Managing Equine Metabolic Syndrome Naturally
Equine Metabolic Syndrome has become increasingly common among our beloved horses, and as caring owners, we often feel overwhelmed when faced with this diagnosis. At Equell, we understand how EMS affects horses and have developed nutritional blends that can help to support their wellbeing alongside veterinary care. If you’re asking yourself - what is a metabolic horse or what to feed a horse with EMS, read on!
What Is Equine Metabolic Syndrome or what is EMS in horses?
There appears to be a genetic disposition to EMS but it is not understood why some develop it and others do not.
What are the signs of EMS in horses?
Early signs of EMS in horses are usually things noticed by owners such as cresty necks. However symptoms include:
- Insulin dysregulation
- Obesity (body condition score >6 out of 9)
- Increased fat deposits ("cresty necks", fat over tailhead/ribs). Not all horses with EMS are overweight, insulin dysregulation can occur in thinner individuals and a high BCS does not automatically mean they will have EMS.
Through our years working with horse owners, vets and equine nutritionists, we've learned that EMS symptoms can be subtle initially. The most obvious sign is regional adiposity, where fat accumulates in specific areas regardless of the horse's overall body condition. The cresty neck is often the first area owners notice, but fat deposits can also appear behind the shoulders, around the tailhead and above the eyes.
Insulin resistance, whilst invisible, creates significant internal challenges. Horses may seem lethargic or lack their usual enthusiasm for work. Some develop a dull coat or show delayed shedding patterns. These seemingly minor changes often indicate the metabolic struggles occurring beneath the surface; struggles which occur long before any signs are shown.
What are the risks of EMS?
Laminitis represents the most serious complication of EMS. This painful condition affects the sensitive structures within the hoof and at best requires swift, careful (and often longterm) tailored management. At worst it can result in death. Laminitis can occur in all equines and can be triggered as a result of stress, steroids and other causes not just diet or obesity. However horses with EMS face an increased risk of developing laminitis episodes, particularly when exposed to high-sugar feeds or lush pasture.
Liver damage - When horses with EMS stop eating, their bodies release large amounts of stored fat into the bloodstream for energy. If too much fat floods the liver at once, the liver can’t process it (a condition called hyperlipemia). Fat then begins to accumulate in the liver, causing liver dysfunction, worsening how the horse feels and reducing appetite even further. This creates a dangerous cycle: the horse doesn’t eat, more fat is mobilised, and the liver becomes increasingly overwhelmed. Without prompt veterinary intervention, this metabolic spiral can quickly become life-threatening.
How is EMS diagnosed?
Diagnosing equine metabolic syndrome (EMS) usually starts with simple blood tests that measure glucose and insulin levels. These samples are typically taken first thing in the morning before feeding, as eating naturally causes insulin and glucose spikes. If a horse's insulin level is above a set threshold, they are considered insulin dysregulated. a key marker for EMS. Because stress and routine changes can influence results, most vets recommend taking samples when the horse is relaxed and at home.
If morning insulin levels are normal, vets may perform additional tests to confirm whether insulin dysregulation is still present. The most common is an Oral Sugar Test (OST), where corn syrup or glucose is given and insulin levels are checked an hour later. This helps assess how strongly the horse's body reacts to sugar. Another option is an Insulin Tolerance Test (ITT), which shows how well the horse's tissues respond to insulin. More advanced tests - such as combined glucose insulin tests - may be used when a clearer picture of insulin sensitivity is needed.
Older horses may undergo testing for PPID as well, because some horses develop both EMS and Cushings, the combination of which can worsen insulin resistance.
How is EMS treated?
The foundation of EMS treatment is diet and lifestyle management. Natural remedies for equine metabolic syndrome aim to reduce sugar and calorie intake whilst supporting steady weight loss and improving insulin sensitivity.
Most horses with EMS require low-sugar forage, ideally hay that tests under 10% NSC (non-structural carbohydrates). Because forage can vary widely, hay analysis is extremely helpful. Soaking hay can reduce sugar levels but results vary so it shouldn't be the only strategy. Straw can be used to pad out hay rations and extend chewing time whilst reducing calories but use quality, dust free forage at no more than 30% of the total hay ration and ensure adequate water is provided to avoid impaction colic.
Weight loss should be slow and steady. Many vets recommend feeding around 1.5% of ideal bodyweight in forage per day, adjusting gradually if needed. Sudden restriction can be dangerous, especially in overweight horses and can actually cause insulin spikes which are counterproductive so all changes should be supervised by your vet. Regular exercise greatly improves insulin sensitivity but should only be introduced if the horse is sound and not experiencing active laminitis.
For overweight horses, owners may need to limit of eliminate pasture access - often with a grazing muzzle. Track systems for horses in the UK are becoming a popular way of encouraging movement whilst restricting or eliminating grass intake. For thinner EMS horses, additional calories should come from low-sugar, high fibre or high fat feeds such as beet pulp or oil, rather than cereal or grains. It is important to remember however that horses don't eat percentages, so be careful when selecting feeds to not exclude what could be perfectly suitable products based on simply the NSC %.
Because many hay-only diets lack essential vitamins and minerals, a daily feed balancer or mineral supplement is essential, especially when feeding soaked hay (as minerals are leached in the water). Complete low NSC feeds and supplements formulated for metabolic horses may also be used.
In some cases, medication such as thyroxine or metformin may be recommended by vets if diet and exercise are not enough.
What Is the Prognosis for Equine Metabolic Syndrome?
Most horses with EMS can improve significantly with the right management. Weight control, low-sugar forage, careful feeding and appropriate exercise often stabilise insulin levels and reduce the risk of laminitis. However, EMS has no permanent “cure.” Ongoing monitoring, routine retesting, and consistent management are essential for long-term success. Horses that remain very overweight or have persistently high insulin levels can be more challenging and may need medical support.
How Can Equine Metabolic Syndrome Be Prevented?
Prevention revolves around maintaining a healthy body condition score and managing access to high-sugar pasture, especially during spring and autumn grass flushes. High-risk breeds -such as native ponies, cobs and easy-keepers - need particularly careful management. Feeding according to the individual horse (not generic bag guidelines), monitoring weight, and keeping horses active wherever possible are the best defences against EMS.
Natural Management Strategies
Our approach to supporting horses with EMS focuses on working with their natural physiology rather than against it. We believe that horses evolved to thrive on diverse plant materials, and modern management practices should respect these evolutionary adaptations.
Supporting Digestive Health
The gut microbiome plays a vital role in metabolic health. We've incorporated this understanding into our supplement formulations, recognising that diverse gut bacteria support better overall health outcomes. Each Equell supplement contains multiple plant fibres designed to promote microbiome diversity, supporting the gut environment that horses need for optimal metabolic function.
Prebiotics help maintain beneficial bacteria populations in the hindgut. These natural compounds feed the good bacteria whilst discouraging harmful microorganisms from establishing themselves.
Our Science-Based Approach
At Equell, we've developed our supplement range specifically with conditions like EMS in mind. Every product we create is suitable for prone individuals and those managing metabolic conditions. This wasn't accidental, it reflects our understanding that modern horses need targeted nutritional support to thrive in today's management systems.
Our formulations are designed to work alongside restricted diets. We understand that EMS horses often have limited feeding options, so our supplements can be added to any base feed without concerns about significantly increasing sugar or starch intake and the small, highly palatable serve makes them ideal for adding to little feeds.
We utilise natural, plant-based ingredients because we believe horses process these most effectively. Each ingredient is selected for specific health benefits, not as cheap fillers or unnecessary additives.
Creating a Comprehensive Management Plan
Managing EMS successfully requires a holistic approach that addresses multiple aspects of horse care. We work with horse owners to understand that no single intervention will solve all problems, but combining several strategies creates the best outcomes.
Regular veterinary monitoring helps track progress and adjust management strategies as needed. Blood tests can measure insulin levels and glucose responses, providing objective data about how well the management plan is working.
Environmental management often requires significant changes. This might mean altering turnout schedules, changing hay suppliers, or investing in slow-feeding systems. These changes can feel overwhelming initially, but they become routine parts of care that significantly benefit the horse's health.
Building Long-Term Success
We've found that successful EMS management requires patience and consistency. Metabolic changes don't happen overnight, and horses need time to respond to dietary and lifestyle modifications. Setting realistic expectations helps owners stay committed to the management plan during the initial adjustment period.
Many owners report feeling more confident about managing their horse's condition once they understand the underlying principles. Knowledge about why certain feeds should be avoided or why exercise timing matters helps owners make informed decisions daily.
Supporting Your Horse's Journey
Our commitment extends beyond providing quality supplements. We believe in supporting horse owners throughout their EMS management journey. The condition can feel isolating, but understanding that many horses live comfortable, active lives with proper management provides hope and motivation.
We've designed our products to integrate seamlessly into EMS management plans. Whether supporting digestive health, maintaining calm behaviour during dietary restrictions, or supporting overall metabolic wellness, our range addresses the multiple challenges EMS horses face.
Our money-back guarantee reflects our confidence in our formulations and our understanding that horse owners need assurance when investing in their horse's health. Managing EMS involves ongoing costs, and we believe our products should demonstrate clear value.
The journey of managing EMS naturally requires dedication, but the reward of seeing horses comfortable and thriving makes every effort worthwhile. With proper support, including targeted nutritional supplementation, most horses with EMS can maintain good quality of life and continue enjoying their partnership with their owners.
