Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis
Authors: M. D. de Laat, M. Sillence, D. Reiche
Journal: Journal of Veterinary Internal Medicine
Summary
# Editorial Summary: Endocrinopathic Laminitis—Phenotypic and Hormonal Profiles in 301 Cases De Laat and colleagues examined 301 horses and ponies presenting with laminitis to characterise the underlying endocrinopathic contributions and hormonal patterns, with the goal of refining clinical risk stratification and management protocols. Using prospective data collection via veterinary questionnaires coupled with serum insulin and plasma ACTH measurement, the researchers identified several clinically relevant associations: animals with concurrent equine metabolic syndrome and pituitary pars intermedia dysfunction exhibited substantially higher basal insulin concentrations (median 49 mIU/L) compared to those with single endocrinopathies, and insulin levels correlated positively with laminitis severity grade. Notably, insulin concentrations were inversely related to body size, with ponies showing markedly elevated basal insulin (median 33 mIU/L) relative to horses (9.5 mIU/L), and spring presented as the season of highest case recruitment. These findings suggest that the degree of hyperinsulinaemia—particularly when multiple endocrine disorders coexist—serves as a useful prognostic marker for lameness severity, which has direct implications for both acute case management and long-term dietary and pharmaceutical intervention strategies. Farriers and veterinarians should recognise that ponies and small horses warrant particularly vigilant insulin screening, whilst concurrent EMS and PPID warrants aggressive metabolic control to mitigate laminitis progression.
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Practical Takeaways
- •Test for both EMS and PPID concurrently in laminitic cases, as combined endocrinopathies produce higher insulin levels and likely worse outcomes than single conditions
- •Ponies with laminitis require particularly aggressive insulin management and metabolic screening due to inherently higher basal insulin concentrations
- •Basal insulin concentration appears to be a useful prognostic indicator for laminitis severity—higher insulin correlates with more severe lameness, supporting aggressive metabolic control as a treatment priority
Key Findings
- •Concurrent EMS and PPID resulted in significantly higher basal insulin concentrations (49 [21.5–141]) compared to single endocrinopathies
- •Basal insulin concentration was negatively correlated with height (r² = −0.38), being higher in ponies (33 [10–14]) than horses (9.5 [3–25.7])
- •Higher basal insulin concentrations were positively correlated with laminitis severity grade (r² = 0.12, P = .05)
- •Most acute laminitis cases were recruited in spring (36.2%), suggesting seasonal pattern in disease presentation