Hyperinsulinemia in Horses: Signs, Testing, Treatment, and Laminitis Risk

By Dr Duncan Houston

Hyperinsulinemia is one of the most important metabolic problems in horses because it is directly linked to laminitis risk.

The word sounds technical, but the core idea is simple: insulin levels are too high for the situation. Sometimes insulin is high at rest. Sometimes it spikes too strongly after grass, hay, grain, or other carbohydrate intake. Sometimes both are happening.

The dangerous part is that a horse can look reasonably normal until the feet become painful. Many owners only discover there is an insulin problem after a laminitis episode, which is like discovering your smoke alarm works after the kitchen has already flambéed itself.

The goal is to identify hyperinsulinemia early, control the diet, manage body condition, test properly, protect the hooves, and use medication only when needed.

Quick Answer

Hyperinsulinemia means a horse has inappropriately high insulin levels, either at rest or after eating sugar and starch. It is a key feature of equine metabolic syndrome and one of the major drivers of hyperinsulinemia-associated laminitis. Management usually focuses on low non-structural carbohydrate forage, pasture restriction, weight control, safe exercise when the horse is sound, insulin testing, farrier support, and veterinary-led medication in selected cases. High insulin should never be ignored because laminitis can develop before obvious lameness is noticed. (MSD Veterinary Manual)

What Is Hyperinsulinemia in Horses?

Hyperinsulinemia means there is too much insulin circulating in the bloodstream.

Insulin is released by the pancreas after a horse eats carbohydrates, especially sugars and starches. Its job is to help regulate blood glucose and move energy into tissues. In a healthy horse, insulin rises after a meal and then settles.

In an insulin dysregulated horse, that response becomes abnormal.

Type of insulin problem	What it means
Basal hyperinsulinemia	Insulin is high even before a sugar or starch challenge
Post-meal hyperinsulinemia	Insulin rises too much after feed, grass, or sugar intake
Tissue insulin resistance	Body tissues do not respond normally to insulin
Mixed insulin dysregulation	More than one of these problems occurs together

In practice, what matters most is whether the insulin pattern is putting the horse at risk of laminitis. MSD Veterinary Manual describes insulin dysregulation as the key problem in equine metabolic syndrome, and notes that high insulin concentrations can lead to laminitis. (MSD Veterinary Manual)

Why Is Hyperinsulinemia So Dangerous?

The main concern is laminitis.

Laminitis occurs when the laminae inside the hoof become damaged. These laminae help suspend the coffin bone within the hoof capsule. When they fail, the horse can develop severe pain, rotation or sinking of the coffin bone, chronic lameness, and in severe cases, loss of use or euthanasia.

Hyperinsulinemia-associated laminitis can be acute, but it is often chronic and recurring, with repeated mild to severe episodes. MSD Veterinary Manual states that hyperinsulinemia-associated laminitis represents approximately 90 percent of laminitis cases in the general equine population. (MSD Veterinary Manual)

That is why insulin control is not just a “nice metabolic goal”. It is hoof protection.

How Does High Insulin Lead to Laminitis?

The exact pathway is still being studied, but the clinical link is strong: high insulin is central to many modern laminitis cases.

In simple terms, sustained or exaggerated insulin exposure can disrupt normal lamellar function inside the hoof. The result is weakening of the structures that support the coffin bone.

This can happen before the horse looks dramatically lame.

That is the part owners need to respect. A horse does not need to be hobbling across the paddock for insulin damage to be developing. Subtle signs such as hoof rings, mild footiness after grass, reluctance to turn, or stronger digital pulses can be the early clues.

Which Horses Are Most at Risk?

Hyperinsulinemia is often linked with equine metabolic syndrome, but not every affected horse looks the same.

Classic higher-risk horses include:

Risk factor	Why it matters
Easy keeper body type	These horses maintain weight on very little feed
Obesity	Excess body fat is commonly linked with insulin dysregulation
Cresty neck	Regional fat deposition is a major warning sign
Fat pads around tailhead, shoulders, sheath, udder, or above eyes	Suggests metabolic risk
Previous laminitis	Strong predictor of future risk
PPID or Cushing’s disease	Can coexist with insulin dysregulation
Limited exercise	Reduces insulin sensitivity and encourages weight gain
High pasture access	Grass can trigger large insulin responses
Grain, sweet feed, molasses, or sugary treats	Can worsen insulin spikes
Pony, donkey, Morgan, Arabian, Paso Fino, Spanish breed, warmblood, or other predisposed type	Some breeds and types are overrepresented

MSU describes EMS as an endocrine condition involving obesity or localized fat deposits, insulin dysregulation, and laminitis, and notes that some predisposed breeds and easy keepers are commonly affected. (MSU Veterinary College)

Can Lean Horses Have Hyperinsulinemia?

Yes.

This is one of the most important points. A horse does not need to be obese to have insulin dysregulation.

MSD Veterinary Manual notes that obesity and a cresty neck are not sufficient to diagnose EMS, and absence of obesity is not enough to exclude insulin dysregulation. (MSD Veterinary Manual)

That means a lean horse with previous laminitis, abnormal hoof rings, regional fat deposits, PPID, or pasture-triggered foot soreness still deserves proper testing.

The fat pony is the obvious one. The lean horse with sneaky high insulin is the one that gets missed.

What Are the Signs of Hyperinsulinemia?

Hyperinsulinemia itself is not always visible. What owners notice are the risk patterns and complications.

Sign	Why it matters
Cresty neck	Common metabolic warning sign
Fat pads	Regional adiposity can suggest insulin dysregulation
Difficulty losing weight	Common in EMS-prone horses
Sore feet after pasture	Possible pasture-associated laminitis
Hoof rings	May suggest previous laminitic episodes
Widened white line	Can occur with chronic hoof stress
Reluctance to turn	Common early laminitis sign
Heat in the feet	Red flag for active laminitis
Strong digital pulses	Red flag for laminitis risk
Recurrent laminitis	Insulin dysregulation should be investigated
Increased thirst or urination	May suggest PPID or other disease, not insulin alone

The biggest mistake is waiting for dramatic lameness. With insulin dysregulation, the best time to act is before the horse is obviously lame.

How Worried Should You Be?

Risk level	What it looks like	What it may mean	What to do
Low risk	Horse is sound, normal body condition, no cresty neck, no laminitis history, controlled diet	Lower current risk	Keep monitoring weight, hooves, diet, and pasture exposure
Moderate risk	Easy keeper, mild crest, weight gain, heavy pasture access, no current lameness	Insulin risk may be developing	Ask your vet about insulin testing and diet review
High risk	Previous laminitis, high insulin result, EMS, PPID, hoof rings, foot soreness, or recurrent pasture sensitivity	Strong laminitis risk	Create a vet-led diet, testing, farrier, and exercise plan
Critical	Heat in feet, strong digital pulses, shifting weight, reluctance to move, sawhorse stance, walking on eggshells	Possible active laminitis	Call your vet immediately

AAEP lists acute laminitis signs including lameness, heat in the feet, increased digital pulse, pain at the toe, a reluctant “walking on eggshells” gait, and a sawhorse stance, and advises seeking veterinary help immediately if laminitis is suspected.

How Do Vets Diagnose Hyperinsulinemia?

Diagnosis should be based on history, physical exam, hoof assessment, diet review, and insulin testing.

Common tests include:

Test	What it tells you
Resting insulin	Screens for high insulin at rest
Oral sugar test	Measures insulin response after a sugar challenge
Oral glucose test	Measures insulin response after glucose intake
Post-meal insulin	Assesses response to the horse’s current diet
ACTH or TRH stimulation testing	Checks for PPID when relevant
Hoof radiographs	Looks for rotation, sinking, or chronic laminitis change

MSD Veterinary Manual notes that a single insulin measurement is useful as a screening test, but a low result does not exclude insulin dysregulation, so oral sugar or oral glucose testing may be needed when suspicion remains. (MSD Veterinary Manual)

Resting Insulin vs Oral Sugar Test

A resting insulin test can identify horses with obvious basal hyperinsulinemia. But some horses only show abnormal insulin after carbohydrate intake. These horses may have normal resting insulin but still be dangerous on grass or high sugar feed.

That is where dynamic testing, such as an oral sugar test, becomes useful.

Testing situation	Why it matters
High resting insulin	Strong evidence of insulin dysregulation
Normal resting insulin but high suspicion	Dynamic testing may be needed
Active laminitis	Your vet may avoid sugar challenge testing and use safer assessment
Previous laminitis	Insulin testing helps guide prevention
PPID horse	Insulin status changes laminitis risk and diet plan

Testing should be planned by your vet because diet, stress, pain, season, current laminitis, and laboratory method can all affect interpretation.

What Else Should Be Ruled Out?

Hyperinsulinemia often overlaps with other problems, but it is not the only reason a horse may be lame, overweight, sore, or losing condition.

Important rule-outs include:

Condition	Why it matters
PPID	Common in older horses and can worsen insulin dysregulation
Hoof abscess	Can mimic laminitis, especially if one foot is affected
Mechanical lameness	Joint, tendon, ligament, or foot pain can reduce exercise
Dental disease	Can change weight and feed choices
Chronic pain	Can alter movement, weight, and insulin testing
Poor nutrition	May cause muscle loss or abnormal body condition
Liver or kidney disease	Can cause weight loss or dullness
Pregnancy	Can affect insulin regulation
Acute illness or stress	Can alter insulin and glucose results

The real question is not “does this horse have high insulin?”
It is: why is insulin high, what is the laminitis risk, and what else is affecting the horse?

How Is Hyperinsulinemia Managed?

Management has three main goals:

1. Reduce insulin spikes

2. Protect the feet

3. Improve long-term metabolic control

The foundation is diet. Exercise helps when safe. Hoof care is essential. Medication may be needed in selected horses.

Diet: The Main Treatment

Diet is the first-line tool for most horses with hyperinsulinemia.

MSD Veterinary Manual states that diet is the most important element in EMS management, and that grazing, grains, and treats should initially be eliminated for EMS patients. It also recommends low non-structural carbohydrate hay based on feed analysis. (MSD Veterinary Manual)

A practical feeding plan often includes:

Feeding step	Why it helps
Test hay when possible	You cannot reliably judge sugar by appearance
Use low NSC forage	Reduces sugar and starch load
Weigh hay	Flakes vary too much to guess accurately
Use slow feeders where safe	Slows intake and reduces long fasting periods
Remove grain and sweet feed	Reduces insulin spikes
Avoid molasses and sugary treats	Small extras can add up
Use a ration balancer if needed	Provides minerals and vitamins without excess calories
Feed multiple small meals	Helps avoid large post-meal insulin surges

For EMS horses, UC Davis notes that hay should ideally be less than 10 percent NSC on a dry matter basis, and that hay analysis is important because forage varies widely. (Center for Equine Health)

Should You Soak Hay?

Soaking hay can reduce water-soluble carbohydrates, but it is not a guarantee.

UC Davis notes that soaking may lower water-soluble carbohydrate concentrations, but the amount reduced is variable, so soaking is not a reliable way to guarantee low NSC forage. (Center for Equine Health)

Use soaking as a support tool, not a substitute for hay testing.

If hay is soaked regularly, the diet should be balanced carefully because minerals can also leach into the soak water.

Pasture Control

Pasture is often the biggest problem because it feels natural and harmless.

For an insulin dysregulated horse, grass can be the thing quietly driving repeated insulin spikes and laminitis risk.

Pasture control may include:

Strategy	Why it helps
Dry lot turnout	Removes grass intake
Grazing muzzle	Reduces intake while allowing movement
Track system	Encourages movement with controlled forage access
Strip grazing	Limits fresh grass intake
No turnout during high-risk pasture periods	Useful for severe cases
Hay before turnout	Reduces hunger-driven grass intake
Avoid lush spring or autumn grass	Often higher risk for metabolic horses
Avoid stressed grass after frost or drought	Can be high risk depending on conditions

MSD notes that EMS horses almost always require severe grazing restriction, and that care is needed when turning horses out during periods of high soluble carbohydrate content, such as spring and autumn. (MSD Veterinary Manual)

Weight Management

Weight loss is helpful when the horse is overweight, but starvation is not treatment.

For overweight EMS horses, UC Davis recommends discussing a diet plan with a veterinarian and initially feeding forage at about 1.5 percent of ideal body weight per day, with careful adjustment if needed. Sudden severe restriction should be avoided because it can worsen metabolic problems. (Center for Equine Health)

Track:

Measurement	Why it helps
Body condition score	Tracks overall fat cover
Weight tape	Tracks trends
Neck crest	Tracks regional metabolic fat
Monthly photos	Makes slow changes visible
Hoof rings	Helps detect previous laminitis stress
Insulin results	Shows whether management is working

A good weight loss plan should be boring, measured, and consistent. Crash dieting a horse is not clever. It is just replacing one problem with another.

Exercise: Helpful, But Only When Safe

Exercise improves insulin sensitivity, helps weight loss, builds muscle, and supports metabolic health.

But exercise is not appropriate during active laminitis.

UC Davis states that exercise can increase weight loss and that horses with controlled and stable laminitis may benefit from walking if approved by a veterinarian, but exercise is not recommended during active laminitis. (Center for Equine Health)

Horse status	Exercise advice
Sound and high risk	Controlled exercise is usually helpful
Overweight and sound	Gradual exercise can support weight loss
Stable previous laminitis	Vet-approved walking may help
Active laminitis	Do not force exercise
Foot sore or reluctant to turn	Stop and reassess
Rotation or sinking on radiographs	Exercise must be vet and farrier guided

Do not “walk them through it” if the feet are painful. That is not fitness. That is adding load to damaged laminae.

Hoof Care Is Part of Insulin Management

Hoof care is not separate from metabolic care. It is one of the ways you detect and reduce damage.

MSD recommends careful foot examination and notes that hoof care by a skilled farrier is essential in EMS cases, even without acute laminitis. It also notes that radiography is recommended in at-risk cases to detect hoof distortion. (MSD Veterinary Manual)

A good hoof plan may include:

Hoof care step	Why it matters
Regular trimming	Maintains balance
Vet and farrier communication	Aligns hoof support with metabolic risk
Radiographs when indicated	Detects rotation or sinking
Monitoring white line	Widening may suggest chronic stress
Watching hoof rings	Can reveal previous laminitic episodes
Supportive boots or pads when needed	Improves comfort in selected cases
Avoiding long toes	Reduces leverage on damaged laminae

The farrier may notice the first evidence that insulin has been affecting the feet. Listen to good farriers. They are hoof detectives with sharper knives.

What About Metformin?

Metformin has been used in horses with insulin dysregulation, but results are variable.

MSD Veterinary Manual notes that metformin is poorly absorbed in horses and has variable effects on insulin sensitivity, although some cases may show reduced insulin concentrations. (MSD Veterinary Manual)

The practical message is this: metformin is not a shortcut around diet.

It may be considered by a veterinarian in selected cases, but it should not be used as a reason to keep feeding high sugar hay, grain, sweet feed, or uncontrolled pasture.

What About SGLT2 Inhibitors?

SGLT2 inhibitors are a newer medication class being used in some difficult hyperinsulinemia cases.

MSD Veterinary Manual notes that SGLT2 inhibitors have shown promising results for managing hyperinsulinemia and hyperinsulinemia-associated laminitis, especially when dietary management fails or in acute cases, but they are used extralabel and require veterinary oversight. (MSD Veterinary Manual)

These medications are not casual paddock hacks. They require monitoring, case selection, and awareness of potential side effects, including changes such as hypertriglyceridemia reported in some cases.

What About Thyroid Medication?

Levothyroxine is sometimes used short term in selected obese EMS horses to support weight loss. But horses with EMS are not usually truly hypothyroid.

MSD notes that levothyroxine has been used to help weight loss in EMS horses, usually for a limited period until target body condition is reached, followed by weaning. (MSD Veterinary Manual)

This matters because thyroid medication is not a metabolism booster for every chunky horse. It should have a clear reason, monitoring plan, and exit strategy.

Supplements: Helpful or Hype?

Many products claim to support insulin sensitivity.

Common examples include magnesium, chromium, cinnamon, omega-3 products, and herbal blends.

The problem is that supplements are often sold as if they can replace the hard work: testing hay, controlling pasture, weighing forage, reducing calories, improving exercise, and monitoring insulin.

UC Davis notes that cinnamon, chromium, and magnesium have been suggested to improve insulin sensitivity, but have not been shown to improve insulin sensitivity in horses in experimental situations. MSD states similarly that numerous supplements have been suggested, but none have been shown to improve insulin regulation in experimental settings. (Center for Equine Health)

Use supplements only to correct a genuine dietary gap or as part of a vet-led plan. Do not let them become expensive glitter on top of unmanaged grass.

When Is This an Emergency?

Hyperinsulinemia itself is not usually an emergency. Laminitis is.

Call your vet urgently if your horse shows:

Red flag	Why it matters
Heat in the feet	Possible active laminitis
Strong or bounding digital pulses	Major warning sign
Reluctance to move	Foot pain until proven otherwise
Shifting weight	Classic laminitis behaviour
Rocked-back stance	Serious front foot pain concern
Walking on eggshells	Painful laminitic gait
Lying down more than usual	May indicate severe foot pain
Sudden soreness after pasture	Strong metabolic warning
Previous laminitis and any new footiness	High recurrence risk
Severe pain or inability to walk	Emergency care needed

If you suspect laminitis, remove grass and sugary feed, keep movement minimal, provide deep soft bedding if safe, and call your vet immediately.

What Should You Do Right Now?

1. Check the feet

Feel for heat, check digital pulses if you know how, watch the horse turn, and look for reluctance to move.

2. Review the diet honestly

List everything: hay, grass, grain, treats, supplements, balancers, lick blocks, carrots, apples, and “just a little scoop”.

That little scoop is often not little to the pancreas.

3. Ask your vet about insulin testing

Do not rely on body shape alone. Testing helps separate guesswork from risk.

4. Test hay where possible

For high-risk horses, hay analysis is one of the most useful tools you have.

5. Restrict pasture if risk is high

Especially if the horse has previous laminitis, high insulin, PPID, foot soreness after grass, or a strong crest.

6. Work with your farrier

Hoof balance, radiographs when needed, and early detection of chronic laminitis changes matter.

7. Exercise only if sound

Exercise helps metabolic health, but not during active laminitis.

8. Monitor trends

Track weight, neck crest, body condition, insulin results, ACTH if relevant, hoof rings, digital pulses, pasture access, and any foot soreness.

Common Mistakes Owners Make

Mistake 1: Waiting for obvious laminitis

By the time the horse is walking on eggshells, the feet are already in trouble.

Mistake 2: Assuming only fat horses are at risk

Lean horses can still have insulin dysregulation, especially with PPID, previous laminitis, abnormal hoof rings, or regional fat deposits.

Mistake 3: Feeding low sugar grain but ignoring pasture

Pasture can be the biggest carbohydrate source in the entire diet.

Mistake 4: Trusting hay by appearance

Beautiful hay can be high in sugar. Rough-looking hay can still be unsuitable. Test where possible.

Mistake 5: Using supplements instead of changing management

Supplements do not fix unlimited grass, high NSC forage, excess calories, or poor monitoring.

Mistake 6: Exercising through foot pain

Exercise helps when the horse is sound. It can worsen damage during active laminitis.

Mistake 7: Testing ACTH but not insulin

PPID monitoring matters, but insulin status is what often determines laminitis risk and diet strictness.

Mistake 8: Treating one insulin result as the whole story

Insulin varies with diet, stress, pain, season, and testing method. Interpret results with your vet.

Prevention: How To Reduce Hyperinsulinemia Risk

Prevention is about controlling the things that drive insulin before the hooves pay the bill.

Prevention step	Why it helps
Keep body condition controlled	Reduces metabolic stress
Track neck crest and fat pads	Detects regional risk early
Test insulin in at-risk horses	Finds risk before laminitis
Screen older horses for PPID when signs appear	PPID and insulin dysregulation can overlap
Feed low NSC forage when needed	Reduces insulin-driving carbohydrate load
Restrict pasture in high-risk horses	Reduces grass-triggered insulin spikes
Avoid grain and sugary treats	Prevents unnecessary insulin surges
Exercise when sound	Improves insulin sensitivity
Maintain regular farrier care	Detects hoof changes early
Use radiographs when indicated	Finds structural changes before guessing
Recheck after diet or medication changes	Confirms whether the plan is working

UC Davis states that many EMS horses respond well to diet and exercise management, but easy keepers or horses with persistently high insulin may require medical treatment and long-term veterinary support. (Center for Equine Health)

Normal Weight vs Metabolic Warning Signs

More reassuring	More concerning
Normal body condition	Obesity or unexplained weight gain
No regional fat pads	Cresty neck or fat pads
No laminitis history	Previous laminitis
Comfortable after pasture	Sore after grass
Normal digital pulses	Strong or bounding pulses
Normal hoof shape	Hoof rings, widened white line, dropped sole
Sound on turns	Reluctance to turn
Insulin normal on appropriate testing	High resting or post-challenge insulin

A horse can move from “watch” to “act now” quickly when hoof signs appear.

Myth vs Reality

Myth	Reality
“Hyperinsulinemia is just diabetes in horses.”	Horses usually maintain normal or near-normal blood glucose. The key issue is abnormal insulin regulation and laminitis risk.
“Only obese ponies get this.”	Obesity is common, but lean horses can still be insulin dysregulated.
“If my horse is not lame, insulin is not a problem.”	Insulin risk can exist before obvious lameness appears.
“Soaking hay makes it safe.”	Soaking can help, but results vary. Testing is better.
“Supplements can fix insulin resistance.”	Diet, pasture control, exercise, testing, hoof care, and veterinary management matter more.
“Metformin or SGLT2 medication means diet does not matter.”	Medication should support management, not replace it.

Will My Horse Be Okay?

Many horses with hyperinsulinemia do very well when the problem is found early and managed properly.

The outlook is better when:

Good sign	Why it helps
Insulin is tested before laminitis	Prevention is easier than repair
Diet is controlled	Reduces insulin spikes
Pasture is restricted when needed	Removes a major trigger
Weight improves gradually	Supports metabolic control
Exercise is used safely	Improves insulin sensitivity
Farrier care is consistent	Detects and reduces hoof damage
PPID is treated if present	Reduces overlapping endocrine risk
Owner acts quickly on foot soreness	Prevents delayed laminitis care

The outlook becomes more guarded when there is repeated laminitis, severe rotation or sinking, persistently high insulin, uncontrolled PPID, poor diet control, or delayed treatment.

Related Horse Health Topics To Link Internally

Related topic	Why it connects
How To Prevent Founder in Horses	Hyperinsulinemia is a major laminitis driver
Equine Metabolic Syndrome in Horses	EMS is centred on insulin dysregulation
How To Monitor Cushing’s Disease in Horses	PPID and insulin dysregulation can overlap
Insulin Response in Older Horses	Senior horses can develop changing insulin risk
Thyroid Supplements for Horses	Levothyroxine is sometimes used in selected EMS cases
Feeding a Laminitis-Prone Horse	Diet is the foundation of prevention

FAQs About Hyperinsulinemia in Horses

Is hyperinsulinemia the same as insulin resistance?

Not exactly. Hyperinsulinemia means insulin levels are too high. Insulin resistance means tissues do not respond normally to insulin. A horse may have one or both, and both fall under the broader problem of insulin dysregulation.

Can high insulin cause laminitis?

Yes. High insulin is strongly linked with hyperinsulinemia-associated laminitis, which is one of the most common forms of laminitis in horses. (MSD Veterinary Manual)

Can a thin horse have hyperinsulinemia?

Yes. Thin or normal-weight horses can still have insulin dysregulation, particularly if they have PPID, previous laminitis, regional fat deposits, or abnormal insulin responses after sugar or starch intake.

What is the best diet for a horse with hyperinsulinemia?

Most insulin dysregulated horses need low NSC forage, restricted pasture, no grain or sweet feed, no sugary treats, controlled calories if overweight, and a balanced vitamin and mineral source. Hay testing is strongly recommended for high-risk horses.

Should I exercise a horse with high insulin?

Exercise is helpful if the horse is sound and not actively laminitic. Do not force exercise if the horse is foot sore, reluctant to move, has strong digital pulses, or is showing laminitis signs.

The Bottom Line

Hyperinsulinemia is not just a blood test abnormality. It is one of the biggest warning signs for laminitis risk in horses.

The most important things to control are sugar and starch intake, pasture exposure, body condition, exercise when safe, PPID if present, and hoof health. Testing matters because you cannot reliably identify every insulin dysregulated horse by appearance alone.

The safest rule is simple: if a horse has high insulin, previous laminitis, a cresty neck, pasture-triggered soreness, or hoof changes, manage them as laminitis-prone until proven otherwise. If there is heat in the feet, strong digital pulses, shifting weight, or reluctance to move, call your vet immediately.

Early insulin control protects feet. Waiting protects nothing.

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If you are unsure whether your horse needs insulin testing, EMS management, PPID assessment, diet changes, or urgent laminitis care, ASK A VET™ can help you understand what signs matter and when veterinary care is needed.