A review of recent developments in the pharmacological prevention and treatment of endocrinopathic laminitis
Authors: de Laat M. A., Sillence M. N.
Journal: Animal Production Science
Summary
# Editorial Summary Endocrinopathic laminitis remains a significant clinical challenge with limited pharmacological interventions, prompting de Laat and Sillence to comprehensively review emerging therapeutic options across the disease pathway. The authors examined pharmacological targets spanning three key areas: insulin dysregulation management, direct lamellar protection, and pain control, synthesising evidence from experimental compounds through to those approaching clinical registration. Reducing post-prandial hyperinsulinaemia emerges as the cornerstone of prevention, with sodium-dependent glucose co-transporter-2 inhibitors representing a particularly promising development for managing equine metabolic dysfunction, though direct lamellar-protective agents remain limited and require deeper understanding of the biochemical cascade leading to lamellar failure. Current pain management relies heavily on well-established options such as phenylbutazone, alongside emerging applications of paracetamol and gabapentin, though long-term efficacy data for these newer approaches remains incomplete. The clinical implication is clear: future management of endocrinopathic laminitis will necessarily integrate pharmacological strategies targeting metabolic dysfunction and tissue protection with stringent dietary control and exercise programmes, rather than relying on either approach in isolation.
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Practical Takeaways
- •Effective endocrinopathic laminitis prevention depends on controlling insulin levels through diet and exercise, with promising new drug classes (SGLT2 inhibitors) emerging to complement these foundational approaches
- •Until lamellar-protective drugs become available, pain management with established NSAIDs like phenylbutazone remains the most reliable pharmacological tool for acute cases
- •Future laminitis protocols will likely combine dietary management, exercise, endocrine-targeting drugs, and pain relief in a coordinated strategy rather than relying on single interventions
Key Findings
- •Reducing hyperinsulinaemia is central to preventing endocrinopathic laminitis, requiring targeted pharmacological intervention on post-prandial insulin secretion and action pathways
- •Sodium-dependent glucose co-transporter-2 inhibitors represent emerging therapeutic prospects for managing equine metabolic dysfunction
- •Lamellar-targeted drugs to prevent damage at the site of lesion are not yet available but novel compounds are under investigation
- •Current laminitis pain management relies primarily on phenylbutazone, with newer applications of paracetamol and gabapentin showing promise but requiring further characterisation