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Ketoacidosis/Ketone stench on a horse WTF

I would like to apologize for using the term ketoacidosis. It came from my experience as an EMT, when it was important to recognize the difference between diabetic ketoacidosis and insulin shock in human patients. I have also know extremely lean, fit athletes and anorexics to have the distinctive smell of ketoacidosis, especially their breath.

I mistakenly applied the human term to veterinary medicine, because I’ve know IR, Cushing’s and other metabolic disease horses to have a similar smell.


Wait! What? This is exactly what I was looking for! Thank you! I have not had close contact with (not well managed) horses with any type of metabolic issue so was not aware there was a similar stink factor.

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My nose must not work right because I have never noticed these things.

My late Cushing’s pony did not have any ketosisish smell (not sure what word is correct). He smelled like a normal horse but he was severely Cushingoid.

It’s probably not your nose. People like me can smell it far before it’s strong enough for most people to pick up on it at all. I am not kidding when I say that I probably could have had other people smell the horse in question the other night and more than likely they would have pronounced, “Smells like a horse. You’re nuts.”

It can be very frustrating - I watched cows grow more ill than necessary before my boss put two and two together and figured out that I was right every time I pointed out a stinky cow that he could not smell. Things got better (and cheaper for him because the earlier you treat, the less likely you are to get $$ complications like abdominal surgery) after that.

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As far as I know the smell associated with ketosis would come from the mouth. Their breath --not the belly. Maybe you are smelling your own ketosis?

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No. I am not ketotic. It was coming from the horse’s belly, likely from lounging in somehorse else’s urine in turnout. Ketone excretion is not limited to exhalation.

Also, please read at least the entire first post for comprehension, I said right there that the horse’s breath and nether regions and her peed on tail flap were all clear of the smell but that her belly was the source of the stink and that I didn’t believe the stink to be emanating from WITHIN her. It was definitely ON her, but I did not believe it was coming from within her.

I did read it. The whole thing is just odd. Get her to pee and sniff that.

It wasn’t coming from within her. If it had been I would have definitely smelled it on her breath, sweat, or her peed on tail flap. It was localized on her belly only. There are a couple of antique candidates in her field that could be the origin of the stink who could have peed on a nice pile of hay that she had a little nap atop of. So, there’s a perfectly plausible explanation for how it got on the horse.

The only things that are really odd are that I personally have never smelled that particular odour on/around a horse and I’ve smelled a LOT of it in my years working with dairy cattle, and in doing a quick search for ketosis and horses, I got very little confirmation that it’s a thing that can happen to horses.

Could it be an odor that develops in horse urine that’s been standing around for a while? Or on organic material?

I don’t think so - I’ve never smelled it anywhere near horses before, but I’m not a scientist of any sort, so I really have no idea whether that’s a possibility or not.

Huh, going to go learn more about this. My hubs has had that alcohol smell a few times lately but said nope not a drop.

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This is my experience, from smelling this emanating from a person. It really smelt as though the individual had been drinking hard liquor.

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I have known “mare in season” pee that has an oddly sweet and fruity smell to it. Particularly choice if they choose to sleep in it.


Ah that’s what I’m smelling in my deteriorating hogfuel paddock (cedar mulch). Whiffs of molasses is what I thought.

I googled it too and they said it can happen but it was rare.

Maybe get some ketone strips at Wal Mart and test everyone pee to see if they test positive?

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Not everyone can smell ketones, there is a genetic component to that ability


I had one vet tell me not only that but very few people can smell it can catch the first whiff as an animal just tips the scales and I was one of the “lucky” ones. Yeah, lucky for the cows, not for me lol. That vet was disappointed he didn’t have the nose for it. Me, in my head: Count yourself lucky!

I think I have it. My 80 year old father is pre-diabetic and I can smell it on him. But sometimes I’ll notice it on other people; a young woman recently at a party for example. She was probably not even 30. I wondered if I should suggest she see a doctor. Then I figured she might know she’s diabetic. Then I wondered if she was on a keto diet? Would that do it?

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A keto diet will do it.

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