Equine Metabolic Syndrome

Veterinary Wellness Partners • August 21, 2025
Veterinary Wellness Partners

Equine Metabolic Syndrome and Weight Management

Is Your Horse Overweight?


Does your horse carry extra weight, have a cresty neck, or fat deposits around the tail head? These are common signs that your horse may be at risk for Equine Metabolic Syndrome (EMS), also known as insulin resistance in horses.


Carrying excess weight doesn’t just affect appearance—it puts strain on your horse’s joints and increases the risk of serious health conditions, especially laminitis (founder).


What Is Equine Metabolic Syndrome?


Equine Metabolic Syndrome is a hormonal and metabolic disorder where the horse’s body cannot properly manage sugar (non-structural carbohydrates, or NSCs) in the diet. This leads to:

  • Insulin resistance – the body overproduces insulin after eating sugars and starches.
  • High insulin levels – a key trigger for laminitis.
  • Increased fat storage – especially in the neck, rump, and shoulders.

Unlike some conditions, EMS is not something we can “medicate away.” Management relies heavily on diet and exercise.


Which Horses Are Most at Risk?


Any overweight horse can develop EMS, but certain breeds are predisposed, including:

  • Ponies
  • Morgans
  • Paso Finos
  • Warmbloods

Although less common, even horses at a healthy weight can sometimes develop EMS and insulin-related laminitis.


How to Manage EMS in Horses


1. Diet Management


The cornerstone of EMS management is controlling sugars and starches (NSC levels) in your horse’s diet.


Test your hay: Knowing the NSC level of your forage is critical. If hay tests high, you can either source lower-NSC hay or soak hay to reduce sugar content.


Choose low-NSC feeds: Avoid high-starch grains like oats. Instead, consider alfalfa pellets or specially formulated EMS-safe commercial feeds.


Control pasture access: During grass season, use a grazing muzzle or provide turnout in a dry lot to limit sugar intake from lush grass.


2. Exercise and Movement


Consistent physical activity helps improve insulin sensitivity and supports healthy weight management. Exercise programs can include:

  • Hand-walking
  • Trail riding
  • Round pen or lunging sessions


The key is consistency, even if the exercise is light.


Can Supplements Help?


Many supplements claim to reduce insulin levels, but as of now, none are proven by scientific studies. Relying solely on supplements without diet and exercise changes will not control EMS.


Diagnosis and Veterinary Support


If you suspect your horse may have EMS, your veterinarian can perform specific blood tests to confirm the condition. At Orrville Veterinary Clinic, we can also create a personalized nutrition and exercise plan tailored to your horse’s needs.


Key Takeaways for Horse Owners

  • Overweight horses are at high risk for EMS and laminitis.
  • Diet and exercise are the most effective ways to manage EMS.
  • Forage testing and careful feed selection are essential for keeping NSC levels low.
  • Veterinary guidance ensures safe and effective management.

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