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FEED ADVICE – HEALTH

Equine Metabolic Syndrome: A Comprehensive Guide

Equine Metabolic Syndrome (EMS) is a complex condition affecting horses and ponies, characterized by insulin dysregulation and an increased risk of laminitis. Insulin dysregulation in EMS leads to abnormal responses to dietary carbohydrates, causing increased insulin secretion and elevated blood glucose levels. This imbalance can result in clinical signs such as obesity, regional fat deposition, infertility, and laminitis.

EMS is often seen in Native breeds such as Welsh, Dartmoor and Shetland ponies, as well as in certain horse breeds like Arabian and Warmbloods. However, it can affect horses of any breed or age.

Key Highlights

EMS involves insulin dysregulation and a high risk of laminitis, especially in ponies and overweight horses.

Risk factors include obesity, breed predisposition, and high-NSC diets (e.g., sugary/starchy feeds).

Signs include a cresty neck, fat pads, and recurrent laminitis.

Management focuses on diet, weight loss, exercise, and vet care to reduce risks and support long-term wellbeing.

Understanding EMS

EMS is an endocrine disorder where horses struggle to regulate the release of insulin. In normal horses, insulin prompts tissue to absorb glucose after a meal. With EMS, fat deposits release hormones that interfere with tissue response to insulin, causing “insulin resistance”. The pancreas increases insulin release to counteract this, resulting in elevated insulin levels after meals and sometimes throughout the day. This mirrors metabolic issues in human type 2 diabetes.

Causes and Risk Factors of Equine Metabolic Syndrome (EMS)

Equine metabolic syndrome (EMS) has various causes and risk factors, including both genetic predisposition and environmental influences. While the exact underlying mechanisms are not fully understood, research suggests that EMS is a multifactorial condition with complex interactions between genetics, diet, and other factors.

Genetic Predisposition

Genetics play a significant role in the development of equine metabolic syndrome (EMS). Certain breeds, such as ponies, donkeys and Arabians, are more susceptible to EMS due to their genetic makeup. These breeds have evolved in harsh environments where resources were limited, leading to a higher efficiency in metabolizing dietary carbohydrates and storing energy.

Within these breeds, there may be individual horses with specific genetic factors that contribute to their inability to respond properly to dietary carbohydrates. These hereditary factors can result in insulin dysregulation and increased risk of developing EMS.

While genetic predisposition is a significant factor, it is essential to note that environmental influences and lifestyle factors also contribute to the development and progression of EMS. Therefore, a holistic approach that considers both genetic and environmental factors is necessary for managing EMS in horses.

Obesity

Obesity in horses can lead to Equine Metabolic Syndrome (EMS) primarily due to its role in promoting insulin resistance. Excess adipose tissue releases inflammatory substances and hormones, which interfere with insulin signalling pathways. This insulin resistance causes cells to become less responsive to insulin, leading to elevated insulin levels as the pancreas compensates. Chronic high insulin levels are a key feature of EMS and contribute to metabolic disturbances such as increased fat deposition.

Dietary Factors

Diets high in easily digestible carbohydrates, such as cereals and rich grass, can overwhelm the horse’s digestive system and lead to spikes in blood glucose levels. This frequent exposure to high-carbohydrate meals can result in insulin resistance over time, as the cells become less responsive to insulin’s signals to take up glucose. Consequently, the pancreas compensates by producing more insulin to regulate blood sugar levels, which can eventually lead to elevated insulin concentrations – a clinical sign of EMS.

Lack of Exercise

The lack of exercise contributes to EMS by reducing insulin sensitivity in horses. Regular physical activity is essential for maintaining insulin sensitivity by promoting glucose uptake into muscles, which helps regulate blood glucose levels effectively. Without adequate exercise, muscles become less responsive to insulin, leading to insulin resistance. This resistance prompts the pancreas to produce more insulin to compensate, eventually resulting in elevated insulin levels—a key characteristic of EMS. Additionally, sedentary horses are more prone to obesity as unused energy from feed is stored as fat, exacerbating insulin resistance and further increasing the risk of EMS.

Recognising clinical signs of EMS

Recognising the clinical signs of EMS is crucial for early diagnosis and effective management. Here are some important symptoms to watch out for:

Obesity:

Excess body fat accumulation, particularly around the neck crest, tailhead, and along the back.

Insulin Dysregulation:

Elevated fasting insulin levels or abnormal response to glucose or insulin challenges.

Laminitis:

Recurrent or chronic inflammation of the hoof laminae, leading to lameness and characteristic hoof changes.

Reproductive Issues:

Reduced fertility or irregular estrous cycles in mares.

Hyperlipidemia:

Elevated blood lipid levels, often associated with insulin resistance.

Increased Risk of Infections:

Due to impaired immune function associated with insulin dysregulation.

Exercise Intolerance:

Decreased stamina or reluctance to exercise, which may exacerbate obesity and insulin resistance.

Muscle Wasting:

In some cases, horses with EMS may exhibit muscle loss despite adequate nutrition, due to altered metabolic processes.

Management and Prevention Strategies

Exercise Strategies

Exercise plays a crucial role in managing EMS primarily by improving insulin sensitivity and promoting weight loss. Strategies include daily turnout in with controlled grazing, which encourages natural movement and reduces obesity risk. Incorporating regular sessions of walking, trotting, and occasional cantering helps improve cardiovascular fitness and muscle tone without undue stress on joints. Additional activities such as lunging, groundwork, hacking on varied terrain, and in-hand work with obstacles provide mental stimulation, enhance coordination, and promote muscle development. For horses needing low-impact options, swimming offers a beneficial alternative. It’s crucial to monitor each horse’s response, gradually increase exercise intensity to prevent injury.

While medications that improve insulin sensitivity are used in human metabolic syndrome, their  efficacy in horses, such as metformin, remains uncertain due to absorption concerns. Various supplements like chromium, magnesium, cinnamon, and chasteberry extract have been suggested for EMS in horses, but current evidence does not support their efficacy, and their use cannot be recommended.

Diagnosis of EMS

Diagnosing EMS typically begins with an assessment based on the appearance of obesity and a history of laminitis. To confirm EMS and assess insulin resistance accurately, testing should be conducted after the horse has fasted and is not in pain or stressed (e.g., during a laminitis episode). Diagnostic methods include:

Single Blood Sample:

This initial test measures insulin and glucose levels to evaluate the risk of developing laminitis. However, some horses with EMS may have normal insulin levels, making this method less reliable alone.

Oral Glucose Challenge Test:

This test provides a more accurate assessment by measuring insulin response to a glucose meal. Blood is drawn, typically two hours after feeding glucose, to determine insulin concentration.

Additional Laboratory Tests:

Blood samples can also be analysed for elevated levels of fats and hormones other than insulin, which are characteristic of EMS. These tests help differentiate EMS from other conditions, including Pituitary Pars Intermedia Dysfunction (PPID).

Radiographs:

X-rays may be taken to confirm laminitis and assess structural changes in the hooves, providing further diagnostic clarity.

Dietary Strategies for a Horse with EMS

The key principles for preventing and treating Equine Metabolic Syndrome (EMS) are straightforward: implement dietary restriction and encourage regular exercise. These measures not only promote weight loss but also enhance overall fitness, improving insulin responsiveness.

Dietary Adjustments:

Providing a low-NSC (non-structural carbohydrate) diet, predominantly comprising high-fibre forage, is crucial. This approach helps regulate blood glucose and insulin levels, facilitating weight loss and reducing the risk of laminitis.

Did you know all of Pure Feed’s low calorie range is suitable for horses with EMS?

Limiting field access, especially during periods of lush growth such as Spring, helps control carbohydrate intake and prevent insulin spikes.

Ensuring a balanced intake of essential nutrients to support metabolic balance.

Did you know all of Pure Feeds complete feeds already contain a balancer! So already contain all of the essential nutrients required!

Omega-3 fatty acid supplementation, sourced from fish oil or linseed oil, may further reduce inflammation, improve insulin sensitivity, and enhance cardiovascular function in horses with EMS.

Pure Linseed is a great source of Omega 3 – and a little goes a long way! Check it out here

Managing insulin spikes with strategies like feeding frequent small meals helps promotes stable blood glucose levels, contributing to effective EMS management.

Consider weight loss strategies such as using a grazing muzzle, soaking hay and triple netting to help control obesity.

Conclusion

In conclusion, managing EMS requires a well-rounded approach. Early recognition of clinical symptoms, like obesity and recurrent laminitis is key for timely treatment. Effective management includes providing a low-NSC (non-structural carbohydrate) diet, limiting field access, ensuring a balanced intake of essential nutrients, and supplementing with omega-3 fatty acids. Regular, appropriate exercise enhances insulin sensitivity and aids in weight loss. Consistent monitoring and veterinary guidance are essential to prevent complications like laminitis and to improve the horse’s overall health.

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Keep your good doers in top condition without overloading them with calories! 🌿🐴

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It also contains a built-in balancer packed with essential vitamins, minerals, pre- & probiotics to support the gut microbiome, biotin for strong hooves, key amino acids for muscle maintenance, and added salt to help hydration.

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👉 Protects cells from oxidative stress – helping to neutralise free radicals.
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Refuel comes with a splash zone warning!
A recovery mash horses just can`t get enough of! Packed with electrolytes, antioxidants and amino acids, Refuel works hard to keep your horse in tip top shape!

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We do things differently.

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Ever wondered why a horse can seem fine on one day of spring grazing, but at risk the next? The answer lies in the grass itself.

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We’ve seen a few posts lately saying straw shouldn’t be fed to horses… and it’s left a lot of people second-guessing what they’re doing.

But straw isn’t some new or risky trend; it’s actually been used for years, and for good reason.

Quite simply, straw is very low in calories but still provides fibre. That makes it really useful for horses that hold weight easily, need their intake controlled, or are on restricted diets. By adding straw into a forage ration, you can bulk it out without piling in extra energy and calories.

It also takes horses longer to chew. That means more time eating, more saliva production, and a more natural, trickle-feeding pattern, all of which support digestive health and help prevent long periods without forage.

That’s why you’ll often see straw used alongside hay or haylage, rather than instead of it. It helps slow things down and stretch the ration out.

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✨ Easy – low-calorie, slow-release energy ideal for horses in light to medium work.
✨ Herbal Treats – a tasty, natural way to reward your horse, free from molasses and cereal!Keep your horse comfortable, happy, and supported with our laminitis-friendly favourites 🩵

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✨ Balance – low-calorie, molasses and cereal-free balancer.
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✨ Switching to Pure Feed couldn’t be easier! Follow these simple steps to get your horse thriving on a gut-friendly, stress-free feeding plan 🐴💛Step-by-Step Guide:
1️⃣ Fill out our diet plan to discover which Pure Feed product is perfect for your horse.
2️⃣ Use the stockist map to find your nearest retailer.
3️⃣ Pick up your first bag of Pure Feed.
4️⃣ Transition slowly: gradually reduce your current feed while increasing Pure Feed over 7–10 days.
5️⃣ Watch your horse thrive on a diet that supports their gut and overall well-being!💡 Tip: Keep an eye on their weight and behaviour during the transitionReady to make feeding simple and stress-free? Tap the link in bio to start your horse’s Pure Feed journey today!

✨ Switching to Pure Feed couldn’t be easier! Follow these simple steps to get your horse thriving on a gut-friendly, stress-free feeding plan 🐴💛

Step-by-Step Guide:
1️⃣ Fill out our diet plan to discover which Pure Feed product is perfect for your horse.
2️⃣ Use the stockist map to find your nearest retailer.
3️⃣ Pick up your first bag of Pure Feed.
4️⃣ Transition slowly: gradually reduce your current feed while increasing Pure Feed over 7–10 days.
5️⃣ Watch your horse thrive on a diet that supports their gut and overall well-being!

💡 Tip: Keep an eye on their weight and behaviour during the transition

Ready to make feeding simple and stress-free? Tap the link in bio to start your horse’s Pure Feed journey today!
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Meet the core of the Pure Feed range. Three feeds formulated to suit each calorie requirement.

💚 Pure Easy – Perfect for horses that maintain weight easily, this feed provides all the essential nutrients without excess energy. Ideal for horses in light work or those prone to weight gain.

💙 Pure Working – Designed for horses in regular work, this feed delivers steady energy and complete nutrition. With a balanced protein and fibre profile, it supports condition and sustained energy for consistent performance without overloading on calories.

💛 Pure Condition – Ideal for horses who need extra calorie support, this feed provides slow-release energy sources to support stamina, explosive power, and recovery. Perfect for competition horses, heavy work, or those needing to gain and maintain condition efficiently.

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Myth: “Ulcers only affect racehorses or horses in heavy work.”Fact: Gastric ulcers are very common, especially in performance horses. Studies show:
• Up to 80–100% of racehorses in training may have ulcers
• Around 40–60% of competition or performance horses
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Myth: “Ulcers only affect racehorses or horses in heavy work.”

Fact: Gastric ulcers are very common, especially in performance horses. Studies show:
• Up to 80–100% of racehorses in training may have ulcers
• Around 40–60% of competition or performance horses
• Even some leisure horses are affected, around 30–40% in surveys

Ulcers often develop not just from workload, but from long gaps without forage, sudden diet changes, stress, and travel. Many horses show subtle signs rather than obvious discomfort, such as an inconsistent appetite, grumpiness, girth sensitivity, or changes in performance.

✨ Key takeaway: Ulcers are common, but not inevitable. Thoughtful feeding and management can reduce the risk and a support long-term normal gastric enviroment.

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Power through every ride with Pure Working:💙 Medium-calorie, naturally balanced feed designed for horses in regular work.
💙 Rapeseed oil and superfibres provide sustained energy
💙 High-quality protein and key amino acids support topline
💙 Pre- and probiotics promote a normal gut
💙 Biotin helps maintain strong hooves.Want to see the difference Pure Working can make? Locate a stockist near you; 🔗  link in bio

Power through every ride with Pure Working:

💙 Medium-calorie, naturally balanced feed designed for horses in regular work.
💙 Rapeseed oil and superfibres provide sustained energy
💙 High-quality protein and key amino acids support topline
💙 Pre- and probiotics promote a normal gut
💙 Biotin helps maintain strong hooves.

Want to see the difference Pure Working can make? Locate a stockist near you; 🔗 link in bio
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Horses don’t work at the same intensity every day, so why should their feed stay the same?Every feed in the Pure Feed range is built on the same carefully selected ingredient base.
The difference? Energy and calorie level.That means you can move up or down the range as workload changes, without changing ingredients, upsetting digestion, or starting again.✔️ Same ingredients
✔️ Same micronutrition
✔️ Different levels to suit the dayFrom rest days to competition days, it’s one feed system that adapts to your horse’s week.💡 Tap our bio for a personalised diet plan today!

Horses don’t work at the same intensity every day, so why should their feed stay the same?

Every feed in the Pure Feed range is built on the same carefully selected ingredient base.
The difference? Energy and calorie level.

That means you can move up or down the range as workload changes, without changing ingredients, upsetting digestion, or starting again.

✔️ Same ingredients
✔️ Same micronutrition
✔️ Different levels to suit the day

From rest days to competition days, it’s one feed system that adapts to your horse’s week.

💡 Tap our bio for a personalised diet plan today!
...

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Some horses react when the girth is tightened, and it’s not just “being tricky.” The reason often comes down to stomach discomfort.Horses produce stomach acid constantly, even when they’re not eating. Unlike humans, their stomachs aren’t designed to be empty for long periods. When a horse’s stomach is empty, or its gut is upset, the acid can irritate the stomach lining.Tightening the girth puts pressure on the lower ribcage and stomach area, which can trigger discomfort or pain, causing the horse to squirm, nip at the girth, or resist being tacked up.Supporting your horse with a fibre-rich diet, consistent feeding schedule, and careful tack fitting can help reduce this type of sensitivity, making tacking up a calmer, more comfortable experience.💡 Have you noticed a difference when switching to Pure Feed? Let us know!

Some horses react when the girth is tightened, and it’s not just “being tricky.” The reason often comes down to stomach discomfort.

Horses produce stomach acid constantly, even when they’re not eating. Unlike humans, their stomachs aren’t designed to be empty for long periods. When a horse’s stomach is empty, or its gut is upset, the acid can irritate the stomach lining.

Tightening the girth puts pressure on the lower ribcage and stomach area, which can trigger discomfort or pain, causing the horse to squirm, nip at the girth, or resist being tacked up.

Supporting your horse with a fibre-rich diet, consistent feeding schedule, and careful tack fitting can help reduce this type of sensitivity, making tacking up a calmer, more comfortable experience.

💡 Have you noticed a difference when switching to Pure Feed? Let us know!
...

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At Pure Feed, almost our entire complete feed range is cereal-free; from Pure Balance to Pure Condition Mix, giving you a low-starch, gut-friendly option✨
Only our Pure Performance contains cereals, as it's designed for horses in heavy work who need extra energy.Why does this matter? Because high-sugar, high-starch feeds can cause a whole host of problems:
🔥 Spikes in stomach acid → gut irritation
⚡ Fizzy, unpredictable behaviour
⚖ Weight gain or uneven condition
💥 Energy crashes mid-work👉 Not sure where to start? Let our Pure Feed diet plan help you find the best feed for your horse’s gut

At Pure Feed, almost our entire complete feed range is cereal-free; from Pure Balance to Pure Condition Mix, giving you a low-starch, gut-friendly option✨
Only our Pure Performance contains cereals, as it`s designed for horses in heavy work who need extra energy.

Why does this matter? Because high-sugar, high-starch feeds can cause a whole host of problems:
🔥 Spikes in stomach acid → gut irritation
⚡ Fizzy, unpredictable behaviour
⚖ Weight gain or uneven condition
💥 Energy crashes mid-work

👉 Not sure where to start? Let our Pure Feed diet plan help you find the best feed for your horse’s gut
...

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Riboflavin (B2) is your horse’s energy converter 👉  turning carbs, fats, and protein into fuel for work, growth, and recovery. It also supports:
• Skin, coat & hooves
• Tissue repair & cellular growth
• Antioxidant protectionEven if your horse looks fine, stress, work, travel, or seasonal changes can increase B2 requirements.✅ The simple solution: Pure Feed complete feeds, formulated to deliver consistent B2 and other essential nutrients every day.Take the guesswork out of feeding 👉  use our Pure Feed diet plan to make sure your horse is getting exactly what it needs to thrive. 🔗 Link in bio

Riboflavin (B2) is your horse’s energy converter 👉 turning carbs, fats, and protein into fuel for work, growth, and recovery. It also supports:
• Skin, coat & hooves
• Tissue repair & cellular growth
• Antioxidant protection

Even if your horse looks fine, stress, work, travel, or seasonal changes can increase B2 requirements.

✅ The simple solution: Pure Feed complete feeds, formulated to deliver consistent B2 and other essential nutrients every day.

Take the guesswork out of feeding 👉 use our Pure Feed diet plan to make sure your horse is getting exactly what it needs to thrive. 🔗 Link in bio
...

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What people say about Pure Feed

A much easier way of feeding
We bought a bag the day after I received the diet plan after she completely refused to eat her previous feed anymore and was practically starving herself. I have been slowly increasing the amount of the pure easy I've been ...
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Cerys
We bought a bag the day after I received the diet plan after she completely refused to eat her previous feed anymore and was practically starving herself. I have been slowly increasing the amount of the pure easy I've been giving her and so far she's loving it! It's a much easier way of feeding, very impressed!
A much easier way of feeding
Cerys
Loving Pure Feed and his tummy is too!
Herbert has been on the Pure condition pellets for a week now and is loving it. His tummy is too, as no faecal water at all - rear end lovely and clean. I'm ordering a pure linseed with my next ...
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Sue
Herbert has been on the Pure condition pellets for a week now and is loving it. His tummy is too, as no faecal water at all - rear end lovely and clean. I'm ordering a pure linseed with my next order. He's having some time off to get some weight on and is out on some grass in the middle of the tracks during the day. Thanks so much Pure Feed!
Loving Pure Feed and his tummy is too!
Sue
A huge improvement in her temperament and skin!
Bonnie is doing amazing on it! I started using it around 3 weeks ago and already there is a huge improvement in her temperament and skin! She still has enough energy for hacking 4 days a week and hunting every weekend too!
Sabrina
Bonnie is doing amazing on it! I started using it around 3 weeks ago and already there is a huge improvement in her temperament and skin! She still has enough energy for hacking 4 days a week and hunting every weekend too!
A huge improvement in her temperament and skin!
Sabrina
My pony has never looked or moved better!
I have been using your feed for 3 years now and I can say that my 25 year old pony has never looked or moved better. He really struggles with the winter so we have him your micronised linseed alongside his pure ...
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Polly
I have been using your feed for 3 years now and I can say that my 25 year old pony has never looked or moved better. He really struggles with the winter so we have him your micronised linseed alongside his pure veteran and his coat and weight maintenance was superb. With the two new ponies we have started to transition them over to the feeds recommended in the diet plan and they seem very happy. It is so reassuring to know that the ponies are getting everything that they need from your feed. So thank you and for all of your advice and knowledge.
My pony has never looked or moved better!
Polly
All look marvellous!
Everything marvellous they are all doing great. Just like it even better when your feed is on offer the gang are looking great with lovely shiny coats
Joyce Simpson
Everything marvellous they are all doing great. Just like it even better when your feed is on offer the gang are looking great with lovely shiny coats
All look marvellous!
Joyce Simpson
I can see a huge difference and improvement
I can see a huge difference and improvement, body and muscle are looking so much better, nearly too good, and I have noticed he's not hungry all the time as before and eats a bit less hay so saving on ...
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Sophie Ferragut
I can see a huge difference and improvement, body and muscle are looking so much better, nearly too good, and I have noticed he's not hungry all the time as before and eats a bit less hay so saving on money al around. Loving your product!
I can see a huge difference and improvement
Sophie Ferragut
A brilliant system
Absolutely over the moon with it, a brilliant system and perfect for my good doer 10000/10 love it and won't be swapping
Aletheia Gardiner
Absolutely over the moon with it, a brilliant system and perfect for my good doer 10000/10 love it and won't be swapping
A brilliant system
Aletheia Gardiner
Genuinely really impressed with Pure Feed!
I am genuinely really impressed with PureFeed. We have been using Pure Easy for around 2 months now - it's very palatable and my horses energy levels have been good, shiny coat etc! It's very reasonably priced which is one of ...
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Emma McFarlane
I am genuinely really impressed with PureFeed. We have been using Pure Easy for around 2 months now - it's very palatable and my horses energy levels have been good, shiny coat etc! It's very reasonably priced which is one of the main reasons I decided to try it!
Genuinely really impressed with Pure Feed!
Emma McFarlane
Wish I'd found it sooner!
It's so simple!.
Leah William
It's so simple!.
Wish I'd found it sooner!
Leah William
Pure Feed transformed my horse!
My old horse did amazing on it. My new horse is now on your feed too, and I have to say it has transformed him
Sara Constable
My old horse did amazing on it. My new horse is now on your feed too, and I have to say it has transformed him
Pure Feed transformed my horse!
Sara Constable
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