The most common root cause of laminitis in horse populations worldwide is some form of underlying endocrine dysfunction, with high blood insulin being the common feature that appears to directly lead to laminitis lesions in horses with Pituitary pars intermedia dysfunction (PPID, or Equine Cushings disease) or Equine Metabolic Syndrome.

“We’ve done a lot of good work over the last 10 years, since Barbaro,” says van Eps. “We know now that there are different mechanisms that can lead to the disease, and we’re working out ways to prevent or ameliorate the different forms.”