Treatment of equine metabolic syndrome: A clinical case series

Morgan, Ruth; Keen, John; McGowan, Catherine

doi:10.1111/evj.12445

Cited by 45 publications

(47 citation statements)

References 45 publications

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“…11 Similarly, horses that lose weight and adiposity can show improved insulin sensitivity. 15 These findings mirror the situation in human medicine, where improved diet, weight loss, and exercise result in increased insulin sensitivity in individuals with type 2 diabetes mellitus (noninsulin-dependent diabetes mellitus) and pre-diabetic states. 15 In human medicine, diagnostic testing of glucose metabolism is performed on subjects who have fasted for at least 8 hours.…”

mentioning

confidence: 65%

“…15 These findings mirror the situation in human medicine, where improved diet, weight loss, and exercise result in increased insulin sensitivity in individuals with type 2 diabetes mellitus (noninsulin-dependent diabetes mellitus) and pre-diabetic states. 15 In human medicine, diagnostic testing of glucose metabolism is performed on subjects who have fasted for at least 8 hours. 16 Published protocols for the OST and IRT in horses have been inconsistent when specifying whether or not the animals should be fasted before the tests are performed, and, if so, for how long.…”

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confidence: 65%

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The Effect of Fasting Duration on Baseline Blood Glucose Concentration, Blood Insulin Concentration, Glucose/Insulin Ratio, Oral Sugar Test, and Insulin Response Test Results in Horses

Bertin

Taylor

Bianco

et al. 2016

Veterinary Internal Medicne

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ObjectivesPublished descriptions of the oral sugar test (OST) and insulin response test (IRT) have been inconsistent when specifying the protocol for fasting horses before testing. The purpose of our study was to examine the effect of fasting duration on blood glucose concentration, blood insulin concentration, glucose/insulin ratio, OST, and IRT results in horses.AnimalsTen healthy adult horses.ProceduresBoth OST and IRT were performed on horses without fasting and after fasting for 3, 6, and 12 hours. Thus, 8 tests were performed per horse in a randomized order. Blood collected at the initial time point of the OST was analysed for both blood glucose and serum insulin concentrations so that baseline concentrations and the glucose/insulin ratio could be determined. Unless fasted, horses had free‐choice access to grass hay.ResultsThere was no effect of fasting and fasting duration on blood glucose concentration, serum insulin concentration, glucose/insulin ratio, or the OST. Response to insulin in the IRT was decreased in fasted horses. The effect increased with fasting duration, with the least response to insulin administration after a 12‐hour fast.Conclusions and Clinical RelevanceThese data indicate that insulin sensitivity is not a fixed trait in horses. Fasting a horse is not recommended for a glucose/insulin ratio or IRT, and fasting a horse for 3 hours is recommended for the OST.

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confidence: 65%

mentioning

confidence: 65%

The Effect of Fasting Duration on Baseline Blood Glucose Concentration, Blood Insulin Concentration, Glucose/Insulin Ratio, Oral Sugar Test, and Insulin Response Test Results in Horses

Bertin

Taylor

Bianco

et al. 2016

Veterinary Internal Medicne

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“…Parenteral delivery of exogenous glucose, insulin, or both has the advantage of decreasing variability associated with gastrointestinal transit and absorption but also omits some possibly important elements of ID including incretin effects. Nevertheless, such tests allow focus on specific elements of ID such as IR and have been successfully used to diagnose and monitor EMS in clinical and research settings …”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…The combined glucose insulin test (CGIT) is based on injection of 150 mg/kg BM glucose IV, directly followed by 0.1 IU/kg BM neutral (regular) insulin IV . In a shortened protocol, both insulin and glucose are measured in the basal sample and after 45 and 75 minutes . Typical healthy horses show a biphasic blood glucose curve starting with hyperglycemia, followed by a negative phase in which glucose drops below the initial baseline value.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

ECEIM consensus statement on equine metabolic syndrome

Durham¹,

Frank

McGowan

et al. 2019

Veterinary Internal Medicne

176

227

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Equine metabolic syndrome (EMS) is a widely recognized collection of risk factors for endocrinopathic laminitis. The most important of these risk factors is insulin dysregulation (ID). Clinicians and horse owners must recognize the presence of these risk factors so that they can be targeted and controlled to reduce the risk of laminitis attacks. Diagnosis of EMS is based partly on the horse's history and clinical examination findings, and partly on laboratory testing. Several choices of test exist which examine different facets of ID and other related metabolic disturbances. EMS is controlled mainly by dietary strategies and exercise programs that aim to improve insulin regulation and decrease obesity where present. In some cases, pharmacologic aids might be useful. Management of an EMS case is a long‐term strategy requiring diligence and discipline by the horse's carer and support and guidance from their veterinarians.

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“…Within the Pony Club system, owners and riders receive a considerable amount of basic information on horse care and management. It has recently been shown that, with appropriate diet and exercise management, insulin dysregulation in horses and ponies with EMS can be minimised . Presumably, this will also reduce the risk of laminitis, although this has not yet been proven in a full prospective study.…”

Section: Discussionmentioning

confidence: 99%

Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south‐eastern Australia

Potter

Bamford

Harries³

et al. 2017

Aust Veterinary J

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This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis.

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Treatment of equine metabolic syndrome: A clinical case series

Abstract: A diet and exercise programme tailored to the needs of the individual animal and implemented by the owner results in weight loss accompanied by improvements in insulin sensitivity.

Cited by 45 publications

References 45 publications

The Effect of Fasting Duration on Baseline Blood Glucose Concentration, Blood Insulin Concentration, Glucose/Insulin Ratio, Oral Sugar Test, and Insulin Response Test Results in Horses

The Effect of Fasting Duration on Baseline Blood Glucose Concentration, Blood Insulin Concentration, Glucose/Insulin Ratio, Oral Sugar Test, and Insulin Response Test Results in Horses

ECEIM consensus statement on equine metabolic syndrome

Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south‐eastern Australia

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