## Overview Neck crest dropping, or fallen crest, occurs when the heavy fatty crest of an obese horse or one with equine metabolic syndrome overwhelms the supporting muscles and ligaments and falls permanently to one side. It is a cosmetic issue and a marker of insulin dysregulation and laminitis risk. Once fallen, the crest does not return to midline. ## Causes Excessive nuchal fat deposition associated with obesity or equine metabolic syndrome. ## Diagnosis Visual appearance of a crest that has flopped to one side, plus assessment for metabolic disease. ## Treatment Weight loss and management of insulin dysregulation. The fallen position itself cannot be corrected. ## Recovery and Prognosis The crest remains fallen. Metabolic control reduces further risk of laminitis. ## Prevention Maintain appropriate body condition and manage equine metabolic syndrome early.
fatty crest falls to one side; irreversible; associated with insulin resistance and laminitis risk
## Overview Neck crest dropping, or fallen crest, occurs when the heavy fatty crest of an obese horse or one with equine metabolic syndrome overwhelms the supporting muscles and ligaments and falls permanently to one side. It is a cosmetic issue and a marker of insulin dysregulation and laminitis risk. Once fallen, the crest does not return to midline. ## Causes Excessive nuchal fat deposition associated with obesity or equine metabolic syndrome. ## Diagnosis Visual appearance of a crest that has flopped to one side, plus assessment for metabolic disease. ## Treatment Weight loss and management of insulin dysregulation. The fallen position itself cannot be corrected. ## Recovery and Prognosis The crest remains fallen. Metabolic control reduces further risk of laminitis. ## Prevention Maintain appropriate body condition and manage equine metabolic syndrome early.
fatty crest falls to one side; irreversible; associated with insulin resistance and laminitis risk