Research continues to unravel the mysteries of equine metabolic syndrome

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British horse feed manufacturer Spillers has cemented its commitment to enhancing equine health and wellbeing with the publication of its 100th research paper relating to equine metabolic syndrome (EMS), obesity, laminitis and weight management in the past 20 years.

During the past two decades, Spillers and the Waltham Equine Studies Group and expert collaborators around the world have been helping to unravel the complex links between EMS, insulin dysregulation, obesity and laminitis. The formation of the Waltham International Laminitis Research consortium in the early 2000s, followed by the formation of the Waltham international Obesity consortium, has brought together world-leading equine veterinary, nutrition and research experts interested in collaborating on these important topics.

The work is summarised in a recently published paper: Equine metabolic syndrome: evolution of understanding over two decades: a personal perspective, by Patricia Harris, Nicholas Bamford and Simon Bailey. It has been published in the journal Animal Production Science.

Nutritionist Clare Barfoot RNutr, Marketing and Research and Development Director at Spillers, said obesity was a major welfare issue for horses and ponies, not only because of the direct weight-associated effects but also through the increased risk it poses for certain clinical conditions, in particular laminitis.

“For many owners and vets, obesity and EMS are synonymous, but our work has shown that this is not necessarily the case,” Barfoot says.

To date, research has shown that while obesity may be an indicator of EMS, lean animals may also have insulin dysregulation, and may still have an increased risk of laminitis, especially if exposed to certain trigger factors such as high intakes of starch and/or sugar.

This has led to the definition of EMS subtly changing from increased general or regional obesity being a key component, to the current recognition that the key consistent feature of EMS is the presence of insulin dysregulation (ID), associated with an increased risk of laminitis, with the variable presence of obesity and/or other metabolic alterations. Testing, especially using dynamic tests such as the oral sugar test has therefore become increasingly important in identifying and monitoring individual animals with ID and EMS.

“All animals with EMS, whether obese or lean, have an increased risk of laminitis,” Barfoot says. “Although for genetic, managemental and environmental reasons, they may not all necessarily develop clinical laminitis.”

She said through the continuing research, the understanding of the interaction between obesity and insulin dysregulation has changed considerably since EMS was first described.

“The emphasis has shifted from tissue or peripheral insulin resistance to insulin dysregulation, with a focus on diet and gut-related factors that appear to be associated with hyperinsulinaemia. However, obesity is still a major problem that needs to be identified and addressed for many health and welfare reasons not least that being obese may make any laminitic episode more severe and result in slower recovery.“

“In simple terms, Equine Metabolic Syndrome (EMS) means your horse has a set of factors that place him or her at higher risk of getting laminitis. It is important that you manage as many of these risk factors as you can, the most obvious two being weight and diet.”

Barfoot’s nutritional management tips include:

· Provide a diet low in non-structural carbohydrate (which includes starch and water-soluble carbohydrates: WSC). WSC consists predominantly of simple sugars and fructans, the ‘storage’ form of sugar in most UK grasses and other plants.

· Restrict or possibly remove access to grazing.

· Ideally feed a low WSC hay (less than 10% on a dry matter basis) or a hay replacer low in starch and sugar. Although soaking helps to reduce WSC, results are highly variable and soaking alone can’t guarantee suitability for those prone to laminitis.

· Unless feeding ad-lib, increase the amount of hay you soak by about 20% (dry matter). Due to the loss of nutrients (and therefore dry matter) into the water, each hay net will contain more water and less ‘hay’ post soaking.

· Manage weight – aim for a body condition score of around 5 out of 9 and remember that it is normal and perfectly healthy for horses and ponies to lose some weight over the winter before the arrival of better grass in the spring.

· Maintain a regular exercise programme where possible and consider increasing the length or intensity of exercise if feasible. However, even small amounts of exercise may help to improve insulin sensitivity.

· Adapt your feeding regimen if you have to reduce the amount of exercise or turnout your animal gets.

· Provide a balanced diet, including suitable levels of vitamins, minerals and quality protein – a feed balancer is an ideal way to provide a balanced diet without excess calories.

· If additional calories are required choose fibre-based feeds that are low in starch and sugar.

· Divide feeds into multiple small meals to help reduce the amount of starch and sugar consumed in any one meal.

· Provide a high fibre diet – do not restrict forage intake to less than 1.5% of current bodyweight (dry matter) per day unless under veterinary supervision. On average, this minimum equates to about 9kg of hay on an ‘as fed’ or ‘fresh weight’ basis (or ~11kg if you intend to soak it) for a 500kg horse without access to grazing.

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