Medication

Management changes are the best approach to dealing with EMS and insulin issues, but those efforts can be supplemented with a few medical resources as well.

“There are a few pharmaceuticals that veterinarians sometimes recommend for horses with EMS,” says Philip Johnson, BVSc, MRCVS, of the University of Missouri. “But we tend to only use these in the advanced cases where management and dietary changes alone aren’t working or to try to protect the horse while waiting for the effects of management changes to appear.”

One such product is levothyroxine, a thyroid hormone supplement that helps to reduce body fat mass when prescribed at higher doses and when combined with dietary changes. Horses remain on the supplement three to six months until weight is lost, then are slowly weaned off of it.

Also commonly recommended is the drug metformin, which is often prescribed for people with diabetes and inhibits the release of glucose into the blood. In horses, the drug mainly inhibits the uptake of glucose and thus prevents blood glucose and insulin levels from spiking, Johnson explains, noting that metformin can also help obese horses lose weight.