Confine the horse.
If shoed, leave the shoe on initially – In the acute stage, pulling off the shoe may cause more laminar separation and causes the horse to load the other foot while this is done.
Provide sole support
Applying conformable material under the sole as well as the rest of the palmar surface of the foot (more required if shod) helps these structures to support the coffin bone (P3) [See * note below]Ease break-over around the foot.As soon as is practical, trim the heels down, to put more load on the back part of the foot and reduce the forces on the tip of P3. [Some people then suggest that the foot should be wedged up, to reduce the forces from the deep flexor tendon. I do not agree with this. The forces from the weight of the horse are, in my opinion, far more significant and the forces from the tendon become significant when the horse moves – which it shouldn’t be allowed to do in the acute stage.Stabilize the hoof wall.The method that would appear to cover these recommendations best is to cast on an EVA support (See Equicast). The EVA pad is conformable, to give sole support, and has a narrower base, to ease break-over around the foot and the Equicast holds the EVA in place and provides stability to the hoof wall.* If it is an acute laminitic episode in a horse with chronic laminitis, sole support has the potential of putting pressure on the sole under the tip of P3, to cause pressure necrosis. In these cases, support under the back half of the foot is safer. An EVA pad may not be suitable in these cases.
Reduce the mechanical forces on the hoof.