4 minute read
SUGAR
SUGAR Does Not Cause EQUINE Metabolic Syndrome
Story and Photos By Eleanor Kellon, VMD Staff Veterinary Specialist
Advertisement
It’s a common belief, but diet does not cause metabolic syndrome.
A prominent fatty crest on the neck is a hallmark of metabolic syndrome.
The wrong diet exacerbates equine metabolic syndrome (EMS) but it doesn’t actually cause it. It’s easy to see where the idea came from. When a horse/pony/donkey has metabolic syndrome it is very important to limit the sugar and starch in the diet. Starch is digested to glucose before being absorbed. The higher the intake, the higher the animal’s insulin levels will go and the higher the laminitis risk. However, these abnormal elevations don’t happen with every horse and evidence continues to grow that metabolic syndrome is genetic. In 2006, Trieber et al published the results of a year-long mixed breed pony herd study following 160 ponies. There were 54 with a previous history of laminitis and 106 were never laminitic. Diet was pasture for all. There were exaggerated responses to spring pasture in the previously and currently laminitic group only and this was “consistent with the expected inheritance of a dominant gene or genes with reduced penetrance”. Genetics as the root cause is entirely consistent with the observation that certain breeds, like Thoroughbreds, Standardbreds, full size Drafts and Warmbloods rarely, if ever, develop EMS unless they also have PPID. On the other hand, ponies, minis, donkeys, Arabians, Morgans, Haflingers and others are at high risk. A study published in 2016 by Bamford et al attempted to induce EMS by making horses obese using a high fat diet or high fat + a high carbohydrate meal. They succeeded in making them obese, but not making them insulin resistant. In fact, the horses also fed high carbohydrate had better insulin sensitivity than those fed high fat alone. This adaptation to higher simple carbohydrate intake has been reported before in normal horses. Work is ongoing to identify the specific genetic components. The most helpful way to think of reactions to sugar is that it is similar to a food allergy. The vast majority of people can eat peanuts but for some it triggers a severe reaction. It’s not that peanuts are inherently dangerous. It’s the individual sensitivity. It’s actually not all that simple. For example, exercise can protect from elevated insulin reactions even in susceptible horses. The point is though that sugar/starch isn’t the villain here. The issue is the individual’s genetics. You cannot cause metabolic syndrome by diet.
DIAGNOSIS
The typical EMS horse is overweight with a fatty crest and often fat deposits at the base of the tail, along the withers, and above the eyes but many horses with EMS are not overweight. The cresty neck is a more universal sign and these horses are all at high risk of laminitis. The only definitive way to diagnose EMS is with blood work. The hallmark of EMS is elevated insulin. Insulin and glucose should be done with the horse nonfasting. Ideally the horse will have access to hay only from the night before and on day of testing. If hay runs out overnight, be sure the horse gets the first meal of the day at least 4 hours before testing to avoid falsely high levels that can occur after that first meal. Do not exercise on the day of testing and shipping can also give false values. Test at home. Horses in their mid-teens or older should also be screened for PPID – pituitary pars intermedia dysfunction, Cushing’s disease. This disorder produces hormonal changes that also lead to elevated insulin. If the horse has PPID, it will need to be treated with pergolide in addition to diet control.
The heart of treatment for EMS is exercise and diet. Exercise should be as much and as often as possible as long as the horse isn’t laminitic. Diet should be based on hay with minerals to balance the hay analysis. Everything the horse eats should be below 10% starch and simple sugar (ESC) combined. As mentioned above, a horse which also had PPID will need pergolide. There are no effective herbal or other dietary supplements for EMS and certainly none that could take the place of diet and exercise. It is helpful to correct common mineral shortages that can impact insulin functioning, metabolism and antioxidant/antiinflammatory defenses. These include magnesium, phosphorus, zinc, copper, iodine and selenium. Severe cases that are refractory to diet and exercise when possible may be helped by pharmaceuticals. For more details on diagnosis and treatment, visit www.ecirhorse.org.
TREATMENT
LOVE TO RIDE! LOVE TO RIDE!
Learn how Nancy can help you create more joy and success in your riding. Go to carouselcoaching.com and arrange your introductory session today!
Dressage Performance and Mindset Coaching Nancy’s unique experience of competition through the Grand Prix level in the U.S. and Europe and her passion for relationships makes her a perfect choice to partner with.
Nancy’s dedication to horsemanship and the health and wellbeing of our youth riders creates a positive environment for growth and success. Lessons and coaching are available at her facilities in New Hampshire (summer) and Florida (winter), or remotely via phone or internet.
Nancy Later Lavoie 561 714 7447
Greenville, NH / Loxahatchee, FL
