Ranch Call | Keeping Horses Healthy Insulin Resistance is not Diabetes By Terri Van Wambeke M
any people refer to their horses as having “diabetes.” But the syndrome they are actually referring to is called Insulin Resistance—or Equine Metabolic Syndrome (EMS), as it is now
commonly called.
Insulin is made by the pancreas and causes body tissues, like muscle and fat, as well as the liver, to take in glucose. This glucose is then stored for energy or made into fat. When a horse has EMS, his tissues and liver do not respond properly to increased insulin levels in the blood. This can lead to secondary problems, such as abnormal fat deposits, obesity, or laminitis.
Horses suffering from EMS can present as the classic and obese easy-keeper, or they may have a thin body but a cresty neck and thick fat pads at the tail head. Horses with EMS are also apt to have other issues, including Cushings Disease, laminitis, and low thyroid levels.
EMS and Cushings. Horses that have Cushings Disease, a malfunction of the pituitary gland, are predisposed to EMS. Horses with both diseases will show signs, such as, increased drinking and urinating, lack of hair coat shedding, loss of skeletal muscle, and possibly laminitis. Horses with Cushings, therefore, should be tested for EMS.
EMS and laminitis. Most horses suffering from EMS have a predisposition to laminitis. Researchers have a few theories as to the reason why. The inability of the tissues to respond to insulin may impair the ability of the hoof wall cells to take up glucose, causing changes in the normal hoof wall connection to underlying tissues. Another theory is that the inability to respond to insulin may decrease the blood flow to the hoof.
These horses are susceptible to the effects of non-structural carbohydrates (NSC) in feeds, which includes sugars, starches, and fructans. These will vary considerably in hays and grass, depending on a variety of factors , such
as weather, location, and time of day. High sugar feeds may make insulin resistance worse in horses, just as it does with humans who have diabetes. Or the elevated sugars in the system may change the normal bacteria in the gastrointestinal system, leading to the release of toxins, which then adversely affect the lamina of the hoof.
EMS and low thyroid levels. Horses with EMS will also have low circulating thyroid levels. Low thyroid is not the primary disease. Low thyroid levels are a consequence of the altered metabolic state of the horse.
How is EMS diagnosed? Diagnosis is based on clinical signs and blood testing. One test, rarely performed because of the complexity and need for hospitalization, is the infusion of sugar through an IV catheter, and then approximately 10 to 15 blood glucose samples are taken throughout the day. The other option is to pull an AM fasting and then a PM glucose-to-insulin ratio. These samples need to be handled carefully and sent to a special laboratory.
Managing EMS Diet and exercise are vital! All horses are placed on a low sugar diet. Thin horses needing more muscle mass are fed extra calories in the form of fat. Obese horses are placed on a slow weight loss program with increasing exercise. Access to pasture for these horses should be limited, and a veterinarian will need to work with you to determine the right feeding and turn-out regimen for your horse. Hay can be tested for sugar content and soaked if necessary to decrease the NSC content. Furthermore, no sweet feeds should be fed, and treats should be limited to low-glycemic products.
Call your veterinarian if you suspect EMS in your equine friend. The earlier the syndrome is caught and managed, the better the prognosis is for long term management.
About the author Terri Van Wambeke, DVM, CVA, CVSMT, is a Certified Veterinary Acupuncturist and Certified Veterinary Chiropractor. Her vet practice ranges from Galt to Chico and is limited to holistic medicine and equine reproduction.
www.entirelyequinevet.com.
6 March-April 2012 | Honest Horses Magazine
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