Signalment: 13 year-old purebred Arabian gelding; Primary complaint: Bilateral thoracic limb lameness with progressive difficulty in movement History: The horse presented with bilateral thoracic limb lameness that had progressed in severity over the course of several months and had been diagnosed with laminitis by the client’s primary veterinarian. The client first noted sporadic lameness of the right front limb five months prior during the early spring. Over the next two months the lameness did not resolve and continued to worsen. The primary veterinarian took radiographs of both front feet. At that time there was radiographic evidence of slight rotation of the right front coffin bone (P3). The left front coffin bone (P3) showed no rotation. Medications started included phenylbutazone paste 2 grams BID. Over the course of the following 3 weeks, the horse continued to deteriorate.