ECEIM consensus statement on equine metabolic syndrome
Authors: A. Durham, N. Frank, C. McGowan, N. Menzies‐Gow, E. Roelfsema, I. Vervuert, K. Feige, K. Fey
Journal: Journal of Veterinary Internal Medicine
Summary
# Editorial Summary: ECEIM Consensus on Equine Metabolic Syndrome Equine metabolic syndrome represents a constellation of interconnected metabolic dysfunction risk factors, with insulin dysregulation as the primary driver of endocrinopathic laminitis—a distinction that has shaped how we now approach preventative management. This 2019 consensus statement synthesises evidence-based diagnostic and management protocols from the European College of Equine Internal Medicine, providing clinicians with standardised approaches across multiple assessment modalities rather than relying on single diagnostic tests. The panel emphasises that EMS diagnosis integrates clinical history and physical findings alongside laboratory investigations of insulin sensitivity and glucose metabolism, recognising that no single biomarker captures the full metabolic picture. Primary management centres on controlled dietary modification and structured exercise programmes designed specifically to improve insulin regulation and address obesity, with pharmacological intervention reserved for cases where lifestyle modification alone proves insufficient. For practitioners involved in equine care, this consensus clarifies that EMS management demands consistent, long-term engagement from both the owner and the veterinary team, requiring systematic monitoring and disciplined adherence to tailored protocols rather than reactive responses to laminitis episodes.
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Practical Takeaways
- •Screen horses for insulin dysregulation through appropriate laboratory tests; this is your main lever for preventing laminitis in metabolically predisposed horses
- •Combine diet (calorie and sugar restriction) with consistent exercise as the foundation of EMS management—these address the root problem, not just symptoms
- •Partner with your veterinarian on long-term monitoring; EMS control requires sustained owner discipline and professional guidance to succeed
Key Findings
- •Insulin dysregulation is the most important risk factor in equine metabolic syndrome and primary target for laminitis prevention
- •EMS diagnosis requires combined approach using clinical history, physical examination, and laboratory testing of multiple metabolic parameters
- •Dietary modification and exercise programs are primary treatment strategies for EMS management
- •Long-term pharmacologic support may be useful in selected EMS cases alongside lifestyle modifications