There’s a growing problem among the equine population, and we do mean growing.

An increase in horses with metabolic disorders like insulin resistance and Equine Metabolic Syndrome has veterinarians and horse owners searching for solutions to prevent these conditions from developing into laminitis, the second leading cause of death among horses.

Dr. Vernon Dryden, DVM, CJF, believes he has found one in the Wellness Ready Stall Side Insulin Test.

We caught up with Dr. Dryden to talk about the current state, and future, of laminitis prevention.

Q: What is Equine Metabolic Syndrome?

Dr. Vernon Dryden: Equine Metabolic Syndrome, or EMS, is a disorder associated with insulin dysregulation, obesity and/or fat deposition, and the presence of laminitis. When horses with EMS consume high amounts of non-structural carbohydrates, as found in lush pasture and grains, their bodies produce higher than normal levels of insulin and are slow to return to baseline values. And we now know that elevated insulin levels can lead to laminitic episodes.

There are genetic factors, but EMS is very much a management problem. In many senses we’ve created an epidemic in horses because we want to see them rolly-polly and dappled out. And in the horse’s natural environment, they don’t look that way. They are grazing and foraging and constantly moving around.

Q: You used the term ‘epidemic.’ How big of an issue has EMS become in horses?

Dr. Dryden: Equine Metabolic Syndrome has become a huge issue for the equine population. We are now realizing that more horses are being diagnosed with Equine Metabolic Syndrome than once thought. It is a vastly growing problem.

Q: What are some common signs of EMS that horse owners can look for?

Dr. Dryden: Your typical horse with Equine Metabolic Syndrome is going to develop fat deposition over the shoulders and over the tail head, and have a cresty neck. They are going to be what we would label as “easy keepers.”

There are several breeds that are predisposed to metabolic syndrome and insulin resistance. Those are: Quarter Horses, Arabians, Saddlebreds, Standardbreds, Friesians, and Warmbloods. Even if your horse doesn’t look like a typical ‘metabolic’ case, your horse may have early onset of insulin resistance or metabolic syndrome.

What horses are at risk

Q: How can we know for certain if a horse has EMS?

Dr. Dryden: EMS is characterized by the horse being overweight, insulin resistant and having a history of laminitis. We can look at a horse and see that it is overweight or possibly laminitic. However, insulin resistance is something that we have to diagnose through a blood test. Elevated blood insulin level is a major risk factor. There is a very close relationship between hyperinsulinemia—elevated levels of insulin in the blood—and laminitis.

For many horse owners, their first introduction to this is when the horse becomes laminitic.  Unfortunately, by that point, it is a very serious and expensive problem. Treating a horse for laminitis can be in the tens of thousands of dollars. What we need to do is have earlier detection and prevention of the disease.

Q: How is EMS diagnosed?

Dr. Dryden: Equine Metabolic Syndrome, historically, has been diagnosed by pulling the horse’s blood in a fasted state and evaluating the insulin level. If the insulin levels are above 50 microU/ml in the fasted state, the horse is considered insulin resistant.

However, if the horse has an insulin level in the high range of normal (35–40) microU/ml in the fasted state, a dynamic glucose challenge needs to be performed to evaluate the horse’s response to glucose. This is done by your veterinarian first pulling blood in a fasted state then administering Karo syrup orally to the horse at a dose of either 0.15ml/kg or 0.45ml/kg. At 90 minutes post administration of the Karo syrup, the veterinarian will take blood samples and compare the insulin response.

If the insulin response is >45 microU/ml after 90 minutes post administration of Karo syrup at the dose of 0.15ml/kg, then the horse is considered insulin resistant. If the insulin response is >65 microU/ml after 90 min post administration of Karo syrup at a dose if 0.45 ml/kg, then the horse is considered insulin resistant.

The problem is that your veterinarian will have to take all of these samples, spin them down, freeze them, put them on dry ice and ship it overnight to a reputable lab facility. The lab will then evaluate the samples and send your results back. So, you’re looking at a minimum of about five days to a week before you have any test results. Some cases don’t have that much time to spare.

Q: How does the new Wellness Ready Equine Insulin Test improve this process?

Dr. Dryden: The Wellness Ready Insulin Test is a stall-side blood test that allows you to instantly determine a horse’s insulin level and possible risk for laminitis. It’s going to change the way that we practice medicine for these metabolic horses. It’s going to allow us to make decisions in real time and also identify horses that may not have been diagnosed otherwise. We can save a lot of lives and prevent a lot of cases of laminitis.

Wellness Ready: The Mission from Wellness Ready on Vimeo.

Dr. Vernon Dryden, DVM, CJF, is the Co-Founder of Wellness Ready, and Founder of Bur Oak Sports Medicine and Lameness. Talk to your vet about Wellness Ready, and visit for more information.