Equine Metabolic Syndrome Flashcards
What is EMS?
A collection of metabolic and clinical features that include insulin dysregulation (ID) as a consistent component resulting in an increased risk of laminitis (HAL)
What is HAL?
Hyperinsulinemia associated laminitis is caused by stretch of the epithelial cells (moreso for HAL) and disruption of the basement membrane (moreso for inflammation). It is often a chronic condition
List some risk factors for insulin dysregulation
- breed: iberic breeds, gaited breeds, morgan’s, minis, arabian’s, warmbloods
- genetics: complex genetic disease
- age: >5 yrs at higher risk
- obesity: regional, generalized, not required
- diet: high nonstructural carbohydrates
what is the biggest component to insulin dysregulation?
postprandial hyperinsulinemia
types of insulin dysregulation
- resting hyperinsulinemia
- postprandial hyperinsulinemia
- tissue insulin resistance
Oral Sugar Test
- Fast for 3-6 hours
- Administer 0.15 ml/kg corn syrup orally via dose syringe
- collect blood at 60 and/or 90 minutes
- measure insulin and glucose
- > 45 uIU/ml are consistent with post prandial hyperinsulinemia
Insulin Tolerance Test
- Do not fast
- Collect blood at time 0 minutes
- Administer 0.10 IU/kg regular insulin
- collect blood at 30 minutes
- measure glucose
- feed hay and small amount or grain after last sample
- < 50% decrease in blood glucose concentrations from baseline is consistent with insulin resistance
What diet should you feed an obese horse with EMS?
- Restrict grazing
- Low NSC (<10%) grass at 1.5% dry matter of current body weight (1.7% as fed)
- assess body weight every 30 days
- soak hay in cold water for 60 minutes before feeding
- slow feeder mechanisms
- mineral/vitamin/protein ration balancer with low sugar content
what should you feed a non obese horse with EMS?
- restrict grazing, recheck insulin if pasture grazing has been reintroduced
- low NSC (<10%) grass hay with low peak insulin concentration 2 hours after feeding
- assess body weight every 30 days
- soak hay in cold water for 60 minutes before feeding
- slow feeder mechanisms
- mineral/vitamin/protein ration balancer with low sugar content
how should a horse with EMS be exercised?
- Do not exercise if laminitis is present
- Once they have recovered from laminitis exercise at low intensity on a soft surface
- Low to moderate exercise > 5 days per week for those who haven’t had laminitis
Medications for EMS
levothyroxine for weight loss resistance for 3-6 months and sodium glucose co transporter inhibitors for severe ID used for 3 months
How should a horse with EMS be monitored?
Postprandial insulin concentrations should be taken for current hay diets, changes in feeds and changes in pasture/season. As the horses age test them for PPID and monitor for signs of laminitis.
Hyperinsulinemia is tested by the __ and tissue insulin resistance is tested by __
Hyperinsulinemia is tested by the oral sugar test and tissue insulin resistance is tested by the insulin tolerance test
