Equine Metabolic Syndrome (EMS)

“Laminitis causes pain and suffering, and it is imperative that we focus effort on diagnosing and managing Equine Metabolic Syndrome in order to prevent this devastating disease from occurring.”

– Nicholas Frank, DVM, PhD, DACVIM


Currently, there is no FDA-approved treatment for EMS (hyperinsulinemia) in horses. If left untreated EMS can lead to the life-threatening condition, laminitis.


EMS is a condition of altered glucose homeostasis and fat metabolism in ponies and horses characterized by obesity, regional adiposity, and laminitis. The underlying pathophysiology of EMS is due to relative resistance or insensitivity of the tissues to insulin (insulin resistance) which results in a variety of physiologic changes at the tissue level. Equine laminar tissue appears to be particularly sensitive to these physiologic alterations, and laminitis is a common and potentially life-threatening sequela of EMS.

equine metabolic syndrome, egus
United States Department of Agriculture has estimated that approximately 5% of the U.S. horse population is overweight or obese. This estimate was based on an owner survey (The USDA –NAHMS 1998)
Insulin dysregulation is the key component of equine metabolic syndrome (EMS), a collection of risk factors associated with the development of laminitis in horses and ponies.2
Horses with insulin dysregulation have higher than normal insulin concentrations (hyperinsulinemia) when feeding and laminitis is thought to develop when hyperinsulinemia occurs for extended periods of time in horses and ponies grazing on pasture. Evidence for an association between hyperinsulinemia and laminitis was first presented by Treiber et al.2 when this group determined that ponies with higher insulin concentrations were more likely to develop pasture-associated laminitis.
3 out of 4 horses/ponies with EMS have an appearance of a cresty neck1
Two-thirds of horses/ponies with EMS have had laminitis or obesity1

If you are concerned that your horse may be suffering from EMS or want to learn more ways to prevent it please talk to your veterinarian.
1Wise Insights, July, 2016. Data on file at KindredBio
2Chameroy KA*, Frank N, Elliott SB. Comparison of plasma active glucagon-like peptide 1concentrations in normal horses and those with equine metabolic syndrome and in horsesplaced on a high-grain diet. J Eq Vet Sci 2016 May;40:16–25.