22/01/2026
I’m going to toss out some numbers. If numbers make you go cross-eyed, give it a chance and stay with me- it’s important.
Latest research shows that non-fasted insulin results (with access to a horse’s normal forage) that were above 21.6uIU/mL resulted in a 22% incidence of laminitis within 4 years of the bloodwork results.
That’s a lot of numbers. What that means is that almost a quarter of horses with an insulin result above 21.6 could become laminitic.
What’s even more concerning is a non-fasted insulin result of 45.2 or higher had a 69% laminitis incidence rate within 4 years.
Considering that many labs say “normal” range for insulin is under 40, and considering that many times this bloodwork is taken fasted (instead of the updated recommendation for non-fasted), many owners may see their horse’s insulin result in the 20s or 30s and think their horse is fine, or think their horse isn’t metabolic, when actually their horse may be walking a fine line of laminae issues.
I’ll tell you about a mare here. This picture is of her feet when she was really quite rotated/foundered, shortly before coming to my farm.
This mare came to my property in October 2025 after struggling with founder and rotation for a few years. The owner had been very diligent, getting tested hay, feeding a quality mineral supplement (one I feed to my rehabs here too), and building a grass-free dry lot. She had a consistent trim every few weeks, and diligent boot use.
Her insulin still would run above range, and the owner even used an SGLT2 inhibitor to help. This DID help with her pain, but even while on it she had an insulin result come back at 140 last year.
The vet recommended more movement to see if this would help with comfort and hoof health as well as body condition, and shortly after that, the mare moved here to the track.
Right before getting here, her insulin wasn’t out of control- it was around 36, while still on an SGLT2 inhibitor to help keep it in check. She was comfortable in boots, but quite cresty necked with fat pads.
After one month living on the track, her insulin went down to 24. She was comfortable at this point, and the vet recommended to stop the medication and check in again in another month or two to see how she was doing. With that, in November, she came off the SGLT2 inhibitor, and we watched and waited.
As she continued to move around the track, eating our tested hay in slow feed hay nets and minerals balanced to the hay test, she slowly lost some of her extra weight. Her feet started growing healthier, with a tighter wall connection making its way down.
Last week, her bloodwork was checked again.
With no medication, the same trim as before, and “simply” increased movement and a balanced diet, her latest insulin result came back at 7.7uIU/mL.
7.7 ! Yes, the decimal is correct. Her insulin was under 10. We have seen that with other cases here too.
Does this mean she is not metabolic?
No. It means right now, with diet and exercise, her metabolic status is controlled.
Did we change the trim? No.
Did we drastically change the diet? No.
The key for this horse was movement. The track system increased the movement, and movement lowered her insulin.
Just like with people, often the best thing we can do for our horses is good movement and a healthy balanced diet.
