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Background: Predisposing factors include a history of excess vaccination and/or drug therapy, especially with the long-term use of steroid drugs. Stress, obesity, old age, lack of exercise, pollution, and poor-quality diets are also likely to be causal or predisposing.
Symptoms: Insulin Resistance or Equine Metabolic Syndrome (the new, more accurate terms for what has been called Cushing's Disease in the past) is characterized by obesity, resistance to weight loss, lumpy fat pads and cresty necks, longer and dry hair, chronic laminitis (that is difficult to treat), chronic infections, insulin resistance, increased or decreased weight gain (often with uneven distribution of fat), and with increased urination and drinking, and poor digestion in the later stages. True Cushing’s disease does exist, but is much less common.
Diagnostics: The diagnosis is not always straightforward and may require a combination of history and blood tests (insulin, glucose, ACTH, cortisol), depending on which symptoms are present. In many cases all blood work will be normal, yet obesity and unhealthy fat distribution are present.
Special Notes: Treatment depends on the degree the horse is affected. Conventional drug therapy is not specific for EMS or IR, so these horses are much better supported with supplementation. Dietary control must be part of the treatment plan.
Principles for Supplementation: Improve glucose metabolism, balance and support hormonal system, achieve weight loss, improve digestion and metabolism.


Formulas: Dosage: Mechanism/Purpose:

OB Formula1,5

1 scoop bid

Hemp-based nutrients to aid glucose metabolism, weight loss.


4 tsp bid

Supports insulin metabolism, tonifies Spleen, useful when no inflammation is present, fat is mildly lumpy.

Four Marvels Powder, Si Miao San14

4 tsp bid

Clears Damp and decreases inflammation, support insulin metabolism, esp. in springtime, with lumpy fat deposits.


1-5 capsules sid

Excellent for antioxidant properties in laminitis cases, especially if anti-inflammatory drugs are not being used.


2-4 capsules sid

Can help stabilize blood sugar.


4-6 capsules sid

Stabilizes blood sugar.

Magnesium Citrate12

1-2 gram bid

Improves insulin receptivity in cell walls.

 Metabolyte Gold2

25-30 cc sid

Supports insulin metabolism, palatable liquid formula.


6-10 mL sid

Adaptogenic herbs, support the immune system, adrenals, reduces stress, helps horses adapt to stress.

Core Level Pituitary11

4 tablets sid

Glandular; supports the hormonal system, usually used with pituitary imbalance, older horses.

Chia Booster (chia seeds)19

1 scoop bid

Stabilizes membranes, source Omega 3 fatty acids.

Flax/Hemp Oil
Flax/Hemp meal, naturally stabilized1

4-8 tbsp oil or
4-8 oz meal bid

Improves glucose metabolism, supports immune system.

Digestive Tonic14

½-? scoop bid

Clears stagnant food; enhances digestion.

Enhance Life14

4 tsp bid

Increases Qi and Blood, tonifies kidney yang, enhances energy levels and performance.

These formulas below are for horses with more advanced symptoms and/or laminitis. Supplements above can be used for support.

 INR Formula 1 scoop bid Hemp-based nutrients to aid insulin resistance and GIT damage.

 Long Dan Xie Gan Tang
(Gentiana Combination)14

4 tsp bid

Later stages IR with laminitis, heat and inflammation, clears Damp Heat.

 Cush X Support Formula2

3-4 scoops sid

Support pituitary function, insulin and glucose metabolism, helps shed winter coats.

Section 1 - Canine and Feline Index of Pages


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