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.