Reducing the risk of laminitis…by managing hormonal disease

08 Jun 2021 (Horse health news)

Reducing the risk of laminitis…by managing hormonal disease

Did you know that 94% of laminitis cases have an underlying hormonal disease?1 The most common hormonal diseases in cases of laminitis are Equine Metabolic Syndrome (EMS) and/or Equine Cushing’s disease (also called Pituitary Pars Intermedia Dysfunction, PPID).

Identifying whether your horse has a hormonal disease is important because treating this disease can reduce your horse’s risk of developing future episodes of laminitis.

Equine Cushing’s disease

This is a condition where excessive levels of hormones are released from the brain, causing a variety of symptoms which can include laminitis. Horses with Equine Cushing’s disease have been shown to be at five times greater risk of developing laminitis compared to horses without this condition.2

If you would like to check your horse for signs of Equine Cushing’s disease, you can download a checklist here.

If your horse is showing any signs of Equine Cushing’s disease it’s a good idea to ask your vet whether a diagnostic blood test to check for the presence of disease is appropriate. The blood test is simple to do, and Care About Cushing’s provides a free* diagnostic testing scheme.

If your horse is diagnosed with Equine Cushing’s disease, it is advisable to treat the disease in order to resolve the symptoms that you originally noticed as well as to reduce the risk of other clinical signs developing such as laminitis.

Treatment for Equine Cushing’s is a daily tablet prescribed by your vet. You can read more about Equine Cushing’s disease and how it is managed on

Equine Metabolic Syndrome (EMS)

This condition is similar to type-2 diabetes in humans and is usually seen in horses and ponies with too much body fat. It is characterised by a collection of risk factors for laminitis, which always includes poor insulin control.3 This means that after horses with this condition eat food their body produces too much insulin, resulting in high levels of insulin in their bloodstream, which causes laminitis.3

Your vet can confirm the presence of EMS by taking a blood sample to check your horse’s insulin levels.

If your horse is diagnosed with EMS, it is advisable to follow your vet’s advice regarding nutrition and exercise in order to try and reduce their insulin levels and therefore reduce their laminitis risk.

  • Nutrition

The main principles for nutritional control of EMS are to limit the sugary food your horse eats, provide good quality forage to replace the grass, and to only feed low sugar feed.

Your vet will be able to provide a bespoke plan for your horse, but usually it is a good idea to consider soaking your horse’s hay for 7-16 hours to reduce the sugar content.3 Do remember though that vitamin, mineral and protein supplementation is then required.

To work out how much forage to feed your horse you need to carry out a calculation:  it is usually advised that your horse should receive approximately 2% of their body weight in dry forage (include hay and grass) every 24 hours to maintain their body weight. If you are concerned about your horse’s weight you should always speak to your vet for specific feeding advice tailored to your horse’s needs.

  • Exercise

If safe for your horse, then exercise is excellent in controlling EMS. It improves insulin regulation, it maintains or improves muscle mass and, perhaps most importantly, improves their bond with you. Any exercise is better than none (unless rest is needed for other reasons), but a minimum to aim for is 30 minutes of trotting or canter work 3 days per week.3

This is much easier and more fun when done in company. Why not get an app and share your rides with friends and keep score of who’s found the most interesting place to hack!

We’d love you to share a photo on our Facebook page of you and your companion on a hack or enjoying the spring sun together!

*free basal ACTH laboratory test fees only. Veterinary practices may apply visit, blood sampling and interpretation fees.


1.De  Laat MA, Reiche DB, Sillence MN, et al. Incidence and risk factors for recurrence of endocrinopathic laminitis in horses. J Vet Intern Med 2019;33:1473–1482.

2. MCGOWAN TW, PINCHBECK GP, McGowan CM. Prevalence, risk factors and clinical signs predictive for equine pituitary pars intermedia dysfunction in aged horses. Equine Vet J 2013;45:74–79.

3. Durham AE, Frank N, McGowan CM, et al. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019;33:335–349.