EMS

Question 1

Equine metabolic syndrome is a collection of risk factors highly associated with an increased risk of what?

Answer 1

(Hyperinsulinemia-associated laminitis)

Question 2

How does laminitis induced by equine metabolic syndrome differ from the other causes of laminitis (fever, sepsis, grain overload, etc.) histologically?

Answer 2

(With other causes, you see both a stretch of the lamellar basal epithelial cells AND separation from the basement membrane, in endocrinopathy related laminitis you typically only see the cellular stretch)

Question 3

What are the two risk factors for equine metabolic syndrome?

Answer 3

(Insulin dysregulation and increased adiposity (regional specifically))

Question 4

What are the three characteristics of insulin dysregulation?

Answer 4

(Resting hyperinsulinemia, postprandial hyperinsulinemia, and/or tissue insulin resistance; a horse does not have to have all three to have insulin dysregulation)

Question 5

What should you do if you suspect a horse has EMS based on PE and their resting insulin concentration comes back as normal?

Answer 5

(Perform an oral sugar test to check for postprandial hyperinsulinemia; if that is negative, might want to consider other dzs, if positive tx insulin dysregulation)

Question 6

When trying to get an obese EMS horse to lose weight, the NSC of the hay being fed should be less than what value?

Answer 6

(<10%)

Question 7

If you have been trying to get an EMS horse to lose weight for 2 months at this point (feeding 1.5% BW dry matter, low NSC hay, regular exercise, no treats/grain, limited pasture access) and they seem resistance to weight loss, what medication can you add to their treatment plan?

Answer 7

(High dose levothyroxine (don’t think we need to know doses but just in case its 0.1 mg/kg, tapered after weight loss is achieved or 3-6 months of tx))

Question 8

What is the purpose of using SGLT2 inhibitors in EMS horses, though it is super expensive?

Answer 8

(Increases kidney excretion of glucose)