EMS

[googol]

My gelding has EMS. It is absolutely not a death sentence and it is manageable. They are likely to have cushings later on in life though. There's no reason they can't continue to do exactly what they do now(ridden wise that is). My guy is not on any medication yet, vet wanted to manage it by lifestyle and dietry first which I agree with. As someone said before get any fat off them and get them down to a good weight and then you have to keep it at that. I muzzle mine once the grass starts shooting through (if not before as it starts before we notice) and that helps. He'll never be able to stay out 24/7 unless he had s restricted area but unfortunately that's not possible with all Livery yards.

Feed wise, you need to feed things with the lowest of sugars and starch. Preferably none but this will never happen as there's naturally occurring sugars in everything. The best is to get both sugar and starch below 10% when it comes to hard feed. I'm at 7.5%. Also a scoop of magnesium really helps with the fatty areas. I avoid any 'mixes' as usually there coated with molasses or they contain barley which can put the weight on.

Forage wise, avoid anything at all which is ryegrass based. You'll bring on a lami episode extremely quickly. Stick to Timothy/meadow hay/haylage. I fed haylage and have no problem at all with it, people are very sceptical about haylage as there seems to be false information somewhere along the line that it contains more sugar than hay which isn't the case(unless it's rye based). Or if you use hay, soaking it is a must. Also weigh whatever you choose to use religiously.

Anything else just ask, I'm happy to help and share any information I know on it

Ps m geldings a coloured cob x with a native, we're not a 100% sure what with but we did reckon a Welsh of some sort, possibly a C

Thanks for sharing your story, sounds very positive. My vet was positive initially but on Monday he really managed my expectations about the future, so I was planning the worst case scenario in my head, then since that evening he has definitely got a bit better (not continually, just from the weekend when he was awful) so now I’m feeling really positive, especially with posts like yours. It hasn’t half been a rollercoaster tho, and I know it’s not over yet. He’s still on 4 Bute per day spread out throughout the day. I’m soaking his forage and he has a tiny amount of happy hoof and high fiber nuts just for the Bute. I’m still giving him his boswellia serrata too which he’s been on for years. I want to get the magnesium but the vet doesn’t want me to try anything new until we are out of the acute phase. He still has a pulse too, but will see what they say on Friday.

 

[googol]

I am in exactly the same position. Mine went down with laminitis three weeks ago, negative for Cushings, some rotation, EMS. It has been horrendous. She is still in a lot of pain, actually called the vet out again this morning as I was worried. She has never had laminitis before. She is Exmoor but not overweight. Fingers crossed for both of us. I have cried many tears into her mane in the last three weeks and hidden from husband how much I have spent on a non ridden, professional companion who I adore. Vet less worried than me. She is 19 and has never been sick or sorry before.

I’m so sorry to hear about your mare, hope she’s doing better now. Like you I have shed many an uncontrollable tear. People probably think I’ve lost my mind. Laminitis is more cruel than I could ever have imagined and I have felt so helpless watching him suffer, terrible. Mine was also never sick or sorry, he’s been stable bound now for more than a week without even a walk, which is the longest he’s spent locked up in over 6 years. What’s the next steps with yours then?

 

[googol]

Sadly both my vets and farrier have said that the last few months have been by far one of the worst they have seen for cases of Laminitis and to horses and ponies that you would never suspect.Many literally just going down overnight with no changes in routine etc.You just have to do the best you can for them and I send my thoughts out to you all that have there best friends going through it-it is by far one of the hardest things I have ever had to deal with in my 35 years with horses.Fingers crossed for you all for Good recoveries.

Thanks fusspot, it really is a terribly cruel condition. Knowing what I know now regarding the EMS, mine probably shouldn’t have been such a big shock, but he’s never had a sick day in 6 years and he’s never had or required any special management. We still don’t know what brought this on to be honest. EMS just makes the most sense in theory

 

[googol]

Sorry you have obviously already had xrays. I would rehab him barefoot for the time being,imagine having shoes nailed onto painful feet.

I definitely see where you are coming from re the barefoot rehab but on this occasion I am taking the advice of my vet and farrier 100% as im simply not experienced or knowledgeable enough to make decisions of my own in this situation. They are both out together on Friday to discuss the best course of action

 

[googol]

I can't quite remember how much I weighed them as (it was a while ago!). I feed half a 35(?)g blue Pro Earth scoop of mag ox and a whole scoop of cinnamon, once a day. This is slightly more than the recommended amounts but it's at these levels that I saw a massive improvement in fat pads. I'll get exact weights when I go home.

Mine has also successfully gone barefoot (a year in June) and, though she still needs boots for stoney ground, she's much more comfortable than in shoes. It also means we can catch any flare-up very early.

Is the cinnamon just normal cinnamon or is it different in any way?

 

[Domirati]

I’m so sorry to hear about your mare, hope she’s doing better now. Like you I have shed many an uncontrollable tear. People probably think I’ve lost my mind. Laminitis is more cruel than I could ever have imagined and I have felt so helpless watching him suffer, terrible. Mine was also never sick or sorry, he’s been stable bound now for more than a week without even a walk, which is the longest he’s spent locked up in over 6 years. What’s the next steps with yours then?

Hi, hope things are looking up for you She has been in for four weeks now. I honestly thought it was curtains on Saturday, she was shaking and sweating and I called the vet as an emergency. He was quite positive. She had a super strong painkiller and, fingers crossed has been a lot happier since. Looking out if the box, moving around better (very lame but she would not move at all previously). It is box rest for the foreseeable future with Bute, then gradually allowed out. She is a non ridden companion who isn’t insured so it has been very costly so far. Vet described it as being a bit like diabetes so the body is not processing sugars properly. She is not even overweight, I think it was frosty grass that triggered it. I am feeding soaked hay and a handful of mollichaff calmer (which the others have) to give her the Bute in. I hope all goes well for you and your boy. It is horrible to watch them in pain. Fingers crossed for both.

 

[ester]

Is the cinnamon just normal cinnamon or is it different in any way?

regarding the cinnamon I got sent this Dr. Kellon quote when it came up in discussion as the advice has recently been revised.

"Cinnamon is no longer routinely recommended. It had been hoped to improve insulin sensitivity, but instead it may lower blood sugar (glucose) without lowering insulin levels. Since most IR horses have glucose in the normal ranges, cinnamon sometimes lowers it too much. For that reason, the ECIR Group doesn't use it routinely. If you have a horse that is a true diabetic - high glucose - then cinnamon may be helpful."

 

[DirectorFury]

Is the cinnamon just normal cinnamon or is it different in any way?

This is the exact stuff I feed: https://progressive-earth.com/product/cinnamon-powder-cassia-healthy-metabolism-weight-control/ . I think it's normal cinnamon but might be wrong!

regarding the cinnamon I got sent this Dr. Kellon quote when it came up in discussion as the advice has recently been revised.

"Cinnamon is no longer routinely recommended. It had been hoped to improve insulin sensitivity, but instead it may lower blood sugar (glucose) without lowering insulin levels. Since most IR horses have glucose in the normal ranges, cinnamon sometimes lowers it too much. For that reason, the ECIR Group doesn't use it routinely. If you have a horse that is a true diabetic - high glucose - then cinnamon may be helpful."

That's really interesting ester. Introducing cinnamon has made the biggest difference to M's fat pads but I might take her off it as a trial. Any idea how low glucose would manifest itself in a horse?

 

[tallyho!]

Don't despair.

EMS is totally manageable through diet and exercise. ECIR group is definitely worth a visit and contrary to widely held beliefs, imo barefoot is best for EMS/laminitics as you are able to spot any changes much quicker and are able to do something about it before it's too late again. Shoes mask symptoms and numb the foot so by the time you spot disaster in a shod horse, often it's already at the rotational stages.

My old boy was diagnosed 8 years ago and was nearly pts but I gave him a chance barefoot, best thing I ever did for him and 8 months later he was doing xc and ht's completely sound with no boots. As fit as he was in his sj days. The no.1 factor is exercise and lots of it to normalise the imbalance of hormones and get the body using energy in the right way. No. 2 is nutrition - not so much diet as he ate practically nothing but I got his minerals right and he was able to graze 24/7 with his mates. No. 3 - the trim and your hoofcare practitioner. It was a steep learning curve, a journey I'll never forget from the tears, to the joy we felt galloping around courses.

Arm yourself with as much information as you can handle! That would be my advice to you now in this low-point and believe it can be different.

 

[fusspot]

Hi, hope things are looking up for you She has been in for four weeks now. I honestly thought it was curtains on Saturday, she was shaking and sweating and I called the vet as an emergency. He was quite positive. She had a super strong painkiller and, fingers crossed has been a lot happier since. Looking out if the box, moving around better (very lame but she would not move at all previously). It is box rest for the foreseeable future with Bute, then gradually allowed out. She is a non ridden companion who isn’t insured so it has been very costly so far. Vet described it as being a bit like diabetes so the body is not processing sugars properly. She is not even overweight, I think it was frosty grass that triggered it. I am feeding soaked hay and a handful of mollichaff calmer (which the others have) to give her the Bute in. I hope all goes well for you and your boy. It is horrible to watch them in pain. Fingers crossed for both.

Hi-Just wanted to say that I would watch the Mollichaff Calmer-I Would Check it’s Sugar Content.My Boy was on Hi Fi Lite and Conditioning Cubes And Fully fit-Literally just done 3 Classes at the Regionals,in July so couldn’t even blame the frost-He had been on this for about 4 years.When he went down the vets said I needed to look at his feed as even a handful of feed when struggling can stop them improving.I was very surprised to see that the Hi Fi Lite was over 7% Sugars-and it’s approved by Laminitis Trust-the Hi Fi Molasses Free is just over 2% and actually a lot more palatable.When I ran what I was going to change him to with the vet,even she couldn’t believe how high the sugar content is in the Hi Fi Lite.I have both still as I have another mare on the Hi Fi Lite And when you look at them next to each other-the amount of Molasses still on the Hi Fi Lite is quite a shock.I would look at the Mollichaff Calmer to Check the Sugar Content isn’t over about 3%.Good Luck And hope yours improves.

 

[OLDGREYMARE]

If you were to read up on the laminitis site you will be well equipped to discuss things with your vet and farrier later. Remedial shoeing is not always(if ever) the way to go. The folk on that site have been there and done it and got the t shirt regarding laminitic horses. they have a fb page ,friends of the laminitis site, where you can get individual advice regarding your horse.

 

[OLDGREYMARE]

by the way it works on Dr Kellon's principles on ems horses and she is a world authority on the subject. She has probably forgotten more than most vets will ever know on the subject.

 

[ester]

This is the exact stuff I feed: https://progressive-earth.com/product/cinnamon-powder-cassia-healthy-metabolism-weight-control/ . I think it's normal cinnamon but might be wrong!



That's really interesting ester. Introducing cinnamon has made the biggest difference to M's fat pads but I might take her off it as a trial. Any idea how low glucose would manifest itself in a horse?

If it appears to be working for you I'd stick with it I think! I was considering adding it (though would have had to investigate effect on the liver) but then a few people I rate told me that the recommendation had changed and that quote was shared (by another hhoer).

I say I'd keep using it because I have always fed a fair amount of mag ox to correct our Ca:Mg ratio. I cut his feed and supplements down because of the liver flare up and the following spring he went cresty. Reintroduction of the Mag has helped but doesn't seem to have taken us back to the previous no crest situation. Of course it may have come up regardless over the period of time but I kind of wish I hadn't ever taken it out!

 

[holeymoley]

Thanks for sharing your story, sounds very positive. My vet was positive initially but on Monday he really managed my expectations about the future, so I was planning the worst case scenario in my head, then since that evening he has definitely got a bit better (not continually, just from the weekend when he was awful) so now I’m feeling really positive, especially with posts like yours. It hasn’t half been a rollercoaster tho, and I know it’s not over yet. He’s still on 4 Bute per day spread out throughout the day. I’m soaking his forage and he has a tiny amount of happy hoof and high fiber nuts just for the Bute. I’m still giving him his boswellia serrata too which he’s been on for years. I want to get the magnesium but the vet doesn’t want me to try anything new until we are out of the acute phase. He still has a pulse too, but will see what they say on Friday.

Yes this is your first giant hurdle that you need to get him over- the laminitis. I'm sure you've had lots of information and advice given to you, all I would say is keep him on the thickest bed possible and listen to him. He'll let you know when he feels better. A lot of people believe movement is the key to helping them which I agree with but it has to be done once they are over the worst at the start.

 

[Domirati]

Hi-Just wanted to say that I would watch the Mollichaff Calmer-I Would Check it’s Sugar Content.My Boy was on Hi Fi Lite and Conditioning Cubes And Fully fit-Literally just done 3 Classes at the Regionals,in July so couldn’t even blame the frost-He had been on this for about 4 years.When he went down the vets said I needed to look at his feed as even a handful of feed when struggling can stop them improving.I was very surprised to see that the Hi Fi Lite was over 7% Sugars-and it’s approved by Laminitis Trust-the Hi Fi Molasses Free is just over 2% and actually a lot more palatable.When I ran what I was going to change him to with the vet,even she couldn’t believe how high the sugar content is in the Hi Fi Lite.I have both still as I have another mare on the Hi Fi Lite And when you look at them next to each other-the amount of Molasses still on the Hi Fi Lite is quite a shock.I would look at the Mollichaff Calmer to Check the Sugar Content isn’t over about 3%.Good Luck And hope yours improves.

Thankyounformthe heads up. I will call at feed shop tomorrow in my way home from work

 

[riversideeu]

Hi I do not have time to read all the messages so sorry if I repeat anything. Coming up 2 years in May my 18 year old cob who was being looked after by a farmer friend who is a feeder went down with laminitis for the first time and looking back she was quite overweight. To keep it as brief as possible we brought her in immediately she had bute and was fed only barley straw top chop zero and antilam. She was tested and had EMS but not cushings. We got rid of the laminitis then she went on Metformin which we had to syringe in like wormer as it tastes so terrible. Once everything was under strict control I exercised her as much as possible walking and lungeing. By August I started to put her out 15 mins then 30 mins and eventually she went out all day on an unfertilised paddock. In January last year she was retested and is now a normal horse again no EMS. She now gets some haylage with her straw and normal vitamins and minerals with her top chop zero. She has a re educated palet and is completely sound at 20. I blame myself but by being strict the whole episode is now behind us BUT YOU MUST BE STRICT IT IS BEING CRUEL TO BE KIND. Good luck.

 

[riversideeu]

Oh and I forgot to say regular foot trimming is a must and do not get too upset if the vet starts to tell you the feet have started to rotate. My blacksmith says Smarties feet are perfectly normal and vets often over estimate the damage. I was told one had rotated but the blacksmith disagreed.

 

[Domirati]

Just to say I hope things are finally looking up for you. Heather took nearly five weeks so don’t get disheartened if not. I thought I had lost her a week ago and now (touch wood) she seems to have turned a corner. Moving around her box much easier and actually pawed at the ground for her minuscule feed last night. Still a long way to go but hopefully light at the end of the tunnel. I am keeping my fingers crossed that your boy is feeling better too. Hang in there.

 

[googol]

Hi everyone, thanks again for all your suggestions, comments and good wishes.

He is doing so much better now. I think we are over the acute stage of the lammi. His bute has been reduced to 2 sachets per day and he is comfortable enough in walk to be turned out in the (very muddy) field on vets advice. This movement has helped his ataxia which looked to get quite uncomfortable, and he’s been rolling and enjoying life a bit more now. He’s also lost a bit of weight so the soaked hay seems to be working, and I don’t feel he’s starved or living a miserable life. Yesterday was 4 weeks from the initial set of x rays and the laminitis symptoms, and he’s been lame now since 19th Feb. Feels like so much longer for me! This is the longest he’s been out of work for 6 years but have started his carrot stretches (with sugar free polos!) again and hopefully soon he can do a little more exercise. On the whole I’m feeling so much more optimistic, there was definitely a time where I thought I had lost him (vet included!)but glad he seems to be over the worst of it.
Thanks again for your support, it was really appreciated
I hope those of you battling lammi with your own horses are seeing light at the end of the tunnel too!

 

[wingedhorse]

I have a 20 year old horse that gets bad recurrent abscesses every winter. He's a non fat, 17hh warmblood. He's tested repeatedly negative for cushings and is not obviously grass sensitive.

An experienced horse person has just said due to abscesses I should get him tested for EMS. I suggested this to my vet a few years back, and he said pointless as has no other symptoms of EMS / Insulin Resistance / Metabolic issue and pretty much refused.

Can winter abscesses be the only sign of EMS when horse is negative for cushings and no other signs? Hoof quality is fine.

 

[googol]

Wingedhorse, I’m afraid I have no idea. I’m very inexperienced with regards to EMS so hopefully there will be someone else with more knowledge following the thread.
What I would say though is that mine had virtually no symptoms prior to the lammi& EMS diagnosis. Knowing what I know now (a tiny amount) he has all the physical symptoms in that he carries weight in all the classical EMS areas. My vets aren’t keen to test him for the EMS because of the chance of triggering the lammi. I agree with this and will just manage him as such going forward. It really is the only explanation for the lammi in the first case in his situation too.

 

[AandK]

I have a 20 year old horse that gets bad recurrent abscesses every winter. He's a non fat, 17hh warmblood. He's tested repeatedly negative for cushings and is not obviously grass sensitive.

An experienced horse person has just said due to abscesses I should get him tested for EMS. I suggested this to my vet a few years back, and he said pointless as has no other symptoms of EMS / Insulin Resistance / Metabolic issue and pretty much refused.

Can winter abscesses be the only sign of EMS when horse is negative for cushings and no other signs? Hoof quality is fine.

Have a look at this: http://forageplustalk.co.uk/horse-hoof-abscesses-and-poor-hoof-quality/ My horse suffered terribly with reoccurring abscesses in winter after moving to a new yard in a new area 5.5yrs ago. I have been feeding minerals for the last 3 years and not had an issue since.

 

[wingedhorse]

Have a look at this: http://forageplustalk.co.uk/horse-hoof-abscesses-and-poor-hoof-quality/ My horse suffered terribly with reoccurring abscesses in winter after moving to a new yard in a new area 5.5yrs ago. I have been feeding minerals for the last 3 years and not had an issue since.

Thanks, sadly I've been feeding minerals last 5 years.

 

[holeymoley]

I'd think is unlikely to be EMS unless he's also showing the other symptoms too. My gelding has EMS and has never in 13years had a hoof abscess.

I had a friend years ago who's horse had terrible hooves, kept getting abscesses and had really bad quality hoof- couldn't keep a shoe on. She moved yards and started feeding Blue Chip and the horse hasn't had an abscess since. She's kept the shoes and now doing BE, now only slowing down due to age.

 

[googol]

Unfortunately my horse has taken a backwards step and is back in the acute phase with more rotation. I am devastated and seriously worried about his future. He had been getting a small amount of fast fibre and some high fibre nuts to get his bute into him but the vet wants me to try syringing this into him so he’s only on hay and water. This is going to be a virtually impossible task (unless there’s some miracle) so just wanting some recommendations for other ideas? Strictly no sugar at all!!
I feel absolutely terrible for him and I’m scared incase this doesn’t end well and he’s spent so much time in so much pain. The whole thing just doesn’t sit right with me at all. But of course I don’t want to give up on him. Heart breaking situation

 

[OLDGREYMARE]

Sorry to hear this.What you need to do is get his feet trimmed to realign the pedal bone over several sessions. Andrea from the Laminitis Site will mark up your recent xrays if you post them on the friends of the laminitis site FB page.All is not lost.Meanwhile make sure his soles are supported with thick foam pads ducktaped on.Obviously with no shoes on. Good luck.

 

[Merlod]

My EMS shetland was on box rest for two months, at the time it feels horrific like they're never going to come right. I put EVA foam matting at the front and deeply bedded all the rest, mucked out over the door. My boy is highly insulin resistant, my vet was shocked how much so. I had to syringe his bute and metformin twice daily, he hated me but needs must! I never went down the remedial shoeing route, boots and pads did provide a small amount of releif but really what you need to do is address the cause and give the horse enough time to heal instead of trying to patch it up with shoes (and im not anti shoes, my riding horse is shod) my wonderful farrier came to trim him every 5 weeks and often popped in to check his feet when he was in the area, xrays were so much help in addressing the rotation he had. I would cut the fast fibre and high fibre nuts - the newer school of thought is 'no gut, no foot, no horse' and I can't tell you the difference since cutting all processed feeds for my boy (even the low sugar things contain a lot of crap and byproducts like oat/wheatfeed, nis, mologlo/molasses coatings and not to mention chemicals used on crops - this can all really affect ems ponies). He now gets honeychop lite and healthy, a sprinkle of thunderbrooks herbal chaff to make it a little more appealing, equimins advance complete, biomos prebiotic and true cinnamon. I really think it was the overhaul in diet and time to heal that has made the world of difference, he's not even on metformin anymore and back to full soundness, now working on getting him fit enough to get back driving. If you had asked me at the time he was suffering laminitis I really did think he'd be pts.

 

[TGM]

Hi-Just wanted to say that I would watch the Mollichaff Calmer-I Would Check it’s Sugar Content.My Boy was on Hi Fi Lite and Conditioning Cubes And Fully fit-Literally just done 3 Classes at the Regionals,in July so couldn’t even blame the frost-He had been on this for about 4 years.When he went down the vets said I needed to look at his feed as even a handful of feed when struggling can stop them improving.I was very surprised to see that the Hi Fi Lite was over 7% Sugars-and it’s approved by Laminitis Trust-the Hi Fi Molasses Free is just over 2% and actually a lot more palatable.When I ran what I was going to change him to with the vet,even she couldn’t believe how high the sugar content is in the Hi Fi Lite.I have both still as I have another mare on the Hi Fi Lite And when you look at them next to each other-the amount of Molasses still on the Hi Fi Lite is quite a shock.I would look at the Mollichaff Calmer to Check the Sugar Content isn’t over about 3%.Good Luck And hope yours improves.

Just wanted to point out that people can get so hung up over sugar levels in relation to laminitis that they forget about starch. Starch can be just as harmful to a laminitic, so you should look at starch/sugar levels combined. You don't say what brand of conditioning cubes you were using, but the majority are pretty high in starch, for example, of those that state the starch content, Spillers are 20% and Saracen are 21%. Even TopSpec Cool Condition Cubes which are marketed as low starch are 9.5% starch, but they don't state the sugar level. So it is quite likely that the total soluble carb level is over the 10% recommended for laminitics. So it is quite possible the conditioning cubes you fed contributed as much, if not more, to the laminitis that your horse suffered.

 

[_HP_]

Sorry to hear this.What you need to do is get his feet trimmed to realign the pedal bone over several sessions. Andrea from the Laminitis Site will mark up your recent xrays if you post them on the friends of the laminitis site FB page.All is not lost.Meanwhile make sure his soles are supported with thick foam pads ducktaped on.Obviously with no shoes on. Good luck.

This...
You need regular trims to correct the rotation...as little as every couple of weeks. This should alleviate the pain. No movement while there is rotation. Good luck

 

[ChesnutsRoasting]

Has the vet suggested what your horses ideal weight is? You should be feeding 1.5% of your horses ideal weight,unless he was deemed obese by the vet & then you could go down to 1%, including any hard feed. Soak the hay for a minimum of 12 hours & feed in a small holed net - preferably divided into four nets per 24 hours. Total box rest on a deep bed & have patience. It’s distressing to see your horse in such pain but with the right management he can recover.