broodmare standing in pasture

Q. My pregnant mare, who was diagnosed with equine metabolic syndrome (EMS) earlier this year, came in sore in both front feet the other day. She is barefoot and the ground has been hard here in Central Kentucky. I can feel digital pulses in her pasterns. I’m concerned she might be laminitic, but the veterinarian can’t make it out until tomorrow. I understand that icing her feet might help. How long should I ice her for, and is that the best thing to do?

A. You’re talking about a metabolic horse here, so ice probably isn’t the primary thing you would do for a metabolic horse at this point. If the horse was previously diagnosed as laminitic or has equine metabolic syndrome (EMS), they are more driven by insulin levels than anything, so you are really looking more at an issue of insulin. Ice helps the pain management, but you’re really past the prodromal (before clinical signs are apparent) phase—you’re already in the acute phase—because the horse is sore at this point. She probably does have some degree of laminitis, so ice probably isn’t the primary treatment you’re going to be looking at for that horse.

Ice is a twofold thing— it’s a more of a protectant, but it can help with pain management, too. That’s why if your horse is in the hospital for colic surgery or something else (i.e., you’re guarding against endotoxemia or supporting-limb laminitis), a lot of times the veterinarian will be icing them, even though they’re not sore yet, because you’re really trying to stop the metabolites that cause the damage and manage pain if they’re acute.

Anytime you have a horse that’s already diagnosed with EMS and comes in sore, your first thought would be that it’s very likely that insulin levels have gone up. Maybe she’s out on pasture and there is a change in season and there’s more lush grass or higher sugar content in the grass, or her turnout time has increased.

My first thought would be to get the horse off pasture, pull her off any high-starch feed, and soak her hay until you figure out what’s wrong. That’s never the wrong thing to do. But absolutely consult your veterinarian before you do anything pain-management-wise. They might advise you to start the horse on non-steroidal anti-inflammatory drugs, but that depends on the individual. But the main thing with these horses is just to get insulin levels low. That is the primary driving factor in an EMS horse and will be your primary concern.

You can absolutely ice them, too. You really want coverage from right below the carpus (knee), and you need contact with the skin all the way down. Otherwise, the icing won’t be truly effective. That makes it difficult because a lot of people don’t have ice boots on hand. Lots of companies make ice boots—it’s just actually having a pair on hand when you need them.

Something is probably better than nothing, so if you have a way to apply ice, do so. You’re not going to go wrong icing them. There is no time maximum, either; they can stay in ice for 24 hours. A lot of people worry about that—if they should ice them a couple hours on, a couple hours off. The horse can stand in ice for extended periods—like for several days—without ever having a break.

It’s not any different than a horse living in a northern part of the country in the winter, where they’re in ice or snow for extended periods, for months at a time. There is some skin damage or dermatitis you can get from the ice rubbing the skin, but that’s usually going to be after several days. So getting them in ice, and keeping them in ice, until the veterinarian can see them is good.