Sweet but Sour: The Metabolic Mayhem of EMS in Horses

Equine Metabolic Syndrome (EMS) is a common endocrine disorder in horses characterised d by insulin dysregulation, abnormal fat deposition, and a predisposition to laminitis. It often affects middle-aged horses but can occur at any age.

Causes of EMS

1. Genetics: Certain breeds, like ponies, Arabians, Morgans, and Andalusians, are more prone to EMS.

2. Obesity: Excess fat tissue, particularly in the crest of the neck or around the tailhead, is a significant risk factor.

3. Diet: High sugar and starch intake contribute to insulin resistance.

4. Physical inactivity: Lack of exercise exacerbates weight gain and insulin dysregulation.

5. Environmental Factors: Seasonal changes in pasture grasses, especially spring or fall, can trigger laminitic episodes.

Pathology

1. Insulin Dysregulation

Hyperinsulinemia:

Horses with EMS often have high levels of insulin in their bloodstream, even when glucose levels are within normal limits.

This hyperinsulinemia is a result of insulin resistance, where tissues (such as muscles and liver) fail to respond effectively to insulin’s action of facilitating glucose uptake.

Insulin Resistance:

Insulin fails to effectively lower blood sugar levels, prompting the pancreas to produce more insulin.

Over time, this creates a cycle of elevated insulin and glucose, leading to metabolic stress.

EMS involves:

1. Insulin Dysregulation:

Horses with EMS exhibit excessive insulin production (hyperinsulinemia) in response to glucose intake.

Insulin resistance (cells fail to respond to insulin normally).

2. Abnormal Fat Metabolism:

Adipose tissue in horses with EMS produces inflammatory cytokines, leading to low-grade inflammation and further insulin resistance.

3. Laminitis:

The most concerning outcome is laminitis, where the sensitive laminae in the hoof are damaged, causing pain, lameness, and in severe cases, structural damage to the hooves.

Herbal and Naturopathic Treatment for EMS

1. Herbs

Cinnamon: May help improve insulin sensitivity.

Fenugreek: Supports glucose metabolism.

Milk Thistle: Protects the liver and helps process fats and sugars.

Nettle: A natural blood sugar regulator and anti-inflammatory.

Burdock Root: Supports liver function and glucose regulation.

Ginkgo Biloba: Improves circulation, particularly in laminitic cases.

2. Supplements

Magnesium and Chromium: Enhance insulin sensitivity.

Omega-3 Fatty Acids: Found in flaxseed or fish oil, reduce inflammation and improve metabolic function.

Vitamin E and Selenium: Support immune and muscle function.

Probiotics: Promote healthy gut flora, which is essential for overall metabolism.

3. Dietary Adjustments

Low-Starch, Low-Sugar Diet:

Eliminate grains and high-starch feeds.

Replace with low-NSC (non-structural carbohydrate) forage.

Soak hay to remove sugars if needed.

Controlled Pasture Access:

Limit grazing, especially during times of high grass sugar (morning and after frosts).

Small, Frequent Meals: Helps regulate glucose levels.

4. Exercise

Gradual and consistent exercise improves insulin sensitivity and promotes weight loss.

Start with walking for obese or laminitic horses and increase intensity as the horse improves.

Treatment Progression

1. Initial Phase (1-2 months):

Transition to a low-starch diet.

Begin herbal supplementation and ensure proper mineral/vitamin balance.

Implement weight control measures like restricted grazing or soaked hay.

Address acute laminitis with veterinary intervention if present.

2. Mid-Phase (3-6 months):

Reassess body condition and insulin levels with your vet.

Gradually introduce regular exercise if not already implemented.

Continue herbal and dietary management.

3. Long-Term Maintenance:

Monitor weight, hoof health, and insulin status regularly.

Adjust diet based on pasture conditions and metabolic changes.

Prevent relapses by maintaining strict dietary controls and exercise.

Important Notes

Always work with your veterinarian to confirm the diagnosis and develop a treatment plan.

EMS management is highly individualised; what works for one horse may not suit another.

Natural remedies should complement, not replace, conventional treatment.