EQUINE METABOLIC SYNDROME (EMS)
EMS refers to a collection of endocrine and metabolic abnormalities associated with obesity and the development of laminitis in horses. Faulty insulin metabolism is a key component of EMS and can include both insulin resistance (IR) and hyperinsulinemia (HI). (Insulin is a vital hormone that transfers glucose from the bloodstream into tissues). IR is the failure of tissues to respond appropriately to insulin, while hyperinsulinemia means elevated levels of insulin in the blood. Both IR and HI fall under the new umbrella term Insulin Dysregulation.
- Middle-aged
EMS is first commonly noticed in horses approximately 8–18 years of age - Abnormal fatty deposits (A)
Horses with EMS may have a cresty neck as well as abnormal “regional” fat pads behind the shoulders, over the tail head, and above the eyes - Breed link
More common in “easy keeper” types such as pony breeds, Morgans, gaited horses, Arabians, and warmbloods, EMS is likely to be an inherited trait - Cresty neck (B)
Cushing’s/Pituitary Pars Intermedia Dysfunction (PPID)
PPID refers to a collection of clinical signs due to overproduction of certain pituitary hormones. It is caused by an enlarged and overactive pituitary gland normally kept in check by inhibitory dopamine from the hypothalamus. In addition to obvious changes in hair coat, signs may also include weight/muscle loss, behavioral changes, increased infections, and laminitis.
- Loss of topline (A)
- Loss of muscle (B)
Muscle wasting is common in horses with this condition and may be seen as loss of topline and a rounded abdomen (caused by decreased abdominal muscling) - Hypertrichosis (C)
50% of PPID horses may be affected by a long, curly hair coat that fails to shed - Older age
Clinical signs are most frequently first seen in horses in their mid-teens
Talk To Your Vet
What to do next…
- If you’re concerned that your horse may have one of these conditions, your first step is to talk to your veterinarian.
- In addition to looking at the physical appearance of your horse, your vet may perform diagnostic tests.
- Once your vet makes a diagnosis, work together to design a treatment, dietary, and management plan for your horse’s individual needs.
Hi, My horse has been diagnosed w/both IR and cushings. He also has hypothyroidism. He is currently on Thyro-L, Pergolide, and Evitex by Emerald Valley. So, what are your recommendation? Thanks.
Low starch diet. Nutrena’s Safe Choice Special Care feed and feed a grass only hay that you have tested by Cornell (or Nutrena will send a rep out to test for you) for protein and sugar levels. You may want to soak your hay before feeding to leech out any extra sugars. Your horse should be turned out in a dry lot year round (No green grass). You really need to monitor his/her weight and have a good exercise routine for horse. You may want to add smartpak metabolic and pituitary supplement’s too, just check with you Vet as your horse needs to be on the regular medicine you have listed. 3 month ACTH tests, 6 month Insulin test and X-rays of horses front feet every 6 months too.
Nutrena feed is too high in sugar and starch. You would be better off feeding beet pulp and have your hay tested and mineral balanced
Nutrena’s Safe Choice Special Care has 15% combined sugar and starch. Not suitable for a horse with IR. Would suggest Wendy get involved with the Equine Cushings and Insulin Resistance internet group that Dr. Kellon, VMD has. It’s free and worth its weight in gold for those of us with affected horses.
My Fjord was diagnosed with EMS, why would he have lameness associated with this? What causes the lameness and how can I help him?
The lameness is caused by the horse’s body inability to process/regulate the hormones and insulin levels in his/her body. This causes the blood vessels in the horses hooves to constrict and not allow blood flow to the hoof laminae area. The bottom of hoof may bow outward-this is founder aka laminitis. You may also see a sunken ring on coronary band. The coffin bone in the hoof will begin to sink/rotate in hoof causing severe pain. You need to have your Vet. test your horse to see if the horse is insulin resistance (Glucose test) and have a hormone-Cortisol imbalance (ACTH test). The horse could have both problems. You need to find out which one it is. Also X-rays of the hoof to reveal if the coffin bone has moved. Regardless of what the tests results show you must do the ACTH test every 3 months and the Sugar/Glucose test plus X-rays of hoofs every 6 months to be sure your horse is properly monitored. Your hay should be tested for sugar/protein levels every year too. Your horse needs to be on a low starch diet such as Nutrena Safe Choice Special Care and your horse should be turned out in a dry lot-no grass area year round. If your horse has laminitis Soft Ride boots will help keep him/her more comfortable through each episode of laminitis. Proper Blacksmith care is extremely important too. Smartpak has supplements for both conditions just speak with one of their reps.
My horse is on pergolide for IR and has recently recovered from founder. He has had therapeutic shoeing from Rood and Riddle what do you recommend for supplements.?
Thanks for your question. It sounds like your horse has some serious medical issues but that you’re doing all the right things (great veterinary care, great farrier care). There are a few supplements that might complement program he is on now such as SmartPituitary Senior Pellets and SmartLamina Pellets, but in your case it’s really important to make any changes to the diet after a consultation with the vets you’re working with as well as the farrier. Here are links to the two products so you can read about them, view a list of ingredients, see reviews, etc.
https://www.smartpakequine.com/ps/smartpituitary-senior-pellets-11815
https://www.smartpakequine.com/ps/smartlamina-pellets-12482
– SmartPaker Carolyn
My mom has a 27yr old Qh mare who is really skinny. her ribs are showing. she doesn’t have much of a top line. She has Cushings. So shes on prasend for that. she gets carb guard and plain hay. the barn owner used to soak the hay for her…but she would not eat it. So no more soaking hay. Somestimes she goes out on grass. but not all the time. She is on a dry lot field with 3 ponies.
is there something the mare can get for weight gain?
Our mare has both IR and diagnosisd cushings we have her on pracend and chromium picolonate an NSC pellet smart metabo lean and Teff hay. The long ugly hair with weird coat patterns shed this summer and she looks like a normal horse. The teff hay has made a huge difference. No green grass
Thanks for your question. As horses get older, sometimes different body systems begin to work less effectively, including the digestive system. Add to that the widespread effects of Cushing’s throughout the body and it’s clear that managing an older horse with this disease can be extra challenging. Now more than ever it’s important to have a close working relationship with your veterinarian and to talk through your concerns, what’s working and what’s not, and ask about additional ideas to improve her condition. Your vet may suggest tasty new calorie sources such as beet pulp, alfalfa cubes, or even the pure fat of a supplement like Cool Calories. In addition, he or she may point you towards a specific supplement designed to complement medication such as SmartPituitary Senior Pellets or provide digestive support like SmartDigest Ultra. Here are some links to supporting healthy weight in senior horses that you might find helpful:
https://www.smartpakequine.com/content/older-horse-weight-loss
http://blog.smartpakequine.com/2013/10/senior-feeding-strategies/
– SmartPaker Carolyn
Can you use the smartpak supplements alone or do you still need to use prescriptions along with the supplements
Hi Amber,
Thanks for your question! We’d recommend talking to your veterinarian about the best program for your horse, because they know your horse’s individual needs best.
– SmartPaker Lexi
Cavalor Fiber Force is what I feed. Not available everywhere.
My vet did a blood draw the end of October because he suspected Cushings by her hairy legs. Started her on Pergolide which was a pain to even get in her. The only way I could was to crush it, mix with applesauce in a syringe and orally give it to her….which a majority would be spit out. So I quit giving her the meds when I ran out. It is now May and she looks better than ever. She has been on Seminole Equalizer for 7 months and Alfalfa Cubes and pasture and coastal hay. I also have added SmartPak Ultra Hoof Pellets and treat her soles with Durasole as needed. She is running and moving better than ever. Weight is the best it has been. She is a 24 yr old Quarter Horse Mare. I’m going to continue with this program and see what she looks like next fall. This spring her coat shed out and she has such a beautiful shiny coat now.
Hello Friends,
My beautiful Cocoa is a rescue who was abandoned for EMS and was suffering terribly when I met her. Upon 1.5 years into our journey, I am happy to share my experience. Cocoa is an Icelandic at 14H. She is approx. 17 years aged. At rescue, her front hooves were convex and Xrays showed a 15 degree rotation. She would founder periodically and was lame often with abscessing. We did some drastic farrier work. She was quite lame and suffered. My vet recommended to put her down. I was honest to know she had not been given a real chance to be nourished and cared for properly therefore I refused that advice and sought another vet and changed farrier. Xrays showed an even further deterioration of a sunken P3 with a sunken hoof at the coronet band. I discovered SmartPak in my research to save Cocoa. The laminar supplements, hoof supplements, senior supplements are key to our success. I give Legends Carb Control Senior Grain daily. The 6 acre, minimal pasture grass allows 24hr turnout with her lifelong pasture mate, Checkers.
Coastal Bermuda Hay is given to the recommended amount per the body weights. Our results are so promising! Top line and body score has improved greatly. Most importantly we have worked through laminitic episodes to grow out new hoof capsules. I have massaged her shoulders and SI joint muscles and hind quarters to her benefit following periods of muscular overcompensation while lame. I am so proud of her progress! Cocoa has a visibly happier expression and despite more work ahead; she is a lovely horse. I have avoided Bute and used Aspirin when really needed. Another very key ingredient to her comfort is the discovery of and 24hr use of Soft-Ride Boots.
Myself, our Vet and Farrier form ‘TEAM COCOA’. The 4-5 week maintenance is crucial and I will never forget their huge hearts and love for their professions. Thank you to SmartPak for the wonderful nutritional assortment and wealth of research available to customers like myself. As of last week’s Veterinary checkup, the Dr. was so impressed and pleased with our progress! I am very encouraged!
I know this an older post, but it was so helpful to read. I have a 30 year old mare who would not leave her stall 7 weeks ago and could not walk. They determined that she had foundered. She was tested and found to have Cushings and started on Prascend. She did not recover and 3 weeks into the process I asked for radiographs. At that time, there was no rotation and I called in a podiatrist. He said it was laminitis but not that bad. Her food was switched to Crypto Aero Wild Forage and we started Heiro. She seemed to improve on left front, but right front got worse. Again, 3 weeks later the podiatrist came out and noticed oozing above her coronary band and immediately did a further radiograph. She had rotated to about 13 degrees and had an obvious infection in her lower leg. The general vet came out because of the infection and did further radiograph and said she had sunk and needed to be pts. I denied that and asked to have the infection treated and further testing for Lyme and re-test ACTH. The podiatrist did review the radiographs and did not concur that she had sunk, but did recommend that further padding be put under her foot to deal with a loss of her soul. I had been sent a SmartPak supplement which I have been using also and I believe it seems to be helping her recover. I needed to read Cocoa’s story!