
Have you heard about insulin and insulin resistance problems from any doctor, veterinarian or friend?
In order to completely understand insulin resistance process, I will explain some important anatomy and physiology terms. Reach far into your memory bank and go back to high school science class. Here we learned that the body contains systems which are made by organs which are made by cells. An example of this is the cardiovascular system, which is made by the heart, veins, arteries and each of these organs is made by a group of cells. All the cells of the body use glucose as their main fuel source for day-to-day activities. This glucose is obtained from food sources as in steaks and rice and beans (also hay, grain, grass, etc. for the horses). The pancreas produces insulin when there is glucose available for the cells to use. The body responses in such a way due to the cells need insulin in order to be able to utilize the fuel (glucose) provided by a meal. Insulin, basically, opens gates on the cells so that glucose can enter and be utilized. When a horse suffers from Insulin Resistance (IR) there is a significant increase in insulin levels in the bloodstream. This is because the gates of the cells can no longer be opened by insulin. Therefore, insulin and glucose stay in the bloodstream rather than inside the cells of the body. This glucose floating in the blood, instead of being utilized for energy production by the cell, goes to other parts of the body and becomes fat. This is why we see that some horses don’t eat much and stay with good body condition (“easy keepers”), or they develop localized fatty deposits around the neck, tail head and other parts.
Metabolic syndrome and one of the most dangerous indicators atherosclerosis in human are due to insulin resistance. Just like atherosclerosis (accumulation of fat in arteries) in horses, the most dangerous indicator of this disease is laminitis.
We are not 100% sure why insulin resistant horses develop laminitis, but we do have some theories. These theories have to do with inflammation, coagulation, poor blood flow to the foot, among others. For the purpose of this article the reasons for developing insulin resistance are not as important as knowing how to recognize the disease early, what to do when it happens and how to prevent it from happening. In future publication we will be talking about why and how insulin resistance develops.
What are the most common signs of insulin resistance in your horse?
- Your horse has a cresty neck and fat in the tailhead
- When your horse loses weight, you can still see the cresty neck and fat in the tailhead
- It is very difficult for your horse to lose weight
- Your horse is foot sore after trimming or shoeing
- Your horse develops feet bruises
- Your horse develops foot lameness without any reason
- Your horse develops laminitis with no apparent reason

To our advantage as horse owners and veterinarians, the body condition changes usually precede the radiographic signs of laminitis. This is why it is very important to accurately diagnose the disease and once diagnosed make sure there are no signs of laminitis. There are multiple tests that your veterinarian can perform in order to diagnose insulin resistance, at the time of writing this article my favourite is oral sugar test. It is important to realize that these tests can sometimes come back negative. Therefore, if the horse continues to show signs but blood work does not correlate with the clinical signs, talk to your veterinarian about other non-traditional testing methods for example TRH (Thyrotropin releasing hormone) stimulation test. Once diagnosed, your veterinarian will guide you with proper diet, hoof care and possibly medications. It is important to have good communication with your veterinarian in order to advise you properly and make sure your horse receives the best possible care.
Insulin resistance and laminitis have affected many horses, owners and trainers in the world. With this article, you have a tool to help prevent many cases of laminitis and the possible disastrous consequences. By noticing the signs early, you can call your veterinarian before your horse shows radiographic signs of laminitis and your horse will have a deep appreciation for you.
Common feet problems could be due to insulin resistance issues
This is a hot topic on the equine business nowadays. Some people call it metabolic syndrome, some people call it insulin resistance.
Have you heard that it’s like diabetes in people? Don’t stop reading to find the answer.
Few months back I had a patient, his name was Buddy. Buddy was, what we call an easy keeper. Never lost weight. He always had a nice looking thick neck, great rump and all these, despite not eating a lot. He always acted and walked perfectly fine. One day, Buddy did not come out of the stall when his owner Shelly went to feed him. She called me right away and after detailed examination of Buddy I found he had laminitis unfortunately. We discovered that the cause of laminitis was due to severe high insulin, values for fasting insulin over 200 (normal would’ve been 35 or less). We tested him, adjusted his diet, treated him very aggressively and after a lot of work and dedication Buddy is back to being ridden.
The insulin test is very easy to do, basically, we draw blood while the horse has fasted overnight, then we give him a little bit of sugar and 1 hr later we draw blood again. We send it to the lab. We can do it at your place or you can bring your horse to us and we take care of it for you.
The perfect diet for an insulin resistance horse
If your veterinarian have already diagnosed your horse with insulin resistance, I will give you the recipe I use for how to feed your horse.
When you read on the internet on how to feed the insulin resistance horse, they start telling you about difficult terms such as NSC (non structural carbohydrates) etc. etc. and they make it so complicated. So I will make it easy. I promise! If my initial recommendations don’t work, then we can re adjust after the next insulin test.
The first thing I do is evaluate what feed is the horse receiving before the test. I check for opportunities of improvement on the diet. What do I mean by that? I want to minimize the amount of sugar such as molasses and corn.
The next thing I do is take a look at the hay we are using. The hard truth is that the best hay to use in our area, at the beginning of the disease, it could be coastal hay. However, I know that a lot of my clients don’t like to use coastal and that’s ok. Then, we need to figure out what to do. You can soak your hay for 1 hr before feeding it. This will take many of the sugars out of it. Yes, this includes timothy hay, orchard, alfalfa and others depending on what area of the country or world you live. I have also learned that there are researchers now exploring the possibility of high protein high fat diets for these horses. Results are not out yet, however they seem promising.
What grain do I feed? Is the most common question I get.
My favourite is not to feed grain, however if you have to feed grain there are many available such as Well Solve by Purina, you can use and follow the labelled instructions. There are also some low starch combinations in the market.
What supplements do I give?
I like to use a nice product called Starch Guard by Equinutrix because it helps to lower the absorption of sugars in the gut. Sometimes I use thyroid supplements to increase the metabolism of the horse. There is an excellent product conveniently named Sugar Free Hoof Supplement that has no sugar on it, a great concentration of biotin. To my knowledge, this is the only completely sugar free supplement on the market right now. There is a very effective Equine Immune Stimulant that we use for these horses. It is natural with no side effects. It is composed of an extract from 4 plants: Carqueja, Llanten (Great Plantain), R. officinalis L. and Astragaloside, from which 52 phytochemicals and flavonoids are extracted and synergistically mixed to create a supplement that has the ability to help strengthen and improve the immune system.
What medications do I use?
If your horse is having cracked feet, thrush, white line the best product is a hoof conditioner called Pro-Care combined with a hoof supplement named Sugar Free Hoof Supplement. Some horses which are very sensitive to insulin, might to be also on a medication called Metformin. This will depend on a case by case, but if you want to discuss, please feel free to give us call.