Understanding, diagnosing and managing endocrinopathic laminitis
Authors: Grenager Nora
Journal: UK-Vet Equine
Summary
Endocrinopathic laminitis, driven primarily by insulin dysregulation, represents the most prevalent form of laminitis in contemporary equine practice, yet many cases remain preventable through vigilant identification of underlying metabolic disease. Grenager's review emphasises that early recognition of insulin resistance—whether as part of equine metabolic syndrome or pituitary pars intermedia dysfunction—substantially reduces the incidence of hyperinsulinaemia-associated laminitis and improves long-term outcomes. Management demands a coordinated three-part strategy: addressing the endocrinopathic cause itself, providing appropriate anti-inflammatory and analgesic cover, and ensuring biomechanical foot support tailored to the diseased digit. The critical window for intervention is narrow; early treatment combined with sustained commitment from the veterinary, farriery and client teams markedly influences prognosis and recovery trajectory. Given the rapid evolution of diagnostic protocols and therapeutic options in equine endocrinology, practitioners across all disciplines must actively maintain current knowledge to implement best-practice management and prevent the progression of insulin dysregulation to overt lameness.
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Practical Takeaways
- •Screen at-risk horses for insulin dysregulation as part of EMS or PPID workup—early detection and management prevents most cases of endocrinopathic laminitis
- •Coordinate closely with farrier and vet on foot biomechanics and pain management alongside treatment of the underlying metabolic condition for best outcomes
- •Stay current on endocrinopathy diagnostics and therapeutics as this field is rapidly evolving with new testing and treatment options
Key Findings
- •Endocrinopathic laminitis is the most common type of laminitis encountered in equine practice
- •Early recognition and diagnosis of insulin dysregulation significantly decreases risk of hyperinsulinaemia-associated laminitis
- •Treatment requires three-pronged approach: treat underlying endocrinopathy, provide anti-inflammatories and analgesics, and provide biomechanical foot support
- •Committed collaboration between client, veterinary, and farriery teams is critical for improved prognosis