Beyond Laminitis: What EMS and PPID Looked Like in My Pony

When people talk about Equine Metabolic Syndrome (EMS) and PPID (Cushing's disease), the conversation often centres around laminitis. For me, laminitis was certainly part of the story, but it wasn't the whole story. My pony lived with EMS, PPID and repeated bouts of laminitis. As time went on, it became clear that these conditions were affecting far more than his feet. I wanted to share his story because many owners may recognise some of these changes in their own horses.

The Beginning

Like many owners, our initial concerns focused on laminitis. His insulin levels were extremely high, and over time his PPID also became increasingly difficult to manage. Medication helped for a period, but eventually he reached the upper limits of the treatment available to him. As the two conditions progressed together, I began to notice changes throughout his body.

It Wasn't Just About His Feet

Laminitis remained a constant battle although there were remission periods. However, other problems gradually appeared. He developed unusual fat deposits in areas of his body that seemed difficult to explain. His eyes often appeared prominent or bulging. He experienced patchy sweating and struggled to regulate his temperature. These changes developed slowly, making them easy to dismiss individually. Looking back, they formed part of a much bigger picture.

Constant Abscesses and Skin Problems

He also suffered from repeated abscesses. These could, of course have been caused by the dead laminae in his hooves that had to go somewhere but I’ve now read that EMS can also be the cause of repeated abscesses. Many horses with PPID can experience changes in immune function, and some become more susceptible to infections or slower healing. As if he didn’t have enough to deal with, he also developed sarcoids potentially as a result of his weakening immune system. Although it is impossible to say exactly why they developed, I often wondered whether his compromised health and underlying endocrine disease potentially played a role.

The Hidden Struggle: Colic and Feeding Challenges

One of the hardest aspects of managing him was feeding. His dental problems meant he could no longer eat hay effectively. So it was a mash only diet with him being fed lots of smaller meals throughout the day (thank goodness he was kept at home) At the same time, his EMS and laminitis meant his diet had to remain extremely carefully controlled. Balancing his nutritional needs while restricting sugars and starches became increasingly difficult. And trying keeping his tummy occupied without leaving long gaps without food. He experienced repeated episodes of colic, adding another layer of worry to his management. Every decision felt like a compromise. Too much restriction carried risks and too much feed carried risks. I was damned if I did and damned if I didn’t. Sometimes there simply wasn't an easy answer.

When Medication Isn't Enough

One of the most difficult realities of EMS and PPID is that treatment does not always restore a horse to perfect health. Medication can make a tremendous difference for many horses. But some horses continue to struggle despite excellent care. If my pony Rascal was struggling, he never showed it – which made making decisions even harder. He was so upbeat, bright eyed and bushy tailed and alert. By the end, my pony was already receiving the maximum amount of medication available to him. There was simply no higher dose to try for the Cushing’s.

As owners, we often carry enormous guilt when our horses deteriorate. We ask ourselves whether we missed something, whether we should have done more, or whether another treatment might have changed the outcome. Sometimes, despite careful management, veterinary support and absolute dedication, the disease continues to progress.

Why I Share His Story

I share this not to frighten owners. Many horses with EMS and PPID live happily for years with appropriate management and Rascal certainly did – nine years in fact, when they say Cushing’s averages two-five years to reach the advanced stages. But I think it is important to recognise that these are whole-body diseases. They do not only affect the feet. They can affect metabolism, immune function, muscle condition, temperature regulation, body fat distribution and quality of life. Every horse is different. My pony's experience will not be every horse's experience. But his story taught me that seemingly unrelated changes may all be part of the same picture.

Looking Back

One thing I wish I had appreciated earlier was how gradually these changes appeared. No single symptom seemed dramatic on its own but over time the pieces joined together. Because I saw him all the time as he was at home, the changes were harder to notice. If I looked at a photo from a year back, say, he looked different. Weight changes, Sweating, fat deposits, colic, changes in comfort and changes in appearance.

When viewed individually, they seemed manageable. When viewed together, they told the story of a pony whose body was fighting multiple battles. EMS and PPID are often described in terms of blood tests and medication doses. But behind every diagnosis is a horse and an owner trying to navigate an often complicated and emotional journey. My pony taught me that these conditions can affect far more than the feet and he taught me the importance of watching the whole horse, not just the numbers on a blood test.

The day finally came where I had to admit that enough was enough. I had to tell him it was time to stop fighting and that was hard, as he so wanted to live, but I couldn’t watch him struggle anymore – it simply wasn’t fair. He left us on a sunny day, with a day on the grass and being stuffed with treats and a last scamper round with his friends. I visit his grave once a week for a little chat. I don’t know why, I just do.

Don’t give up people. Some horses do not have such a bad time – Rascal still had a good quality of life much of the time. I did my best for him because I loved him. I let him go because I loved him too.

 This article reflects one owner's experience and should not replace veterinary advice. If you have concerns about your own horse, please consult your veterinary surgeon.

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