Early detection and intervention are key to managing any disease process. With laminitis, picking up on the subtle signs of hyperinsulinemia (high levels of insulin in the blood resulting from insulin resistance) before the horse suffers a serious laminitic event is one way caretakers and veterinarians can try to halt the hoof disease in its tracks. At the 6th International Equine Conference on Laminitis and Diseases of the Foot, Donald Walsh, DVM, of the Animal Health Foundation, in Pacific, Mo., described easily detectable changes in hoof growth that might hint at the development of hyperinsulinemia and laminitis.

Laminitic changes associated with hyperinsulinemia start and progress slowly. Walsh believes abnormal division of insulin basal cells (the bottom cell layer of the epidermis) and stimulation of insulinlike growth factor receptors on laminar cells cause the laminae, which connect the horse’s hoof to the coffin bone, to stretch and lengthen. "If hyperinsulinemia is not addressed and blood insulin levels normalized (through diet, exercise, and appropriate medication), then continued abnormal hoof growth may lead to further weakening of the laminae and the development of laminitis," he explained.

Early signs of hoof damage due to hyperinsulinemia can include abnormal growth rings in the external hoof wall, separation of the hoof wall from the white line when looking at the bottom of the horse’s foot, and a "seedy" toe (increased width of the white line, where the sole and the hoof wall meet) as the laminae weaken. Small areas of hemorrhage (caused by damage to the laminar vessels) in the seedy toe area might also be visible.