Laminitis in horses has been proposed to be one of the most common causes of euthanasia in horses next to colic. The condition comes about due to a variety of factors with some horses being more predisposed than others and the condition has varying levels of presentation in terms of severity. Ultimately, we have to ask ourselves why the condition occurs, what is going on at a cellular level and what can we do better to manage the problem and improve the outcome for the patient? In my many years of managing laminitis, I have found that the outcomes are best when we address the needs of the patient through nutritional type of resources, which I believe aid in better long term management and often improved overall health. Here is my approach when it comes to laminitis in horses for optimal outcomes.