Rehabbing Laminitis - The Humble Hoof

This episode of the Humble Hoof Podcast features a powerful case study on the rehabilitation of a severely laminitic pony in central Texas, shared by hoof care provider Amber Greeson. The pony, a previously active show horse, developed full-blown laminitis after a combination of metabolic issues (PPID and insulin dysregulation), a severe colitis episode, and prolonged exposure to high-sugar grass during nighttime turnout. Despite initial misdiagnosis and delayed treatment, the horse was saved through a multi-pronged approach: switching to an SGLT2 inhibitor (Invokana), implementing Cloud Boots for comfort, adopting a strict ECIR protocol for diet and management, and using a customized trim that prioritized minimal intervention during acute pain. The recovery was slow but transformative—by summer 2025, the pony was barefoot, rock-crunching on caliche roads, and fully sound. Amber emphasizes the importance of trusting intuition, recognizing subtle laminitis signs like toe flicking and foot striping, and the critical role of proactive management even after stabilization. She also warns about the risks of steroid use and the need for ongoing vigilance in metabolic horses. Key takeaways include: 1) Early detection of subtle laminitis signs (toe flick, foot striping, gait changes) can prevent catastrophic progression; 2) SGLT2 inhibitors like Invokana can be life-saving for refractory cases, especially when combined with L-carnitine and L-glycine to manage triglycerides; 3) A strict, ECIR-aligned management plan—low-sugar hay, grazing muzzles, track management, and regular testing—is essential for long-term stability; 4) Trust your instincts and don’t delay vet involvement when something feels off; 5) Even after recovery, metabolic horses require lifelong monitoring and management to prevent relapse. The episode ends on an uplifting note, highlighting the power of community, shared knowledge, and persistence in overcoming seemingly hopeless cases.