A recent posting over on the American Farriers Journal refers to "Hitting the Wall With Chronic Laminitis"...
I can dig it. Just worked on one I've been doing for many years. They can be quite frustrating.
The problem is that the malady isn't really in the hooves. Heck, I can fix the hooves. And have fixed them time and again. Pushed the bone column back up off the ground. Built-up a solid, thick sole. Got the dorsal surface of the wall parallel to the front of the coffin bone. Better feet by all measurements than many 'sound' horses are wearing... Back to regular shoes or barefoot, and all is well for a while.
Then "kersplat!"... Sole goes flat. Abscesses all over. Hoof capsule warping all out of shape...
So I fix him again. And again... In time it becomes apparent that he's still stilt-legged, even when his feet are in good shape. And he's starting to look like a skinny wooly mammoth in the Summertime.
There's the rub. The source of the problem is ultimately in the endocrine system, and the flexor muscles and tendons. Put perfect feet on the legs of a horse whose flexor muscles are drawing up into balls, and with a pituitary sending out haywire signals to have the horse essentially poison himself, and the feet won't stay perfect long.
But people get a little upset if you try to take the nippers to these bits.
Brain surgery to get rid of a pituitary tumor isn't really plausible with most horses. Various drug, supplement, diets, and hormone treatments are tried, but they only work 'sometimes', as the nature of the condition is constantly changing.
Deep flexor tenotomy can help... But vets are often reluctant to try it.
So I just keep fixing the feet.
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