Equine Metabolic Syndrome and Hyperlipemia

Question 1

which breeds are predisposed to equine metabolic syndrome?

Answer 1

ponies
morgan horses
paso finos
warmbloods
saddlebreds
arabians
donkeys

Question 2

which three factors are present in equine metabolic syndrome?

Answer 2

regional adiposity
insulin dysregulation
increased risk for laminitis

Question 3

what does insulin dysregulation include?

Answer 3

resting hyperinsulinemia
increased insulin response to oral sugars
tissue insulin resistance

Question 4

what is laminitis?

Answer 4

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

Question 5

how do we judge risk of laminitis?

Answer 5

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

Question 6

what endocrine things increase with equine metabolic syndrome?

Answer 6

insulin
triglycerides
leptin

Question 7

how sensitive is resting glucose and insulin?

Answer 7

low: only abnormal in severe cases

Question 8

should you fast a horse for measuring resting insulin?

Answer 8

no
no grain, but hay or pasture okay

Question 9

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

Answer 9

decrease calories and sugar
increase exercise

Question 10

why should you employ slow feeding in equine metabolic syndrome?

Answer 10

manage postprandial hyperinsulinemia

Question 11

what is levothyroxine for?

Answer 11

to manage obesity if diet and management changes fail

Question 12

what are SGLT2 inhibitors useful for?

Answer 12

managing hyperinsulinemia

Question 13

who does hyperlipemia occur in?

Answer 13

at risk animals that enter a negative energy balance

Question 14

who is at risk for hyperlipemia?

Answer 14

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

Question 15

what is hyperlipemia?

Answer 15

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

Question 16

what is hyperlipidemia?

Answer 16

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

Question 17

what do we do to reverse negative energy balance?

Answer 17

encourage oral intake
intravenous dextrose
insulin

Question 18

who is at increased risk for equine metabolic syndrome?

Answer 18

breed predisposition
diet/management: obesity

Question 19

is insulin dysregulation pretty easy to determine?

Answer 19

no- most tricky to determine

Question 20

what leads to insulin dysregulation?

Answer 20

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

Question 21

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

Answer 21

insulin
triglycerides
leptin
HMW adiponectin
PPID testing

Question 22

when are resting glucose and insulin abnormal?

Answer 22

severe cases of equine metabolic syndrome

Question 23

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

Answer 23

> 45 microU/ml
65 microU/ml

Question 24

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

Answer 24

metformin
SGLT2 inhibitors

Question 25

what should you remove from the diet of a horse with insulin dysregulation?

Answer 25

high sugar/carbohydrate feeds

Question 26

what must the exercise be like for insulin dysregulation and previous laminitis?

Answer 26

regular for >30 minutes
fast trotting and canter
soft surface and unridden
only once sound/stable

Question 27

what is the side effect of levothyroxine?

Answer 27

will eat more and gain weight if not on feed restriction

Question 28

what does metformin help with?

Answer 28

decreases glucose absorption from gastrointestinal tract
bioavailability too low to impact peripheral insulin sensitivity

Question 29

what does negative energy balance cause an increase of?

Answer 29

stress hormones

Question 30

what causes blood non-esterified fatty acids to increase in negative energy balance?

Answer 30

hormone-sensitive lipase activated
triglycerides in adipose hydrolyzed

Question 31

what is severe hyperlipemia?

Answer 31

> 1000 mg/dL