The Foundation for the Horse has awarded Dr. Kimberly Hallowell, a Ph.D. student in NC State’s Comparative Biomedical Sciences Program, a 2025 Young Investigator Grant to support her research into using metabolic indicators to predict which horses are at risk of developing laminitis after receiving steroid injections.

Steroids are commonly and effectively used to treat equine joint disease and pain, but recent studies have shown that they often elevate a horse’s insulin and glucose levels for days. High insulin levels increase a horse’s risk of developing laminitis, a painful and debilitating hoof condition. 

Hallowell’s research into the steroid-insulin-laminitis connection began when she was completing an internship in equine medicine at the NC State College of Veterinary Medicine and carried through her residency in internal medicine.

‘I am so honored by the Foundation for the Horse’s continued support of our projects and grateful for their commitment to funding research that directly benefits horses,” Hallowell says. “We are all doing this for the horses, and the foundation’s grant funding has brought us several steps closer to understanding the safest ways to use corticosteroids in our equine patients.”

Now a T32 program fellow at NC State, she has made creating guidelines for safe steroid use in horses the focus of her Ph.D. research. The T32 program, funded by the National Institutes of Health, offers stipends to support predoctoral and postdoctoral research training. At NC State, the specific NIH T32 Comparative Medicine and Translational Research Training Program that funds Hallowell is designed to help specialty-trained DVMs complete Ph.Ds and rapidly transition to research-intensive careers, especially as faculty members in academia.

With the Young Investigator Grant, Hallowell plans to build upon earlier research and try to identify blood markers that would help veterinarians anticipate how an individual horse’s insulin levels might respond to steroids. 

Hallowell’s grant application explained that veterinarians sometimes test a horse’s insulin levels at a single timepoint before injecting steroids into joints but that no evidence exists that a baseline test can predict the response. Severe insulin increases can occur even in horses with low baseline insulin concentrations. 

“In this study, we aim to identify diagnostic markers that could be used by veterinarians to predict an individual horse’s insulin response to steroids,” she said in the application. “By evaluating multiple tests at once followed immediately by a steroid injection trial, we hope to identify diagnostic markers that are highly predictive of the insulin response to steroid administration. This would allow veterinarians to adjust their therapeutic approach in high-risk animals and greatly reduce the impact of steroid-induced laminitis.” 

Dr. Lauren Schnabel, the director of the NIH T32-funded Comparative Medicine and Translational Research Training Program and an associate director of the Comparative Medicine Institute, also is Hallowell’s Ph.D. adviser. Most of Hallowell’s research has been conducted under Schnabel’s mentorship. 

Schnabel, also a professor of equine surgery, is the principal investigator on a recent $50,000 grant from the Foundation for the Horse’s new Chromatic Fund for her and Hallowell to study whether horses fare better with the recommended several low doses of steroids or with a single large dose. 

“We’ve always thought it’s safer to give a low dose repeatedly, but insulin rise can last upward of two weeks,” Hallowell says. “Are we actually doing more harm than good by having these horses have an insulin spike and then get back to normal for a week or two, then we inject them again, and it spikes again?” 

With the Young Investigator Grant, Hallowell will look for ways to dynamically test horses in the field to better identify those who risk extreme insulin spikes after steroid treatments.

 “We’re doing an oral sugar test, and then we’re doing some other dynamic tests like feeding the horse high protein grain and seeing what happens to its insulin after and another one where you give them a small dose of insulin,” Schnabel says. “They are all tests that feasibly someone could perform in the field. And the goal is to say, is there anything we can tell practitioners they can do to identify these horses at risk?”

Once she is awarded her Ph.D., Hallowell, a native of New Hampshire who received her DVM from Tufts University, plans to stay in academia.

“I love teaching. I love research. I love managing clinical cases and being able to tie all of those things together,” Hallowell says. “So my dream job is to be Lauren.”

“You will be better!” Schnabel immediately answers.

Since its inception in 2019, The Foundation’s Young Investigators Research Grant program has awarded $763,214 supporting 41 impactful research projects by up-and-coming investigators. Hallowell’s award is one of seven this year. 

This post was originally published in Veterinary Medicine News.