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The Dummy's Guide to Equine Metabolic Syndrome

Tess Lawrence - Sunday, June 29, 2014

Here at Stance, we've created a culture to educate and help horse owners in need. Recently, we have had a call to action to produce some easy to understand information on Equine Metabolic Syndrome (EMS) and insulin resistance, so here is the result! We understand that most horse owners aren't scientists or academics, so we have endeavored to create the ultimate 'Dummy's Guide to Equine Metabolic Syndrome'.

We hope this blog breaks down the issues you really need to know about in an easy to understand, usable text. As always, if you do have any questions about the topic, or simply wish to know more, please email us here- we're happy to help!

What is Equine Metabolic Syndrome?

Equine Metabolic Syndrome (or EMS) is a condition that can describe a myriad of ailments. To a large extent, conditions that fall under this heading are caused by insulin resistance, a term that is popping up more and more in the horse world. Insulin resistance in horses is essentially the equine form of diabetes, and may be a major contributor to both Cushing's and Laminitis- both of which carry serious consequences. 

While this condition may be a genetic dysfunction, more often than not insulin resistance is caused by a diet that is too rich in non structural carbohydrates (NSC). NSC are the digestible carbohydrates, or sugar and starch in feed- the equivalent to the glycemic index (GI) in human food. They are measured by calculating the water soluble carbohydrates and starch of a feed. It is now thought that feeds with more than 12% NSC may increase the chance of insulin resistance, particularly if exercise levels are low.

Insulin resistance effects the normal process that a horses body would take when digesting a meal. Normally, when horses eat, the pancreas will release insulin to assist the liver cells and muscles absorb the glucose in the food, and the blood glucose levels will subside quite quickly. When the body becomes insensitive to insulin, blood glucose levels may remain elevated for a prolonged period of time.

Read on for a breakdown of how Insulin Resistance can occur:

  1. The horse ingests high levels of NSC in their feed, which is absorbed into the blood as glucose.
  2. The pancreas produces a normal amount of insulin to signal to the liver cells and muscles to absorb and break down the glucose.
  3. The liver cells and muscles, which have become dull and unresponsive, don't recognise to the signals from the pancreas to absorb the glucose.
  4. The pancreas continues to pump out insulin, flooding the body and increasing the amount of time it will take for the blood glucose levels to return to normal levels, if they do at all.
This process of an insulin resistant mimics what humans generally know as an 'insulin spike', and this is why horses with insulin resistance can often be overweight or obese.

Symptoms of Insulin Resistance

  • One of the most prominent, telltale signs of insulin resistance, is the appearance of abnormal fatty deposits. These mostly appear on the crest of the neck, the rump and just above the horses eyes. The horse below shows the typical areas where the fatty deposits sit.

  • Another possible symptom is a gluttonous appetite, which stems from the insulin spikes discussed earlier. Although this may simply be a 'healthy appetite', if your horse is suddenly becoming ravenous and displaying other symptoms associated with insulin resistance, it might be worth closely monitoring.

  • Symptoms of Cushing's Syndrome- such as a thick wavy coat, excessive thirst, excessive, large amount of urination and general lethargy and decreased immune system function. A horse with Cushing's is not always insulin resistant, but it is a common occurrence. The below picture is a typical Cushingoid coat.
  • Symptoms of Laminitis- Most laminitic horses are typically also insulin resistant. One of the biggest signs of a horse or pony that is suffering laminitis is their stance. Rocked back on their haunches, so as to take the weight off their very sore and tender front feet. Check out the picture below to see this stance. Read one of our previous blogs here, to find out more about laminitis and founder.

These symptoms are not conclusive of insulin resistance, nor is list exhaustive of all possible signs. These are common symptoms, however a veterinary professional should always be consulted to make a diagnosis!

How to manage insulin resistance

If your horse is diagnosed with EMS or insulin resistance, don't give up- there are some very easy ways that you can manage their condition. We learned earlier that this syndrome is often caused or inflamed by feeds with a high NSC content. Some simple feeds, like corn and oats contain over 40% NSC- not something that is often advertised. The tables below lists some other common feeds in the USA and Australia and how much NSC they contain;

As you can see, Stance Equine CoolStance premium copra meal comes in at the lowest end of the scale in both tables, with 12% NSC, which is recommended for horses with insulin resistance. Stance also recommends to check the NSC content in the roughage that you choose for your horse. Some hays, like Timothy hay, have been found to contain over 30% sugar by Rocky Mountain Research. Medium quality grassy hay generally has lower levels of sugars and starch, which may be more suitable for EMS horses. 

Another important step to managing horses with insulin resistance, particularly given the fact that many of these horses can be prone to being overweight, is adequate exercise and turn out time. Diet is no substitute for exercise, nor vice versa. If you aren't able to turn out your horse at times, make sure they are getting their exercise by being ridden or otherwise exercised as much as you can. Another way to encourage horses to be active in their paddocks is to give them something to play with. Most horses are naturally inquisitive, and if given a simple toy like a soccer ball, or even an empty milk bottle with a cut up carrot in it, they can spend a substantial amount of time chasing it around, and 'having a ball' (pun intended)! These activities also stimulate their brains, which is always a good thing!

To conclude, the most important thing you can do for your horse, whether it has EMS or not- is to continually monitor them- their physical appearance, their diet and their behaviour. Just like you would with your children, set them up NOW with good diet and exercise practises for the future. If you do have a horse that you suspect might be insulin resistant, seek veterinarian advice. And remember- you are not alone in your journey with your insulin resistant horse! Here at Stance, we're constantly investigating new ways to assist horses with these conditions, and we encourage everyone to actively seek this information from us. We are not only your feed supplier, but your fellow horse owner, and we often have the same issues that you do. We hope this blog has acted as a guide to insulin resistance and how to manage it!

 Good luck, and happy riding! 


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CoolStance copra is a unique horse feed because it has low Non Structural Carbohydrate (NSC), and yet has a high digestible energy content.
Learn More



PowerStance is a unique powdered coconut oil supplement.  PowerStance delivers the secret ingredient from CoolStance as a powder.
Learn More