{"id":15666,"date":"2019-06-16T07:23:24","date_gmt":"2019-06-16T12:23:24","guid":{"rendered":"https:\/\/be55915bbd.nxcli.net\/?p=15666"},"modified":"2026-04-26T08:07:23","modified_gmt":"2026-04-26T13:07:23","slug":"metabolic-syndrome-insulin-resistance-horse-new-therapy-options","status":"publish","type":"post","link":"https:\/\/nouvelleresearch.com\/index.php\/articles\/15666-metabolic-syndrome-insulin-resistance-horse-new-therapy-options","title":{"rendered":"Metabolic Syndrome and Insulin Resistance in the Horse; New Therapy Options"},"content":{"rendered":"<p>Equine metabolic syndrome and insulin resistance is an ongoing epidemic in current times.\u00a0 Although the case load is very high, as is the morbidity rate, options for better management are not keeping up with nor offering improved outcomes for the horse.\u00a0 Laminitis and chronic foot ailments are often associated with EMS and insulin resistance, which adds to the pain and suffering associated with the metabolic condition in the horse.\u00a0 The laminitic condition is one common reason for euthanasia in the horse, many times associated with equine metabolic syndrome.\u00a0 In prior articles, I have outlined the problem on many levels, correlating with our research findings.\u00a0 In this final part 4 of the article series, I plan to outline specific therapy options that we are implementing in our equine patients with very high levels of success.<!--more--><\/p>\n<figure id=\"attachment_15867\" aria-describedby=\"caption-attachment-15867\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-15867 size-medium\" title=\"EMS and Ketones in the Horse\" src=\"https:\/\/nouvelleresearch.com\/wp-content\/uploads\/High-Res-1-300x225.jpg\" alt=\"Equine Metabolic Syndrome and Ketones\" width=\"300\" height=\"225\" \/><figcaption id=\"caption-attachment-15867\" class=\"wp-caption-text\">EMS and Ketones in the Horse<\/figcaption><\/figure>\n<p>Equine metabolic syndrome and insulin resistance is on the ever increasing rise in the horse world and the problem is complex.\u00a0 Despite the complexity, most owners and veterinarians are seeking one option, one pill, one supplement, or one injection that will solve all the associated problems.\u00a0 While this is desired, it is not reality.\u00a0 The horse&#8217;s body, like ours, is very complex and there are many factors that are leading to and also being created as a result of that insulin level rise and overweight body condition.<\/p>\n<p>There are various factors that need to be modified in every equine metabolic and insulin resistant horse, which include:<\/p>\n<ul>\n<li>Diet (reducing and eliminating grains, improving forage quality)<\/li>\n<li>Exercise (an absolute must component)<\/li>\n<li>Proper foot care, trimming and balancing<\/li>\n<\/ul>\n<p>If these factors are not modified, the results will be greatly diminished in every horse with EMS or IR.\u00a0 There is no two ways around diet and exercise.\u00a0 Despite claiming you are feeding a low NSC grain, or a low-carbohydrate forage, or even soaking your hay to reduce carbohydrates, this may or may not be acceptable for your horse and produce clinical improvement.\u00a0 <span style=\"color: #ff0000;\">Step back, look at what you are doing, then ask yourself one simple question.<\/span><\/p>\n<p style=\"text-align: center;\"><em><strong>&#8220;Is what I am doing helping, hurting, or just holding my horse steady in his or her metabolic status?&#8221;<\/strong><\/em><\/p>\n<p>This question needs to be asked in every case.\u00a0 The reason being is that most owners that I interact with are using the advice of another, applying it, and in the end have up to 10 different supplements and regimens in place, but despite, are still having problems regarding body condition, foot pain and ability to resume pasture life in their metabolic horse.\u00a0 If this is the case, your regimen is not working.\u00a0 There is no sense in continuing to do something that is not helping and could quite possibly be hurting your horse&#8217;s progress or health.<\/p>\n<h3><span style=\"color: #3366ff;\">Step One for the Metabolic Horse:<\/span><\/h3>\n<p>In most metabolic equine patients, my goal is to address the internal inflammatory response and address digestive health, which is a known problem and addressed in many other articles I have posted. In almost every EMS or IR horse, I will start those patients on the <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-total-support\">Cur-OST EQ Total Support<\/a><\/strong><\/span> formula as a baseline.\u00a0 This formula is dosed at full dose twice daily for 14 days, and can greatly assist us with promoting a healthy inflammatory response and regaining balance to the digestive tract.\u00a0 The results are greatly increased in the horse if the diet is modified additionally and exercise is implemented.<\/p>\n<p>In most EMS and IR patients, I personally discontinue ALL grains, and only utilize an alfalfa or other grass hay pellet as a medium for supplement administration.\u00a0 In addition, I encourage owners to feed those horses a higher quality of hay forage, often an alfalfa mix, at 1.5% BW per day, which helps us to fulfill nutrient demands and provide higher quality fiber for digestive support.\u00a0 All other supplements are discontinued in most cases, unless there is a medical need.\u00a0 This includes all vitamin\/mineral feed or ration balancers.\u00a0 These are inorganic, synthetic nutrients often in a base of artificial flavoring and sugars to improve palatability.<\/p>\n<p>You want to provide for your horse&#8217;s body naturally, ideally through food, not inorganic vitamins and minerals.\u00a0 There are many positive aspects to &#8216;real food&#8217; that are just not acquired through these feed balancers.\u00a0 Your horse is missing out on the <strong><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/articles\/15791-whole-food-horses-truths-misperceptions\">real benefits of true foo<\/a><\/span><\/strong>d.\u00a0 Take advantage of it and help your horse to help himself.<\/p>\n<p>As a part of monitoring in the EMS or IR horse patient, I will use insulin levels every 2-4 weeks to assess for progress.\u00a0 In addition, I personally utilize <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/equine-fecal-dysbiosis-culture\" rel=\"nofollow\">fecal cultures<\/a><\/strong><\/span> initially and again 4 weeks after starting a regimen to assess for progress.\u00a0 In our laboratory, I will also measure and monitor free radical and antioxidant levels in the blood.\u00a0 It is also possible for you, as the owner, to evaluate blood or urine ketone and sugar levels.\u00a0 All of these tests are very useful to indicate our progress and also to show us how much damage may already be present.\u00a0 Through repeated monitoring, you can then adjust the regimen as needed, keeping in mind that not every horse is the same and different needs arise.<\/p>\n<h3><span style=\"color: #3366ff;\">Step Two for the Metabolic Horse:<\/span><\/h3>\n<p>After 2 weeks of supplementation of the <strong><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-total-support\">Cur-OST EQ Total Support<\/a><\/span><\/strong>, along with diet, exercise and proper foot care implementation, the horse should be re-evaluated.\u00a0 Progress should be determined.\u00a0 It is not expected to have a complete resolution to the body condition problem, reduction in elevated insulin levels, or even foot soreness.\u00a0 What you are looking for is an improved circumstance or situation.\u00a0 <em>Is your horse improved?<\/em>\u00a0 Maybe more comfortable?\u00a0 Able to walk more freely?\u00a0 Not requiring the boots as much or not at all?\u00a0 How does your horse compare NOW as compared to 2-weeks ago?<\/p>\n<p>If there is improvement, then often I will choose to continue our course of therapy with the Cur-OST EQ Total Support formula.\u00a0 If there is no improvement or there is a desire to take it to the next level, then there are many new therapy options available to do just that!<\/p>\n<p><strong>Let&#8217;s now enter the &#8216;Phases of Metabolic Support in the Horse&#8221;<\/strong><\/p>\n<h3><span style=\"color: #3366ff;\">Phase One Metabolic Support in the Horse<\/span><\/h3>\n<p>The first phase that I will often implement in the EMS and IR horse, not to mention the PSSM horse or any horse in need of improved cellular and energy support, is through the use of <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-keto-oil\">Cur-OST EQ Keto <\/a>Oil<\/strong><\/span>. This first phase is often used in combination with the Cur-OST EQ Total Support formula along with a completely &#8216;grain free diet&#8217; and higher quality forage, with exercise.<\/p>\n<p><strong>Ketone bodies are an alternate fuel source for cells throughout the body and the real kicker here is that the higher the ketone level in the blood, the lower the insulin level.<\/strong>\u00a0 This means that if you are able to drive up ketone generation in the body, cells are functioning on a higher level, and with that insulin and sugar metabolism are more regulated.<\/p>\n<p>Ketone bodies serve many valuable functions to the horse and overall health.\u00a0 They are used as a vital source of energy, regulate insulin and sugar, impact the immune response, immune function, and even the digestive health on a positive level.\u00a0 A well balanced and complete source of medium chain triglycerides is the best option to encourage ketone generation in the horse&#8217;s body.\u00a0 Supplementation with the Cur-OST EQ Keto Oil, even as a solo-therapy, has been shown to raise ketone levels post- prandial by as much as 0.5 mmol\/ml.\u00a0 However, not every horse responds as you would like them to.\u00a0 This is where monitoring comes into play, although not absolutely essential.<\/p>\n<p><strong><em>Unfortunately, the Cur-OST EQ Keto Oil has been discontinued,<\/em><\/strong> honestly due to improper usage by horse owners which is due to a lack of understanding.\u00a0 One can create more problems if they are not careful and so, we have decided to discontinue this formula.\u00a0 HOWEVER, ketones are very valuable in more ways than one and in place, you can use the <span style=\"color: #ff0000;\"><strong><a style=\"color: #ff0000;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-keto-bhb\">Cur-OST EQ Keto BHB<\/a><\/strong><\/span>, which is mentioned below.<\/p>\n<h3><span style=\"color: #3366ff;\">Phase Two Metabolic Support in the Horse<\/span><\/h3>\n<p>A high percentage of metabolic horses respond very nicely to the Cur-OST EQ Total Support and the Cur-OST EQ Keto Oil or Cur-OST EQ Keto BHB.\u00a0 <em>However, some of those horses are very damaged on a cellular level and fail to respond as desired.<\/em>\u00a0 In fact, if you do some laboratory work on those horses with monitoring, you will find that those are the ones that fail to generate adequate ketones post-prandial and also demonstrate a lower than desired internal antioxidant and even free radical level load.\u00a0 These are the more critical cases, indicating a higher level of damage on a cellular level.\u00a0 Thus, they require more attention if we desire to reach our goals and help them to be more comfortable.<\/p>\n<p>Phase two in the metabolic horse in our program generally involves the use of the <strong><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-cell-repair-atp-nrf2\">Cur-OST EQ Cell Repair<\/a> ATP &amp; NRF2 <\/span><\/strong>formula.\u00a0 This is a high level and potent antioxidant blend that addresses cellular health, mitochondrial function, and internal antioxidant production.\u00a0 Very critical stuff when it comes to your horse&#8217;s health.\u00a0 One isolated antioxidant is not helpful in these matters, such as vitamin C or E.\u00a0 In fact, many times, these isolated forms can create more harm than good.\u00a0 This is addressed in my article on <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/articles\/15237-vitamin-e-in-the-neurological-horse-maybe-more-harm-than-good\">Vitamin E in the horse<\/a><\/strong><\/span>.<\/p>\n<p>You want and desire specific antioxidants that boost mitochondrial function and are not compromised in situations where the horse is not generating their own internal defenses such as glutathione.\u00a0 The Cur-OST EQ Cell Repair formula utilizes a concentrated Astaxanthin 1.5% extract, Acetyl-Carnitine, Alpha Lipoic Acid, and Vitamin C at research doses to achieve cellular benefit.\u00a0 In our research patients, we are able to raise the antioxidant level by over 300-400 points in one week of daily supplementation. In addition, the before below normal free radical level load is more often back up in the normal range, which indicates improved cellular function.\u00a0 These specific antioxidants also impact insulin and glucose function, and do assist with ketone generation in the body.<\/p>\n<p>In most horses, once we reach phase two, I will either maintain on the EQ Total with the EQ KetoBHB and add in the EQ Cell Repair, OR, I will discontinue the EQ Total Support and replace it with the EQ Cell Repair.\u00a0 This decision is based on how the horse responded in the first 2-4 weeks to the prior regimen.\u00a0 If I do go with the Cur-OST EQ Cell Repair, I will use the full dose once daily for 14 days, reassess and if the horse is demonstrating improvement, I will reduce the dose by half and continue. If at any time the horse begins to regress, the dose is immediately increased.\u00a0 In almost all horses, I will use the EQ Cell Repair formula alongside of the EQ Keto BHB.\u00a0 Very important for cellular energy production!<\/p>\n<h3><span style=\"color: #0000ff;\">Phase Three Metabolic Support in the Horse<\/span><\/h3>\n<p>While it is labeled as Phase Three, this phase really coincides with phase two.\u00a0 After the first 2 weeks, using diet, exercise and the EQ Total Support, the horse is re-evaluated, often with repeat fecal cultures and other parameters.\u00a0 If the horse is making progress, and all parties are content, but yet, feel there is some improvement to be gained further, I will implement Phase Three, which is our <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-p450-metabolic\">Cur-OST EQ P450<\/a> <\/strong><\/span>formula.<\/p>\n<p><em>I&#8217;m not trying to make things complicated, EMS is just complex by itself and each horse is different.<\/em>\u00a0 If that horse is showing improvement, that is good, but if the sugar and insulin levels are still elevated and not showing signs of budging, then we have some work to do, especially if foot pain is persistent.\u00a0 However, some of these horses may not be as critical on blood work or on clinical exam and in need of a potent formula like the EQ Cell Repair.\u00a0 This is where the Cur-OST EQ P450 comes into play.<\/p>\n<p>Cur-OST EQ P450 is a unique blend of Astragalus membranaceus, Wild Yam, Wild Yam concentrated Diosogenin, Ginger Root, Turmeric Root, and Tangerine Peel.\u00a0 All of these herbs are used in research doses, which means high levels.\u00a0 Every one of these herbs has direct benefits when it comes to insulin and glucose function, digestive health, and inflammation.\u00a0 The Cur-OST EQ P450 is added to the EQ Total Support and EQ Keto Oils to boost protection.\u00a0 In many cases, after a couple of weeks, the horse is showing nice signs of progress clinically and on repeat blood markers.\u00a0 In fact, many of these horses can have their EQ Total Support dose reduced by half or even eliminated.\u00a0 This is due to the ability of the EQ P450 to modulate various health aspects in the horse.<\/p>\n<h3><span style=\"color: #0000ff;\">Phase Four Metabolic Support in the Horse<\/span><\/h3>\n<p>The final phase of metabolic support in the horse revolves around ketone generation and is often reserved for those more stubborn horses that fail to respond to prior measures.\u00a0 Ketones are one of the most potent substrates for energy in the body and can directly impact insulin and sugar levels, not to mention other health parameters in the horse.<\/p>\n<p style=\"text-align: center;\"><strong><em>We are attempting to boost ketone levels in all three prior phases, either directly through the EQ Keto Oil or indirectly through improvement of cellular function.\u00a0 However, some horses are very damaged on a cellular level and cannot generate sufficient ketones for optimal cellular function.<\/em><\/strong><\/p>\n<p>Phase four revolves around the <span style=\"color: #993366;\"><strong><a style=\"color: #993366;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/product\/cur-ost-eq-keto-bhb\">Cur-OST EQ Keto BHB<\/a><\/strong><\/span> formula, which is a direct ketone salt supplement containing the more prominent ketone body, <a href=\"https:\/\/en.wikipedia.org\/wiki\/Beta-Hydroxybutyric_acid\">beta-hydroxybutyrate<\/a>, which is coupled with magnesium.\u00a0 Through direct supplementation with a ketone salt, ketone levels are almost instantly raised without the need for the horse&#8217;s body to generate ketones.\u00a0 The EQ Keto BHB formula is readily absorbed and in most cases will raise 2-hour post prandial ketone levels by 0.5-1.0 mmol\/l.\u00a0 This level can greatly enhance internal cellular energy production and directly impact insulin and sugar metabolism.\u00a0 However, the levels will not remain high for long, as the ketones are used for energy in the body.\u00a0 It is typical for levels to gradually taper off over 4-6 hours, thus twice daily supplementation is required.<\/p>\n<p>In most cases, I will supplement the EQ Keto BHB at 20 grams twice daily, which does provide approximately 1800 mg of Magnesium.\u00a0 Don&#8217;t forget that and factor that into your other supplements if using a magnesium supplement.\u00a0 Most horses will respond to the EQ Keto BHB with a perceived state of relaxation, which is attributed both to the magnesium but also the ketone body and associated improved cellular function.\u00a0 Ketones impact cellular energy and function, and additionally can impact pain pathways secondarily.\u00a0 Thus, if pain is lower, there is a higher state of relaxation.<\/p>\n<p>I will personally monitor the horse&#8217;s blood ketone levels before and after meals for about 7-10 days, along with their clinical response.\u00a0 In most cases, I will decrease the dose by half, to about 10 grams twice daily after the first 10-14 days of usage of the EQ Keto BHB.\u00a0 Most horses, if other the supplements are implemented, along with diet and exercise, do not require longer than 30-45 days of EQ Keto BHB usage.\u00a0 The reason for this is that cellular function is often improved and the horse&#8217;s body is now capable of generating internal ketones.\u00a0 In some horses, however, daily usage may be required or intermittent doses as needed.<\/p>\n<h3><span style=\"color: #3366ff;\">EMS in the Horse; Wrapping it all UP!<\/span><\/h3>\n<p>Equine metabolic syndrome is a complex condition all by itself.\u00a0 I also firmly believe that we, as man, as owner, create this condition over time due to the practices and regimens put into place.\u00a0 Considering this, the solution lies in unraveling the condition that we have created and altering or restoring cellular pathways is not always an easy task.\u00a0 There will never be &#8216;ONE&#8217; thing to resolve the EMS epidemic that is occurring, no different than there will never be &#8216;ONE&#8217; thing that resolves the obesity and diabetic problem present in humans.\u00a0 These are conditions created out of choice and reversing our choices is not always easy.<\/p>\n<p>Reversing equine metabolic syndrome in the horse and even laminitis is possible, but it takes work, patience, understanding and time.\u00a0 The concepts posed within this article are extracted from the human side of research and medicine, demonstrating benefit in people under similar conditions.\u00a0 The concept of ketogenesis, the ketogenic diet, inflammation, and oxidative stress cellular damage are not new concepts.\u00a0 They have been around in research and mainstream medicine for decades, if not centuries in some cases, but are just ignored or not applied due to complexity in the approach.\u00a0 The sad reality is that in all honesty, only these approaches stand the test of time and have real merit or potential in regards to managing health conditions in people and in the horse.<\/p>\n<p>I encourage you, as the horse owner with an EMS horse, to take the time to read and re-read this article and prior articles in this series in order to gain a higher understanding.\u00a0 Do not take me on my word, as that is not my goal.\u00a0 Instead, research the principles, then put things into action step by step and assess your results.\u00a0 Every horse is different and depending on the level of cellular damage present, some cases are just more challenging than others.<\/p>\n<p>I have faith and full belief that metabolic syndrome and even laminitis in the horse can be remedied over time, with health being restored.\u00a0 You just have to define your goals and realize that sometimes a higher level of effort may be required.\u00a0 <em><strong>The bottom line is to restore health on various levels for your horse.\u00a0 As you are able to do that, then the regimen becomes simpler and more defined, mainly due to changes in lifestyle now revealing their benefits.\u00a0<\/strong><\/em> As health is restored, there is less dependence upon veterinary care and your costs and concerns begin to vanish.<\/p>\n<p>Keep in mind that our mainstay of therapy in the equine metabolic patient is the Cur-OST EQ Total Support along with a proper diet, lifestyle, and elimination of other &#8216;junk&#8217; from the supplement regimen.\u00a0 This is the point that you are striving to get to, and most are maintained simply on this regimen. The other formulas mentioned above are used to assist you and your horse over a hurdle and on the path forward to health. Over time, the goal is to wean back, fix the other problems, and simplify the regimen.\u00a0 This is all outlined in our course, <span style=\"color: #ff0000;\"><strong><a style=\"color: #ff0000;\" href=\"https:\/\/nouvelleresearch.teachable.com\/p\/equine-metabolic-syndrome-understanding-cause-and-therapy-easily\">Equine Metabolic Syndrome<\/a><\/strong><\/span>.<\/p>\n<p>Recommended Reading:<\/p>\n<p><span style=\"color: #ff0000;\"><a style=\"color: #ff0000;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/articles\/15478-metabolic-horse-understanding-problem-part-one\">Article One on the EMS Horse<\/a><\/span><\/p>\n<p><span style=\"color: #ff0000;\"><a style=\"color: #ff0000;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/articles\/15491-metabolic-horse-digging-deeper-insulin-diagnosis-part-two\">Article Two on the EMS Horse<\/a><\/span><\/p>\n<p><span style=\"color: #ff0000;\"><a style=\"color: #ff0000;\" href=\"https:\/\/nouvelleresearch.com\/index.php\/articles\/15558-metabolic-horse-going-ketogenic-cellular-health-part-three\">Article Three on the EMS Horse<\/a><\/span><\/p>\n<p>Author:\u00a0 Tom Schell, D.V.M, CVCH, CHN<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Equine metabolic syndrome and insulin resistance is an ongoing epidemic in current times.\u00a0 Although the case load is very high, as is the morbidity rate, options for better management are not keeping up with nor offering improved outcomes for the horse.\u00a0 Laminitis and chronic foot ailments [&hellip;]<\/p>\n","protected":false},"author":2524,"featured_media":15867,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[12],"tags":[5005,5004,1178,208,221,352,207,210,4857,4858,233,5003,279,1309,1310,213,312],"class_list":["post-15666","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-equine-articles","tag-beta-hydroxybutyrate","tag-coconut-oil","tag-ems","tag-equine","tag-free-radicals","tag-hoof","tag-horse","tag-inflammation","tag-ketogenic-diet","tag-ketones","tag-laminitis","tag-mct-oil","tag-metabolic-syndrome","tag-obese","tag-overweight","tag-oxidative-stress","tag-pain"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Equine Metabolic Syndrome, Insulin Resistance, Ketones and Therapies<\/title>\n<meta name=\"description\" content=\"Equine 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