Equine Metabolic Syndrome (EMS)

Equine Metabolic Syndrome (EMS) - also known as Peripheral Cushing's Disease and Equine Syndrome X - is a metabolic condition that is increasingly believed to play a roll in laminitis and a result of modern horse keeping caused by the lifestyle keepers have created for domesticated horses.  There are many factors that can cause EMS, including cortisol metabolism and adipocyte (fat cell) turnover, but the primary cause is insulin resistance, similar to Type II Diabetes in humans.  The hormone insulin is produced in the pancreas to bind onto specific cells to uptake glucose (sugar) levels from the bloodstream and into the stimulated cell.  When a horse has a resistance to insulin, the insulin is not taken up as efficiently, causing the pancreas to produce more than the normal amount of insulin, resulting in an insulin imbalance in the bloodstream, trying to keep the blood sugar levels regular.

EMS is typical in horses considered "easy keepers:" those who can thrive efficiently on pasture alone, animals between the ages of 5-15 years, and horse breeds which evolved in harsh climates, such as the Spanish Mustang and Peruvian Pasos.  Affected horses tend to be obese and have abnormal fat deposits in neck, shoulders, above the eyes, loin and tail head, even when the rest of their body is in normal condition.  They can become pot bellied, polydipsic (displaying excessive thirst), acyclic and lethargic.  It initially presents  as laminitis, but without the pituitary-ardenal gland axis.  Factors that predispose a horse of any breed to EMS are:

DIET:
Horses who are allowed to graze on lush grass and are regularly fed grains.  Horses who are fed high protein, startch or sugar diets.  Horses, who's intestines evolved to process high levels of fibre, instead need high fibre diets in order to maintain energy.  Fibre is typically low in sugars.  When the starch-fibre ratio becomes unbalanced, so will the metabolism.

EXCERSISE:
Excersise is crutial to stimulate feed through the intestines, improve digestion, increase circulation, maintain metabolic rates, prevent obesity , blood sugar levels and decrease stress.

STRESS:
Stress heightens the levels of blood sugar by elevating cortisol levels.  Frequent causes of stress are irregular feedings, physical pain, confinement, over-training, neglect and emotional distress.

Although EMS can only be managed and not cured, there are many ways to maintain horse's health, ranging from natural remedies, dietary/excersise changes to drugs.  There are two drugs commonly used to treat EMS, both originally designed for consumption by humans:

PERGOLIDE:
A drug originally produced for humans suffering Parkinson's Disease, it is now off the market in the U.S for human use after studies revealed a link between the drug and valvular disfucntion.

CYPROHEPTADINE:
A drug that treats a range of symptoms and disorders, like allergies (specifically Hay Fever), nightmares, PTSD, sexual disfunction and clinical vomiting syndrome, to name a few.  It has been shown to suppress the growth hormone, cause dizziness, blurred vision, and conspitaton, among others, and also used to treat agressive behavior in domesticated felines.

Dietary strageties (for horses with EMS) include:

• Restriction of ALL grass grazing
• Low sugar, high fibre hay only
• Elimination of all alfalfa, and all grains, including oats, barely, corn, COB, sweet feed, extruded feeds, complete feeds or anything else with an added sweetner.
• Use of slow feeders which allow horse to eat small amounts throughout the day
• Increase fibre intake by feeding coarse hay, soaked beet pulp or soaked soybean hulls.
• Avoid overusing antibiotics 
• Excersise and freedom to move

Natural remedies:

(Please note: these should be used ONLY after the consultation and permission from your vet.)

• Give good quality probiotic daily for 1-2 months to replenish healthy bacteria culture in horse'shindgut
• Use a colon cleanser like psyllium seed (not husk), slippery elm, or aloe vera to remove overload of mal-digested material, bacteria, toxins and acids, daily for 6-8 weeks, following dosaging system on product
• Feed vitamin B6 (500-900mgs depending on weight) daily for up to four months
• Feed Siberian ginseng powder in presence of Cushing's two or three tsps a day for for months to strengthen ardenal glands, support pituitary gland, stabilize blood sugar etc
• Yucca root for laminitis and inflammation to relieve discomfort as long as required

 

SOURCES:

http://en.wikipedia.org/wiki/Equine_metabolic_syndrome

http://www.thehorse.com/Free-Reports/View.aspx?n=equine-metabolic-syndrome&id=23

Horse-Canada(.com) magazine, November/December issue, Marijke van de Water B.Sc, DHMS

IMAGES:

janicekritchevskyvmd.com.p11.hostingprod.com (1)

completerider.com (2)

http://www.tonette.co.uk/photo_album1.html (3, 4)