My pony first had laminitis (stress-induced, we believe) aged 12. We managed her, with diet, restricted grazing and exercise for 10 years, until she had another few, awful bouts, which came from nowhere. Blood tests were -ve for cushings, but she was eventually diagnosed with equine metabolic syndrome, placed on a v strict management regime, incl remedial shoeing and enrolled on a clinical trial (trilostane). For the last ten years of her life, she was laminitis free and eventually medication free, as the cost became prohibitive and we decided to give her a month without it, before making a decision, but she stayed sound.
Long story short, she died a couple of months back, aged 32, from a heart attack. She was sound and happy (barefoot, managed by an excellent farrier, cantered around the field the day she died)
Her X-rays, upon diagnosis, were about as bad as you get, rotation-wise (no sinking). Nobody could have predicted the outcome we had and while I appreciate that we were very lucky, I just wanted to share a positive story :)