Equine endocrinology cases

Question 1

Case 1
* Slim = 10y/o cob
* Hx = unwilling to walk + won’t come in from field
- fine in the morning - only like this 4hrs after turnout
- “eats nothing and lives off fresh air”
* Clinical exam = bounding digital pulses in all feet, reluctant to walk, can’t lift front limbs, mild tachycardia, normothermic

• What is likely the cause? Why do you think this? what else could be seen?

Answer 1

• Laminitis - pulses, reluctant to walk, bilateral / multi foot pain
• front feet out infront, hindlegs under the body
• heat in foot, growth rings
• bruising in the sole of the foot, thickening of white line
• depression at coronary band

Question 2

What are the 3 underlying causes of laminitis?

Answer 2

• PPID / EMS - cushings - endocrinopathic
• Septic - colitis / RFM
• weight bearing laminitis - supporting limb
• Iatrogenic - corticosteroids (endocrinopathic)

Question 3

What are the difference obel laminitis grades?

Answer 3

• Obel grade 1 = At rest, the horse shifts its weight between the forelimbs; the horse is sound at the walk, but the gait is stilted at the trot in a straight line and on turning
• Obel grade 2 = The gait is stilted at the walk and the horse turns with great difficulty, but one forelimb can be lifted
• Obel grade 3 = The horse is reluctant to walk and one forelimb can only be lifted with great difficulty
• Obel grade 4 = The horse will only move if forced to

Question 4

How would you treat the laminitis in this horse?

Answer 4

• Pain management - phenylbutazone / flunixin / paracetamol
• Cooling the feet - cryotherapy
• Box rest - deep bedding
• Soaked hay + STOP feeding concentrates
• Heel wedges

Question 5

Regarding basal insulin results what do they tell you?

Answer 5

• <32 ulU/ml = normal
• 32-75 = insulin dysregulation likely if consistent clinical signs
• > 75 Insulin dysregulation

Question 6

Why would you want to excrete glucose in urine of EMS horses?

Answer 6

• Lower glucose = lower insulin
• High Insulin predisposes laminitis

Question 7

What happens in hypoglycaemic horses?

Answer 7

• Low glucose = horses breakdown fat for energy = releasing a lot of triglycerids = hypertricylceridaemia = more fat deposition in blood and liver
• Hypertriglyceridaemia = white substance in blood.