Nutritional Considerations for Horses with Endocrine Disorders

Coexisting Forces: PPID and EMS The presence of insulin dysregulation in certain horses diagnosed with PPID indicates EMS and PPID can coexist. According to researchers, testing for PPID using ACTH concentrations or thyrotropin-releasing hormone stimulation test should be considered in horses with insulin dysregulation and/or laminitis, especially in horses over 10 years of age.

Differential Diagnoses Aside from PPID and EMS, few other endocrinopathies are diagnosed in horses. Differential diagnoses include diabetes mellitus (persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both), neoplasia-associated hypoglycemia (such as insulinoma, a usually benign pancreatic neoplasm characterized by uncontrolled insulin secretion and consequent hypoglycemia), thyroid disorders (hypothyroidism, hyperthyroidism, and hyperparathyroidism), and adrenal diseases. An experienced veterinary specialist can help sort through the clinical signs and diagnostic tests necessary to achieve an accurate diagnosis.

About Kentucky Equine Research For over 30 years Kentucky Equine Research® has continually developed innovative solutions to the health and nutritional challenges inherent in modern equine management. The results of studies conducted at its research farms, as well as advances in equine nutrition from institutions around the world, are applied and thoroughly tested in the creation of KER products.

KER Targeted Nutrition is a brand of innovative equine health and nutrition supplements developed by Kentucky Equine Research, the leader in equine nutrition technology.

TECHNICAL BULLETIN

Nutritional Considerations for Horses with Endocrine Disorders As a species, horses have a longer average lifespan now than ever before. Due to advances in veterinary and nutritional management, a protracted lifespan often equates to an extended working life.

Once their usefulness ebbs and retirement looms, many horses retain value as companions, both to other horses and humans.

Because of this, interest in disorders that affect aged horses has grown among horse owners and veterinarians, with keen attention given to endocrine diseases.

Recent research efforts have amplified the knowledge of endocrine

FURTHER READING:

disorders, though certain aspects of these diseases remain elusive,

Durham, A.E., N. Frank, C.M. McGowan, N.J. Menzies-Gow, E. Roelfsema, I. Vervuert, K. Feige, and K. Fey. 2019. ECEIM consensus statement on equine metabolic syndrome.

Journal of Veterinary Internal Medicine 33:335-349.

such as gold standard diagnostic tests. As such, diagnosis relies on

McFarlane, D. 2011. Equine pituitary pars intermedia dysfunction. Veterinary Clinics of North America Equine Practice 27:93-113.

can be implemented once a diagnosis is made.

Kentucky Equine Research® • ker.com 3910 Delaney Ferry Road 2/35 Dunlop Road Versailles, KY 40383 Mulgrave, Victoria 3170 USA • 888.873.1988 AUSTRALIA • 03.8562.7000

clinical presentation and current diagnostic procedures. Shifts in how horses are managed, including any necessary changes to the diet,

The most common diagnosed endocrine disorders are pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS).

Thoughtful management strategies, including careful attention to nutrition and exercise requirements, can provide some relief, especially when paired with appropriate medications.

Pituitary Pars Intermedia Dysfunction

Equine Metabolic Syndrome

Strategic nutritional management will cure neither PPID nor EMS.

Pituitary pars intermedia dysfunction (PPID), also known as Cushing’s

Equine metabolic syndrome (EMS) is a collection of endocrine and

horses with PPID often show clinical improvement with the help of

disease, is a slowly progressive endocrine disorder that affects many

metabolic abnormalities associated with increased susceptibility to

certain medications, most prominent of which is pergolide. Moreover,

older horses and ponies. The disorder is characterized by pituitary gland

laminitis in horses and ponies, including insulin dysregulation and

adherence to a strict diet and exercise program can stave off laminitis

abnormalities, including benign tumors, hyperplasia, or hypertrophy.

fat redistribution.

in some horses diagnosed with EMS. Metformin, a medication that

Most animals are over the age of 15 years old when diagnosed, though occasionally younger horses may be affected.

• Breeds affected: All breeds of horses and ponies.

• Clinical signs: long, wavy hair coat, often with delayed shedding; muscle wasting, especially over the topline; increased thirst and urination; increased sweating; behavioral changes, notably lethargy; subfertility; abnormal fat deposits, despite sometimes appearing thin; increased risk for opportunistic infections, likely due to immune system

In addition to dietary changes and clipping of the coat in hot weather,

guidelines can be challenging. If necessary, seek the assistance of a

Finos, Quarter Horses, and ponies of all types. Predilection for EMS

qualified equine nutritionist.

relates to members of these breeds thought to be easy keepers. While no evidence directly links EMS with geography or season, an indirect association between EMS and geography with regard to high pasture quality may occur.

• Clinical signs: general obesity as well as increased fat accumulation in specific locations, also called regional adiposity (neck, shoulder bed, tailhead, sheath, mammary gland); insulin dysregulation; predisposition

coat changes, are often sufficient for diagnosis, though earlier and milder disease may be more difficult to detect; screening can be achieved through measurement of resting adrenocorticotropic hormone (ACTH), which

to development of laminitis depending on other influences such as genetic and management factors, including overfeeding.

• Risk factors: genetic predisposition; excessive feeding of carbohydrates, usually over years; sedentary lifestyle with little or no exercise.

• Diagnosis:

physical examination and clinical signs, most notably obesity

Feeding Suggestions for Laminitis-Prone Horses Horses and ponies with PPID and EMS are prone to laminitis.

Nutritional countermeasures may, however, keep susceptible horses from developing laminitis. Dietary management focuses on restricting intake of nonstructural carbohydrates (NSC), namely sugars, starches, and fructans. The consumption of these increases the risk of laminitis through hyperinsulinemia or hindgut disturbances in laminitis-prone horses.

• Diets should be based on appropriate forage, such as grass hay (or hay substitute) with a low NSC content (less than 12% dry matter) fed at a rate

is frequently elevated in those animals with PPID, and other diagnostic

and laminitis, generally point to EMS; diagnostic tests for EMS include

of approximately 1.5-2% body weight. Mature hay typically has lower

tests, such as the thyrotropin-releasing hormone stimulation test, which

endocrine and metabolic status panel, oral sugar challenge test, and

digestible energy and NSC content when compared to less mature grass

generally seems to be more accurate than measurement of resting

the two-step insulin-response test; confirmation of systemic insulin

hay and legumes, such as alfalfa and clover. NSC content also depends

ACTH alone.

dysregulation, including postprandial hyperinsulinemia.

on environmental factors during growth and harvesting. Whenever possible, a forage analysis should be performed on hay intended for horses with PPID and EMS. Soaking hay for 30-60 minutes before feeding

Nutrient requirements for PPID

Nutrient requirements for EMS

Nutrient requirements depend largely on whether horses have been

Because obesity is a characterizing feature of EMS, nutritional

diagnosed with insulin dysregulation and laminitis.

considerations center on managing weight loss and, when horses are

absence of a forage analysis.

• Restrict or avoid access to pasture. The NSC content of some forages can escalate to 40% dry matter at certain times of the year. Consumption of

Unsound horses can be encouraged to move in drylots or turnout areas

or laminitic episodes, good-quality forage fed at a rate of 1.5-2% of body

pasture can be controlled through the regular use of a well-fitted grazing

by thoughtful placement of water, forage, and salt at opposite ends of the

weight per day; for those with concomitant insulin dysfunction, laminitis

muzzle; strip-grazing behind other horses or sheep; or mowing the

enclosure or through the addition of a younger, more playful pasturemate.

pasture short and removing the clippings. Other grazing considerations

can be exacerbated by high levels of nonstructural carbohydrates (NSC) of some pasture grasses and hays, so extreme care must be taken in regard to hay selection (tested to be 12% or less NSC) and pasture access; some horses especially sensitive to carbohydrate intake must be restricted from all pasture intake through the use of a grazing muzzle or drylot and appropriate preserved forage for these horses tends to be mature grass hays.

• Concentrate: for horses with no insulin dysfunction or laminitic episodes that need to gain weight or have difficulty maintaining body condition, a low-starch or senior feed can be given at the rate recommended by the manufacturer and fat supplements can be added to provide additional energy; for horses with insulin dysfunction and laminitis that are in moderate to obese body condition, no commercial feeds or straight grains should be given, though a well-formulated balancer pellet to satisfy protein, vitamin, and mineral requirements should be fed.

natural-source vitamin E such as Nano-E ; body-wide inflammation ®

can be reduced with omega-3 fatty acids, the most bioavailable of which are obtained from marine-derived sources, like EO-3™; in horses with muscle wasting, a high-quality amino acid supplement may counteract this clinical sign; MFM Pellet™ contains the essential branchedchain amino acids important in rebuilding muscle tissue for horses experiencing muscle wasting; a well-formulated vitamin and mineral supplement, like Micro-Max™, can provide essential nutrients to horses on all-forage diets.

include choosing a time of day when NSC are lowest in plants (late at • Forage:

maximizing calories from forage supports gastrointestinal

night through early morning), avoiding spring or autumn grazing (before

health and fosters normal foraging behavior; pasture access should be

flower development or seeding), and steering clear of stressed grasses,

limited or restricted in horses with EMS, though extent of restriction

such as those subjected to frost or drought. In situations that call for

depends on the degree

severe restriction of NSC intake, no grazing should be allowed, though an

of obesity, as some horses are able to be turned out on pasture

appropriate forage alternative can be fed in a drylot.

with a grazing muzzle, while others must be maintained in a drylot or kept off pasture completely; mature grass hay fed at a rate of 1.25-1.5% of body weight per day and provided in a way that slows consumption (e.g., slow-feed haynet); hay low in NSC (less than 12%) should be selected for horses with insulin resistance; when hay contains marginal levels of NSC, it can be soaked prior to feeding.

manufacturer and fat supplements can be added to provide additional energy; for obese horses, no commercial feeds or straight grains should be given, though a well-formulated balancer pellet to satisfy protein, vitamin, and mineral requirements should be fed.

• Supplements: horses without access to fresh forage should be fed a natural-source vitamin E such as Nano-E ; body-wide ®

inflammation can be reduced with omega-3 fatty acids, the most bioavailable of which are obtained from marine-derived sources, like EO-3™; a well-formulated vitamin and mineral supplement, like Micro-Max™, can provide essential nutrients to horses on allforage diets.

• Feed a low-calorie balancer pellet or an appropriate vitamin and mineral supplement to horses and ponies on an all-forage diet. A balancer pellet usually contains a source of high-quality protein such as soybean meal.

For aged horses or those with signs of muscle wasting, a balancer pellet might be more appropriate than a vitamin and mineral supplement.

• Avoid feedstuffs high in NSC, such as straight cereal grains (plain oats,

• Concentrate:

for EMS horses in low or moderate body condition, low-starch pelleted feed can be given at the rate recommended by the

• Supplements: horses without access to fresh forage should be fed a

A nutritionist or veterinarian may suggest other management strategies based on the individual horse.

When to Graze: Protecting At-Risk Horses During photosynthesis plants convert sunlight, water, and carbon dioxide into oxygen and chemical energy in the form of sugar. Plants use sugars to support metabolism, growth, and tissue repair. When photosynthetic production of sugars outpaces the immediate energy requirements of plants, sugars transform into one of two storage carbohydrates, starch or fructan. Warm-season grasses accumulate sugars and starch, but cool-season grasses accumulate sugars, starch, and fructans.

Because photosynthesis only occurs in the presence of sunlight, plants produce and store carbohydrates during the day. At nighttime, when photosynthesis is on hold, plants use stored carbohydrates to power physiologic processes.

Given this cycle of accumulation and depletion, carbohydrate levels are generally highest from 10:00 a.m. to 11:00 p.m., making the hours between 5:00 a.m. and 10:00 a.m. the safest, most practical time for laminitis-prone horses to graze.

is thought to leach sugars and fructans, and may be prudent in the

sound, instituting an exercise program to improve insulin sensitivity.

• Forage: for horses with clinical signs of PPID but no insulin dysfunction

an acceptable weight range.

dysregulation. Revising a diet to fit the parameters given within these

Saddlebreds, Andalusians, Morgans, Tennessee Walking Horses, Paso

dental disease; insulin dysregulation; and laminitis.

• Diagnosis: age coupled with the appearance of clinical signs, especially

Attention to changes in weight or body condition score can keep horses in

increases insulin sensitivity, has been used in horses with insulin • Breeds

affected: genetic link to insulin resistance and EMS in American

suppression, including chronic hoof abscesses, skin infections, and

• Risk factors: only age has been reported as a risk factor.

• Monitor

body weight through regular weighing or body condition scoring.

for example) or sweet feeds. Sweet feeds that contain primarily cereal grains and molasses can boost the NSC content to 45-50%.

• For lean horses or horses in work, other feedstuffs may be necessary for maintenance of weight. Concentrates low in starch and sugar content (15-25% NSC) when compared to traditional concentrates (30-50% NSC) may be appropriate in some instances. Energy is usually conferred by fat (vegetable oil, stabilized rice bran) and fermentable fiber (beet pulp, soy hulls) sources in these low-starch feeds. In other situations, unmolassed, soaked beet pulp or hay cubes with or without added vegetable oil can provide calories to horses at risk for laminitis.

Aside from time of day, carbohydrate levels vary widely based on temperature, light intensity, moisture content, soil fertility, and genetic potential of a plant species. Further, stress encourages plants to store starch and fructan rather than using it for growth. Common stressors include drought, frost, temperatures below 40° F (4° C), soil infertility, and poor pasture management, all of which might make grazing risky for laminitis-prone horses, even during hours when grasses are traditionally considered safer.

When setting out to create a safe grazing space for at-risk horses, sensible pasture management comes into play.

Regular mowing and grazing is essential as both stimulate growth. Plants tap into their carbohydrate reserves to push new growth, which reduces accumulation of starch and fructan within the plant.

Pituitary Pars Intermedia Dysfunction

Equine Metabolic Syndrome

Strategic nutritional management will cure neither PPID nor EMS.

Pituitary pars intermedia dysfunction (PPID), also known as Cushing’s

Equine metabolic syndrome (EMS) is a collection of endocrine and

horses with PPID often show clinical improvement with the help of

disease, is a slowly progressive endocrine disorder that affects many

metabolic abnormalities associated with increased susceptibility to

certain medications, most prominent of which is pergolide. Moreover,

older horses and ponies. The disorder is characterized by pituitary gland

laminitis in horses and ponies, including insulin dysregulation and

adherence to a strict diet and exercise program can stave off laminitis

abnormalities, including benign tumors, hyperplasia, or hypertrophy.

fat redistribution.

in some horses diagnosed with EMS. Metformin, a medication that

Most animals are over the age of 15 years old when diagnosed, though occasionally younger horses may be affected.

• Breeds affected: All breeds of horses and ponies.

• Clinical signs: long, wavy hair coat, often with delayed shedding; muscle wasting, especially over the topline; increased thirst and urination; increased sweating; behavioral changes, notably lethargy; subfertility; abnormal fat deposits, despite sometimes appearing thin; increased risk for opportunistic infections, likely due to immune system

In addition to dietary changes and clipping of the coat in hot weather,

guidelines can be challenging. If necessary, seek the assistance of a

Finos, Quarter Horses, and ponies of all types. Predilection for EMS

qualified equine nutritionist.

relates to members of these breeds thought to be easy keepers. While no evidence directly links EMS with geography or season, an indirect association between EMS and geography with regard to high pasture quality may occur.

• Clinical signs: general obesity as well as increased fat accumulation in specific locations, also called regional adiposity (neck, shoulder bed, tailhead, sheath, mammary gland); insulin dysregulation; predisposition

coat changes, are often sufficient for diagnosis, though earlier and milder disease may be more difficult to detect; screening can be achieved through measurement of resting adrenocorticotropic hormone (ACTH), which

to development of laminitis depending on other influences such as genetic and management factors, including overfeeding.

• Risk factors: genetic predisposition; excessive feeding of carbohydrates, usually over years; sedentary lifestyle with little or no exercise.

• Diagnosis:

physical examination and clinical signs, most notably obesity

Feeding Suggestions for Laminitis-Prone Horses Horses and ponies with PPID and EMS are prone to laminitis.

Nutritional countermeasures may, however, keep susceptible horses from developing laminitis. Dietary management focuses on restricting intake of nonstructural carbohydrates (NSC), namely sugars, starches, and fructans. The consumption of these increases the risk of laminitis through hyperinsulinemia or hindgut disturbances in laminitis-prone horses.

• Diets should be based on appropriate forage, such as grass hay (or hay substitute) with a low NSC content (less than 12% dry matter) fed at a rate

is frequently elevated in those animals with PPID, and other diagnostic

and laminitis, generally point to EMS; diagnostic tests for EMS include

of approximately 1.5-2% body weight. Mature hay typically has lower

tests, such as the thyrotropin-releasing hormone stimulation test, which

endocrine and metabolic status panel, oral sugar challenge test, and

digestible energy and NSC content when compared to less mature grass

generally seems to be more accurate than measurement of resting

the two-step insulin-response test; confirmation of systemic insulin

hay and legumes, such as alfalfa and clover. NSC content also depends

ACTH alone.

dysregulation, including postprandial hyperinsulinemia.

on environmental factors during growth and harvesting. Whenever possible, a forage analysis should be performed on hay intended for horses with PPID and EMS. Soaking hay for 30-60 minutes before feeding

Nutrient requirements for PPID

Nutrient requirements for EMS

Nutrient requirements depend largely on whether horses have been

Because obesity is a characterizing feature of EMS, nutritional

diagnosed with insulin dysregulation and laminitis.

considerations center on managing weight loss and, when horses are

absence of a forage analysis.

• Restrict or avoid access to pasture. The NSC content of some forages can escalate to 40% dry matter at certain times of the year. Consumption of

Unsound horses can be encouraged to move in drylots or turnout areas

or laminitic episodes, good-quality forage fed at a rate of 1.5-2% of body

pasture can be controlled through the regular use of a well-fitted grazing

by thoughtful placement of water, forage, and salt at opposite ends of the

weight per day; for those with concomitant insulin dysfunction, laminitis

muzzle; strip-grazing behind other horses or sheep; or mowing the

enclosure or through the addition of a younger, more playful pasturemate.

pasture short and removing the clippings. Other grazing considerations

can be exacerbated by high levels of nonstructural carbohydrates (NSC) of some pasture grasses and hays, so extreme care must be taken in regard to hay selection (tested to be 12% or less NSC) and pasture access; some horses especially sensitive to carbohydrate intake must be restricted from all pasture intake through the use of a grazing muzzle or drylot and appropriate preserved forage for these horses tends to be mature grass hays.

• Concentrate: for horses with no insulin dysfunction or laminitic episodes that need to gain weight or have difficulty maintaining body condition, a low-starch or senior feed can be given at the rate recommended by the manufacturer and fat supplements can be added to provide additional energy; for horses with insulin dysfunction and laminitis that are in moderate to obese body condition, no commercial feeds or straight grains should be given, though a well-formulated balancer pellet to satisfy protein, vitamin, and mineral requirements should be fed.

natural-source vitamin E such as Nano-E ; body-wide inflammation ®

can be reduced with omega-3 fatty acids, the most bioavailable of which are obtained from marine-derived sources, like EO-3™; in horses with muscle wasting, a high-quality amino acid supplement may counteract this clinical sign; MFM Pellet™ contains the essential branchedchain amino acids important in rebuilding muscle tissue for horses experiencing muscle wasting; a well-formulated vitamin and mineral supplement, like Micro-Max™, can provide essential nutrients to horses on all-forage diets.

include choosing a time of day when NSC are lowest in plants (late at • Forage:

maximizing calories from forage supports gastrointestinal

night through early morning), avoiding spring or autumn grazing (before

health and fosters normal foraging behavior; pasture access should be

flower development or seeding), and steering clear of stressed grasses,

limited or restricted in horses with EMS, though extent of restriction

such as those subjected to frost or drought. In situations that call for

depends on the degree

severe restriction of NSC intake, no grazing should be allowed, though an

of obesity, as some horses are able to be turned out on pasture

appropriate forage alternative can be fed in a drylot.

with a grazing muzzle, while others must be maintained in a drylot or kept off pasture completely; mature grass hay fed at a rate of 1.25-1.5% of body weight per day and provided in a way that slows consumption (e.g., slow-feed haynet); hay low in NSC (less than 12%) should be selected for horses with insulin resistance; when hay contains marginal levels of NSC, it can be soaked prior to feeding.

manufacturer and fat supplements can be added to provide additional energy; for obese horses, no commercial feeds or straight grains should be given, though a well-formulated balancer pellet to satisfy protein, vitamin, and mineral requirements should be fed.

• Supplements: horses without access to fresh forage should be fed a natural-source vitamin E such as Nano-E ; body-wide ®

inflammation can be reduced with omega-3 fatty acids, the most bioavailable of which are obtained from marine-derived sources, like EO-3™; a well-formulated vitamin and mineral supplement, like Micro-Max™, can provide essential nutrients to horses on allforage diets.

• Feed a low-calorie balancer pellet or an appropriate vitamin and mineral supplement to horses and ponies on an all-forage diet. A balancer pellet usually contains a source of high-quality protein such as soybean meal.

For aged horses or those with signs of muscle wasting, a balancer pellet might be more appropriate than a vitamin and mineral supplement.

• Avoid feedstuffs high in NSC, such as straight cereal grains (plain oats,

• Concentrate:

for EMS horses in low or moderate body condition, low-starch pelleted feed can be given at the rate recommended by the

• Supplements: horses without access to fresh forage should be fed a

A nutritionist or veterinarian may suggest other management strategies based on the individual horse.

When to Graze: Protecting At-Risk Horses During photosynthesis plants convert sunlight, water, and carbon dioxide into oxygen and chemical energy in the form of sugar. Plants use sugars to support metabolism, growth, and tissue repair. When photosynthetic production of sugars outpaces the immediate energy requirements of plants, sugars transform into one of two storage carbohydrates, starch or fructan. Warm-season grasses accumulate sugars and starch, but cool-season grasses accumulate sugars, starch, and fructans.

Because photosynthesis only occurs in the presence of sunlight, plants produce and store carbohydrates during the day. At nighttime, when photosynthesis is on hold, plants use stored carbohydrates to power physiologic processes.

Given this cycle of accumulation and depletion, carbohydrate levels are generally highest from 10:00 a.m. to 11:00 p.m., making the hours between 5:00 a.m. and 10:00 a.m. the safest, most practical time for laminitis-prone horses to graze.

is thought to leach sugars and fructans, and may be prudent in the

sound, instituting an exercise program to improve insulin sensitivity.

• Forage: for horses with clinical signs of PPID but no insulin dysfunction

an acceptable weight range.

dysregulation. Revising a diet to fit the parameters given within these

Saddlebreds, Andalusians, Morgans, Tennessee Walking Horses, Paso

dental disease; insulin dysregulation; and laminitis.

• Diagnosis: age coupled with the appearance of clinical signs, especially

Attention to changes in weight or body condition score can keep horses in

increases insulin sensitivity, has been used in horses with insulin • Breeds

affected: genetic link to insulin resistance and EMS in American

suppression, including chronic hoof abscesses, skin infections, and

• Risk factors: only age has been reported as a risk factor.

• Monitor

body weight through regular weighing or body condition scoring.

for example) or sweet feeds. Sweet feeds that contain primarily cereal grains and molasses can boost the NSC content to 45-50%.

• For lean horses or horses in work, other feedstuffs may be necessary for maintenance of weight. Concentrates low in starch and sugar content (15-25% NSC) when compared to traditional concentrates (30-50% NSC) may be appropriate in some instances. Energy is usually conferred by fat (vegetable oil, stabilized rice bran) and fermentable fiber (beet pulp, soy hulls) sources in these low-starch feeds. In other situations, unmolassed, soaked beet pulp or hay cubes with or without added vegetable oil can provide calories to horses at risk for laminitis.

Aside from time of day, carbohydrate levels vary widely based on temperature, light intensity, moisture content, soil fertility, and genetic potential of a plant species. Further, stress encourages plants to store starch and fructan rather than using it for growth. Common stressors include drought, frost, temperatures below 40° F (4° C), soil infertility, and poor pasture management, all of which might make grazing risky for laminitis-prone horses, even during hours when grasses are traditionally considered safer.

When setting out to create a safe grazing space for at-risk horses, sensible pasture management comes into play.

Regular mowing and grazing is essential as both stimulate growth. Plants tap into their carbohydrate reserves to push new growth, which reduces accumulation of starch and fructan within the plant.

Coexisting Forces: PPID and EMS The presence of insulin dysregulation in certain horses diagnosed with PPID indicates EMS and PPID can coexist. According to researchers, testing for PPID using ACTH concentrations or thyrotropin-releasing hormone stimulation test should be considered in horses with insulin dysregulation and/or laminitis, especially in horses over 10 years of age.

Differential Diagnoses Aside from PPID and EMS, few other endocrinopathies are diagnosed in horses. Differential diagnoses include diabetes mellitus (persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both), neoplasia-associated hypoglycemia (such as insulinoma, a usually benign pancreatic neoplasm characterized by uncontrolled insulin secretion and consequent hypoglycemia), thyroid disorders (hypothyroidism, hyperthyroidism, and hyperparathyroidism), and adrenal diseases. An experienced veterinary specialist can help sort through the clinical signs and diagnostic tests necessary to achieve an accurate diagnosis.

About Kentucky Equine Research For over 30 years Kentucky Equine Research® has continually developed innovative solutions to the health and nutritional challenges inherent in modern equine management. The results of studies conducted at its research farms, as well as advances in equine nutrition from institutions around the world, are applied and thoroughly tested in the creation of KER products.

KER Targeted Nutrition is a brand of innovative equine health and nutrition supplements developed by Kentucky Equine Research, the leader in equine nutrition technology.

TECHNICAL BULLETIN

Nutritional Considerations for Horses with Endocrine Disorders As a species, horses have a longer average lifespan now than ever before. Due to advances in veterinary and nutritional management, a protracted lifespan often equates to an extended working life.

Once their usefulness ebbs and retirement looms, many horses retain value as companions, both to other horses and humans.

Because of this, interest in disorders that affect aged horses has grown among horse owners and veterinarians, with keen attention given to endocrine diseases.

Recent research efforts have amplified the knowledge of endocrine

FURTHER READING:

disorders, though certain aspects of these diseases remain elusive,

Durham, A.E., N. Frank, C.M. McGowan, N.J. Menzies-Gow, E. Roelfsema, I. Vervuert, K. Feige, and K. Fey. 2019. ECEIM consensus statement on equine metabolic syndrome.

Journal of Veterinary Internal Medicine 33:335-349.

such as gold standard diagnostic tests. As such, diagnosis relies on

McFarlane, D. 2011. Equine pituitary pars intermedia dysfunction. Veterinary Clinics of North America Equine Practice 27:93-113.

can be implemented once a diagnosis is made.

Kentucky Equine Research® • ker.com 3910 Delaney Ferry Road 2/35 Dunlop Road Versailles, KY 40383 Mulgrave, Victoria 3170 USA • 888.873.1988 AUSTRALIA • 03.8562.7000

clinical presentation and current diagnostic procedures. Shifts in how horses are managed, including any necessary changes to the diet,

The most common diagnosed endocrine disorders are pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS).

Thoughtful management strategies, including careful attention to nutrition and exercise requirements, can provide some relief, especially when paired with appropriate medications.