Horse Care

What is Equine Metabolic Syndrome (EMS)?

Equine Metabolic Syndrome (EMS) is a condition in horses characterised by a group of metabolic abnormalities that increase the risk of developing laminitis.

It’s similar in some ways to metabolic syndrome in humans, which is a risk factor for diabetes and cardiovascular disease.

EMS is particularly prevalent in pony breeds and certain horse breeds that are “easy keepers,” meaning they gain weight easily and are prone to obesity.

The primary components of Equine Metabolic Syndrome include:

  1. Insulin resistance: The cells in the horse’s body become less responsive to insulin, which is the hormone responsible for regulating blood sugar levels. As a result, the pancreas produces more insulin to compensate, leading to hyperinsulinemia.
  2. Obesity or regional adiposity: Horses with EMS often have generalised obesity or fat deposits in specific areas like the neck (“cresty neck”) or tailhead. However, it’s worth noting that not all obese horses have EMS, and not all horses with EMS are overtly obese.
  3. Predisposition to laminitis: The metabolic changes and high insulin levels increase the risk of developing laminitis, a painful and potentially crippling condition affecting the hooves.

Diagnosis of EMS typically involves clinical assessment, blood tests to measure insulin and glucose levels, and sometimes additional tests like an oral sugar test or an insulin sensitivity test.

Imaging studies may also be conducted to assess the state of the hooves, especially if laminitis is suspected.

Management of EMS involves:

  • Dietary changes: A low-carbohydrate and low-sugar diet is usually recommended to improve insulin sensitivity. High-fiber forages and feeds that are specifically formulated for metabolic issues may be advised.
  • Exercise: Physical activity is crucial for improving metabolic function and aiding in weight loss. However, exercise regimens need to be tailored to individual horses, especially if they have other conditions like laminitis.
  • Medication: While there are no drugs specifically approved for treating EMS, medications like metformin may be used off-label to improve insulin sensitivity in some cases.
  • Regular monitoring: Blood tests, weight measurements, and body condition scoring are generally performed at regular intervals to assess the effectiveness of the management plan and make any necessary adjustments.

If left untreated, EMS can lead to a range of complications including recurrent laminitis, which can have serious long-term implications for a horse’s health and quality of life.

Early diagnosis and proactive management are crucial.

A horse with EMS can still live a long and healthy life so long as the condition is taken into consideration and the horse’s diet and lifestyle are managed well.

What does treatment and management include for an EMS horse?

EMS is primarily managed and treated through a combination of dietary management, exercise, and sometimes medical therapy, although it’s important to note that there is no government-approved drug to treat EMS.

Here’s a breakdown of the treatment and management approaches based on various reputable sources:

  1. Dietary management:
    • The cornerstone of managing EMS involves dietary modifications. Restricting non-structural carbohydrates (NSC), sugar, and total calorie intake is crucial. This can be achieved by feeding soaked hay (note: soaking hay leeches out nutrients as well as sugars, so this isn’t always a good idea), providing a low-calorie balancer, or eliminating pasture access to control the horse’s caloric intake and prevent obesity​.
  2. Exercise:
    • Regular exercise can help reduce body weight and insulin levels, which is vital for managing EMS. Implementing an exercise program tailored to the individual horse’s needs can assist in weight management and improve insulin sensitivity​.
  3. Weight management:
    • Keeping the horse at a healthy weight is crucial to decrease the risk of developing EMS. This involves a combination of dietary management and an exercise program to ensure that the horse maintains a healthy weight or loses weight if necessary​.
  4. Medical therapy:
    • In cases where diet and exercise alone are not sufficient, medical therapy may be needed. Although there isn’t a specific government-approved medication for EMS, a veterinarian might prescribe certain medications to manage symptoms or complications arising from EMS​.
  5. Supplementation:
    • Supplements may also be used to support normal metabolic function, although they should be used under the guidance of a veterinarian to ensure they are safe and effective for the individual horse​.
  6. Monitoring and regular veterinary check-ups:
    • Regular monitoring of the horse’s body condition and regular veterinary check-ups are crucial to effectively manage EMS and adjust the treatment plan as necessary.
  7. Education and awareness:
    • Owners and caretakers should be educated about EMS, its risks, and the necessary management strategies to prevent and treat this condition.

Each horse is unique, and what works well for one horse may not work for another.

A customised approach under the guidance of a veterinarian is essential for the successful management of EMS in horses.

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