105: The Hidden Cost of Chasing Symptoms Instead of Root Causes

In our last episode, we explored five reasons metabolic horses struggle in the fall. Today, we’re going a layer deeper, exploring the liver, its role, what may strain it, and signs that your horse’s liver may be under pressure. We also explore why two horses can respond very differently to the same environment. The Liver The liver plays an important role in regulating blood sugar, clearing insulin, processing fats, and converting thyroid hormones. When the liver is under strain, these functions may be affected, potentially contributing to metabolic challenges. Insulin Resistance High insulin is often associated with excess sugar in the diet and increased insulin production by the pancreas. However, the liver also helps clear insulin from the bloodstream, so its role may be worth considering. Research into this connection in horses is still developing. Increased Workload A horse’s liver may be coping with several demands at once, including excess sugar, concentrated vegetable oils, high protein intake, certain supplement ingredients, chemical residues in feed, or excess iron. Ongoing stress can also add to this burden by raising cortisol levels and increasing the amount of sugar released into the bloodstream. Feed and Supplements Look closely at feed and supplement labels for concentrated vegetable oils, preservatives, artificial flavourings, synthetic additives, and inorganic minerals. Consider whether each product is truly necessary and whether its ingredients are actually appropriate for your horse. Routine Treatments Think about the cumulative effect of medications and dewormers over a horse’s lifetime. Then consider how many deworming treatments and medications your horse has received, rather than overlooking these, to reduce the strain on your horse's liver. Water and Environmental Exposure Well water can contain excess iron, as can supplements containing inorganic iron, such as ferrous sulfate. Testing your water and reviewing supplement labels can help you to identify potential sources. You also need to consider the chemical residues from herbicides, pesticides, and fertilisers in your hay and pasture. Signs of Liver Strain A persistent crest or fat pads, slow progress despite management changes, sensitivity to feed or supplements, recurring skin problems, inconsistent manure, and low energy may all warrant closer attention. Hives, swelling, and laminitis can also indicate metabolic problems. No single sign shows that the liver is under pressure. Swelling and Recurring Eye Problems Swelling in the legs, sheath, or belly may indicate fluid retention. Swelling in the lower legs sometimes improves with movement. I have also noticed recurring weepy eyes in some horses but have no research to support this connection. Routine Blood Tests Routine liver enzyme tests can indicate liver cell damage, but they will not necessarily reveal every aspect of the liver's function or how much work it is managing. Normal results therefore do not rule out every possible concern. Any signs of ill health still need to be considered. Beyond Restricted Feed Reducing sugar intake may be essential for a metabolic horse, but feed restriction alone may not address every contributing factor. It is also worth reviewing supplements, water quality, environmental exposures, and stress rather than focusing only on feed rations. A Whole-Horse Approach Stress, toxicity, and nutrient deficiencies are the three main drivers of insulin resistance. Simply restricting the horse’s feed will not address these three factors. The key is to identify what may be straining your horse’s system, remove what you can, and support the horse’s ability to eliminate unwanted substances. Always consider the root cause before symptoms! Links and resources: Connect with Elisha Edwards on her website. Your Horse's Root Cause Reset: Join the waitlist FREE TRAINING: Why Your Metabolic Horse Isn't Getting Better: The Three Drivers of Equine Metabolic Syndrome (EMS) Join my email lis

Fall can be a challenging time for horses with metabolic issues, even when you’ve spent months doing everything right. Today, we’re exploring five reasons metabolic horses struggle in the fall. You’ll learn how to recognize seasonal setbacks, track meaningful signs of improvement, and support your horse without abandoning a program that may still be working. Metabolic horses Shorter days trigger hormonal changes that prepare horses for winter. Rising ACTH and cortisol can increase blood sugar and insulin, promoting fat storage. Metabolic horses may also develop fat pads, retain fluid, and experience increased inflammation. Fall grass Sunny days followed by cold nights can cause sugars to accumulate in grass. Frost-stressed, short or brown grass may also be high in sugar, increasing risks for sensitive horses. Dietary changes Abruptly switching from grass to hay disrupts the hindgut microbiome and may contribute to inflammation and digestive problems. Instead, transition gradually over two to three weeks. Inflammation Digestive problems, unresolved hoof damage, and poor circulation can contribute to inflammation. Inflammation may increase insulin, while high insulin promotes fat storage. Fat deposits can further contribute to inflammation. Stress Feed restriction, prolonged isolation and confinement can all increase stress and cortisol levels, even when a horse shows no obvious signs of anxiety. Some horses become withdrawn and apathetic rather than restless or agitated. Supporting metabolic health therefore means looking beyond diet to the horse’s overall well-being, with particular attention to the three Fs: forage, freedom and friendship. Setbacks Horses with existing metabolic dysfunction or incompletely healed hooves are more vulnerable to seasonal changes. Temporary setbacks do not automatically mean your management plan has failed. Keep track Track the horse’s energy, comfort level, mobility, digestion, and social engagement alongside physical changes. Record symptoms and pain levels to establish a baseline and objectively measure the horse’s progress. Hoof problems Stronger digital pulses, reluctance to move, or changes in stance warrant prompt attention. Assess the horse’s hoof trim, circulation, existing pathologies, and provide nutritional support. Hormone tests ACTH and insulin levels naturally fluctuate with the seasons, making isolated test results difficult to interpret. Assess the results alongside seasonal reference ranges and also consider the horse’s clinical signs and, ideally, hormone measurements taken over time. A single elevated result during fall should not automatically trigger a diagnosis or a decision to begin lifelong medication, as treatment decisions require a more complete picture of the horse’s health. Preparing for fall Transition gradually to hay, obtain a hay analysis, monitor pasture after cold nights, and maintain appropriate hoof care. Address stress, nutrition, and any other potential contributors to metabolic dysfunction. Root causes Persistent problems despite careful sugar management may be due to stress, gut dysfunction, nutrient deficiencies, toxicity, or chronic hoof inflammation. Similar symptoms can have different underlying causes, so each horse requires an individualized approach. Recovery takes time Equine metabolic syndrome requires consistent, long-term management. Addressing the underlying causes may help reduce seasonal setbacks and improve recovery over time. My forthcoming course, Your Horse's Root Cause Reset for Equine Metabolic Syndrome, will focus on identifying these causes. Takeaways Fall setbacks are not necessarily evidence of failure. Owners need to understand seasonal changes, track meaningful improvements, and investigate the horse’s individual needs rather than reacting to isolated symptoms. Remember that no two horses are the same, so their management programs should always address each horse’s individual needs. Links and resources: Connect with Elisha Edward

Last week, we explored how to tell whether your horse is on the right track, why the original symptom often lasts the longest, and how looking at the whole horse lets you see real changes long before that one symptom catches up. If you haven’t listened to that episode yet, I suggest you listen first, because today’s episode picks up right where we left off. Stay tuned to find out why, even after you start noticing changes, it can still be so hard to trust what you’re seeing. Past Disappointments Repeated attempts that fail—supplements, feed, restriction plans, or other approaches—can leave you emotionally, financially, and physically depleted. You may then protect yourself from further disappointment by refusing to believe something is actually working. That could lead you to change a plan just as your horse begins to respond. The Last Thing to Change Weight tape and blood work measure specific things at a specific point in time. Your horse can have better energy, digestion, swelling, or movement even when the weight tape hasn’t changed. The most important symptom is often the last thing to change. Doubt Information from the internet or AI should not override what you observe in your horse. Searching for answers can expose you to stories about horses that failed to improve or had negative outcomes, and those stories might make you question the positive changes you see in your horse. Previous Decisions Many owners believe they should have recognized their horse’s problems sooner. That can make it difficult to trust their judgment when the horse starts improving. Remember that you did the best you could with what you knew at the time. The instinct that told you something was wrong is the same instinct that helps you recognize improvement. Beliefs Affect Decisions You can make changes that support your horse while still believing that recovery is impossible without medication. That belief can move you toward medication. A medication-free approach requires you to trust your decisions, your intuition, and your horse to heal. How to Measure Progress Horses don’t heal in a straight line, and one rough day does not necessarily mean a setback. So, instead of comparing how the horse was yesterday, compare your horse with its baseline, where it was a month ago or three months ago. That is where real change becomes easier to see. Keep Notes Record a few observations several times a week. Note changes such as meeting you at the gate, trotting to the water, improved digestion, or changes in movement. Your notes will give you evidence to return to when doubt appears. Patterns Matter Patterns help you distinguish noise from information. A single good day may be a fluke, and a single bad day may not mean anything significant. Consistent changes over several weeks provide a far more useful measure of progress. Your Observations Knowing your horse and documenting what you see makes you a better advocate for them. Mention your observations to others involved in your horse’s care rather than relying entirely on their opinions. Your notes can also give your veterinarian information they cannot get from a short appointment. Visible Symptoms Your horse’s energy, demeanor, digestion, swelling, and movement may improve while the most visible symptom remains unchanged. That can make you think you need to do more when the horse’s overall picture is actually improving. Remember that the goal is progress, not immediate resolution of every symptom. Staying the Course Changing the plan too soon could undo any progress already made. Some parts of recovery take longer than others. In Skip’s case, his hooves recovered the slowest because hoof growth, strengthening, and improvement in laminar integrity take time. Building Trust Trust develops through observations and patterns over longer periods, not just one good day. Look at your horse’s progress over one to three months rather than expecting immediate change. Remember, no two horses are the same, so no two pr

Last week, we spoke about supplements, exploring how to select them, how to combine them intentionally, and how a simpler program that focuses on the actual root cause will almost always outperform those built around symptoms. If you haven’t listened to Episode 107 yet, I recommend starting there because we’re picking up right where we left off today, looking at what real healing looks like, why patience matters, and why you shouldn’t give up on a treatment plan before the original symptom has been resolved. The Whole Horse Once you have a plan based on the underlying cause, assess the improvement across the whole horse, not just the symptom that initially caused concern. The original complaint is often the most advanced problem and can be the last thing to resolve. If you focus exclusively on it, you may miss significant improvements happening elsewhere. Healing Takes Time Recovery rarely happens in a straight line. There will often be periods of noticeable improvement, pauses, and even temporary setbacks. Years of dysfunction cannot necessarily be reversed quickly, so consistency and patience are essential. The horse’s body needs time and a stable environment in which to recover. Early Signs Changes in the horse’s energy and engagement can appear before any visible physical changes. A horse may greet you more readily, enjoy its food, play with other horses, or show more vitality. Those subtle changes can indicate that things are beginning to shift at a foundational level. Brighter Demeanor More alert eyes, greater interest in the surroundings, and the return of personality can be meaningful signs of improvement. Horses with equine metabolic syndrome can experience fatigue and what appears to be depression, which can sometimes be mistaken for normal behavior until their vitality begins to return. Valuable Information More consistent manure, less gas and bloating, and reduced puffiness can all provide valuable information. In horses with equine metabolic syndrome, digestive improvements are especially important because gut health is closely connected to the broader picture of metabolism, inflammation, detoxification, and absorption. Partial Improvement Swelling can improve in stages rather than disappearing completely at once. Even partial improvement can be meaningful. A noticeable reduction in swelling during the first week or two may indicate that the horse is moving in the right direction, while further improvement can take time. Metabolic Changes The crest and fat pads provide valuable information about what is happening metabolically, but they may be among the last things to resolve completely. A crest may first soften and then gradually decrease, while fat pads can take time to reduce. Hoof Recovery Comfortable movement is important, and appropriate hoof care and support are essential. Hoof inflammation and pain often take longer to resolve, particularly following laminitis, founder, or prolonged hoof problems. You may also need to correct trimming issues and allow the hoof capsule to grow out over time. Don't Abandon a Plan Too Quickly If the original symptom is not resolved, it can be tempting to change direction or add more supplements. Before changing course, however, give the existing plan enough time to work, and look for any other improvements that may have occurred. Your Horse's Baseline Pay attention to how the horse moves in the morning, how its crest and fat pads feel, how it greets you, how it eats, and how it interacts with its environment. You don’t need to record every detail obsessively. Just become familiar enough with the horse’s baseline to notice any changes. Keep a Record When you record where your horse started and look back periodically, improvements that seemed insignificant at the time can become obvious. With root-cause work, changes can often occur gradually and quietly, so don't abandon your plan simply because the progress you see isn't dramatic. Skip’s Progress After Skip's program was si

Last week, we explored why a supplement that produces remarkable results in one horse can make virtually no difference in another, and what that comes down to. If you haven’t listened to that episode yet, go back and listen to it first, because we’re building on it today. Supplements A full supplement shelf doesn’t necessarily mean you’re doing enough for your horse. Although each product may have been selected initially to address a specific symptom, the combination is unlikely to address the root cause of a horse’s problems. How to Evaluate Supplements Consider whether or not a supplement is actually helping your horse. Look beyond the testimonials and social media, examine the ingredients and the company’s reputation, and be willing to acknowledge when something isn’t working. Root Causes Treating each symptom with a separate supplement can mean missing the underlying imbalance that is driving the problem. Identifying and addressing the root cause can make some supplements unnecessary. When Supplements Are Combined Different supplements can contain overlapping ingredients, so some may be redundant or unnecessary. Using too many different supplements can also make the digestive system and liver work much harder without providing any additional benefit. Simplifying the Program Removing certain supplements can make owners worry that they aren’t doing enough for their horses. However, simplifying the program helps them focus on addressing what the horse actually needs rather than simply adding more products. Diet and Lifestyle Matter Supplements cannot fix a hungry horse or address stress caused by prolonged hunger. So, owners must consider diet, forage, feeding schedule, lifestyle, and stress levels when addressing a horse’s health issues. Skip’s Story Skip is a 12-year-old Quarter Horse with EMS who was placed on several supplements to address various problems. Despite the owner’s careful efforts, his progress stalled. When evaluating his entire picture, it emerged that stress, due to severe hay restriction, was a key issue. So his supplements were replaced with specific B vitamins and bioavailable magnesium, while his owner focused on providing consistent forage and feeding, a better lifestyle, and nervous-system support. Within weeks, Skip was more relaxed, his vitality improved, and he began to gain muscle and become more active and playful. What to Remember No two horses are the same, so no two programs should be either. Horses’ programs should always address root causes rather than simply treating symptoms, and supplements should be used for a specific reason. Links and resources: Connect with Elisha Edwards on her website. Healing Horses their Way: Get more information and join the waitlist Join my email list to be notified about new podcast releases and upcoming webinars.