Equine Metabolic Syndrome (EMS)

Endocrine and MetabolicEquineNew

Key Points

Equine metabolic syndrome (EMS) is an endocrine disorder characterised by 3 key features: insulin dysregulation, generalised or regional adiposity and high risk of laminitis
- Hyperinsulinaemia is the key driver of EMS-associated laminitis
Native breeds and ponies are especially at-risk
Clinical signs include regional adiposity or obesity, recurrent laminitis, reluctance to exercise or turn and hoof sensitivity
Diagnosis requires confirmation of insulin dysregulation through dynamic tests such as the oral sugar test (OST)
Treatment is primarily management-focused with weight control, low-NSC diet and controlled exercise if sound
- Medications such as metformin may be used as adjuncts but are not sole treatments
Diet control, weight management and careful monitoring of at-risk animals are essential for prevention

Differential Diagnoses

Pituitary pars intermedia dysfunction (PPID)
Obesity
Non-endocrinopathic laminitis

Educational content only. This factsheet is for general veterinary education and is not a substitute for professional veterinary advice, diagnosis, or treatment. Not for use in an emergency — contact a veterinarian or emergency service. Full disclaimer →