I recall a possibly simplistic rule of thumb that if a horse limps more on hard ground it’s likely hoof and if they limp more on soft ground, it’s further up the leg. All the advice for acute laminitis is pad, pad, pad whether that’s easy boot clouds or foam taped to the hoof or deep bedding. Reduce the stressors on the hoof capsule while it’s vulnerable. Active laminitis is hot and painful. It could be triggered by sugar in feed, carb overload, metabolic issues, fever, vaccine reaction, bad hoof angles, intense work on hard surfaces, or even a hoof trim that changes the angles (in my observation).
You need to be active in fixing the cause, take pressure off the foot, ice and use anti-inflammatories.
If you’re fortunate the active laminitis will resolve and the horse will not founder. I understand that a horse with a good trim and hoof shape is less likely to founder from a single laminitis episode than one with a stretched toe and under run heels.
There are also trimmers who identify what they call “subclinical” laminitis, which might mean low grade ongoing hoof inflammation that the owner hasn’t yet noticed, or could be the effects of founder, or poor ongoing hoof maintenance, or could be imaginary.
But anyhow, laminitis is acute and an emergency situation that needs to be resolved ASAP to limit long term damage through founder. Padding any way you can is important.
Founder is the long term modification of the hoof capsule after being weakened by laminitis (or perhaps really bad trimming) and it also needs hoof padding plus a therapeutic trim program to fix the hoof angles as much as possible.
Horses with hoof abscess or hoof bruise will also seek out softer footing. Our barn has stalls with mats, variable amounts of shavings (it’s DIY so everyone does what seems best for their horse), and small runout paddocks (sand or hogfuel cedar mulch). Horses under my care have always been on hogfuel paddocks and they absolutely prefer the paddock to the stall when they have an abscess. But neither the stalls nor the paddocks get so deep and fluffy that the horses have trouble moving around! I deep bed half the stall and it tends to pack down to a similar feel to the paddocks, and the horses will choose to sleep and stand resting on that side.
I have been very lucky to not have dealt with any soft tissue injuries except once very long ago. My horse as a kid once pulled something at the back of her heel slipping on wet grass and was acutely lame. I hand walked her home several miles, wrapped the fetlock for a week, gave her stall rest, and she made a full recovery. No vet care. I guess I looked at an anatomy chart because my notes to self from then that I found (on the fly leaf of an old horse first aid book) said “digital tendon sprain??” But I wonder now if it was, because she recovered so fast and so completely. She did have a very deep bedded stall, a foot of shavings over concrete.
Anyhow, I haven’t had any experience with acute soft tissue injury as an adult so no idea what the current best practice is.
But for hooves, it’s padding/ soft footing.
I haven’t dealt with full blown laminitis either, but I’ve gone down the barefoot trimmer rabbit hole, including a Pete Ramey 2 day clinic, and rehabbing founder is a huge part of what interests that world. So I know more theoretically about managing laminitis and founder. What I do know more hands on is abscesses! Barefoot horses and a wet climate.
I really appreciate the real-life review - My horse is well past the critical stage, he is comfortable in his SoftRides and I’m just thinking to add a little cush or maybe he could be comfortable enough out of them when in his stall and let his feet breathe a little bit.