My mare was putting absolutely no weight on her heels, because while most shift weight OFF their toes initially, they then shift weight OFF the heels to unload the deep digital flexor tendon. Bruising can happen from broken blood vessels which is associate with laminae death. There is no such thing as sugar pooling in the hooves. Out of control blood sugars secondary to insulin resistance and PPID causes systemic inflammation, laminae become inflamed, blood flow is impaired and vessels damaged, laminae can die, and this lack of internal support along with the forces on the coffin bone are what cause rotation. I think we're on the same page. Absolutely all horses can have different long term outcomes, but what may look severe symptomatically does not necessarily mean severe structual damage has been done. Of course boots are not the sole solution. It is a multipronged and aggressive approach from all fronts to hopefully have a good outcome, working with vets and farriers who know their stuff and who can collaborate using imaging. My mare had permanent lamellar death based upon her current hoof growth, but she's had no further rotation or sinking - permanent damage does not necessarily mean the horse will continue to have issues. You're right - I hope a vet did not say those words, so I should not think negatively of the professionals when we are hearing a translation from someone else.