Accurate diagnosis of equine metabolic syndrome through appropriate testing is essential before implementing management changes that significantly affect horses' diet and lifestyle.
Accurate EMS diagnosis before implementing management changes serves welfare by ensuring appropriate rather than unnecessary dietary restriction. Over-restricting a horse that does not have insulin dysregulation based on appearance alone causes nutritional welfare harm without providing the protection from laminitis that motivates restriction. Correctly diagnosing coexisting PPID ensures that the pituitary component of the problem receives appropriate treatment. The diagnostic investment in proper testing, though more expensive than dietary restriction alone, provides the evidence base for welfare-centered management rather than assumptions.