Horses with more than 15 degrees of rotation accompanied by downward displacement of the coffin bone into the hoof capsule within 4-6 weeks of the initial episode of laminitis have a poor prognosis. Considering the enormous pain for the horse, it seems inhumane to treat a horse with prolapse of the coffin bone through the sole. In protracted and/or severe painful cases of laminitis, euthanasia should be considered.