Q. My horse had a laminitic episode two months ago. He is back to being sound walking and trotting in-hand, but I am worried I will accidentally cause more damage if I start riding him. What do you recommend for a horse coming back into work after a laminitis episode? What should I keep an eye out for, and what can I do to keep him sound and comfortable?

A. It is always important to work with your veterinarian and farrier to make sure your horse is ready to resume exercise, particularly ridden exercise, after an episode of laminitis. A lot will depend on the nature and severity of the laminitis episode and what amount of damage exists within the feet, which is best determined by X ray evaluation, in most cases, as well as the clinical experience of your veterinarian. Exercise, and even paddock turnout (uncontrolled exercise), too soon can put too much strain on the feet and cause further damage—so it is important not to turn a horse out too soon, even if it appears sound.

A good general rule for rehabilitation after an acute laminitis episode is that the horse should be rested (and ideally confined to a stall) for a week for every day it was lame. So a horse that was lame for four days needs a month of strict stall rest. After this, it is always best to begin with carefully controlled exercise—hand-walking only—starting with five minutes once a day for a week and building up to 10 or 20 minutes a day if well tolerated. It might then be possible, after consultation with your vet and farrier team, to incorporate some ridden exercise, starting gradually. In addition to obvious lameness at the walk, look out for persistent heat in the feet, treading/weight shifting in the front limbs when standing still, pointing front feet, or other changes to posture when at rest, as these are signs of foot pain. Subtle foot pain might also manifest as behavioral change. If your horse is unwilling to work, resents the girth, or displays other changes in behavior, consult your veterinarian. It is always a good idea for a horse that has had laminitis to get foot X rays at least annually to track changes.