Equine Metabolic Syndrome Flashcards
List the 4 main features of equine metabolic syndrome
Insulin resistance
Dyslipidaemia
Abdominal obesity
Hypertension
What is the role of insulin?
To drive glucose into cells when the levels are high so if cells are responding to insulin they glucose isn’t being driven into cells
What are the 3 consequences of insulin resistance?
Diabetes
Obesity
Dyslipidaemia
Describe compensatory hyperinsulinaemia
- Increased triglycerides from liver, abnormal lipoprotein profile, endothelial dysfunction, pro-coagulant state
- Cardiovascular disease, hypertension, fatty liver etc
Give a definition of equine metabolic syndrome
Collection of risk factors for endocrinopathic laminitis
What is the most important factor of equine metabolic disease?
Insulin dysregulation - cells fail to respond to insulin
What factor predisposes to equine metabolic syndrome?
Obesity
What is the clinical effect of equine metabolic syndrome?
Laminitis
What happens in a horses gut when something sweet is eaten?
In horses gut endocrine cells cause an exaggerated insulin response when something sweet is eaten
Where does obesity show most obviously in a horses body?
Bulging supraorbital fat, enlarged crest, fat pads
Other than laminitis what foot problems are caused by equine metabolic syndrome?
Frequent foot abscesses, white line disease, lamellar rings, seedy toe, dropped sole
Describe the relationship between insulin and laminitis
Obesity and/or PPID
-> Insulin resistance/Dysregulation +CHO (NSC) = hyperinsulinaemia
-> Laminitis
How is equine metabolic syndrome diagnosed?
Diagnosis can be confirmed using resting hyperinsulinemia
Unfasted >20 µIU/ml
Fasted > 5 µIU/ml
Name some dynamic testing options for EMS
Oral sugar or oral glucose tests* most common
Two-step Insulin tolerance test
In feed sugar tests
Describe how to carry out in feed sugar tests
- Fast for 6-12hr (need to be hungry)
- Offer small amount (1/2 scoop) of forage chaff with 1.0g glucose powder per kg body weight added in
- Take blood sample 2hr later and measure insulin
Compare EMS and PPID
Both have laminitis
Both have high insulin
Both have budging supraorbital fat
Long coat in PPID
PPID = older horses
Horses with EMS will have a negative PPID test result
How is obesity management used in horses with EMS
- Reduce caloric intake – 1.5%-2% BWT Hay (fresh)
- Soak hay to reduce NSC 8-16 hours (50% reduction)
- This is a STRICT diet so must be monitored
- Provide roughage, protein, vitamins and trace minerals plus salts if soaking
- Exercise – better than diet only if possible
- Recognise & manage obesity and teach your clients to also
How can you reduce hyperinsulinaemia/ improvement of insulin sensitivity (regulation) in horses with EMS?
- Exercise
- Diet
- Drug therapy
- Nutraceuticals
Put the following in order of importance in managing EMS:
- Diet
- Drugs
- Exercise
Exercise
Diet
Drugs
