunatics they cry. Stay away.
What if we said something really 'loony' - that the metabolic cascade leading to failing laminae and then the subsequent displacement of P3, wasn’t caused by metabolism at all.
Just hold on before you call us cult one more time… just read… calm yourselves.
What if we said that what was really happening we now define as Hoof Capsule Divergence (HCD) - when the outer hoof capsule fixes P3 into painful and sometimes catastrophic positions causing not only the tearing of the laminae, but other tissues too, and in many cases degeneration of P3 itself (osteonecrosis).
That the old well rooted story of laminitis being a metabolic cascade that causes the laminae to fail, is not what is happening at all.
Hang on… now wait... we haven’t said stuff your horses full of sugary food and grass yet have we? Read on.
Now the reason we say this, that HCD is the true root of the problem, is not because we are actually really loonies, or cult members, or that I am a narcissist desperate for social media attention - no - the reason we say this is because in every single situation of P3 being ‘displaced’ in the capsule, the hoof capsule itself is out of balance.
Every. Single. Time.
Sometimes extremely obviously so, other times subtly so, but nevertheless, out of balance.
But this very simple problem, leading in fact to a fairly straightforward fix, has become so twisted and complicated... because no-one ever looked properly at the hoof capsule itself.
Owners didn’t know what balance meant. They couldn’t read x-rays and so relied heavily on their vets, who in turn also couldn’t read hoof balance correctly, either because their focus was never on the capsule itself but on the actual position of the bone - or they largely felt the hoof capsule was irrelevant.
And absolutely no-one turned to the HCP. That would be a step too far.
The HCPs who were actually trimming, manipulating, nippering and rasping the hooves… who them? They are the nicest people in the world (and most actually really are)… they couldn’t have caused this awful laminitis could they? No. Absolutely, definitely, demonstrably not.
So the person actually at the ‘rock face’ of the foot - well they were conveniently just let off the hook. Of course a hoof problem never started with the hoof right? Oh… but it did.
And that is apparently why most people hate us - for stating the obvious.
Read on.
And so this word laminitis spawned an era of increasingly desperate (often quite pricey and sometimes quite weird) interventions - from box rest, to remedial shoeing, to resections, to tenotomies (cutting the DDFT - yes they still do that), to raising the heels, to chopping off more toes, and to ultimately huge failures in laminitis treatments leading to no end in sight for the mass suffering and death.
Yet everyone was still ‘trying their best’ to fix laminitis - “such a dreadful disease”.
Except they weren’t ‘trying their best’ and they hadn’t for decades.
The one thing that was never routinely checked (rather unbelievably) was the hoof capsule itself. The one thing everyone could actually see and obsess over.
No-one was diligent enough, from owner to HCP to vet, to take regular hoof imaging histories - photos or x-rays - over time to see how the hoof capsule changed trim to trim, and what effect that actually had on the position of P3.
And because no-one did that, every time they saw an overweight horse that had been on grass, who had an x-ray of P3 in the ‘wrong position’ - they would scream “laminitis” caused by metabolism.
But it got worse. Laminitis became so feared, that even when horses were actually sick with an infection that had nothing to do with the feet whatsoever - they still claimed it was laminitis.
Vets somehow, not all of course, but far too many to be believable, lost the ability to triage sickness, and instead jumped on the laminitis bandwagon, and then down the route of metabolic drugs they would go.
And if the horse was skinny, a good weight, no metabolic markers at all? Well they got ‘laminitis’ because of other reasons, from the weather, to stress, to… well anything that 'might' fit the bill.
Now, then came along some bright souls that realised metabolism might not be the cause 'always' - and they thought that sometimes it had to be mechanical - because there were far too many horses being diagnosed with laminitis that had absolutely no metabolic issues whatsoever. And, some horses no matter how much you changed the diet and put them on tracks, took them off the grass, the ‘bouts of laminitis’ still continued.
So these people then called this mechanical 'failure', hoof capsule rotation - or lever forces tearing laminae from the ‘long toes’.
And then - the crazy hysteria of toe chopping really took off in full incredible swing. Manically so. "Oh look that toe is long" (not really at all) but still "GET IT OFFFF!"
Now pause for a moment. I have a saying… do something to one part of the foot, you better not be so naive to think it isn’t going to cause a massive issue in another part of the foot (and body).
Chop the toes, feedback is lost, growth rates slow down. Heels rise far quicker. And no matter how many times we show this, and how many times owners witness this, it is still ignored and blamed on… you guessed it…
‘Laminitis’.
But the truth was - whenever P3 was displaced, it was simply a non willing victim of hoof capsule imbalance between planes, not an actual rotation of the capsule per se, but an imbalance that caused such strain and tension throughout the capsule that it actually tore the laminae apart.
And how do we know? Because we have done the one thing that the majority of the world has never done. We rehabbed using internal balance as a reference, took copious hoof photos, measurements, and x-rays, and monitored the horse rehab over time. And we did it without any interventions other than some painkillers when needed, and hoof boots, also when needed.
No fancy interventions whatsoever. And we documented it all the way. Oooh dirty word that - 'documentation'.
Keep reading.
Not only did we do that, but we also showed the world what we were doing in plain sight. Literally, here you go, do this to the foot, x-ray it every month and oh look, P3 doesn’t move. Shocking revelation when the laminae are still torn. Successful rehab in huge waves all across the world as owners (working this out) all start copying and doing the same.
You would think that would be enough to convince most other people how simple and comforting it would be that this ‘laminitis’ could be stopped. Hoorah - we’ve fixed it.
Be diligent, measure the hoof capsules regularly, take photos with your smartphone (because pretty much everyone has one nowadays), learn a little about x-rays, and hoof balance… and bingo - fixed before any hideous osteonecrosis has set in to cause long term lameness - forever.
But no. Not at all. Those of us who are saying, come on world, start taking photos and measurements, be diligent now, don’t leave your horses’ hooves in the hands of someone who is also not taking sequential photos, and be more pro-active at learning about hoof balance.. instead, we were thrown to the wolves. The cult was born.
But alas, sadly, the word laminitis has got such a hold on owners of the world, because of the fear, suffering and death it causes, that even though we are saying something rather straightforward that would be a fairly easy thing to do and learn - most people want to hang on to the horror of something which is only a horror story if you let the hoof capsule go out of balance - because you never MEASURED IT or TOOK ENOUGH GOOD PHOTOS.
And even if you didn’t believe us, eh? What have you actually got to lose? Well your horse you might say… not so if you balance their hooves correctly.
Instead most watch their equines get worse from the ‘laminitis lameness’ they have been doomed to live with, whilst the HCPs keep on manipulating the hooves.
And to everyone else on the sidelines saying - ok it might be a hoof balance issue but lamin-itis is still inflammation of the laminae and is caused by my horse eating too much grass… we would ask this… every single time you think your horse is getting inflammation of the laminae, becoming footsore, getting strong pulses, hot feet… check the hoof capsules again and measure them correctly. Be diligent.
Because we bet you, on all the 1000s of lives of the horses we have saved that the traditional world couldn’t, that if you actually looked, and we mean really looked and critically assessed the hoof capsules over time, you would see hoof imbalance, not a mystery metabolic disease - you would see Hoof Capsule Divergence (HCD).
Yes that is our term. And one day, when the dust has really settled, (and the book is out) you will understand why. Sorry little plug there for a treat in the future.
But wait…
… did we say put your horse out on grass to get fatter and fatter and sink into the depths of EMS and PPID? No we didn’t.
But what we did say, is that when you think it is diet, you better sure as hell have good measurements and photos of the hoof capsules - and x-rays - not fancy angles - just plain old simple measurements of the heels, and make sure your HCP isn’t taking off the toe.
Do we have a range of caudal heel measurements? Yes we do. And to find out more about that go join the group mentioned below, when you have finished reading.
Now, we debunked lever forces many years ago. We debunked rotation, sinking and pe*******on, years ago (that is simply the hoof capsule being manipulated and trimmed incorrectly).
And the final piece of the puzzle, does laminae inflame and stretch in a perfectly balanced hoof capsule causing pain and suffering? The answer is no.
We said it. No. Now we could be wrong here, and I am more than happy to hold my hands up and say when I am wrong - IF you can find a perfectly balanced hoof capsule, that has never been manipulated, with full hoof imaging history, that has laminae separation. I know you will never ever find that with rotation - but now we are being more refined and saying just separation.
Did we used to think separation was caused by diet in the absence of rotation? Yes we did. And there are videos of me out there on Facebook saying that very thing. But rotation? We always knew that was a hoof capsule problem and was easy to prove.
Are we allowed to change, deeply research, clarify and bring more clarity to this. Yes we are. And we did. Because we did our due diligence.
And we are teaching our fantastic HMB Pro students and qualified pros to do the same.
All the peer reviewed papers out there that looked at the metabolism - looked at the histology - never did their due diligence by keeping good hoof imaging histories, before, during or after the experiments - and they didn't rehab.
But only when you rehab carefully do you see that all of the horror associated with that scary word laminitis was in fact just a massive mistake - because the equine world did not to do their due diligence and actually measure and photo (and hopefully x-ray) the hoof capsules.
That is not our bad. That is theirs. Or yours. My conscience is now clear. Did I screw up in the past? Oh yes I did. But now I know what I know, not a single horse ever on my watch will suffer from the dreaded ‘laminitis’ ever again.
Because we (and you) could fix this, if you learnt properly about hoof balance.
Obviously don't let your horses get overweight - but please, just check the hoof capsules first. And take lots of photos. Always.
So. Don’t scream and shout at us. Or me. Do the one thing we keep asking you to do. If you think we are dangerous and you don’t believe us, do this one simple thing:
>> Put up your photos and your x-rays - sequential ones - to show the recovery or downfall of your horse with laminitis… and we will show you Hoof Capsule Divergence (HCD). If you can’t, then everything you have ever said about laminitis is just correlation.
No more… my horse got into the grain and suddenly rotated - or, my horse was on the grass and suddenly rotated and was crippled - because P3 cannot suddenly rotate, we have proved that even with separated damaged torn laminae >> P3 remains stable once the hoof capsule is rebalanced.
Go look at your equines’ laminitic feet - right now. Go and REALLY LOOK. And if you are not sure what you are looking at, then join the loony bin mad nutters over in The Phoenix Way: Path 2 Hoof Health - and learn.
And if that is too much, go watch the free YouTube videos, where we give you hundreds of hours of information about hooves - and balance - and laminitis - and rotation. Go see. It literally is totally free.
But whatever you do, don’t continue to shoot the messenger because you never did your due diligence and didn’t understand hoof balance.
And a final lovely note to all the dedicated diligent owners out there following us and rehabbing your horses from HCD… get on, you beautiful and amazingly strong hoof heroes, you have worked it out, stand proud. We salute you! Phoenix Warriors unite 💪
And to our wonderful students and pros, we couldn't do this without you - you are my personal hoof heroes. The world needs you. Stay strong.
It is just going to take a whole load more suffering, pain and death probably for a few more years yet, until the rest of the world works out what you have proven to yourselves and your horses over and over. Fix the balance. The laminitis goes away.
That’s it. Stop hoof imbalance. Bye-bye ‘laminitis’. Simple. But perhaps too simple for some.
Lindsay Setchell
HM.
>> Join our free rehab group if you have a horse diagnosed with laminitis - The Phoenix Way: Path 2 Hoof Health
>> Watch the hundreds of hours of YouTube videos here - https://www.youtube.com/
