New laminitis treatment and pre-cushing/insulin resistance

Hi, I have a twelve year old AQHA who has suffered with laminitis for the past three Autumn seasons. My question to other horse owners is has anyone seen a 12 year old develop Insulin Resistance/Pre-Cushing’s like the vet is diagnosing? It seems very young. He is a cutting/reining horse so his “competing season” is throughout the summer where he is very fit and healthy. He get treatments of salt water therapy from a travelling equine spa that comes to our shows all summer. This year I decided to treat his laminitis with the Cold Water Salt Water Spa and he has fully recovered this season was earlier than the vets expected. However his blood ACTH levels still tend to fluctuate. The company the makes the spas does sell portable and permanent units and I am considering purchasing a unit for my barn to manage his feet/laminitis but I am still concerned about his ACTH when he does not get a ton of sugar and he is only 12 years old. Any insight or experience with IR/Pre-Cushing in younger horses is much appreciated!

I’d look to dietary modifications +/- medication before I dropped a serious chunk of change on a glorified tub of water as a laminitis “cure”.


I agree with Ghazzu, work on making some lifestyle changes to see if you can fix the root of the issue. Limited grass or none at all (grazing muzzle or dry lot), low NSC hay, no grain just a ration balancer if you need it (I personally do a vit/min supplement in some beet pulp). The exercise and good fitness is great, of course. The ECIR group has some good info.


You don’t mention what his living situation is? Stall, paddock? Grass turnout? So many ways to change his environment to limit what triggers his laminitis flares each Fall.


So this is basically an expensive way to cold soak hooves. That’s just treating a symptom. It isn’t getting to the cause of the metabolic disorder.


some horses as young as 5 develop PPID

Insulin Resistance is a whole 'nother beast and can easily start showing up once the high energy use of a growing horse becomes the “normal” energy use of an adult. A lot of young adult horses are IR.

Because you don’t have him on Prascend.

Can you list when he was tested, with what test, and what the numbers were?

I would far, far rather see you put the money and time into preventing laminitis, over reactive cold therapy you can DIY. Granted, a machine would make things easier, but unless you start addressing the root problem, just continuing to address symptoms is going to end up with a very, very unhappy, and potentially non-existent horse.

ACTH is pointing to his PPID.
PPID isn’t a sugar thing, though higher sugar diets may contribute to the development of insulin resistance.
Many PPID horses end up IR down the road

Starch is the bigger issue than sugar. There’s a good chance his hay/grass is high in starch.

he’s not terribly young for PPID, and especially not for IR. is a place you need to join, and if you’re on Facebook, the ECIR Group is where you need to be



What tests, what were the results. Then people can advise treatment. What did the vet want you to do?

A salt water soak is not going to change a pituitary gland disorder, if that is what he has. Nor will it do anything to address fall laminitis if it is from diet alone.


Younger horses certainly can be insulin resistant; it happens all the time. Even Cushing’s, though usually a disease of older horses, can, on rare occasions, appear in relative youngsters. My vet tells me she’s seen it in horses as young as six.

I agree with the people who say skip the whacky gadgets and spend your money on every test your vet recommends. That would be a much more productive use of your hard-earned cash.


I think some people don’t realize how strict you have to be in the management of an IR horse. There are dangers in the autumn grass, and if you know the horse is metabolic/IR/tends toward that, then you must be extremely careful. Is the horse on grass?

The NSC (especially the sugar) needs to be very, very, low with these horses. Test your hay, and you have to be very selective with any concentrates you might feed.

It’s not at all impossible or even that questionable doe a 12 year old to develop Cushings or be IR. Might not be the “norm” for Cushings age, but it happens.

If the horse has fluctuating ACTH levels, he needs to be properly treated for that, medically, regardless of age or whatever status.

The horse should also not be overweight.


He needs meds and a good baseline from testing. Change his diet, no soy, soak and rinse beet pulp, vitamin mineral supplement, test your hay and soak. Plus zero grass. Then add vitamin e.

Grain still puts some horses other the edge, it does my pony.

In agreement with the other posters; it would be helpful to know current diet and pasture situation.

My 4 year old went through a bought of mild laminitis this spring, even with a grazing muzzle. Bloodwork and rads showed nothing abnormal thankfully but we did a complete overhaul of his routine and diet.

Pre Laminitis:
12+ hours overnight on 20 acres very lush pasture shared with 3 other horses. Grazing muzzle put on as the grass started growing.
6 flakes of hay per day
Supplement mix of 1C beet pulp, 1/2 C flax, Cal Trace.

Post Laminitis:
Moved to smaller “fat” pasture and was brought onto it in 15 minute intervals to get to 6 hours out during the day. Grazing muzzle on.
3 flakes of hay per day
Same supplement mix but switch to CT Plus and added a Harmany OB Formula

This got us down about 150 lbs and we are now in maintenance mode. He is getting 4 flakes of hay, and that will prob get bumped up a little more as we are approaching winter. He is a week out from having the grazing muzzle removed. Come spring, he will get the muzzle back and slowly worked up to being on pasture again as needed.

This is my first experience with an easy keeper, but you have to address the underlying issues. In our case it was easy to address; less hay/less pasture/weight loss. If your horse is flaring up in the fall, it sounds environmental which should give you some options to avoid it entirely. Why let it get to the point that it needs to be treated and have potential damage done?

the PPID horse doesn’t have to be treated with kid gloves like the IR horse does. PPID isn’t IR. Lots and lots and lots of PPID horses get plenty grass.

But I WOULD treat the PPID horse as if he’s borderline IR, meaning, hard feed should be ESC + starch close to or less than 10%, with starch close to or less than 4%. But as long as it was all less than 15% or so, without high starch, that’s fine too.

The amount fed matters, so if it’s 1lb of something that’s 14% ESC + starch, that’s less total than something that’s 10% but fed at 5lb.

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12 is not abnormally young for a PPID diagnosis. And, while cold water soaking may temporarily ease his discomfort, it will do nothing for the underlying medical condition.


Fall laminitis is a recognized early sign of PPID. There’s an amazing PPID group on Facebook ( where you can get some really good advice.