ems horses tend to become obese very easily, depositing fat in the crest, shoulders, loin, above the eyes, around the tail head, and the mammary glands or prepuce, even when the rest of the body appears to be in normal condition. some horses may have regional adiposity, and others may even appear normal weight, so obesity is not a definitive clinical sign of a horse with ems. horses will be insulin resistant (ir), and may have hyperinsulinemia, have abnormal blood glucose, or abnormal insulin responses to glucose. ir predisposes the animal to laminitis, and horses with ems may have had previous episodes in their history.