Endocrine Disorders in Horses Flashcards
most important 3 endocrine disorders in horses
- Equine Metabolic Syndrome
- Pituitary Pars Intermedia Dysfunction
- Thyroid Diseases
Equine Metabolic Syndrome (EMS)
- who is affected? age and breeds? etiology?
- Usually affects mature horses
> any adult horse can get this!
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Breed predisposition: - Pony breeds
- Morgan
- Icelandic
- Miniature Horses
- Donkeys
<><> - Genetic predisposition: suspected but not confirmed
Equine Metabolic Syndrome (EMS)
- clinical signs
Obesity - general or regional adiposity
* Cresty neck
* Tail head
* Supraorbital fat pads
* Mammary, sheath
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* “Easy keepers”
* Poor fertility
* Clinical or subclinical laminitis
Equine Metabolic Syndrome (EMS)
* Pathophysiology vs normal
Normal insluin response after a meal:
- increased glucose in the SI
> relesase of incretin hormones
> increase insulin secretion
> clearance of insulin
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Hyperinsulinemia
- increased glucose in the SI
> VERY increased release of incretin hormones
> VERY increased insulin secretion
> VERY decreased clearance of insulin
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Hyperinsulinemia and laminitis (not fully understood yet)
- hyperinsulinemia > ectivation of IGF=1 receptors in the blood vessels > vascular dysfunction > hyperinsulinemia-associated laminitis
Equine Metabolic Syndrome (EMS)
* The “triad”
- hyperglycemia (eg. after eating, normal)
> stimulates beta cell secretion - hyperinsulnemia
> compensatory pancreatic secretion, reduced insulin clearance - insulin resistance
> reduced suppression of lipolysis and hepatic VLDL synthesis - hypertriglyceridemia
<><> - insulin resistance also impairs insulin signalling, stimulates lipogenesis
> Hyperinsulinemia - also impairs glucose uptage, reduces suppesttion of gluconeogenesis
> hyperglycemia
Equine Metabolic Syndrome (EMS)
* Diagnosis
clinical signs and tests:
* Obesity
* Laminitis
* Hyperinsulinemia
> single measurement - basal inslulin
> dynamic test - oral glucose tolerance test, or combined glucose-insulin tolerance test
Equine Metabolic Syndrome (EMS)
- treatment and management
- DIET > minimize carbohydrates and sugar
- Turn out/exercise
- Laminitis management
<><><><> - Metformin
- Levothyroxine
- Sodium-glucose co-transporter 2 (SGLT2)
Pituitary Pars Intermedia Dysfunction (PPID)
- who is affected?
- clinical signs?
- Usually affects horses older than 10-years-old
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Clinical signs: - Hypertrichosis (hirsutism)
- Poor hair coat
- Hyperhidrosis
- Laminitis
- Lethargy
- Recurrent infections
- Weight loss/muscle wasting
- Pendulous abdomen/fat redistribution
- PU/PD
Pituitary Pars Intermedia Dysfunction (PPID)
- pathophysiology, normal vs PPID
HEALTHY:
- dopamine from hypothalamic neurons inhibits cells in the pituitary pars intermediata
- this limits release of ACTH and related peptides from pars intermediata cells into the blood stream
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PPID:
- hypothalamic dopaminergic neurons undergo oxidative stress and degenerate
- results in loss of inhibition of the pars intermediata, leading to hyperplasia or adenoma formation
- pars intermedia release of ACTH and related peptides increases (eg. POMC)
Pituitary Pars Intermedia Dysfunction (PPID)
* Diagnosis:
- Basal tests > Plasma ACTH: changes based on month, but overall if ACTH is very high, that supports a diagnosis
- Dynamic tests > TRH stimulation test: stimulates ACTH to be released, PPID horses will have a larger increase that takes longer to go down
Pituitary Pars Intermedia Dysfunction (PPID)
* Treatment:
- Pergolide (dopamine D2 receptor agonist)
- Good quality feed + geriatric care
EMS and PPID connection?
Horses can have EMS and PPID at the same time!
Thyroid Diseases in horses - what do we see
- Congenital hypothyroidism
- Hypothyroidism in adult horses
- Thyroid tumors
Congenital hypothyroidism
- what will our gland look like?
- other things we might see in these foals?
- Thyroid gland hyperplasia!
<><> - Goiter > inconsistent finding
<><> - Prolonged gestation
- Congenital musculoskeletal abnormalities
> Flexural deformities
> Incomplete ossification of cuboidal bones
> Mandibular prognathy
> Domed forehead - ie. signs of dysmaturity in a mare that is overdue
Congenital hypothyroidism
risk factors?
- Might be associated with excess iodine consumption during pregnancy or not
- Risk factors:
- Lack of mineral supplementation during pregnancy
- Grazing irrigated pasture
- Eating immature cereal crop
- Eating forage that contains nitrate
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Higher prevalence in Western Canada!