Metabolic Laminitis

Metabolic laminitis is laminitis associated with hormonal and metabolic dysfunction, particularly insulin dysregulation. It is commonly linked with Equine Metabolic Syndrome (EMS) and may also occur in horses with Pituitary Pars Intermedia Dysfunction (PPID).

Laminitis is a painful and potentially serious condition affecting the sensitive structures that support the pedal bone within the hoof. When metabolic factors are involved, controlling the underlying metabolic problem is an important part of reducing the risk of further episodes.

Suspect laminitis? Contact your veterinary surgeon promptly. Laminitis should always be treated as a veterinary problem.

What is metabolic laminitis?

Laminitis describes inflammation and damage within the lamellae of the hoof — the specialised tissues that help suspend the pedal bone inside the hoof capsule.

There are several different pathways by which laminitis can develop. Metabolic, or endocrinopathic, laminitis is associated with abnormalities in the horse's hormonal and metabolic system.

A particularly important factor is insulin dysregulation.

After eating feeds or forage containing sugars and starches, insulin normally helps regulate the way glucose is handled by the body. In an insulin-dysregulated horse, the insulin response may become abnormal and insulin concentrations can remain excessively high.

Persistently or markedly elevated insulin concentrations — known as hyperinsulinaemia — are strongly associated with laminitis.

The precise biological mechanism by which high insulin damages the lamellae is still being investigated, but the relationship between insulin dysregulation and laminitis is now well established.

Why is metabolic laminitis important?

A very large proportion of laminitis encountered in horses and ponies is associated with underlying endocrine disease.

Metabolic laminitis can also be frustrating because simply treating the painful feet does not address the reason the episode occurred.

Long-term management therefore usually has two objectives:

Manage the current laminitis and protect the feet.
Identify and control the underlying metabolic or hormonal problem.

Without addressing the second part, the horse may remain at increased risk of another episode.

Horses that may be at greater risk

Metabolic laminitis is particularly associated with horses and ponies that have:

Equine Metabolic Syndrome (EMS)
insulin dysregulation
PPID, particularly where insulin dysregulation is also present
generalised obesity
a cresty neck or abnormal regional fat deposits
a history of previous laminitis
difficulty maintaining a healthy body condition
a tendency to gain weight very easily.

Native breeds and other naturally efficient horses and ponies are commonly represented, but metabolic laminitis is not restricted to overweight ponies.

A horse can have insulin dysregulation while appearing to be a relatively normal weight.

Recognising the signs

Laminitis does not always begin with the dramatic stance that many owners associate with the condition.

Early or relatively subtle signs can include:

a shortened or pottery stride
reluctance to walk on hard or stony surfaces
reluctance to turn tightly
repeatedly shifting weight between the feet
increased or bounding digital pulses
unusual warmth around the feet
reluctance to pick up a foot
changes in behaviour or willingness to move
unexplained reduction in performance.

More severely affected horses may become obviously lame, adopt a characteristic stance to unload painful feet or become extremely reluctant to move.

If you suspect laminitis

Contact your veterinary surgeon promptly.

Do not exercise a horse in an attempt to "walk it off". Movement can potentially cause further damage when the supporting structures within the hoof are compromised.

Your vet can advise how the horse should be managed while awaiting examination.

Finding the underlying metabolic cause

Once the immediate laminitis has been assessed, your vet may recommend investigating why it developed.

This can include assessment for:

Insulin dysregulation

Blood testing can help identify abnormal insulin regulation. Depending upon the horse and circumstances, your vet may recommend resting insulin measurements or a dynamic test that examines the insulin response following a controlled sugar challenge.

Equine Metabolic Syndrome

EMS is characterised particularly by insulin dysregulation and an increased susceptibility to laminitis, often — although not always — accompanied by generalised or regional obesity.

PPID

PPID becomes increasingly common with age and can also increase laminitis risk. Horses suspected of PPID may require appropriate hormonal testing.

A horse can have more than one metabolic problem, so investigation should be tailored to the individual.

Managing metabolic laminitis

There is rarely one single change that solves the problem.

Successful long-term management usually combines veterinary care, appropriate hoof care, dietary management, weight control where required and careful monitoring.

Veterinary treatment

During an active episode, veterinary treatment may include pain relief and measures intended to reduce further damage to the feet.

Radiographs may be recommended, particularly in significant, prolonged or recurrent cases, to assess the position of the pedal bone and guide subsequent hoof management.

Farriery and hoof care

Your veterinary surgeon and farrier may need to work together.

Appropriate trimming, support and foot balance can become particularly important where structural changes have occurred within the hoof.

Regular hoof care remains important after the acute episode has resolved.

Diet and metabolic control

For horses with insulin dysregulation, reducing excessive sugar and starch intake can be an important part of management.

This does not mean simply removing hard feed.

Grass and conserved forage can contribute significant amounts of water-soluble carbohydrate, and concentrations can vary considerably.

Management may therefore include:

analysing forage where appropriate
selecting suitable lower-sugar forage
soaking hay where recommended
avoiding unnecessary cereal-based feeds
choosing feeds appropriate for horses requiring controlled sugar and starch intake
controlling access to grazing
using a correctly fitted grazing muzzle where appropriate
ensuring the overall ration still supplies adequate protein, vitamins, minerals and fibre.

Severe forage restriction should not be undertaken without professional advice. Horses still need sufficient fibre to support normal digestive function and welfare.

A veterinary surgeon or suitably qualified equine nutritionist can help formulate an appropriate ration.

Weight management

Where the horse is overweight, controlled weight reduction is often an important part of reducing metabolic risk.

Useful monitoring tools include:

regular body condition scoring
cresty neck scoring
weigh-tape measurements
photographs taken from consistent positions
keeping a simple weight-management record.

Changes are often easier to recognise when measurements are recorded rather than judged from memory.

The aim should be controlled, sustainable weight loss, rather than sudden or severe feed restriction.

What about exercise?

Exercise can improve metabolic health and insulin regulation in suitable horses.

However:

A horse with active or suspected laminitis should not be exercised unless your veterinary surgeon has confirmed that it is safe to do so.

Once the feet are stable and veterinary approval has been given, an appropriate exercise programme may form an important part of longer-term metabolic management.

Grazing needs particular attention

Grass intake can be one of the most difficult aspects of managing a metabolically susceptible horse.

Risk does not disappear simply because spring has passed.

Grass sugar concentrations change with weather, temperature, sunlight, season, pasture management and plant growth.

Depending upon the individual horse, strategies might include:

restricted grazing periods
grazing muzzles
track systems
turnout on appropriately managed pasture
grass-free turnout
providing controlled forage away from pasture.

The correct approach depends on the horse, its metabolic status, body condition and management environment.

FreeStep nutritional support

FreeStep

FreeStep is particularly relevant to horses and ponies being managed for laminitis risk and forms part of the FreeStep range of nutritional support products.

It is intended to provide nutritional support alongside appropriate veterinary care, hoof management, controlled nutrition and management of the underlying metabolic risk factors.

A supplement should never be used as a substitute for veterinary investigation or as justification for allowing unrestricted access to feeds or grazing that are inappropriate for an insulin-dysregulated horse.

FreeStep does not treat or cure laminitis, EMS, PPID or insulin dysregulation.

FreeStep CSH

FreeStep CSH may also be relevant where metabolic management and ongoing nutritional support are required.

As with FreeStep, it should form part of a wider management programme rather than being regarded as a treatment for laminitis itself.

Explore FreeStep →
Explore FreeStep CSH →

Reducing the risk of another episode

A previous episode of metabolic laminitis should be regarded as an important warning that the horse may remain metabolically susceptible.

Long-term prevention may therefore include:

maintaining an appropriate body condition
monitoring the crest and regional fat deposits
controlling dietary sugar and starch
managing grazing carefully
regularly reassessing insulin regulation where your vet recommends it
testing for PPID where appropriate
maintaining regular hoof care
introducing exercise when medically appropriate
watching for subtle early signs of foot discomfort.

Management may need to change throughout the year.

A grazing system that works successfully during winter may not provide adequate control when grass growth changes.

When to seek veterinary advice

Contact your veterinary surgeon promptly if your horse:

develops a strong or bounding digital pulse
becomes unexpectedly footsore
is reluctant to turn
develops a short or pottery gait
repeatedly shifts weight between its feet
suddenly becomes reluctant to move
has previously suffered laminitis and begins showing similar signs again.

Early veterinary intervention can be extremely important.

The key message

Metabolic laminitis is not simply a problem with the feet.

In many affected horses, abnormal insulin regulation is an important part of the disease process. Successful management therefore requires attention to both the hoof and the underlying metabolic problem.

Veterinary investigation, appropriate farriery, careful control of diet and grazing, healthy body condition and ongoing monitoring can substantially improve long-term management.

For horses known to be metabolically susceptible, prevention should become part of everyday management rather than something considered only during the traditional spring laminitis season.

Suggested Graphics

Graphic 1 — Hero Graphic: “Metabolic Laminitis — The Metabolic–Hoof Connection”

Purpose: Immediately explain that metabolic laminitis begins with a metabolic problem but results in disease within the hoof.

Visual concept: A clean illustration of a horse or pony with a simple pathway running alongside it:

Sugar/starch intake → abnormal insulin response → high circulating insulin → lamellar damage → laminitis

Include a cutaway illustration of the hoof showing the hoof wall, lamellae and pedal bone.

The graphic should avoid suggesting that eating sugar directly causes laminitis in every horse; the abnormal metabolic response is the important intermediary.

Standalone text on graphic:

METABOLIC LAMINITIS
In susceptible horses, insulin dysregulation can result in excessively high insulin concentrations and an increased risk of laminitis.

Laminitis is painful and potentially serious. If you suspect laminitis, contact your veterinary surgeon promptly.

JCG Health Hub | jcgsupplements.com

The JCG identity and website should remain visible if the image is downloaded, shared or printed separately from the page.

Graphic 2 — “Could My Horse Be at Metabolic Laminitis Risk?”

Purpose: A practical owner-recognition infographic suitable for saving or printing.

Use a horse silhouette with clearly illustrated areas of regional adiposity, particularly the neck crest, shoulder, rump/tail head and supraorbital area.

Surround it with simple risk indicators:

Watch for:

cresty neck
abnormal fat pads
easy weight gain
difficulty losing weight
previous laminitis
known insulin dysregulation
EMS
PPID
unexplained recurrent foot soreness.

Include:

Important: Not every insulin-dysregulated horse is overweight. Normal body condition does not completely exclude metabolic risk.

Footer:

JCG Health Hub — Owner education for better equine health
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If you are concerned about metabolic disease or laminitis, speak to your veterinary surgeon.

Graphic 3 — “Managing Metabolic Laminitis Risk — The Five-Part Approach”

Purpose: Turn the long-term management section into a memorable owner reference.

A five-segment circular or horseshoe-shaped graphic:

1. KNOW THE CAUSE
Veterinary investigation for insulin dysregulation, EMS and PPID where appropriate.

2. CONTROL THE DIET
Manage sugar, starch, forage and grazing while maintaining adequate fibre and balanced nutrition.

3. MANAGE BODY CONDITION
Regular weight, body condition and cresty-neck monitoring.

4. PROTECT THE FEET
Regular hoof care and veterinary/farrier collaboration following laminitis.

5. MONITOR & ADAPT
Management requirements can change with weight, fitness, grass growth and season.

A smaller highlighted panel:

Nutritional support: FreeStep / FreeStep CSH
Nutritional support complements — but does not replace — veterinary care, dietary management and appropriate hoof care.