Equine Metabolic Diseases

Question 1

List the three factors that Equine Metabolic Syndrome is characterised by.

Answer 1

Obesity or regional adiposity
Insulin dysregulation/resistance (IR)
Subclinical or clinical laminitis

Question 2

Briefly describe insulin derugulation in EMS

Answer 2

Hyperinsulinaemia
Euglycaemia
Common
May only have this at rest or only as a response to feeding.

Question 3

Which breeds have a genetic predisposition for IR?

Answer 3

Hardy breeds

Question 4

List three sites of regional adiposity in EMS

Answer 4

Cresty neck
Tail head
Preputial swelling/mammary glands

Question 5

Describe the best first line test to take for EMS

Answer 5

Starve overnight
(Take resting glucose and insulin)
Feed 1kg glucose in horse’s breakfast/syringe in karolyte syrup
Continue starving
Insulin and glucose at 2-3 hours

Question 6

List four methods to help with weightloss in horses.

Answer 6

Feed 1/3 less than they were
Not less than 1kg forage per 100kg
Soak hay > 1 hour
Haynet with small holes

Question 7

Which drug can you use to increase insulin sensitvity in the horse and how does it work?

Answer 7

Metformin
Aids weight loss and reduces glucose spikes by blocking SI carbohydrate absorption

Question 8

What is the best treatment for equine metabolic syndrome?

Answer 8

Weight loss

Question 9

Define hyperlipaemia

Answer 9

Serum triglyceride concentration in excess of 500mg/dl.
Leads to fatty infiltration of liver.
Clinical signs of liver disease.
Poor prognosis

Question 10

Define hyperlipidaemia

Answer 10

Increase in serum triglyceride (but less than 500mg/dl)
Without grossly lactescent blood
Without fatty infiltration of liver

Question 11

List four risk factors for hyperliaemia

Answer 11

Obesity
Ponies
In foal
Donkeys

Question 12

What is the rate limiting enzyme for hyperlipaemia?

Answer 12

Endothelial lipoprotein lipase

Question 13

List three ways in which insulin impedes the development of hyperlipaemia

Answer 13

Inhibits HSL (lipolysis of adipose tissue)
Inhibits gluconeogenesis in liver
Activating LPL (uptake VLDL to adipose tissue)

Question 14

How to diagnose hyperlipaemia?

Answer 14

Blood triglyceride level
In hyperlipaemia there is opalescent blood
Raised serum activity of liver enzymes
Raised bile acids

Question 15

List 5 signs of hypocalcaemia

Answer 15

Synchronous diaphragmatic flutter
Hypocalcaemic tetany
Hypocalcaemic seizures
Ileus
Retained placenta