Equine Metabolic Syndrome

Management of dietary intake is the MAIN treatment for EMS

1) Minimise sugar/starch intake:

• Stop all treats, fruit and vegetables - these are all high in sugar/starch
• Avoid grains or cereal based feed – when choosing feeds for your horse please discuss with your vet and feed store. The key is to think about what your horse actually needs!
• Don't overfeed - Many native breeds and cobs require little additional feed on top of their forage. 
• Avoid sugary food - try to find feed with a combined sugar and starch content LESS than 10%.
• Feed poor quality hay– avoid grass, haylage, and good quality hay.

2) Manage Forage Intake:

• Use poor quality hay where possible – forage analysis can be useful to ascertain the sugar content of your forage.
• Restrict intake: 1.5% of your horse’s bodyweight in dry forage over a whole 24 hour period (i.e. 7.5kg of hay for a 500kg horse is sufficient for 24 hours)

Try to slow your horses eating so that this lasts for the whole 24hour period:

• Split forage between several nets that are given throughout the day
• Double net hay to slow intake
• Hang the net away from the wall (but be careful that the horse can’t get caught in the net)
• Soaking forage reduces the glucose and therefore your horse’s insulin response to eating it. Soak forage for approximately 12hours – remember you must swap the water each time you soak!
• Grazing & turnout

 ALWAYS consult your vet before introducing grazing/turnout in EMS horses. In general grazing should be avoided until your horse’s EMS is well controlled, or unless advised by your vet.

Grazing should be included in your forage intake (calculated above) – i.e. it is included in your 1.5% bodyweight dry matter intake. 

• When grazing your horses forage intake is massively increased and even restricting time out has limited effect due to gorging!
• Grazing muzzles are VERY effective at controlling forage intake, and also has the added benefits of increasing exercise and foraging time (reducing risk of gastric ulcers!)

Exercise MUST be avoided in horses with current or very recent laminitis episodes.

• High intensity exercise is a very effective way to help weight loss and management of EMS. 

1. Remember to gradually increase your exercise regime according to your horses current fitness!
2.  Healthy laminitic horses with EMS should do a MINIMUM of 30 minutes of canter or intense trotting 5 times per week 
3. If your horse has a history of laminitis then you should first consult your vet to ensure that exercise is appropriate. Lower intensity exercise is recommended in these cases. Minimum recommendations are at least 30 minutes of fast trot or canter, 3+ times per week, on a soft surface unridden. 

Most horses DO NOT require medical treatment. Your vet will discuss medical options if required.

•  In general many EMS horses can be managed without medical treatment. 
• Medications that may be advised by your vet include:

Metformin:

• Reduces absorption of glucose. 

• Ideally given twice daily 30-60 minutes before food via syringe into mouth, or given in food.

Levothyroxine:

• Increases your horse metabolic rate, to improve weight loss.

• Given once daily into the mouth.