EMS (Equine Metabolic Syndrome)

• EMS is the most common metabolic disease in horses
• Typical signs include fat deposits on the crest of the neck, around the hips and at the tail head
• Management of diet and exercise is particularly important for treatment
• Early detection is particularly important to prevent laminitis

Together with PPID, equine metabolic syndrome (EMS) is one of the most common metabolic diseases in horses. In this disease, excess fat tissue usually triggers an inflammatory response in the body by producing hormones and inflammatory mediators.

Part of the clinical picture is impaired insulin regulation, which shows as insulin dysregulation or insulin resistance.

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Typical signs of EMS are regional fat deposits, mainly on the crest of the neck, around the hips and at the tail head, although fat can also be distributed over the whole body. Insulin dysregulation or insulin resistance leads to increased insulin secretion, which markedly raises the risk of laminitis. Laminitis is often the reason why EMS is investigated in the first place.

EMS often develops gradually and insidiously. It starts with subtle insulin dysregulation, which over a longer period leads to progressive fat accumulation and metabolic disturbance. Without timely treatment, this can eventually lead to recurrent episodes of laminitis, which can have serious consequences in advanced stages.

The diagnosis of EMS is based on a thorough clinical examination combined with a detailed history. The history often already points to EMS, even though not all affected horses appear overweight. To confirm the diagnosis, various tests are used to detect or rule out insulin dysregulation or insulin resistance. These include blood tests measuring glucose and insulin levels, and dynamic tests such as the oral sugar test.

Treatment of EMS focuses primarily on adapting diet and exercise. A specially formulated diet with reduced sugar and starch content is essential to control insulin levels. This is supplemented by a targeted exercise program to regulate body weight and improve insulin sensitivity. Exercise should only take place when the horse does not have acute laminitis.

The prognosis for EMS depends largely on whether laminitis has already occurred. If EMS is detected early and management is adapted, laminitis can often be prevented. If laminitis is already present, the prognosis depends on its severity. In severe cases, laminitis can even lead to euthanasia. Early detection and optimized feeding and exercise are therefore very important.