Characterization of the intravenous glucose tolerance test and the combined glucose-insulin test in donkeys

Metabolic and Endocrine Insights in Donkeys

Donkey medicine is gaining attention due to their increased use as companion animals, in shows, asinotherapy, etc. The increasing demand and unique aspects call for specialized care, requiring new information (physiology, infectious disorders, pharmacology, etc.). Since obesity is common in this species, hyperlipemia, metabolic syndrome and insulin dysregulation (ID) are common disorders in donkeys, in some cases with high mortality, either directly (multiorgan dysfunction) or indirectly due to poor quality of life (chronic laminitis). Donkeys have long-life expectancy and are often afflicted with pituitary pars intermedia dysfunction (PPID), a neurodegenerative and endocrine disease. Hyperlipemia is diagnosed based on high plasma triglyceride concentration in association with clinical findings and laboratory abnormalities from affected tissues (liver, kidney and pancreas). The measurement of resting serum insulin and plasma ACTH concentrations is the first step in ID and PPID diagnosis. In donkeys with clinical signs of ID (obesity or recurrent laminitis) or PPID (hypertrichosis, regional adiposity, laminitis and weight loss), where these hormones are in the normal or non-diagnostic range (donkey-specific cut-off values and reference ranges need to be established), dynamic tests are recommended (oral sugar test or thyrotropin-releasing hormone, respectively). Equine treatment protocols apply to donkeys, although pharmacological studies for most drugs, except pergolide, are lacking.

Seasonal variation of endogenous adrenocorticotropic hormone concentrations in healthy non-geriatric donkeys in Northern California

Elevated plasma adrenocorticotropic hormone (ACTH) is often used to diagnose pituitary pars intermedia dysfunction (PPID) in horses. The hormone naturally increases in the fall in horses, and donkeys have been found to have higher ACTH concentrations than horses. However, circannual variation of ACTH has not been assessed in donkeys. The objective of the study was to establish seasonal variation of basal plasma ACTH concentrations over the course of a year in clinically healthy, non-geriatric donkeys. It was hypothesized that donkey ACTH concentrations would be higher than those reported in horses without PPID in all seasons, and that, similarly to horses, ACTH concentrations would further increase in the fall months. Twenty-six healthy adult donkeys (10 standards, 16 miniatures), a median (range) of 6 (2–13) years of age, were included. Donkeys were housed at a single location. Serial plasma samples were obtained monthly for 12 months. Plasma ACTH concentrations were determined by immunoassay. Data are presented as median (range), with a P-value < 0.05 considered significant. ACTH concentrations were lowest in the winter and spring [12.8 (5.0–73.6) pg/ml and 12.5 (2.8–62.6) pg/ml, respectively], with an increase in the summer [53.2 (29.7–305.0) pg/ml], and peak in the fall [77.1 (12.4–319.0) pg/ml]. ACTH concentrations were highest in the month of September [122.0 (41.7–319.0) pg/ml]. Donkey ACTH concentrations were higher than equine reference ranges from May through November but showed similar circannual variation with dramatic increases in the fall months. Species-specific reference ranges are necessary for accurate interpretation of endocrinopathy screenings in donkeys.

Characterisation of the oral glucose and sugar tolerance tests and the enteroinsular axis response in healthy adult donkeys

BACKGROUND

Insulin dysregulation (ID) is diagnosed in horses and ponies using oral glucose (OGTT) and oral sugar (OSTT) tolerance tests. The enteroinsular axis plays a major role in postprandial glucose disposal and insulin response in horses, ponies and foals. The insulin and incretin response to oral carbohydrate challenges has not been characterised in donkeys.

OBJECTIVES

(a) To characterise OGTT and OSTT, and (b) to assess the plasma incretin response to OGTT and OSTT in healthy donkeys.

STUDY DESIGN

In vivo experiments.

METHODS

Six healthy adult female Andalusian donkeys were challenged with OGTT (1 g/kg glucose, 20% solution by nasogastric tube) and OSTT (0.45 mL/kg corn syrup orally by syringe) with a 1-week washout. Blood samples were collected for glucose (spectrophotometry), insulin (radioimmunoassay), glucose-dependent insulinotropic polypeptide (GIP, ELISA) and active glucagon-like peptide-1 (aGLP-1, ELISA) determination over 6 hours. Curves were analysed and proxies calculated.

RESULTS

Glucose and insulin concentrations peaked at 180 minutes in OGTT, but at 300 and 150 minutes in OSTT, respectively. Plasma GIP concentrations increased in the OGTT and OSTT (peaked at 180 and 360 minutes, respectively), but aGLP-1 increased only in OGTT (240 minutes).

MAIN LIMITATIONS

Single breed, narrow age and sample, diet, season and not having donkeys with evidence of ID to provide clinical validation.

CONCLUSIONS

Donkeys have a functional enteroinsular axis that is activated by enteral carbohydrates. Donkeys have evident endocrine differences with horses, supporting the validation of the OSTT and OGTT to assess insulin sensitivity in this species to avoid extrapolation from horses.

Evaluation of the combined glucose-insulin and intravenous glucose tolerance tests for insulin dysregulation diagnosis in donkeys

BACKGROUND

Insulin dysregulation (ID) and donkey metabolic syndrome (DMS) are common in this species. Contrary to horses, diagnostic guidelines compiling insulin cut-offs values and dynamic testing interpretations have not been reported for this species.

OBJECTIVES

To evaluate resting serum insulin concentrations, the combined glucose-insulin test (CGIT) and the glucose intravenous tolerance test (IVGTT) for the diagnosis of DMS with ID suspicion.

STUDY DESIGN

Diagnostic test comparison.

METHODS

Six of 80 mix-breed adult donkeys fulfilled the inclusion criteria for DMS based on history or clinical evidence of recurrent laminitis, body condition >6 and neck score >2 or baseline insulin and leptin concentrations >20 µIU/mL and >12 ng/mL respectively. CGIT and IVGTT were performed in all donkeys within a week and interpreted following guidelines reported for equine metabolic syndrome (EMS). Insulin and glucose curves were analysed, proxies calculated and correlations and multivariate analysis assessed.

RESULTS

Following EMS guidelines, CGIT classified 2 (using glucose-positive phase duration) or 3 (using insulin concentration) and IVGTT classified 5 donkeys as ID. ID donkeys showed a lower glucose/insulin ratio, QUICKI and RISQI, and a higher insulin/glucose ratio, MIRG and HOMA-B%.

MAIN LIMITATIONS

Comparison of these tests with additional dynamic testing including a larger number of ID donkeys is necessary.

CONCLUSIONS

This is the first study evaluating dynamic tests to assess ID/DMS in DMS-suspected donkeys. IVGTT detected more ID donkeys than CGIT. EMS recommendations could also be used for DMS diagnosis, although a baseline insulin cut-off value is needed.

Energy hormone response to fasting-induced dyslipidemia in obese and non-obese donkeys

Metabolic and endocrine disorders, such as dyslipidemia, are common in donkeys. Negative energy balance due to fasting, stressful conditions, or disease is a major trigger for fat mobilization often leading to dyslipidemia. The hormonal response to fasting has not been well characterized in donkeys. Therefore, this work aimed to study variations in insulin, glucagon, leptin, total adiponectin, ghrelin, and insulin-like growth factor-1 concentrations, insulin-to-glucagon (IGR) and glucagon-to-insulin (GIR) molar ratios, and lipid and carbohydrate parameters during a 66 h fasting period in 8 adult donkeys, and to determine differences depending on body condition. Obese donkeys developed earlier lipid mobilization (increased plasma total triglyceride and total cholesterol concentrations) compared to non-obese donkeys. Plasma glucose and leptin concentrations decreased in obese animals. After 60 h fasting, obese donkeys showed a significant increase in glucagon and decrease in leptin. GIR significantly increased, while insulin and IGR decreased in both groups. These findings support faster lipid mobilization in response to negative energy status in obese donkeys during fasting, which could be linked to greater glucagonemia and could explain the predisposition of these animals to dyslipidemia.

Pituitary Pars Intermedia Dysfunction and Metabolic Syndrome in Donkeys

Simple Summary

Donkeys are one of the six species of the equid family. Even though they may look similar to horses, there are optical, behavioral, and physiological differences between the two species. The most important endocrine diseases in horses (equine metabolic syndrome and pituitary pars intermedia dysfunction: PPID) also exist in donkeys. The key symptoms of asinine metabolic syndrome (AMS), similar to horses, are obesity, insulin dysregulation, and laminitis. It can be diagnosed with either basal glucose and insulin concentration or dynamic tests. The intravenous glucose tolerance test and the combined glucose insulin tolerance test were evaluated for donkeys. The therapy of AMS is aimed at weight and exercise management. Donkeys suffering from PPID are often laminitic. Other authors have reported on hypertrichosis as a cardinal sign. Donkey-specific differences in shedding compared to horses have to be considered. The PPID can be diagnosed with donkey-specific reference values or dynamic testing. The dexamethasone suppression test, the thyrotropin releasing hormone (TRH) test, and the combined dexamethasone suppression/TRH test were evaluated for donkeys.

Abstract

Appropriate medical care for donkeys is challenging despite being important working animals in non-industrialized countries and pets in first world countries. Although the same principles of diagnosis and therapy as in horses are commonly applied, there are differences in reference values and physiologic reaction to dynamic tests. However, donkeys seem to suffer from typical equine diseases, such as metabolic syndrome and pituitary pars intermedia dysfunction (PPID). Asinine metabolic syndrome (AMS) comprises obesity, insulin dysregulation, and laminitis. The principles of diagnosis are similar to horses. Donkey-specific reference ranges for insulin and glucose have been evaluated previously. Examinations regarding dynamic testing revealed differences in the intravenous glucose tolerance test and the combined insulin tolerance test compared to horses. The therapy of AMS is based mainly on weight loss and exercise. There are conflicting data regarding the incidence of PPID in donkeys. Laminitis and hypertrichosis were described as the main clinical signs. Species-specific and seasonal reference ranges were defined to diagnose PPID in donkeys. Furthermore, the dexamethasone suppression test, the thyrotropin releasing hormone (TRH) test and the combined dexamethasone suppression/TRH test were evaluated. Pergolide is commonly recommended for treatment.

Meloxicam ameliorates the systemic inflammatory response syndrome associated with experimentally induced endotoxemia in adult donkeys

Background

Little information is available about endotoxemia in donkeys. Characterizing the systemic inflammatory response (SIRS) to lipopolysaccharide (LPS) in donkeys would provide valuable clinical and therapeutic information. The effects of meloxicam on endotoxemia have not been studied in this species.

Objectives

To study the pathophysiology and gene expression associated with experimentally induced endotoxemia, and evaluate the effects of meloxicam on experimentally induced endotoxemia in donkeys and in equine monocyte cultures.

Animals

Six healthy adult female donkeys.

Methods

Endotoxemia was induced by an IV infusion of LPS for 30 minutes. Animals either received 20 mL of saline or 0.6 mg/kg of meloxicam IV after LPS infusion. The experiments lasted 6 hours. Blood samples were collected serially for hematology, serum biochemistry, interleukin measurement, and leukocyte gene expression analysis. Vital signs were recorded throughout the study. Monocyte cultures were used to test the effects of meloxicam on LPS‐activated monocytes.

Results

Lipopolysaccharide induced fever, leukopenia, and neutropenia of similar magnitude in both groups, but meloxicam attenuated increases in plasma lactate, tumor necrosis factor‐alpha (TNFα), and interleukin 1β concentrations compared to controls. No differences were detected between groups for cytokine mRNA expression. Furthermore, meloxicam decreased TNFα release in LPS‐activated monocyte cultures.

Conclusions and Clinical Importance

Meloxicam could be a feasible option for the treatment of endotoxemia and SIRS in donkeys. Additional studies are necessary to investigate possible meloxicam‐related posttranscriptional regulation and to compare this drug with other nonsteroidal anti‐inflammatory drugs (NSAIDs) in animals with endotoxemia.

Genetics, Evolution, and Physiology of Donkeys and Mules

The genus Equus is made up of donkeys, horses, and zebras. Despite significant variation in chromosome number across these species, interspecies breeding results in healthy, although infertile, hybrid offspring. Most notable among these are the horse-donkey hybrids, the mule and hinny. Donkeys presently are used for everything from companion animals to beasts of burden. Although closely related from an evolutionary standpoint, differences in anatomy and physiology preclude the assumption that they can be treated identically to the domestic horse. Veterinarians should be aware of these differences and adjust their practice accordingly.

Metabolic and Endocrine Disorders in Donkeys

The donkey evolved under harsh and arid environmental conditions, developing unique energy-efficiency traits, with an efficiency to rapidly mobilize fat in situations of increased energy demands or when food is scarce. This evolution has led to an inherent predisposition of donkeys to obesity, dyslipidemias, insulin dysregulation/metabolic syndrome, pituitary pars intermedia dysfunction, and endocrinopathic laminitis. Marked differences have been described in hormone dynamics and testing protocols for the diagnosis of these endocrine and metabolic diseases in donkeys compared with horses, underlining the necessity of a species-specific approach in order to avoid misdiagnosis, unnecessary or inadequate treatments, and additional costs.

Donkey Internal Medicine—Part I: Metabolic, Endocrine, and Alimentary Tract Disturbances

Metabolic and endocrine disturbances are common in donkeys. This species has an inherent ability to thrive with limited and poor-quality roughage. Donkeys are extremely efficient in energy storage and mobilization, which predisposes to hyperlipemia, obesity, and metabolic syndrome. The prevalence of dyslipidemias is higher in donkeys than other equids, which is more evident under stressful conditions. Diagnosis of endocrine and metabolic disorders in donkeys should be based on species-specific information considering that differences in a multitude of variables compared with horses have been demonstrated. Protocols to assess endocrine disorders (e.g., pituitary pars intermedia dysfunction, metabolic syndrome, and thyroid illness) are unavailable, and extrapolation from horse data can be misleading. Treatment guidelines for these conditions in donkeys are currently not reported. On the other hand, the typical stoic and hardy behavior of donkeys can hinder prompt diagnosis of gastrointestinal problems, specifically colic, which is commonly caused by dental issues in this species. Moreover, subclinical gastric ulcer syndrome appears to be a common pathology in this species, especially in working donkeys.

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Donkeys are different to horses.

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Numerous physiological and clinic-pathologic idiosyncrasies are reported in horses.

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Data published for horses should not be extrapolated for donkeys.

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Specific reference ranges, doses, and protocols have to be used for donkeys.

The effect of eggshell thickness on hatchability of quail eggs

Background and Aim:

The aim of the successful incubation period is to achieve maximum health chicks in each batch. Therefore, all factors affecting incubation have to be investigated in detail. This study investigated the effect of eggshell thickness on hatchability of quail eggs.

Materials and Methods:

A total of 1415 eggs were collected from the same flock at the ages of 23 and 41 weeks. Two different incubations were performed at these eggs. Eggshell thicknesses of all eggs were determined with an ultrasonic gauge before incubation. Incubation period was applied as for 18 days. After 15 days of incubation, eggs were transferred to hatching machine. Eggs were classified as thin-, medium-, and thick-shelled according to eggshell thickness values.

Results:

Eggshell thicknesses were ranged between 0.24 and 0.36 mm, and the differences between the hatching rates of thickness values were not found significant. Hatchability of thin-, medium-, and thick-shelled eggs was found as 69.2%, 69.4%, and 82.4% for Experiment 1. These values were as 87.8%, 89.2%, and 91.9% for Experiment 2, respectively. Similar to eggshell thickness frequencies, the differences between hatching rates of eggshell thickness groups were found insignificant.

Conclusion:

Results of this study showed that eggshell thickness does not affect hatchability.