Equine metabolic syndrome affects a significant proportion of leisure horses, and insulin dysregulation leading to laminitis represents one of the most preventable but still common causes of severe, chronic pain in horses.
Equine metabolic syndrome welfare is substantially a management disease — one that develops from feeding and management practices inconsistent with the evolved physiology of horses and ponies bred for sparse environments. The welfare consequence of inadequately managed EMS is laminitis, one of the most severe and prolonged painful conditions horses experience: inflammation and ischemia within the hoof capsule causes excruciating pain with each step, progressive coffin bone rotation, and in severe cases penetration of the sole. The preventability of laminitis through proactive dietary management, weight control, and insulin testing makes its occurrence in known EMS horses particularly significant from a welfare perspective. The genetic predisposition of many native and draft breeds means that owners of these animals carry special responsibility for understanding and managing metabolic risk.