Equine Metabolic Syndrome Management (2025)

Overview

All cases of laminitis in horses should be presumed to be associated with insulin dysregulation (hyperinsulinemia-associated laminitis, HAL) unless directly linked to severe infection or catastrophic contralateral injury. Insulindysregulation is a key feature of Equine Metabolic Syndrome (EMS) and managed primarily through diet by reducing non-structural carbohydrates.

Additional strategies include medications like levothyroxine, metformin, and pioglitazone, though results have been inconsistent. Exercise helps improve insulin sensitivity but must be tailored to each horse’s condition and lameness severity.

A newer class of drugs, SGLT2 inhibitors, offers promising results by reducing insulin concentrations through glucose excretion in urine. Those drugs have shown efficacy, but more research is needed to validate their use. Proper diet, collaboration with a farrier, and ongoing research into these treatments are essential for effective management and prevention of HAL.

Presenters

Dr. François-René Bertin DVM, MS, PhD, FHEA, Dip. ACVIM (LAIM)