Laminitis is a frustrating disease for horse-owners, veterinarians and researchers alike. New research findings often disprove older theories, and disparate results from both epidemiological and pathophysiological investigations co-exist. When this iscompounded by the perpetuation of out-dated information and extrapolation of misleading data, the overall disease mosaic is further complicated. Recently, there has been a shift of research focus to the study of endocrinopathic laminitis, defined as laminitis developing from hormonal influences. Endocrinopathic laminitis constitutes two categories of disease, namely, (1) those associated with glucocorticoids, including pituitary pars intermedia dysfunction (PPID) and iatrogenic corticosteroids, and (2)those associated with insulin resistance, namely equine metabolic syndrome (EMS) and pasture-associated laminitis (now considered to reflect an abnormal response to high carbohydrate content, rather than a true car-bohydrate/fructan overload). Common toeach of these conditions is the dysregulation of glucose and insulin, potentiating insulin resistance and the development of hyperinsulinaemia. Although experimental and field studies have substantiated a link between hyperinsulinaemia and endocrinopathic laminitis, what is the strength of evidence to suggest that this is important?
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