Clinical Endocrinology (EQ)

Question 1

What is the underlying pathophysiology of PPID?

Answer 1

Loss of dopaminergic inhibition of pars intermedia –> inc ACTH and B lipotropin

Question 2

At what age do horses generally suffer from PPID?

Answer 2

> 15y, not under 10y

Question 3

What 2 sequalae of PPID are seen more often in ponies than horses?

Answer 3

Hirsutism

Laminitis

Question 4

What signs of PPID are seen in both horses and ponies?

Answer 4

Hirsutism
Laminitis
Weight Redistribution
Bulging supraorbital fat
PUPD
Exercise intolerance
Sweating

Question 5

Measuring insulin in PPID can give an indication of what?

Answer 5

PROGNOSIS - survival good if <62uU/ml

Question 6

What is the tier 1 test for PPID?

Answer 6

Resting ACTH
80% spec in summer and 99% in Autumn.

Use PLASTIC EDTA tube.

Question 7

What is the Tier 2 test and when should it be used?

Answer 7

Test 1 -ve but signs present.

TRH stimulation test or LDDST (lammy risk)

Question 8

What is the Tx of choice for PPID?

Answer 8

Pergolide

Question 9

What is the ideal monitoring protocol for PPID?

Answer 9

Monthly evaluation of ACTH/insulin for 3m.
If Stable: 3m evaluation for 9m.
Then less freq if stable.

Question 10

What is Equine Metabolic Syndrome?

Answer 10

obesity leading to hyperinsulinaemia and insulin resistance - predisposes horse to laminitis

Question 11

What test and result is diagnostic for EMS?

Answer 11

Resting hyperinsulinaemia (>20uIU/ml)

NOT HYPERGLYCAEMIA

Question 12

What is the ideal Tx for EMS?

Answer 12

Diet/Obesity mgmt
Metformin (insulin sensitizer)
Thyroxine (metabolism booster)