Equine Digest, May 24 2026
Editor's note
A thread runs through this issue: the gap between what we can see at first glance and what is actually going on. New field data on SGLT2 diabetes drugs for insulin-dysregulated horses shows most respond, but a meaningful minority do not, and a smaller group spikes their fat levels into hyperlipaemia. Peritoneal fluid testing finds quiet pancreatic disease in many colic cases that look like ordinary obstructive belly aches. A cone beam CT study shows that "cervical arthritis" calls on plain neck radiographs are routinely too generous. A salivary hormone study quantifies how regular, calm handling shifts cortisol and oxytocin in horses that look the same on the outside. And two rehab papers (carrot stretches and the eye-removal decision in horses with chronic uveitis) confirm that some of the most pragmatic interventions in horse care are also the most quietly effective. Read with that filter in mind.
SGLT2 diabetes drugs for insulin-dysregulated horses: real-world data is in, and the safety story matters
Two studies published days apart give the most complete picture yet of how SGLT2 inhibitors (a class of human diabetes drugs being repurposed for equine metabolic syndrome and insulin dysregulation) behave outside tightly controlled trials. In a field study of 70 client-owned horses and ponies, three weeks of daily oral canagliflozin cut average post-meal insulin roughly in half (from 304 to 171 µIU/mL). The catch: 13% of horses did not respond at all, triglycerides rose across the group, and 9% developed hyperlipaemia-range triglycerides above 5.6 mmol/L. A placebo-controlled crossover trial of a related drug, bexagliflozin, in 10 Arabian horses found the higher dose (0.06 mg/kg) controlled insulin while keeping triglyceride changes mild. If you and your vet are considering one of these drugs for a laminitis-prone horse, plan for monthly bloodwork on insulin, liver enzymes, and triglycerides; it is not a set-and-forget prescription.
Bottom line
SGLT2 inhibitors work for most insulin-dysregulated horses but require ongoing lipid and insulin monitoring, and a real minority either won't respond or will spike triglycerides.
Hällbom M, Lindåse ST, Wartel M, Bröjer J (2026). Equine Veterinary Journal. DOI: 10.1002/evj.70181. Lowndes CR, Luethy D, Skelton G, et al. (2026). Journal of the American Veterinary Medical Association. DOI: 10.2460/javma.26.02.0098.
Colic may be hiding pancreatitis more often than we thought
A study comparing peritoneal fluid lipase activity in colic horses against healthy controls found something quietly surprising: peritoneal DGGR lipase (an enzyme that climbs when the pancreas is inflamed) was significantly elevated in horses with strangulating lesions and in horses that did not survive. Histology on the pancreases of the colic cases sampled showed fibrosis or active pancreatitis lesions in most of them. Horses are not normally thought of as a "pancreatitis species," so this is a meaningful reframe: some of what looks like ordinary obstructive colic may be a concurrent pancreatic process that influences prognosis. The owner-facing message is not "ask your vet for a lipase test"; it is "if your vet is running peritoneal fluid on a colic, this is one of the markers being watched, and elevated values are part of why the outlook can shift quickly."
Bottom line
Pancreatitis appears to accompany a significant share of equine colic cases and may help explain why some horses deteriorate despite standard care.
Greer HR, Whitfield-Cargile C, Sebastian D, et al. (2026). Journal of the American Veterinary Medical Association. DOI: 10.2460/javma.25.11.0720.
"Cervical arthritis" on neck x-rays is being over-called
Caudal cervical arthritis (osteoarthritis at the C7-T1 joint, the base of the neck where it meets the shoulder) is one of the diagnoses that increasingly drives expensive injection protocols, career changes, and tough conversations about a horse's future. A study of 94 horses imaged with both plain lateral radiographs and standing cone beam CT found that radiographs systematically overestimate the size of the articular processes at C7-T1, the very measurement used to flag arthritis. CBCT (a newer, more accurate, three-dimensional imaging technique done with the horse standing) showed better agreement between readers and a stronger correlation between joint size and actual osteoarthritis grade. Radiographic interpretation at this site, the authors conclude, should be approached cautiously. If your horse has been flagged for caudal cervical OA on plain rads alone, it is reasonable to ask about CBCT before committing to a treatment plan.
Bottom line
A "cervical arthritis" call based on plain neck radiographs alone is frequently overstated; ask about CBCT before pursuing injections or retirement.
Cianci JM, Bills KW, Skelton G, et al. (2026). Equine Veterinary Journal. DOI: 10.1002/evj.70184.
Salivary cortisol and oxytocin: the hormonal fingerprint of consistent handling
Researchers measured cortisol, oxytocin, and serotonin in plasma and saliva from 40 horses and tested how well saliva tracked blood. Cortisol and oxytocin correlated well between the two samples (r² of 0.44 and 0.59); serotonin did not. The clinically interesting comparison: horses that received consistent human contact had lower cortisol and higher oxytocin than minimally handled horses, even with no other differences in care. Once the team corrected for multiple comparisons, hormone levels did not predict temperament scores, so this is not a tool for choosing a horse. It is, however, the cleanest piece of evidence yet that a daily routine of calm handling shifts the stress and bonding hormones measurably, and that salivary cortisol is the practical field tool if you want to monitor stress without drawing blood.
Bottom line
Consistent calm handling lowers cortisol and raises oxytocin measurably; saliva is a reasonable non-invasive proxy for blood cortisol.
Choi Y, Jung Y, Wickens CL, Park Y, Yoon M (2026). Scientific Reports. DOI: 10.1038/s41598-026-51061-5.
Carrot stretches and belly lifts: which ones actually fire the muscles you want
Owners doing in-hand topline work often have a vague sense that some of the exercises are working harder than others. A study using surface electromyography on seven horses measured which "dynamic mobilization" and "trunk" exercises produced the largest activation of the abdominal and back muscles. The clear winner: a carrot stretch directing the horse toward the hip (asking them to bend laterally to follow the treat past their flank) lit up the abdominal obliques, rectus abdominis, and longissimus dorsi at T14 well above other versions. Pelvic rounding (the belly-lift "tuck" by pressing under the abdomen) was the standout for activating the longissimus dorsi closer to the lumbar spine. The everyday takeaway: not all carrot stretches are equal, and the hip-direction one earns its place in the warm-up.
Bottom line
Carrot stretches to the hip and pelvic-rounding belly lifts are the two in-hand exercises with the strongest measured core activation; prioritise these in topline work.
Harrison LM, St George LB, Goff LM, et al. (2026). Journal of Equine Veterinary Science. DOI: 10.1016/j.jevs.2026.105940.
Bilateral eye removal in horses with chronic uveitis: owners report quality of life improves
Equine recurrent uveitis (a progressive, painful, immune-mediated inflammation of the eye, most common in Appaloosas) is one of the more agonising long-term ophthalmic conditions in horses. When both eyes are involved and medical management has run its course, owners face a difficult question: bilateral enucleation (removing both eyes surgically) or euthanasia. A retrospective study of 21 horses with bilateral enucleation across a European referral practice followed up via owner surveys. Mean age was 20.6 years, 95% had recurrent uveitis. All horses were reported by their owners to show improved quality of life. Most returned to previous activity levels. Median satisfaction was 5/5 overall and 4/5 for recommending the procedure. The sample is modest and the design retrospective, but until now this decision has been guided largely by clinical instinct. The numbers, where they exist, are reassuring.
Bottom line
For horses with chronic bilateral uveitis, bilateral enucleation appears to preserve quality of life and is worth discussing alongside euthanasia.
Gasco J, Sauvage A, Monclin SJ, Narinx F (2026). Equine Veterinary Journal. DOI: 10.1002/evj.70190.
Coming up
Next issue we look at what is moving on the parasite resistance and microbiome fronts, plus whether anything new lands on rein tension and contact research, an area where the literature has been quietly building.
