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      What Is Metabolic Syndrome In Horses – Treatment Options

      Equine Metabolic Syndrome is a condition that affects many horses and ponies. EMS can cause a wide range of problems, and when left untreated, it can ultimately be deadly. However, dedicated horse owners can take steps to manage their horse’s condition and improve their quality of life.

      In this article, we will discuss the symptoms of metabolic syndrome, the causes, and potential treatment options. We will also answer some frequently asked questions about EMS.

      What Is Equine Metabolic Syndrome?

      Equine Metabolic Syndrome (EMS) is a syndrome that impacts horses’ ability to regulate insulin. Insulin dysregulation can lead to laminitis, obesity, and other health problems.



      We discuss these problems in more detail below.

      Symptoms of EMS

      Several symptoms can indicate that a horse has metabolic problems.

      Clinical signs include:

      Insulin Resistance (or Reduced Insulin Sensitivity)

      This is a condition in which the horse’s body does not respond appropriately to insulin. Insulin is a hormone that helps the body to process glucose (sugar).

      In horses with metabolic syndrome and insulin resistance, insulin doesn’t absorb into the body’s tissues as efficiently as it would in a healthy horse. The pancreas’ response to insulin resistance is to release even more insulin, leading to a high insulin concentration in the blood.

      Insulin resistance is a significant indicator of EMS.


      Another sign of EMS is obesity. Obesity in horses is often defined by a “cresty” neck, numerous fat deposits and/or a pot-bellied appearance. Obesity is a concern because it can both be a sign of an underlying health issue, like EMS, and the origin of other health problems.

      Of course, a horse can be obese without having metabolic issues, and not all obese horses will have metabolic syndrome.


      Laminitis is a condition that affects the hooves. It is characterized by inflammation of the laminae, the tissues connecting the hoof wall to the bone.

      Laminitis is a serious and painful condition that causes lameness and makes mobility difficult. It is a common complication of EMS, so affected horses may need to be checked for metabolic disorders, especially if they also have weight problems.

      Increased Appetite

      Many horses with metabolic syndrome have an increased appetite. This may be due to the horse’s body trying to compensate for the insulin resistance.

      If you’ve noticed that your horse is always hungry and eager for more food, it may be a sign of Equine Metabolic Syndrome.


      Infertility is another symptom. Horses with this condition may have difficulty conceiving or may experience early embryonic death. They may also have altered ovarian function.

      How Is Equine Metabolic Syndrome Diagnosed?

      If you think your horse may have metabolic problems, the first step is to talk to your veterinarian. They will ask about your horse’s medical history and perform a physical examination.

      Your veterinarian may also recommend one or more of the following tests:

      Blood Glucose Concentration

      Testing the blood glucose concentration is an important step when diagnosing this syndrome. A high blood sugar concentration may indicate insulin resistance. As such, it’s crucial to test the blood glucose concentrations if a metabolic disorder is suspected.

      If the blood glucose concentrations are in the normal range, your horse may have a different health situation that needs to be addressed.

      Insulin Measurements

      A horse with EMS may have difficulty regulating insulin, so the insulin concentrations in the horse’s blood after eating can give vets great insight. Testing insulin concentration with a blood sample can help confirm an EMS diagnosis.

      The oral sugar test is a popular insulin tolerance test that involves fasting. The horse must fast up to 12 hours before the oral sugar test. After fasting, a sugar solution is given orally, and blood samples are taken at regular intervals for the next two hours. If the horse has an abnormal insulin response to an insulin tolerance test, it may have EMS.

      Finally, a combined insulin/glucose test may also be used to test insulin sensitivity. This test is similar to the oral glucose test, but it’s performed through IV infusion. The vet typically infuses a small amount of insulin and dextrose into the horse’s vein for this test. Then, blood samples are taken to see the body’s response.

      After an initial examination, your vet can help you choose the best diagnostic path, whether that’s an oral sugar test, a combined insulin/glucose test or something else. Diagnosis can sometimes be difficult, so more than one test may be required.

      Treatments for Equine Metabolic Syndrome

      Once your horse has been diagnosed, developing a treatment plan is next. The goal of treatment is to reduce the risk of complications, such as laminitis.

      There is no one-size-fits-all treatment for this syndrome, but some common treatments include:

      Weight Management

      Weight management is key to treating EMS. Reducing the amount of food your horse eats and increasing exercise can go a long way when it comes to regulating insulin levels and decreasing body weight.

      A standard weight management method is using a body condition score (BCS). This system assigns a number to the horse based on how much fat they have. A higher number means the horse is overweight, while a lower number means the horse is underweight.

      You can use a body condition score chart to assess your horse’s weight. Once you’ve determined their BCS, you can work with your vet to create a weight management plan.


      Conditioning refers to exercise. Increased exercise can help to improve insulin regulation and allow the horse to lose weight.

      Treadmills are an excellent tool for horses who need to reduce or maintain body weight. Treadmills are a safe and effective way to boost the horse’s strength and help with weight reduction without putting too much stress on the horse’s body.

      You can either use a dry or water treadmill to exercise your horse.

      Water Treadmill:

      A water treadmill is gentle and therapeutic. It doesn’t stress the horse’s body, and it’s great for rehabilitation. This type of treadmill is often used for horses with health problems, especially laminitis, that require a milder approach to working out. It’s a safe form of exercise that doesn’t cause further damage.


      horse water treadmill in use


      The water treatment is also ideal for horses struggling with swelling, abrasions or other conditions that need soothing care.

      One of the significant benefits of a water treadmill is that many treadmills of this type also work as dry treadmills.

      Dry Treadmill:

      A dry treadmill is a more intense form of exercise. It’s often used for performance horses because it helps to increase stamina and endurance. If your horse is healthy and able to handle the activity, a dry treadmill can be a great way to decrease body weight.

      You can also condition your horse by riding them. Riding is a great way to get your horse moving and can be done at any level, from light to strenuous.

      Talk to your vet if you’re unsure how to condition your horse. They can help you create a safe and effective plan.

      Dietary Modification

      Dietary management is another crucial part of treatment. A diet high in fibre and low in sugar can help regulate insulin levels and encourage weight loss.

      You can work with a nutritionist to create a diet plan for your horse. They can support you in choosing the right foods and the right amount of nourishment to give your horse every day, depending on their age, size, overall health and activity level.

      Some common high-fibre, low-sugar foods include hay, grass and vegetables. That said, your vet or nutritionist may recommend decreasing pasture time as horses tend to gain weight when eating rich grass. Alternatively, you may turn your horse out to pasture with a grazing muzzle to limit grass intake.

      Never enforce a sudden feed restriction on your horse, as that can cause serious health problems. Instead, create a dietary management plan and make diet changes slowly.

      Nutritional Supplements

      Numerous dietary supplements can be used to help treat Equine Metabolic Syndrome and facilitate better health. Some common horse supplements include chromium, magnesium, and omega-three fatty acids. Mineral supplements are commonly fed to horses with EMS.

      Discuss nutritional supplements with your vet to determine which supplements are best for your horse. The vet can help you pick the right supplements and the correct dosage of each supplement for your horse’s circumstances.


      In addition to nutritional supplements, some medications can be used to treat metabolic syndrome. These medications may improve insulin sensitivity and promote weight loss.

      If medical therapy is needed, that’s something that should be discussed with a veterinary professional. An equine vet can choose the correct medication and the proper dosage.

      Other Treatments:

      If your horse suffers from laminitis due to EMS, hoof boots that provide pulsed electromagnetic field therapy may speed healing and relieve pain.

      EMS: Frequently Asked Questions

      EMS is a complicated condition, and there’s a lot to learn about it. Here are answers to some frequently asked questions about EMS.

      What Causes EMS?

      The exact cause of EMS is often unknown, but some risk factors have been identified. These include obesity, insulin dysregulation, hormonal imbalances, genetic predisposition and inflammation.

      Conditioning and nutrition are two simple methods for prevention, but since both environmental factors and genetics play a role in the development of this syndrome, it’s not always possible to prevent EMS.

      Can EMS Be Cured?

      Unfortunately, there is currently no cure for EMS. Still, most affected horses can lead happy, comfortable lives with proper treatment, including weight management strategies designed to support your horse in maintaining a normal weight.

      Early diagnosis and treatment are essential for the best prognosis.

      How Do I Know If My Horse Has EMS?

      Several clinical signs indicate EMS. These include laminitis, recurrent infections, weight gain, insulin dysregulation and abnormal fat deposits. Your vet can help you determine if your horse has EMS.

      Your Horse’s Prognosis

      The prognosis for horses with this health issue is generally good. With early diagnosis and proper treatment, most horses can live a long and healthy life with minimal clinical signs of the disorder.

      However, it’s essential to remember that EMS is a chronic condition, so treatment will need to be ongoing. Also, please remember the prognosis largely depends on the specific horse and the severity of their condition.

      Preventing Equine Metabolic Syndrome

      While some otherwise healthy horses may develop EMS even when they maintain normal weight and insulin concentrations over their lifetime, you can do a few things to help prevent your horse from developing Equine Metabolic Syndrome.

      Many preventative methods are also part of the treatment plan for affected horses.

      • Maintain a healthy body weight: One of the best things you can do for your horse is to help them maintain healthy body weight. If necessary, you can do this by monitoring their diet and exercise and working with your vet to create a weight-loss plan.
      • Provide plenty of exercise: Exercise is essential for all horses, but it’s vital for those at risk of this syndrome. Make sure your horse gets plenty of opportunities for activity every day, whether you need to use a treadmill, take your horse for a ride or lunge them in a paddock.
      • Choose the right food: Feeding your horse a diet high in fibre and low in sugar can help reduce insulin dysregulation and facilitate weight loss. You can work with a nutritionist to create a diet plan for your horse.
      • Consider supplements: There are a number of nutritional supplements that may ease insulin dysregulation, strengthen your horse’s immune system and nurture excellent health.
      • Talk to your vet: Your vet can create a plan to help prevent EMS. They can also educate you to ensure you identify the early signs of the condition so you can start treatment immediately.

      Whether your horse is predisposed to developing EMS or already has the condition, it’s essential to keep in mind that you aren’t helpless. The treatments and therapies we’ve discussed can help your horse live comfortably, perhaps for many, many years.

      If you think your horse may have EMS or other metabolic issues, seek out a prompt diagnosis and treatment for the condition for the best outcome.

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