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Discussion on Major Update to EMS article
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Moderator:
DrO
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Posted on Thursday, Oct 8, 2009 - 11:26 am:
Obesity has become the most common nutritional problem of horses in the developed world. The reason is an inability for easy keeping horses to readily adapt to the affordable improved feedstuffs and declining work loads seen with pleasure horses. Horses evolved to take advantage of the good seasonal times with efficient storage of energy that would then get them through the lean times of the year when forage became scarce. As far as food is concerned it has become Thanksgiving everyday and that is the beginning of the Equine Metabolic SynDrOme (EMS) story. EMS is essentially a disease of obesity and the resulting insulin resistance which leads to a predisposition to founder. This article discusses the physiological events leading to Equine Metabolic SynDrOme, clinical signs, diagnosis, treatment, and prevention of this common problem of some breeds of horses, access article.
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Member:
shedwall
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Posted on Thursday, Oct 8, 2009 - 12:56 pm:
Hi Dr. O.,
Thank you for your updated article on EMS. I have a 5 year old Paso Fino mare who is not ... and never has been overweight. She was born here on my ranch and has been in my care from the day she was born. When Ali turned 4 she became sick with a virus (that was the diagnosis from my vet at the time - a CBC was run which exhibited abnormalities in the red/white cells). Ali exhibited all over lameness. She was treated with antibiotics at the time. Complete Xrays were taken as it was believed that she might have joint issues. Xrays were taken of the hooves and revealed rotation of the coffin bone. It was determined that the founder was a one time episode as a result of a reaction to the virus.
My horseshoer came out and adjusted her angles - shod her and within a week she was sound and acted like she had never foundered before in her life. The initial Xrays showed a 7% rotation.
Six months later Ali came up lame again. Xrays were taken - 10% rotation in one hoof, eleven in the other. My vet came and took more blood for a complete endocrine test. The results revealed insulin in excess of 2500 and glucose at 16.9.
Ali's completed history was sent to Littleton Large Animal Clinic - their thought EMS. Also sent to CSU Ft. Collins - their thought was EMS as well - not Cushings. Pergolide was discontinued per my vets instructions.
Adjustments have been made to her diet. Removed from Equine Adult and placed on Well Solve L/S (3 cups per day). Eliminated Majesty Flex (Glucosamine, etc) cookies. Hay is tested - a grass alfalfa mix 60/40 produced the lowest sugar/starch ratio - no sugar treats - no pasture - lots of exercise.
At the time of the endocrine test, my vet believed that Ali was cushinoid. She also had low thyroid. She was started on Pergolide 0.5 for several months. Not much improvement - Pergolide upped to 1.0 per day - still no notable improvement. Ali was also given Thyroxine (I believe, I would have to check the bottle). The thyroid medication made her extremely aggressive - after we discontinued - the behavior stopped.
I refused the DEX suppression test as I had read about the risk that it could bring on another episode of founder - one which Ali cannot tolerate.
Anyway - at this point - with tested hay (low in sugar and starch0, Well Solve L/S, Beet Pulp, and no sugar treats - and Heiro (I did post in Heiro section), her insulin 45 days ago was 1700 - glucose 8+. Long ways to go!!!! Lot of walks for her and turnout with her friend.
Any recommendations - is there something else I can do. I don't want to lose her! I started the Heiro (kind of a last ditch effort). Also when I called them they said not to worry I would have a normal horse soon. Something you want to hear as a horseowner who has no idea what else to do!
Shelley
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Member:
scooter
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Posted on Thursday, Oct 8, 2009 - 10:25 pm:
Shelley, it's strange that your horse had 7 degrees of rotation and was sound in a week. Rotation can be deceiving on radiographs sometimes ex. a long toe or high heels heel can make rotation appear worse than it is. (not saying your horse has this just an example )
Have you tried pure grass hay on her? Though I know you say she is not fat it would seem some horses just don't tolerate alfalfa well as it seems to rich for them even if it is low sugar/starch.
When I asked in the other thread how she was other than the high insulin/glucose you said she was doing well, so don't panic yet
I guess one other thing kind of sticks out is you say she is exercised by turn out in an arena with a friend and hand walking. FME with my IR/EMS horses (since this new article I am confused which they are) and mine lean towards fat too, but that would not be considered enough exercise to get the "blood flowing" Can you lunge her?
Hopefully Dr.O. can give you some ideas, but your horse certainly doesn't sound like a "typical" EMS/IR horse. Do you have a picture you can post?
Good Luck, hope you figure it out soon.
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Member:
shedwall
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Posted on Friday, Oct 9, 2009 - 12:44 am:
Ali was originally on straight grass hay - but in testing the hay - mountain grasses can have extremely high sugar content. Still was foundering on pure grass - so began testing and started slowly weaning her to grass/alfalfa. The switch was made after her last founder - so far no new lameness - slightly lower insulin levels.
I will post a picture of her. She is an absolutely gorgeous girl!
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Moderator:
DrO
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Posted on Friday, Oct 9, 2009 - 8:03 am:
Hello ShellyH,
Let me help you get started off right as there are several advantages to you if discussions are kept separate: - there is no confusion about which question is being discussed
- it will help keep Horseadvice more organized
- you review the Article and "ALL" the existing discussions
- more folks are likely to see your post and so you will receive quicker and more responses
You will find the "Start New Discussion" button at the bottom of the "List of Discussions ". This list is on the parent page to this discussion along with an "Article". Getting there is easy, for example on this page: - Scroll to the top of this frame where you will find a navigation bar.
- Click on the "parent page" link. The parent page is the page immediately preceding the title for this discussion.
Before posting you should review the article as you will find helpful information. If it does not answer your question and you don't see a related discussion that answers your question you should "Start a New Discussion" with your question. For more on this and other important information see Help & Information on Using This Site ยป Welcome to The Horseman's Advisor.
Thanks for helping us stay organized.
DrO
PS, by copying your post you can easily paste it into a new discussion.
PSS When you repost also include the following information:
- Where the tests done after the horse has fasted for 12 hours?
- What are the units of your lab's results?
- What are the laboratory normals?
- Lastly what laboratory are you using?
DrO
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