Equine Metabolic Syndrome and Hyperlipemia Flashcards

1
Q

which breeds are predisposed to equine metabolic syndrome?

A

ponies
morgan horses
paso finos
warmbloods
saddlebreds
arabians
donkeys

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2
Q

which three factors are present in equine metabolic syndrome?

A

regional adiposity
insulin dysregulation
increased risk for laminitis

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3
Q

what does insulin dysregulation include?

A

resting hyperinsulinemia
increased insulin response to oral sugars
tissue insulin resistance

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4
Q

what is laminitis?

A

damage to laminae of the hoof
separation of the dermal-epidermal laminae
displacement of P3

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5
Q

how do we judge risk of laminitis?

A

divergent hoof rings
expanded white line
episodes of foot soreness or previous laminitis

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6
Q

what endocrine things increase with equine metabolic syndrome?

A

insulin
triglycerides
leptin

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7
Q

how sensitive is resting glucose and insulin?

A

low: only abnormal in severe cases

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8
Q

should you fast a horse for measuring resting insulin?

A

no
no grain, but hay or pasture okay

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9
Q

how can you use diet and exercise to manage equine metabolic syndrome?

A

decrease calories and sugar
increase exercise

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10
Q

why should you employ slow feeding in equine metabolic syndrome?

A

manage postprandial hyperinsulinemia

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11
Q

what is levothyroxine for?

A

to manage obesity if diet and management changes fail

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12
Q

what are SGLT2 inhibitors useful for?

A

managing hyperinsulinemia

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13
Q

who does hyperlipemia occur in?

A

at risk animals that enter a negative energy balance

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14
Q

who is at risk for hyperlipemia?

A

ponies, miniature horses, donkeys
obesity/EMS
pregnant/lactating mares

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15
Q

what is hyperlipemia?

A

serum triglyceride concentration >500 mg/dL with grossly discolored plasma or serum
often signs of liver disease with guarded prognosis

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16
Q

what is hyperlipidemia?

A

increase in serum triglyceride concentration (<500 mg/dL) without grossly lactescent blood or fatty infiltration of the liver

17
Q

what do we do to reverse negative energy balance?

A

encourage oral intake
intravenous dextrose
insulin

18
Q

who is at increased risk for equine metabolic syndrome?

A

breed predisposition
diet/management: obesity

19
Q

is insulin dysregulation pretty easy to determine?

A

no- most tricky to determine

20
Q

what leads to insulin dysregulation?

A

seasonal adaptation to expect weight loss in winter and weight gain in summer
domestication eradicated winter weight loss: gain weight over time
breed adaptations to harsh wild environments

21
Q

what do we test in endocrine testing for equine metabolic syndrome?

A

insulin
triglycerides
leptin
HMW adiponectin
PPID testing

22
Q

when are resting glucose and insulin abnormal?

A

severe cases of equine metabolic syndrome

23
Q

at what levels of insulin in an oral sugar test is it positive for insulin dysregulation?

A

> 45 microU/ml
65 microU/ml

24
Q

what are some antidiabetics that can be used to manage hyperinsulinemia?

A

metformin
SGLT2 inhibitors

25
what should you remove from the diet of a horse with insulin dysregulation?
high sugar/carbohydrate feeds
26
what must the exercise be like for insulin dysregulation and previous laminitis?
regular for >30 minutes fast trotting and canter soft surface and unridden only once sound/stable
27
what is the side effect of levothyroxine?
will eat more and gain weight if not on feed restriction
28
what does metformin help with?
decreases glucose absorption from gastrointestinal tract bioavailability too low to impact peripheral insulin sensitivity
29
what does negative energy balance cause an increase of?
stress hormones
30
what causes blood non-esterified fatty acids to increase in negative energy balance?
hormone-sensitive lipase activated triglycerides in adipose hydrolyzed
31
what is severe hyperlipemia?
>1000 mg/dL