This week, we are revisiting the topics of insulin resistance and equine metabolic syndrome (EMS).

Those issues have been on my mind recently due to the many questions I have received, and because I am currently working on a project with an insulin-resistant mare that is struggling to make any progress at the facility I manage.

Join me as I share my insights on how these recoveries typically unfold.

Act Early and Monitor Progress

Recognize any changes in your horse before they become serious problems. Prevention is always the key, as long-term, unmanaged insulin resistance can lead to laminitis and permanent damage. 

The Danger of Repeated Relapses

Each time a horse swings between recovery and relapse, it becomes harder to reverse insulin resistance. Aim for consistent recovery, with no symptoms and healthy blood work. After that, you will need to maintain those results through controlled management.

Safe Grass Reintroduction

Horses benefit from a natural herd life and grazing, but returning to pasture should be gradual. Monitor the horse closely for swelling, fat pads, or any early sign of regression, and adjust its turnout times accordingly.

Key Physical Signs

Fat pads behind the shoulders or on the tail dock, and a crested neck, are usually indicators of insulin resistance, even before blood work confirms it. Unexpected weight gain or puffiness can also signal trouble.

Behavioral Clues

Food aggression and irritability can result from poor satiety-hormone regulation and blood sugar swings. That is often mistaken for personality, but improving the metabolic balance usually reduces that behavior.

Thirst and Urination Changes

Increased thirst and urination may indicate that the horse's body is working hard to flush out excess sugar. That often tends to occur in spring or when grass intake increases.

Edema and Fluid Retention

Swelling in the sheath, udder, legs, or above the eyes often links to high sugar intake and reduced movement. Increasing the horse's daily activity can quickly improve that.

Laminitis Risks

High insulin can damage hoof tissues, and reduced movement worsens the problem. Support hoof comfort, but keep the horse moving to break the inflammation–insulin cycle.

General Inflammation and Soreness

Insulin resistance can cause full-body soreness, joint stiffness, and mobility issues, which can sometimes be mistaken for aging. Addressing diet and movement can often reverse those symptoms, even in older horses.

Consistent Management

Recovery is not always linear. Track the symptoms over 30, 60, and 90 days, and adapt your management, if necessary, for any setbacks caused by weather, limited movement, or dietary slips.

Final Thoughts

Insulin resistance and equine metabolic syndrome require early recognition, consistent management, and ongoing monitoring. Watching for key physical and behavioral signs, addressing issues before there are any changes in the blood work, and maintaining a steady diet and movement routine will allow you to break the cycle of relapse and protect the long-term health of your horse.

Links and resources:

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