LIFE as a veterinarian or farrier in the 21st century involves the diagnosis, treatment and management of one of the most debilitating conditions to affect the horse throughout history: laminitis. This article provides a commentary on the scientific evidence and is aimed at helping equine clinicians in their understanding of laminitis and highlighting potential areas for future research. New research in the field of paleopathology (the study of ancient diseases) has found evidence of laminitis in prehistoric horses, millions of years before equine species were domesticated (Wallet 2013). A study of wild horses also identified pathology associated with laminitis (Hampson and others 2011) which was thought to be influenced by environmental factors (Hampson and others 2012). In domesticated horses, the frequency of laminitis has been reported to range from 3 to 17.1 per cent. However, a recent study in Great Britain found that active episodes of laminitis accounted for nearly one in 200 veterinary visits (Wylie and others 2013), and in a study summarised on p 72 of this issue of Veterinary Record , the prevalence of supporting limb laminitis in one particular referral practice in the UK was found to be 0.02 per cent (Wylie and others 2014). With a long history of laminitis in prehistoric, wild and domesticated equids, the question is why, as veterinarians …