Understanding Equine Metabolic Syndrome (EMS)

Obesity and chronic laminitis are linked. These horses are labelled with terms such as Pre-Cushing's, Cushingoid, Syndrome-X, Hypothyroid, and Metabolic Syndrome. These descriptors, however, are only partially accurate because many horses with chronic laminitis caused by obesity don't show significant improvement with typical treatments for Pituitary Pars Intermedia Dysfunction (PPID)/Cushing's Disease, like pergolide. Thyroid drug supplementation also has limited effects. That's because these horses didn't have true PPID or hypothyroidism.

Recent research has shed more light on this condition, leading to the adoption of Equine Metabolic Syndrome (EMS) to define this unique metabolic profile. 

A defining trait of EMS is hyperinsulinemia, often paired with insulin resistance. Such horses don't handle carbohydrates well, and this insulin elevation can be tracked to aid in diagnosis and monitoring.

Clarifying EMS: It's Not a Disease 

It's crucial to note that EMS isn't a disease per se. Think of it more like an allergy in humans. Just as someone might be allergic to peanuts or strawberries without being "diseased," a horse with hyperinsulinemia has a metabolic intolerance to specific diets and management methods. This isn't something that can be "cured" but instead managed by understanding and avoiding triggers.

Dietary Management for EMS Horses 

The best approach for horses exclusively with EMS (or those with both PPID and IR) is a mineral-balanced diet low in carbs and fats. 

Avoid giving them grain products and letting them graze freely on pastures until all EMS symptoms have resolved. Choose tested hay or forages below 10% in Ethanol Soluble Carbohydrates (ESC) + Starch, or hay that's been soaked to remove soluble sugars is typically safe for most horses.

Supplements like Missy's Bucket can be highly beneficial in this dietary context. As a vitamin and mineral supplement designed for horses on a restricted diet, Missy's Bucket helps fill nutritional gaps. It supports overall health, making it an excellent choice for EMS management.

However, be careful not to reduce a horse's feed intake below 1.5% of its body weight to decrease its weight. This can aggravate Insulin Resistance and lead to Hyperlipemia, a condition where triglyceride and cholesterol are in the blood, potentially endangering the horse's life, especially in ponies. 

Simply put, it's essential not to starve the horse. Extreme calorie restriction can induce Insulin Resistance.

Recognising EMS and Insulin Resistance 

Look for signs such as: 

• Distinctive fat deposits, like a pronounced neck crest or stubborn fatty patches, which remain even after weight loss. 
• A fatty sheath or udder. 
• A history of laminitis, often triggered by grass. 
• Swelling in the recesses above the eyes. 
• In more severe cases, symptoms might also include excessive thirst and urination, decreased body mass, muscle depletion, and diminished energy. 
• Insulin levels that are higher than average yet have regular blood glucose. Glucose levels might also elevate in advanced instances or when the diet isn't suitable.