A syndrome is a collection of signs or symptoms. In EMS the signs are variable but commonly include obesity and regional adiposity (Cresty neck and fat pads on the rump) coupled with insulin dysregulation. These horses and ponies are highly susceptible to laminitis. They have an abnormal response to sugars and Insulin Resistance is the underlying pathology with abnormally high blood insulin levels even when blood glucose is normal.
Tests for the condition include oral administration of sugar or corn syrup, or intravenous administration of glucose followed by monitoring blood glucose and insulin levels to assess the insulin response.
Management of the condition is based on avoidance of laminitis by carefully limiting the intake of carbohydrates, especially starch, sugars and fructan. Strategies include removing grain or sweetfeeds from the diet and limiting grazing to night- time when pasture NSC is likely to be low. Avoid frosted pasture or spring / autumn pasture when NSC may be high. Use of grazing muzzles and strip grazing with careful pasture management is appropriate. Rations should be forage based using soaked Lucerne which tends to have lower NSC than grass or cereal hay. Weight gain should be avoided and condition score or bodyweight monitored. Veterinary advice on planned dietary management of EMS should be sought.