Equine Syndromes

Question 1

EMS CS (4)

Answer 1

• Profound insulin resistance
• increase in blood triglycerides
• increase in likelihood of laminitis
• elevated fasting insulin, even if normoglycaemic

Question 2

EMS pathogenesis

Answer 2

adipose tissue prodcues cytokines;
-TNF, IL-1 and IL-6 cause direct laminar inflammation
-11B-hydroxysteroid dehydrogenase:
   increases with omental fat
   produces resitin, FFA, cortisol and leptin
   insulin resistence
   vascular comprimis
   hypercoagulable state
   laminitis

Question 3

EMS Diagnosis

Answer 3

Dx: combined insulin-glucose tollwerance test
Tx: 
-progressive weightloss +/- thyroxine
-antihyperglycemic agents (metformin)
-address laminitis
-exercise once laminitis has resolved

Question 4

hyperlipidaemia disease (5)

Answer 4

• excessive mobilization of fat
• hepatic lipidosis
• insulin resistence
• hyperlipaemia (hepatic dysfunctuion (plasma triglycerides >5mmol/l)
• hyperlipidaemia (elevation of blood lipids)

Question 5

hyperlipaemia risk factors (8)

Answer 5

intrinsic: native, female, pregnant/lactating
extrinsic: inappetence, feed restriction, obesity, stress, inactivity
suspect in any poorly obese/periparturient animal

Question 6

hyperlipaemia clinical signs

Answer 6

initial: depression and lethargy, weakness, adipsia, decreased borborygmi, mucous coated inspissated faeces

mild/progressive: reluctance to move, muscle fasiculations, intermittent abdominal pain, diarrhoea, CNS dysfunction (ataxia, head pressing, circling)

late: recumbancy, convulsions

Question 7

hyperlipaemia Dx and Tx

Answer 7

Dx:

• opaque plasma
• TGL >5mmol/l
• increase cholesterol and liver enzymes (SDH for cellular degeneration, GGT for biliary destruction, bile acids for liver function), hypoglycaemia
• azotemia
• metabolic acidosis
• electrolyte disturbances

Tx:

• GET THEM TO EAT!: increase in blood glucose –> increase in insulin –> decrease in lipolysis
• correct fluids and electrolytes
• decrease lipolysis and increase clearance of lipids (exogenous insulin and heparin)

Question 8

Gastric ulcer syndrome

• risk factors (4)
• CS (5)
• Tx (2)

Answer 8

-athelets, serious illness, insufficent grazing/forage, chronic NSAID administration

CS:

• poor appetite
• pain after eating
• loss of performance
• reduced body condition
• dullness, weightloss, lethargy

Tx:

• managemental and feeding changes
• omeprazole (PPI)

Question 9

psychogenic polydipsia

• definition
• CS (3)
• Tx

Answer 9

healthy horse, just drinking like a maniac

CS:

• PU/PD
• on water deprivation test SG > 1.025
• bloods are normal

Tx: decrease the amount of water the horse has access to