Early metabolic screening key to preventing laminitis in horses, vets reveal at 2026 conference

Veterinary specialists at the 2026 American College of Veterinary Internal Medicine Forum highlight the importance of early insulin dysregulation detection to prevent laminitis, emphasising regular metabolic testing and lifestyle management.

Laminitis is often under way before a horse becomes obviously lame, which is why specialists are focusing on metabolic screening as a frontline defence. At the 2026 American College of Veterinary Internal Medicine Forum in Seattle, Andrew van Eps of the University of Pennsylvania’s New Bolton Centre said the key is to identify insulin dysregulation early, before damage to the lamellae in the hoof has begun.

He described persistently elevated insulin as the main driver of endocrinopathic laminitis. Obesity, pituitary pars intermedia dysfunction, age, stress, pregnancy, certain medicines and high non-structural carbohydrate intake can all contribute, but the hormone surge itself is what injures the hoof structures.

Van Eps advised regular testing, with annual screening for most horses under 10 and twice-yearly checks in older animals and higher-risk breeds such as ponies, Warmbloods and gaited horses. He also pointed to adiponectin as a useful marker: low levels may signal risk even when insulin looks normal.

Management centres on reducing insulin spikes through low-NSC forage, controlled grazing and weight loss where needed. The safest grazing window is generally late night or early morning, with frosty, drought-stressed and lush spring or autumn pasture best avoided. If lifestyle measures are not enough, veterinarians may consider medicines such as SGLT2 inhibitors or pioglitazone, while metformin is no longer regarded as a first-line option.