Q. What is the most important risk factor that make some horses more prone or predisposed to laminitis than others?

Lisa, Dublin, Ireland

A. Risk factors are an area we really try to target and reduce as must as possible. Probably the No. 1 risk factor that we’re learning more and more about every day is insulin resistance (IR). That can be due to horses that have equine metabolic syndrome (EMS) or equine Cushing’s disease (pituitary pars intermedia dysfunction, PPID).

The EMS horse is the younger, easy keeper that seems to survive on just air and water and will a lot of times have fat pads on their cresty neck, above the tailhead, or at the withers. The Cushing’s horses are often older and have similar fast distributions, as well as a long, curly coat that doesn’t shed well in the spring, and many other associated clinical signs.

The common ground is that both types of horses can have IR, and the occurrence of laminitis is significantly higher than in other horses. IR is a complicated matter that researchers are still sorting out, but it changes the way blood flows to the hoof and how nutrients get delivered and even the strength of the hoof tissues, which puts the horse at risk for laminitis.