Association between hyperinsulinaemia and laminitis severity at the time of pituitary<i>pars intermedia</i>dysfunction diagnosis

Tadros, Elizabeth M.; Fowlie, J. G.; Refsal, Kent R.; Marteniuk, J. V.; Schott, Harold C.

doi:10.1111/evj.12963

Cited by 37 publications

(59 citation statements)

References 38 publications

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“…Clinicians should also endeavor to educate horse/pony owners about the requirement for timely intervention for an animal with laminitis that might be in considerable pain, given the concerning finding from the current study that just over 50% of cases waited >10 days for veterinary attention. Recent reports that owners might fail to recognize laminitis in its early or mild stages is supportive of this perception . However, it is also possible that farriery assistance was sought before veterinary intervention in some cases in the current study.…”

Section: Discussionmentioning

confidence: 52%

“…The median insulin concentration was higher (P < .02) in animals with both equine metabolic syndrome (EMS) and pituitary pars intermedia dysfunction (PPID), compared to animals with EMS, PPID, or a pasture-associated cause of the disease (A). The insulin concentration was negatively correlated with height at the withers in the cohort (B); however, the insulin concentration did not differ among the seasons (C) 8.5 [3][4][5][6][7][8][9][10][11]…”

Section: Descriptive Epidemiology: Laminitismentioning

confidence: 99%

“…Although previous research has focused on the inflammatory forms of the disease, recent data support that endocrinopathic laminitis is a worldwide welfare issue that is presented to equine practitioners reasonably frequently . Currently, data on the clinical features of laminitis specific to the endocrinopathic form of the disease are limited, and owners might fail to recognize the disease, particularly in early or mild cases …”

Section: Introductionmentioning

confidence: 99%

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Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Laat

Sillence

Reiche

2019

Veterinary Internal Medicne

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Background Equine endocrinopathic laminitis is common and can be associated with an underlying endocrinopathy, such as equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID), pasture consumption, or any combination of these factors. Objectives The aim of the study was to improve the risk assessment capabilities of clinicians, and to inform management strategies, for acute endocrinopathic laminitis by prospectively examining the phenotypic, hormonal, and clinical characteristics of the disease in a large cohort. Animals Privately owned horses and ponies (n = 301) of any age, sex, or breed diagnosed with laminitis by a veterinarian. A history of laminitis was acceptable. Methods This was a prospective cohort study. Veterinarians provided information on each case via an online questionnaire after informed consent from the animal's owner, and all data were de‐identified before analysis. Serum insulin and plasma adrenocorticotrophic hormone concentrations were measured in each case. Results Most cases were recruited in spring (109/301; 36.2%). Concurrent EMS and PPID resulted in higher basal insulin concentrations (49 [21.5‐141]; P < .02) than if an animal had a single underlying cause for their laminitis. The insulin concentration was negatively correlated (r 2 = −0.38; P < .001) with the animal's height, being higher in ponies (33[10‐14]; P < .001) than horses (9.5 [3‐25.7]) and was positively correlated (r 2 = 0.12; P = .05) with their grade (severity) of laminitis. Conclusions and Clinical Importance Horses and ponies with concurrent endocrinopathies have more marked hyperinsulinemia. Higher basal insulin concentrations were associated with more severe lameness.

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Section: Discussionmentioning

confidence: 52%

Section: Descriptive Epidemiology: Laminitismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Laat

Sillence

Reiche

2019

Veterinary Internal Medicne

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“…Laminitis is an acute disease, with the early subclinical phase usually undetectable . Furthermore, horse owners might not be particularly skilled at identifying the disease . Another recent study examining this same cohort of animals also found that owners frequently did not call the veterinarian until later in the clinical time course of the disease .…”

Section: Discussionmentioning

confidence: 99%

“…The critical factor in cases of endocrinopathic laminitis appears to be insulin dysregulation (ID), which results from a complex, often multifactorial disruption to the normal interactions between glucose and insulin. The diagnosis and management of ID can be challenging, and failure to recognize and control the underlying endocrinopathy means that laminitis might recur and become chronic . Furthermore, the management of ID currently relies on ongoing strategies to mitigate hyperinsulinemia, such as dietary restriction, weight loss, and exercise, the success of which is dependent on owner compliance …”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Laat

Reiche

Sillence

et al. 2019

Veterinary Internal Medicne

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Background Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. Objectives To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. Animals Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). Methods This prospective cohort study collected data on veterinary‐diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non‐endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow‐up data were collected at regular intervals to determine whether the laminitis recurred in the 2‐year period after diagnosis. Results The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2‐year study period increased with basal, fasted serum insulin concentration ( P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0‐20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely ( P = .05) to recur sooner. Conclusions and clinical importance Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.

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Genetics and Signaling Pathways of Laminitis

Galantino‐Homer

Brooks

2020

Veterinary Clinics of North America: Equine Practice

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Association between hyperinsulinaemia and laminitis severity at the time of pituitarypars intermediadysfunction diagnosis

Cited by 37 publications

References 38 publications

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Genetics and Signaling Pathways of Laminitis

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