Is it related to breed, sex or age?

In all the years since the penny dropped about the effects of grass we have not observed any correlation with breed or age but some conditions like Cushing’s are usually age related.
It boils down to the fact that horses evolved on UNFERTILE country, they were never meant to be confined behind fences eating re-growth grass. They would rarely eat legumes (Clover, Lucerne, Soy etc), grains in any great quantity and they would have access to a far more varied high fibre diet.

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Are any breeds or genders more susceptible?

While some breeds are more prone to becoming over-weight and EMS, any horse of any breed or gender can be affected...
SIZE has an influence: for example we have observed over the years that ponies and smaller horses have more of a *tendency to become EMS and prone to laminitis and the larger horses are more likely to become head-shakers, develop sacro-iliac issues and other neuro-muscular issues and/or exhibit undesirable ‘behaviours’.

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*This is certainly not hard and fast and there are some horses who can exhibit all of the above concurrently. It is a significant fact that head-flicking is rare in very small ponies

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My horse does well on what I am currently feeding him...

If I change will he keep weight on?

You will be pleasantly surprised how little horses need to retain good body weight once their nutritional requirements are correctly met.
The Calm Healthy Horses Plan offers an economical and healthy way of feeding your horses without affecting a healthy body weight.

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When is it OK to use Bute ?

Phenylbutazone, usually referred to as ‘Bute’ is a ‘Non-steroidal anti-inflammatory drug’ which is appropriate to relieve mild pain. The extreme pain of acute laminitis or serious wounds may require much stronger and more effective pain relief from your veterinarian.

People have a somewhat unwarranted aversion to using ‘Bute’ but there are occasions when it is the humane thing to do on a SHORT term basis. It can provide much needed pain relief so long as you follow the vet’s instructions. (Long term over-use of ‘Bute’ can lead to serious problems such as ulcers, blood abnormalities and kidney problems).

Of course it is inappropriate, unethical and unfair on any horse to use ‘Bute’ to mask mild pain long term in order to be able to work or sell the horse or for the purpose of being able to compete.

Most veterinarians, and rightfully so, will not give you ‘Bute’ without a visit first. This is to ensure that the horse’s condition isn’t a lot worse than what you may have thought and that ‘Bute’ would be suitable pain relief.
It’s important to remember that ‘Bute’ does not ‘cure’ the problem. It reduces inflammation and therefore pain ensuring the horse is more comfortable when suffering from various ailments.

It usually results in the horse ‘perking up’ as pain relief kicks in. The horse becoming more depressed, or off its feed would be cause for concern.
‘Bute’ is not appropriate for any form of ‘colic’ which is an emergency when the vet should be called urgently anyway.