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Understanding Laminitis, Cushing’s, and EMS in Horses


Equine metabolic disorders can significantly impact a horse’s health and well-being. Laminitis, Cushing’s Disease (PPID), and Equine Metabolic Syndrome (EMS) are three interconnected conditions that every horse owner should understand. Proper management and early intervention can make a crucial difference in a horse’s quality of life.

Laminitis: More Than Just Sore Feet

Laminitis is a painful and potentially debilitating condition affecting the sensitive laminae within the hoof. These structures connect the hoof wall to the coffin bone, and when inflamed, they weaken, causing extreme discomfort and, in severe cases, rotation of the coffin bone (founder).

Causes of Laminitis

Laminitis can be triggered by several factors, including:

  • Metabolic disorders – Horses with Cushing’s or EMS are at a higher risk due to insulin resistance.

  • Overfeeding rich pasture – High sugar content in spring or autumn grass can overload the system.

  • Obesity – Overweight horses are more prone to metabolic imbalances that contribute to laminitis.

  • Systemic illness or infections – Conditions like colic, retained placenta, or sepsis can lead to laminitis.

  • Excessive concussion – Working on hard surfaces for prolonged periods can mechanically trigger laminitis.

Signs of Laminitis

  • Reluctance to move or shifting weight frequently

  • Lameness, especially when turning

  • Increased digital pulse in the hooves

  • Heat in the hooves

  • The classic "rocked back" stance, where the horse shifts weight off the front feet

Managing and Preventing Laminitis

  • Diet Control: Avoid high-sugar feeds and lush pastures. Use low-calorie, low-sugar forage.

  • Weight Management: Keep your horse at a healthy body condition to reduce the risk.

  • Regular Farrier Care: Hoof trimming helps support the structure of the hoof and prevents further damage.

  • Veterinary Support: Seek immediate veterinary care if laminitis is suspected. Anti-inflammatory medications and special hoof support may be needed.

Cushing’s Disease (PPID) in Horses

Cushing’s Disease, or Pituitary Pars Intermedia Dysfunction (PPID), is a hormonal disorder caused by dysfunction of the pituitary gland. This leads to excessive production of hormones, particularly ACTH, which results in metabolic imbalances. It is most common in older horses but can occur in younger ones too.

Signs of Cushing’s Disease

  • Long, curly coat that doesn’t shed properly

  • Increased thirst and urination

  • Muscle wastage and a pot-bellied appearance

  • Lethargy and reduced energy levels

  • Increased risk of laminitis

  • Recurrent infections due to a weakened immune system

Managing Cushing’s Disease

  • Medication: Pergolide (Prascend) is the primary treatment used to manage hormone levels.

  • Diet Adjustments: Low sugar, high-fibre diets are essential. Avoid rich grass and sugary treats.

  • Regular Clipping: If your horse struggles to shed their coat, regular clipping can improve comfort.

  • Routine Veterinary Monitoring: Regular blood tests can help manage the condition effectively.

While Cushing’s Disease is not curable, with the right care, horses can live comfortably for many years.

Equine Metabolic Syndrome (EMS): The Equine "Diabetes"

EMS is a metabolic disorder that affects insulin regulation, leading to weight gain and an increased risk of laminitis. It is often seen in overweight horses and ponies, particularly in breeds predisposed to easy weight gain, such as native ponies, cobs, and warmbloods.

Signs of EMS

  • Obesity or abnormal fat deposits (e.g., cresty neck, fat pads over the shoulders and tailhead)

  • Insulin resistance, leading to difficulty processing sugars

  • Increased risk of laminitis, even on seemingly normal pasture or diet

Managing EMS

  • Strict Diet Control: Limit access to rich pasture and use a haynet to slow down hay consumption.

  • Regular Exercise: Even light work can improve insulin sensitivity.

  • Weight Monitoring: Body condition scoring helps track progress and prevent weight gain.

  • Veterinary Support: Blood tests can assess insulin levels and confirm the diagnosis.

EMS can often be managed effectively through lifestyle changes, but it requires lifelong monitoring to prevent complications.

The Link Between These Conditions

Laminitis, Cushing’s, and EMS are closely related, with metabolic imbalances playing a key role in all three. Horses with Cushing’s or EMS are at a higher risk of developing laminitis due to insulin dysregulation. Proper management, a controlled diet, and veterinary supervision can help reduce risks and ensure your horse stays comfortable and healthy.

Early detection and proactive management are crucial. If you suspect your horse is at risk, consult your vet for tailored advice and testing. With the right approach, horses with these conditions can continue to lead happy, fulfilling lives.

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