Equine metabolic syndrome (EMS) affects a growing proportion of domestic horses and ponies, causing laminitis risk and welfare compromise. Management through diet and exercise is effective but requires commitment.
Horses and ponies with EMS carry a laminitis risk that makes every grazing opportunity a potential welfare emergency — the spring flush of grass that others enjoy brings genuine danger to EMS animals who could develop acute laminitis from insulin-mediated lamellar disruption within days. The welfare management of EMS requires restricting access to the natural behavior (grazing) most central to equine wellbeing while maintaining physical health. This is a genuine welfare trade-off that requires careful management: soaked hay to reduce sugar content, controlled exercise that improves insulin sensitivity, grazing muzzles that allow some grazing while limiting intake. The horses who have the best welfare outcomes are those whose owners understand EMS well enough to implement effective, sustainable management without unnecessary restriction.