Hyperinsulinemia: What the Research Says
Evidence from 43 peer-reviewed studies
8 RCT
18 Cohort Study
7 Case Report
10 Expert Opinion
What Professionals Should Know
- •Canagliflozin effectively reduces insulin response in healthy horses, supporting its potential use for laminitis prevention in insulin-dysregulated horses; however, long-term safety and efficacy data in at-risk populations are still needed
- •The observed increase in liver enzyme (GLDH) at higher doses warrants monitoring during clinical use and suggests caution with dose escalation
- •Effective insulin reduction occurs at both tested doses without obvious clinical signs, allowing flexibility in dosing strategy pending further clinical trials
- •Velagliflozin at 0.3 mg/kg once daily is an effective pharmacological tool for managing hyperinsulinemia in horses with insulin dysregulation, with substantial reductions in resting insulin levels
- •Monitor triglyceride concentrations during treatment as transient elevations occur, though no clinical complications were observed in this study
- •Expect weight loss in treated horses (approximately 1 BCS point over 20 weeks), which may be beneficial for insulin dysregulation management but requires nutritional monitoring
- •Essential oil supplementation may help manage insulin dysregulation in horses, particularly those with more severe cases, potentially reducing metabolic disease risk
- •The supplement appears to work through metabolic changes affecting amino acid and energy metabolism pathways rather than simple glucose clearance mechanisms
- •This nutritional intervention could be incorporated into management protocols for horses prone to laminitis or metabolic syndrome, though field efficacy and optimal dosing require further investigation
- •Sirolimus shows promise as a potential therapeutic agent for managing hyperinsulinemia in horses, with measurable reductions in post-glucose insulin responses within 24 hours of administration
- •The drug's long half-life (approximately 2.5 days) supports feasibility for practical clinical dosing schedules
- •Further investigation with longer treatment periods and larger sample sizes is needed before clinical implementation; this preliminary evidence warrants monitoring for potential application in horses with metabolic syndrome and insulin dysregulation
- •Canagliflozin shows significant promise for reducing postprandial hyperinsulinemia in ID horses, a key mechanism for laminitis prevention
- •Short-term weight loss observed with canagliflozin may be beneficial for metabolically affected horses, though long-term effects require evaluation
- •Triglyceride elevation warrants monitoring during treatment and further investigation regarding clinical significance
- •Velagliflozin offers a promising pharmacological option for preventing laminitis in insulin-dysregulated horses and ponies by significantly reducing hyperinsulinemia
- •This treatment could be particularly valuable for high-risk animals during spring/summer when pasture NSC content is elevated, or for those on concentrate-based diets
- •Safe medication profile with no observed adverse effects means it could be incorporated into laminitis prevention protocols alongside dietary management and exercise
- •Velagliflozin offers a pharmacological option for managing insulin dysregulation in ponies when dietary management alone is insufficient, with established safety profile over extended use
- •Practitioners should note this SGLT2 inhibitor requires daily oral dosing and response should be monitored via standardized feeding challenges rather than fasting insulin alone
- •Effects appear reversible upon withdrawal, suggesting the drug controls rather than resolves the underlying condition
- •Gymnema sylvestre at 10 mg/kg may help reduce insulin spikes in insulin-dysregulated horses fed carbohydrate-rich meals, though effects are modest (~25% reduction)
- •In vitro efficacy does not guarantee in vivo effectiveness (lactisole example), so clinical testing is essential before recommending new supplements
- •This is early-stage research; practitioners should await further optimization of dose/delivery methods and direct receptor testing before implementing these compounds in practice
- •Laboratory reference ranges for insulin should account for seasonal variation, with winter baseline values expected to be higher; adjust clinical interpretation accordingly
- •Breed-specific insulin profiles matter clinically—Shetland and Welsh ponies are inherently higher insulin responders and require lower thresholds for metabolic disease concern
- •Sex and age influence insulin levels; older females will naturally have higher concentrations, which should inform your laminitis risk assessment and management strategy rather than trigger unnecessary treatment escalation
- •Don't assume all overweight horses are metabolically abnormal—check insulin and glucose levels; obesity and hyperinsulinemia are independent risk factors requiring separate management strategies
- •Hyperinsulinemia appears to be the primary driver of metabolic dysfunction rather than weight alone; focus diagnostic and management efforts on insulin status regardless of body condition
- •Laminitis cases showed unexpected metabolic patterns (lower glucose, higher IGF-1); consider individual biochemical profiling rather than relying solely on body weight or condition scoring
- •The Tosoh AIA-360 is a reliable automated platform for measuring insulin in horses and can be confidently used to identify and monitor hyperinsulinemia, a treatable laminitis risk factor
- •Do not use Immulite 2000/2000XPi analyzers for equine insulin measurement as they produce unreliable results; ELISA and Cobas e are acceptable alternatives if Tosoh is unavailable
- •When monitoring insulin-sensitive horses or those at laminitis risk, consistent use of the same assay is important given inter-assay variation; document which method was used for longitudinal comparisons
- •PZI can be used as a practical substitute for RHI in insulin-tolerance testing since it is veterinary-approved and more accessible to practitioners
- •When using PZI for insulin-tolerance testing, apply a 40% glucose reduction threshold at 30 minutes rather than the standard 50% to improve diagnostic accuracy for insulin resistance
- •No safety concerns were observed with either insulin formulation, making PZI a viable alternative for practitioners without access to RHI
- •Measuring triglyceride and NEFA responses during oral glucose testing may help identify horses with tissue insulin resistance, potentially aiding in earlier detection of Equine Metabolic Syndrome
- •Hyperinsulinemia alone without insulin resistance does not appear to alter lipid metabolism patterns during glucose challenge, suggesting different metabolic pathways may be involved
- •Lipid markers during OGT could complement existing diagnostic protocols for metabolic screening in horses showing signs of metabolic syndrome
- •Arthrospira-based feed additive enriched with chromium, magnesium, and manganese may help manage insulin resistance and weight in metabolically affected horses as part of a comprehensive EMS management program
- •This supplement shows promise for reducing inflammatory markers and improving body condition in horses with EMS, potentially reducing reliance on other management interventions
- •Consider this as a complementary strategy alongside diet management and exercise for horses struggling with metabolic syndrome
- •OGT and IV insulin response tests detect different aspects of insulin dysregulation; OGT identifies hyperinsulinemia while IV tests identify peripheral insulin resistance — use both or choose based on clinical suspicion to avoid missing cases
- •A modified 2-step IRT with porcine zinc insulin may over-identify insulin resistance compared to oral testing; interpret results cautiously and consider combining tests for comprehensive metabolic assessment
- •Not all hyperinsulinemic horses demonstrate proportional peripheral insulin resistance, so a normal IV glucose clearance does not rule out metabolic dysfunction or laminitis risk in susceptible breeds like Icelandic horses
- •Ponies with insulin dysregulation have disproportionately elevated biologically active cortisol relative to total cortisol, suggesting breed-specific hormonal mechanisms that may require different monitoring or management strategies
- •Baseline ACTH is naturally higher in healthy ponies, so reference ranges should not be directly compared between horses and ponies when evaluating HPA axis function
- •Assessment of insulin dysregulation risk in ponies should consider that breed-related hormonal differences may amplify cortisol's antagonistic effects on insulin signaling
- •Horses with high insulin responses show specific metabolite abnormalities (low arginine and carnitine) that could be therapeutic targets to manage insulin dysregulation
- •A simple baseline blood test using 7 metabolites may reliably identify insulin-dysregulated horses without the time and expense of oral glucose testing
- •Evidence of low-grade inflammation during glucose challenges suggests metabolic monitoring and anti-inflammatory management strategies warrant consideration in insulin-dysregulated horses
- •Insulin dysregulation in laminitis-prone horses may cause amino acid imbalances that compromise hoof tissue integrity; monitoring insulin status becomes increasingly important for prevention
- •Dietary amino acid supplementation or insulin management strategies targeting hypoaminoacidemia may offer therapeutic potential for endocrinopathic laminitis cases
- •Understanding the hyperinsulinemia-hypoaminoacidemia-laminitis pathway helps explain why insulin control is critical in laminitis management
- •Digital hypothermia effectively suppresses the inflammatory cascade in hyperinsulinemic laminitis by down-regulating key pro-inflammatory cytokines and chemokines, supporting its use as a first-aid intervention in acute severe cases
- •The mechanism appears to involve reduced STAT3 signaling rather than altered STAT1, suggesting hypothermia may work through selective pathway inhibition rather than broad immunosuppression
- •This evidence supports implementing continuous digital cooling protocols early in cases of acute laminitis associated with metabolic syndrome, as it may prevent or delay lamellar failure through inflammatory control
- •Weight loss programs directly improve insulin regulation—track body weight changes alongside monitoring laminitis risk in susceptible horses
- •Oral glucose testing can objectively measure whether your weight loss intervention is actually reducing insulin dysregulation, not just pounds
- •For high-risk breeds like Icelanders, even modest weight reduction yields measurable metabolic improvements
- •Genetic testing based on these four candidate regions may eventually help identify horses predisposed to EMS before clinical signs develop, enabling earlier preventative management
- •Metabolomic biomarkers identified in this study could lead to faster, more accurate diagnostic tools than current insulin assays, improving the timeliness of EMS diagnosis and treatment
- •Understanding the genetic basis of EMS susceptibility may inform selective breeding decisions to reduce the prevalence of metabolic syndrome in at-risk populations like Arabians
- •A synergistic polyphenol-leucine supplement may help reduce hyperinsulinemia and associated laminitis risk in EMS/insulin dysregulated horses at a lower cost than high-dose formulations
- •Monitor baseline adiponectin levels and insulin response to oral challenge as practical markers of supplement efficacy in your EMS cases
- •Weight loss occurred alongside metabolic improvements, suggesting this supplement may support overall metabolic health management in affected horses
- •Assess cresty neck appearance as a key screening tool for insulin dysregulation in ponies — it's more reliable than general body condition score alone
- •Ponies with obvious neck crests warrant metabolic testing and management intervention even if overall body condition appears normal, as they have 5-fold increased risk of insulin dysfunction
- •Regional fat distribution (neck crest) matters more than total body fat for identifying metabolic risk in ponies; focus management strategies on reducing regional adiposity
- •Plasma metabolite profiles (trans-4-hydroxyproline and methionine sulfoxide) may serve as biomarkers for identifying horses with insulin dysregulation before laminitis develops
- •Understanding metabolic pathway involvement in insulin dysregulation could inform dietary and management interventions to prevent hoof complications
- •Early detection of metabolic dysfunction through targeted metabolomics may enable preventive strategies in at-risk horses
- •Genetic screening using BIEC2-263524 or FAM174A markers could identify at-risk Arabian horses before obesity and laminitis develop, allowing early preventative dietary and exercise interventions.
- •Horses carrying the 11-G allele at FAM174A show significantly higher insulin and body condition scores, making them candidates for stricter nutritional management and monitoring programs.
- •This genetic test could help owners and veterinarians make informed breeding decisions and implement targeted metabolic management in genetically predisposed individuals.
- •Monitor body condition score closely in horses and ponies as a key laminitis prevention strategy, particularly in mares where obesity increases inflammatory markers
- •Consider hyperinsulinemia and inflammatory cytokine status when assessing laminitis risk in obese animals
- •Weight management and condition control should be prioritized as part of laminitis prevention protocols
- •Canagliflozin (an SGLT2 inhibitor) may be considered for horses with documented hyperinsulinemia and laminitis that fail to respond to diet control, metformin, levothyroxine, and pergolide
- •This medication requires monitoring of renal function (serum creatinine, blood urea nitrogen) before use and regular urinalysis every 2 weeks to detect glucosuria and screen for complications
- •Canagliflozin should be reserved for refractory cases and must be combined with core therapies: strict dietary control of sugars/starch, exercise when possible, and appropriate PPID treatment if indicated
- •Neutrophil-mediated inflammation contributes to metabolic laminitis, suggesting anti-inflammatory strategies targeting neutrophil activity may be therapeutically relevant
- •Early lamellar changes in hyperinsulinemic horses involve inflammatory cascades detectable at histological level before clinical lameness becomes obvious
- •Understanding the neutrophil activation pathway in endocrinopathic laminitis may lead to novel diagnostic or preventive interventions beyond traditional metabolic management
- •Hyperinsulinemia causes direct lamellar tissue damage through microvascular dysfunction and complement cascade activation—this supports aggressive insulin management in metabolically predisposed horses as preventive strategy
- •Novel biomarkers (talin-1, vinculin, fibrinogen, heat shock protein 90) identified in this study may enable earlier detection of endocrinopathic laminitis before clinical signs appear
- •The tissue-specific nature of lamellar damage (absent in cardiac tissue) suggests targeted lamellar therapeutics rather than systemic interventions may be most effective
- •Horses with endocrinopathies causing hyperinsulinemia develop laminitis through cellular stress mechanisms involving protein misfolding—aggressive insulin control may help prevent tissue damage progression
- •Understanding that endocrinopathic laminitis involves cellular stress at the ER level supports the importance of metabolic management and early endocrinopathy detection in at-risk horses
- •This cellular mechanism explains why chronically hyperinsulinemic horses are vulnerable to laminitis and emphasizes need for insulin regulation through diet, exercise, and medication where appropriate
- •High insulin levels cause laminitis through a mechanism that does NOT involve direct binding to IGF-1 receptors in the lamellae—the cause remains to be identified and may involve systemic metabolic effects rather than local receptor activation
- •Managing endocrinopathic laminitis through insulin control remains critical, but understanding the true mechanism of insulin injury may lead to more targeted therapeutic approaches beyond glucose/insulin regulation alone
- •Current research does not support IGF-1 receptor antagonism as a therapeutic strategy for insulin-associated laminitis
- •If immediate serum separation and freezing is unavailable, samples can be stored at room temperature for up to 72 hours without compromising diagnostic accuracy for endocrinopathy screening
- •Clinicians can confidently submit whole blood or serum samples to reference labs without requiring special handling or cooling during transport, improving logistics for field-based testing
- •Sample storage method does not affect whether results exceed diagnostic thresholds used for detecting endocrinopathic disease in horses
- •Hyperinsulinemic laminitis develops through subclinical episodes before obvious clinical signs appear—early insulin testing and management of at-risk horses (obese, Cushings, metabolic syndrome) is critical for prevention.
- •The abaxial location of lesions in endocrinopathic laminitis differs from inflammatory laminitis, suggesting different underlying mechanisms that may require distinct therapeutic approaches.
- •Lesion severity at necropsy does not predict clinical duration, so mild clinical signs do not guarantee minor pathological changes; consistent long-term management of insulin regulation remains essential even after apparent recovery.
- •Consider SGLT2 inhibitor therapy (ertugliflozin) when administering intra-articular corticosteroids to horses with insulin dysregulation to reduce hyperinsulinemia and laminitis risk
- •Horses with existing ID warrant enhanced metabolic monitoring following IA corticosteroid injection
- •SGLT2i drugs offer a pharmacological strategy to mitigate an important side effect of a common therapeutic intervention
- •SGLT2 inhibitors have a physiological basis for use in equine EMS management, with confirmed transporter presence in target tissues
- •Different SGLT2i drugs may have varying efficacy or side effect profiles in horses due to differential drug specificity and tissue expression patterns—selecting the appropriate agent matters
- •The presence of these transporters in liver and pancreas explains why SGLT2i may help manage insulin dysregulation beyond simple renal effects
- •When evaluating insulin levels in your horses, know which assay method your laboratory uses—reference ranges are NOT interchangeable between methods
- •The Immulite® 1000 offers a practical alternative to RIA for insulin testing with good reliability, potentially improving availability of hyperinsulinemia diagnosis
- •Always request assay-specific cut values from your laboratory when interpreting insulin results for metabolic syndrome assessment
- •Maintain mares at optimal body condition score before breeding—obesity-related metabolic dysfunction impairs fertility and compromises pregnancy outcomes, affecting both mare and foal health
- •Monitor insulin status in overweight or insulin-dysregulated mares, as hyperinsulinemia during pregnancy increases foal susceptibility to developmental orthopedic disease and metabolic problems later in life
- •Consider weight management and metabolic assessment as essential preventative strategies for reproductive success and long-term foal welfare, not just a cosmetic or general health issue
- •Don't rely solely on the dexamethasone suppression test for early PPID diagnosis—consider basal ACTH sampling in autumn for better detection of subclinical disease
- •Hyperinsulinemia and laminitis are common concurrent findings in PPID cases; screen for insulin dysfunction when managing PPID patients
- •Pergolide mesylate remains the primary medical treatment; recent pharmacokinetic and long-term outcome data now support clinical decision-making
- •Understanding differential vascular responses between laminar arteries and veins to insulin may help explain the vascular component of hyperinsulinemia-induced laminitis in clinical cases
- •This in vitro model provides a potential tool for testing new therapeutic interventions targeting insulin-related vascular dysfunction in laminitis-prone horses
- •Hyperinsulinemic horses may have compromised laminar vascular regulation that could contribute to laminitis development, supporting the importance of insulin management in at-risk individuals
- •Identify and manage hyperinsulinemia in at-risk horses as a direct laminitis prevention strategy, not just as a marker of insulin resistance
- •Focus on dietary and metabolic management to reduce circulating insulin levels in horses with laminitis risk factors
- •Recognize that insulin-associated laminitis is increasingly common in modern equine populations and requires targeted metabolic intervention
- •Screen horses and ponies for hyperinsulinemia before laminitis develops clinically, as subclinical disease causes progressive foot damage
- •Implement early intervention strategies targeting insulin control rather than waiting for lameness to appear
- •Counsel owners that prevention through management is more beneficial and cost-effective than treating established laminitic changes
- •Screen horses for metabolic syndrome components (obesity, elevated insulin, triglycerides) as these increase laminitis risk—early identification enables preventive management
- •Weight management and insulin resistance control may reduce laminitis predisposition in affected horses, though specific mechanisms require further research
- •Consider inflammatory and vascular dysfunction pathways when managing laminitis in metabolically compromised horses, not just mechanical load factors
- •Endocrinopathic laminitis remains a significant clinical problem with limited treatment options; understanding the IGF-1R mechanism may lead to new therapeutic strategies beyond pain relief
- •Managing hyperinsulinemia through diet and weight control is crucial, as pharmacologic alternatives targeting the IGF-1R pathway are still in early development
- •This research represents foundational work toward novel monoclonal antibody therapy; practitioners should monitor for future clinical trials of anti-IGF-1R treatments
Key Research Findings
Canagliflozin showed dose-proportional pharmacokinetics with Cmax of 2623 ng/mL at 1.8 mg/kg and 4975 ng/mL at 3.6 mg/kg, with half-lives of approximately 22-23 hours
Insulin AUC was reduced 22-29% with canagliflozin compared to placebo following glucose infusion (p < 0.001)
Glucose AUC was reduced 14-15% with canagliflozin compared to placebo following glucose infusion (p < 0.001)
No clinical adverse effects observed, though GLDH levels significantly increased with the 3.6 mg/kg dose (p < 0.05)
Velagliflozin treatment reduced resting insulin concentration to 71 µIU/mL compared to 157 µIU/mL in placebo group (p<0.0001), with an average treatment effect of 155 µIU/mL reduction
Horses previously receiving placebo showed further insulin reduction to 50 µIU/mL when switched to velagliflozin in the open-label phase (p<0.0001)
All horses experienced transient increases in serum triglyceride concentration during velagliflozin treatment with no reported clinical abnormalities
Horses receiving velagliflozin showed greater body condition score reduction (median 1 point lower than baseline, p=0.02) compared to placebo group
Essential oil supplementation reduced insulin concentrations at 75 minutes post-glucose challenge (p ≤ 0.002) and positive phase time (p = 0.05) in horses with more severe insulin dysregulation
EO treatment significantly reduced insulinemic response to oral sugar test in horses with higher pre-treatment insulin responses (p ≤ 0.006)
702 metabolites were uniquely altered with EO treatment, with pathway analysis showing changes in amino acid, linoleic acid, TCA-cycle intermediates and bile acid metabolism
Changes in metabolic pathways are consistent with improved insulin sensitivity based on comparison with other models
Sirolimus achieved peak concentration of 277.0 ng/mL within 5 minutes with a half-life of 3552 minutes and oral bioavailability of 9.5%
24 hours after a single sirolimus dose, insulin concentration at 60 minutes was 37% lower than placebo (5.0 vs 8.7 μIU/mL, P=0.03)
Insulin response at 120 minutes post-glucose was 28% lower with sirolimus than placebo 24 hours after dosing (10.2 vs 14.9 μIU/mL, P=0.02)
Evidence Base
Canagliflozin: Pharmacokinetics, tolerability and glucose/insulin effects of supratherapeutic doses in healthy horses.
Michanek Peter, Bröjer Johan, Lilliehöök Inger et al. (2025) — Veterinary journal (London, England : 1997)
RCT
Effects of the Sodium-Glucose Cotransporter-2 Inhibitor Velagliflozin on Insulin Concentrations in Horses With Insulin Dysregulation.
Thane Kristen, Voth Rebecca, Klee Rebecca et al. (2025) — Journal of veterinary internal medicine
RCT
Essential oil supplementation improves insulin sensitivity and modulates the plasma metabolome of hyperinsulinemic horses.
Loos Caroline M M, Zhao Shuang, Li Liang et al. (2024) — Frontiers in veterinary science
RCT
Effect of sirolimus on insulin dynamics in horses.
de Tonnerre Demia J, Medina Torres Carlos E, Stefanovski Darko et al. (2023) — Journal of veterinary internal medicine
RCT
Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: A randomized, placebo-controlled, double-blind, study.
Lindåse Sanna, Nostell Katarina, Forslund Anders et al. (2023) — Journal of veterinary internal medicine
RCT
The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies.
Meier, Reiche, de Laat et al. (2019) — PloS one
RCT
The efficacy and safety of velagliflozin over 16 weeks as a treatment for insulin dysregulation in ponies.
Meier A, de Laat M, Reiche D et al. (2019) — BMC veterinary research
RCT
Sweet taste receptor inhibitors: Potential treatment for equine insulin dysregulation.
de Laat Melody Anne, Kheder Murad Hasan, Pollitt Christopher Charles et al. (2018) — PloS one
RCT
The Seasonality of Serum Insulin Concentrations in Equids and the Association With Breed, Age, and Sex.
Lopes Ana, Huber Laura, Durham Andy E (2025) — Journal of veterinary internal medicine
Cohort Study
Investigations on metabolic diseases of horses in Egypt.
Aboelmaaty Amal M, Ahdy Ahmed M, El-Khodery Sabry et al. (2025) — Frontiers in veterinary science
Cohort Study
Evaluation of an Automated Fluorescence Enzyme Immunoassay for Quantification of Equine Insulin and Comparison to Five Other Immunoassays.
Nolen-Walston Rose D, Kulp Jeaneen C, Stefanovski Darko et al. (2025) — Journal of veterinary internal medicine
Cohort Study
Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin.
Grob A J, Delarocque J, Feige K et al. (2024) — Veterinary journal (London, England : 1997)
Cohort Study
Value of measuring markers of lipid metabolism in horses during an oral glucose test.
Zemek Claire H K, Kemp Kate L, Bertin François-René (2024) — Journal of veterinary internal medicine
Cohort Study
Arthrospira platensis enriched with Cr(III), Mg(II), and Mn(II) ions improves insulin sensitivity and reduces systemic inflammation in equine metabolic affected horses.
Artur Tomal, Jolanta Szłapka-Kosarzewska, Małgorzata Mironiuk et al. (2024) — Frontiers in endocrinology
Cohort Study
Comparison of a modified 2-step insulin response test performed with porcine zinc insulin and an oral glucose test to detect hyperinsulinemic Icelandic horses.
Frers F, Delarocque J, Huber K et al. (2023) — Veterinary journal (London, England : 1997)
Cohort Study
Circulating Hypothalamic-Pituitary-Adrenal Axis Hormones and Insulin Concentrations in Horses and Ponies.
Vaughn Sarah A, Norton Natalie A, Hart Kelsey A (2022) — Journal of equine veterinary science
Cohort Study
Metabolic changes induced by oral glucose tests in horses and their diagnostic use.
Delarocque Julien, Frers Florian, Feige Karsten et al. (2021) — Journal of veterinary internal medicine
Cohort Study
Plasma amino acid concentrations during experimental hyperinsulinemia in 2 laminitis models.
Stokes Simon M, Stefanovski Darko, Bertin François-René et al. (2021) — Journal of veterinary internal medicine
Cohort Study
Effect of digital hypothermia on lamellar inflammatory signaling in the euglycemic hyperinsulinemic clamp laminitis model.
Stokes Simon M, Burns Teresa A, Watts Mauria R et al. (2020) — Journal of veterinary internal medicine
Cohort Study
Weight loss is linearly associated with a reduction of the insulin response to an oral glucose test in Icelandic horses.
Delarocque Julien, Frers Florian, Huber Korinna et al. (2020) — BMC veterinary research
Cohort Study
Show 23 more references
Metabogenomics reveals four candidate regions involved in the pathophysiology of Equine Metabolic Syndrome.
L. Patterson Rosa, M. Mallicote, M. Long et al. (2020) — Molecular and cellular probes
Cohort Study
Investigation of the Effects of a Dietary Supplement on Insulin and Adipokine Concentrations in Equine Metabolic Syndrome/Insulin Dysregulation.
J. Manfredi, E. Stapley, J. Nadeau et al. (2020) — Journal of equine veterinary science
Cohort Study
The cresty neck score is an independent predictor of insulin dysregulation in ponies.
Fitzgerald Danielle M, Anderson Stephen T, Sillence Martin N et al. (2019) — PloS one
Cohort Study
Lower plasma trans-4-hydroxyproline and methionine sulfoxide levels are associated with insulin dysregulation in horses.
Kenéz Ákos, Warnken Tobias, Feige Karsten et al. (2018) — BMC veterinary research
Cohort Study
Genomewide association study reveals a risk locus for equine metabolic syndrome in the Arabian horse.
S. L. Lewis, H. Holl, C. Streeter et al. (2017) — Journal of animal science
Cohort Study
Relationships between body condition score and plasma inflammatory cytokines, insulin, and lipids in a mixed population of light-breed horses.
Suagee J K, Corl B A, Crisman M V et al. (2013) — Journal of veterinary internal medicine
Cohort Study
Use of the SGLT2 inhibitor canagliflozin for control of refractory equine hyperinsulinemia and laminitis
E. Kellon, K. Gustafson (2022) — Open Veterinary Journal
Case Report
Presence of Myeloperoxidase in Lamellar Tissue of Horses Induced by an Euglycemic Hyperinsulinemic Clamp.
Storms Nazare, Medina Torres Carlos, Franck Thierry et al. (2022) — Frontiers in veterinary science
Case Report
Differential Proteomic Expression of Equine Cardiac and Lamellar Tissue During Insulin-Induced Laminitis.
Campolo Allison, Frantz Matthew W, de Laat Melody A et al. (2020) — Frontiers in veterinary science
Case Report
Detection of endoplasmic reticulum stress and the unfolded protein response in naturally-occurring endocrinopathic equine laminitis.
Cassimeris Lynne, Engiles Julie B, Galantino-Homer Hannah (2019) — BMC veterinary research
Case Report
Characterization of insulin and IGF-1 receptor binding in equine liver and lamellar tissue: implications for endocrinopathic laminitis.
S. Nanayakkara, S. Rahnama, P. Harris et al. (2019) — Domestic animal endocrinology
Case Report
Serum insulin concentration in horses: Effect of storage and handling.
Carslake Harry, Karikoski Ninja, Pinchbeck Gina et al. (2016) — Veterinary journal (London, England : 1997)
Case Report
Pathology of Natural Cases of Equine Endocrinopathic Laminitis Associated With Hyperinsulinemia.
Karikoski N P, McGowan C M, Singer E R et al. (2015) — Veterinary pathology
Case Report
Treatment with ertugliflozin mitigates the hyperinsulinemic response to intra-articular triamcinolone acetonide.
Page Allen E, McPeek Jenna L, McGreevy Ella et al. (2026) — Equine veterinary journal
Expert Opinion
Sodium-glucose transporters SGLT1 and SGLT2 in equine renal, hepatic and pancreatic tissue.
Anger-Håål Camilla, Fjordbakk Cathrine T, Ekstrand Carl et al. (2025) — BMC veterinary research
Expert Opinion
Clinical evaluation of the Immulite® 1000 chemiluminescent immunoassay for measurement of equine serum insulin.
Go Yun Young, Hazard Nicole W, Balasuriya Udeni B R et al. (2023) — Frontiers in veterinary science
Expert Opinion
The effects of obesity and insulin dysregulation on mare reproduction, pregnancy, and foal health: a review.
Hallman Isa, Karikoski Ninja, Kareskoski Maria (2023) — Frontiers in veterinary science
Expert Opinion
Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
Spelta Caroline (2015) — Veterinary Medicine: Research and Reports
Expert Opinion
Vasorelaxation responses to insulin in laminar vessel rings from healthy, lean horses.
Wooldridge A A, Waguespack R W, Schwartz D D et al. (2014) — Veterinary journal (London, England : 1997)
Expert Opinion
Hyperinsulinemic laminitis.
de Laat, McGowan, Sillence et al. (2010) — The Veterinary clinics of North America. Equine practice
Expert Opinion
Field treatment and management of endocrinopathic laminitis in horses and ponies.
Walsh (2010) — The Veterinary clinics of North America. Equine practice
Expert Opinion
Metabolic syndrome-From human organ disease to laminar failure in equids.
Geor, Frank (2009) — Veterinary immunology and immunopathology
Expert Opinion
Endocrinopathic laminitis in the horse
Johnson Philip J., Messer Nat T., Slight Simon H. et al. (2004) — Clinical Techniques in Equine Practice
Expert Opinion