What is Equine Metabolic Syndrome (EMS)?

EMS is an endocrine (hormonal) disorder in horses, similar to metabolic syndrome in humans, that is characterized by obesity, insulin resistance, and regional adiposity (abnormal fat deposits), which can predispose affected horses to chronic  laminitis.

What types of horses are affected? 

First and foremost, most horses do not suffer from EMS.  Most horses tolerate dietary carbohydrates (e.g. NSC, starch, sugar, fructan) quite well, and thrive on this important and readily available source of energy.   Performance horses in particular need sufficient NSC in their diets for work and recovery after exercise.  Too little starch and sugar in the diet can actually diminish athletic performance over time in non-EMS horses.

Tess the pony indulges

That being said, EMS can occur in any breed, however ponies, Morgans, Paso Finos, and horses that tend to be “easy keepers” seem to be most vulnerable to developing EMS.  It should also be noted that not all obese (fat) horses are insulin resistant, and not all insulin resistant horses are fat.

How do I know if my horse is insulin resistant (IR)?

Veterinary diagnostic testing (blood work) is recommended to confirm IR, but here are some other classic signs of insulin resistance in horses and ponies:

  • A classic sign of IR is a “cresty neck”, of which a clear correlation between neck circumference and IR has been documented.
  • Horses with regional deposits of lumpy or dimpled fat pads (e.g. behind the shoulder, around tailhead, over the loin), are suspect of being IR.
  • Horses that seem to gain weight rapidly, or blow up easily, particularly in spring with new pasture growth, relative to other horses may indicate IR.
  • Horses that are tender footed, and/or that demonstrate rings on the hoof wall, expanded white line and blood spots on the soles of their feet,  suggests mild, chronic bouts of laminitis and IR.

EMS is easily confused with other clinical disease such as Cushing’s Disease (a.k.a. pituitary pars intermedia dysfunction) and hypothyroidism due to similar clinical signs, despite different underlying causes.  It is very important to work with a trusted vet to ensure an accurate diagnosis if any of these conditions are suspected.

A word of caution, single blood samples for the diagnosis of IR can be very unreliable and misleading as several factors unrelated to EMS influence glucose and insulin levels (time and content of horse’s last meal, type of feed horse is adapted to, time of day sample is collected, stress level of horse), leading to false conclusions.  Taking multiple blood samples over several days, or utilizing techniques such as the euglycemic insulin clamp or a combined glucose insulin tolerance test (CGIT) are more involved, but can lend more validity to the lab analysis.  In any case, early detection of EMS and other endocrine disorders is preferable.

11 Replies to “What is Equine Metabolic Syndrome (EMS)?”

  1. my Morgan has been diagnosed with laminitis, he is off pasture andis fed 1 cup of grow n win twice a day along with some hay that has beenwatered down for 12 hrs. does Nutrena have a feed that is comparable or better?

    1. Hello Annie, Thank you for your question. Assuming your horse is in good flesh and maintaining well on the current diet, we would recommend Empower Balance.

      As a side note, we would encourage you to read this article on hay soaking. The length of time you are soaking your hay is longer than recommended, which introduces risk of microbial growth. No need to soak more than 1 hr in cold water or 30 min warm. Just drain off the liquid well afterwards, or you could find a source of tested hay that has a low NSC value (under 15% NSC).

      Good luck, and let us know if you have further questions! Thanks ~ Gina T.

  2. Will Nutrena offer help choosing the right feed and quantity of feed for a horse if the owner has a current hay analysis to work off of? I have always fed Nutrena feeds and been very happy with them. However I have a 10 yo QH gelding who was recently diagnosed with EMS and I am looking to get him on a more balanced feed program that more adequately provides for his vitamin/mineral needs without the added calories.

    1. Hi Pat, thanks for your question. Both products are low in starch and sugar, or non-structural carbohydrates (NSC), Empower Balance being the lowest. The major difference in the two products is the digestible energy content, or calories. Safe Choice Special Care is higher in calories compared to Empower Balance. Empower Balance is a low calorie ration balancer, providing amino acids, organic trace minerals, vitamins, pre- and probiotics in a concentrated form, designed to balance and compliment the nutrition coming from forage. Because Empower Balance is concentrated, the feeding rate (lbs per day) is much lower compared to Safe Choice Special Care. For horses needing additional calories above what the forage component of their diet is providing while keeping the diet balanced, Safe Choice Special Care would be a great choice. For horses that are overweight, or doing just fine with the forage they receive and not needing extra calories, but would benefit from balancing the total diet with regard to amino acids, vitamins, minerals, Empower Balance would be a good fit.

      Here are a couple of common scenarios to consider when deciding what product design best fits your horse’s needs. If you find that your horse is gaining too much condition on Safe Choice Special Care at the recommended feeding rate, or you are feeding below the minimum recommended feeding rate per your class of horse, then it would be appropriate to switch to a ration balancer like Empower Balance. The horse would still benefit from the balanced nutrition, as well as pre- and probiotics, without the NSC. If you find that your horse needs more energy, or needs to gain body condition, despite feeding adequate amounts of good quality forage (recommend having forage tested especially for special needs horses), than SafeChoice Special Care would be a great solution to balance the diet, provide pre- and probiotics to support gut function, and provide additional calories coming from digestible fiber and fat that a special needs horse can use well. Estimating the horse’s target body weight and doing a body condition score are great tools to help determine which feed is best for your horse as well as how much to feed them based on manufacturer recommendations.

      Kind Regards,
      Emily Lamprecht, Ph.D.

  3. My senior horses , have been fed alfalfa hay for some months and have just had grass hay added to their diet.they also get neutrana safechoice senior Both have cushings and are on presend once a day. Is this an a good diet girl them?.

    1. Hi Karen,

      Thank for your question. Yes, this sounds like you are doing all the right things. First and foremost, I recommend working with a trusted vet if you have any concerns or questions with your horses health and any changes you may notice.

      From a nutrition standpoint, the basis of the diet should be forage as long as your horses can chew grass and hay pretty well, which sounds like this is the case. SafeChoice Senior is also a great choice for horses that can chew, and need a complete feed that mashes easily to make up for their inability to chew and consume adequate amounts of forage.

      For any horse that has challenges with NSC or starches and sugars in their diet, I strongly recommend getting every load of forage tested (Nutrena does provide this service upon request) due to the high variability of nutrients and quality from cutting to cutting and between species. Providing good quality hay (digestible and palatable to the horses) is very important. We recommend that the water soluble carbohydrate (WSC) + starch content be under 15% in forages to avoid exacerbating an insulin resistance, which is a common clinical symptom of Cushings. For a horse in good body condition, good quality hay (RFV of 102 or higher on an analysis) should be provided at a minimum of 2% of the horses bodyweight per day.

      Secondly, ensuring that the proper amount of Safechoice Senior is being provided per day per your horse’s body weight and desired body condition. A guide to estimating bodyweight and body condition can be found on our blog site http://www.horsefeedblog.com/ . Under feeding a Sr. feed is a common mistake, and can result in a nutrient (amino acids, minerals, vitamins) and energy deficits. As an example, a 1200 lb horse that can eat adqate amounts of forage should receive 6 – 8.5 lbs of SafeChoice Senior per day, divided up into 2 or more meals. Depending on hay quality and horse’s condition, these feeding rates should be adjusted accordingly. If you find you are feeding below or over manufacturer’s recommendations, an adjustment should be made to ensure diet is properly balanced. Feed should be weighed, as it is very difficult to estimate how much a scoop or serving of feed weighs (lbs or kg) by looking at it. There are feed scales available on Nutrena’s e-store for under $5.00. http://nutrena.corpmerchandise.com/ProductList.aspx?did=19287
      Other than that, access to fresh water and white salt should be provided at all times.

      There are more tips on how to manage horses with Cushings, and senior horses on our blog. Please don’t hesitate to reach out with any further questions or concerns. Happy trails.

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