1
|
Sundra T, Kelty E, Rossi G, Rendle D. Retrospective assessment of the use of extended-release cabergoline in the management of equine pituitary pars intermedia dysfunction. Front Vet Sci 2024; 11:1332337. [PMID: 38511195 PMCID: PMC10951098 DOI: 10.3389/fvets.2024.1332337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Dopaminergic agonists are accepted as the most effective treatment for pituitary pars intermedia dysfunction. However, some horses are refractory to daily oral pergolide, the recommended registered treatment. Extended-release cabergoline (ERC) injection may offer an alternative. The objective of this retrospective case series was to describe clinical and endocrinological responses to ERC. Methods Medical records of horses treated with weekly intramuscular injections of ERC (5 mg/mL, BOVA Aus) at either 0.01 mg/kg (high dose, HD) (n = 10) or 0.005 mg/kg (low dose, LD) (n = 30) were reviewed. Short-term ACTH responses were assessed at 5-8 days using a Wilcoxon signed ranked test. Longer-term ACTH responses (30 to 365 days) were assessed using generalised estimating equations. Results Five to eight days after the first dose of LDERC, median adrenocorticotropic hormone (ACTH) concentration was lower (p = 0.001), changing from 153 pg/mL (IQR: 78, 331) to 57 pg/mL (IQR: 30, 102). With HDERC, median ACTH concentration was also 153 pg/mL (IQR: 96, 185) before and then 56 pg/mL (IQR: 29, 86) after 5-8 days of treatment (p = 0.047). Over 12 months of treatment, ACTH concentration ranged from 14 to >1,250 pg/mL (median: 51 pg/mL) in horses treated with LDERC and 20 to 472 pg/mL (median: 50 pg/mL) in horses treated with HDERC. Measurements remained above the seasonal reference range in 39.3 and 52.3% of horses treated with LDERC and HDERC, respectively. Clinical improvement was reported by owners in 78.3 and 100% of horses treated with LDERC and HDERC, respectively. Partial, self-limiting inappetence was reported in 30.0% of LDERC and 60% HDERC cases. Seven horses exhibited lethargy (5 LDERC, 2 HDERC). Insulin concentrations measured 30 days post-ERC treatment were no different from baseline. Discussion Clinical and endocrinological responses were consistent with results of previous reports of oral pergolide treatment. Weekly injection of ERC may be an effective alternative to pergolide; the 0.005 mg/kg dose appeared to be as effective, with less risk of inappetence, than the 0.01 mg/kg dose that has been reported previously.
Collapse
Affiliation(s)
- Tania Sundra
- Avon Ridge Equine Veterinary Services, Brigadoon, WA, Australia
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Erin Kelty
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Gabriele Rossi
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | | |
Collapse
|
2
|
Colbath AC, Fortin JS, Burglass CM, Panek C, Vergara-Hernandez FB, Johnson TN, Robison CA, Logan AA, Nelson NA, Nielsen BD, Schott HC. Lumbar vertebral bone density is decreased in horses with pituitary pars intermedia dysfunction. Equine Vet J 2024; 56:368-376. [PMID: 38151767 DOI: 10.1111/evj.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Pathological fractures have been reported in equids with pituitary pars intermedia dysfunction (PPID) but their prevalence and pathogenesis is unknown. OBJECTIVES To compare: (1) bone mineral density (BMD) in weight bearing and nonweight bearing bones in PPID+ equids and aged and young PPID- controls; and (2) biomechanical properties of the fourth lumbar vertebral body in PPID+ equids and aged PPID- equids. STUDY DESIGN Case-control study: five PPID+ equids and six aged and four young PPID- control horses. METHODS PPID status was based on clinical signs and necropsy examination of the pituitary gland (PG). The lumbar vertebral column, right front third metacarpus (MC3), left hind third metatarsus (MT3), and PG were removed after euthanasia. BMD was determined by quantitative computed tomography of regions of interest (ROI) in each bone and biomechanical testing was performed on the fourth lumbar vertebral body. Serum concentrations of parathormone (PTH), ionised Ca++ , 25-hydroxyvitamin D, and osteocalcin (OC) were also measured. Data were analysed using one-way ANOVA and correlation analyses. RESULTS BMD of trabecular and cortical regions of interest (ROI) of the third, fourth (L4), and fifth lumbar vertebrae were significantly lower in PPID+ equids as compared with aged (p < 0. 001) and young (p < 0.01) PPID- controls. In contrast, no differences were found in BMD of trabecular or cortical ROIs of MC3 and MT3 between groups. No differences were detected in force at fracture, displacement at fracture, Young's modulus or strain of L4 between PPID+ and aged PPID- horses. No differences were found in serum PTH, ionised Ca++ , 25-hydroxyvitamin D, or OC concentrations between groups. MAIN LIMITATIONS Limited number of equids studied and variation in test results. CONCLUSIONS BMD of nonweight bearing bones can be decreased with PPID and could increase risk of developing pathological fractures.
Collapse
Affiliation(s)
- Aimee C Colbath
- Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Jessica S Fortin
- Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Caroline M Burglass
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Char Panek
- Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Fernando B Vergara-Hernandez
- Animal Sciences, College of Agriculture and Natural Resources, Michigan State University, East Lansing, Michigan, USA
| | - Tyler N Johnson
- Chemical Engineering and Materials Science, College of Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Cara A Robison
- Animal Sciences, College of Agriculture and Natural Resources, Michigan State University, East Lansing, Michigan, USA
| | - Alyssa A Logan
- Animal Sciences, College of Agriculture and Natural Resources, Michigan State University, East Lansing, Michigan, USA
| | - Nathan A Nelson
- Molecular Biologic Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Brian D Nielsen
- Animal Sciences, College of Agriculture and Natural Resources, Michigan State University, East Lansing, Michigan, USA
| | - Harold C Schott
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
3
|
Bamford NJ, Stewart AJ, El-Hage CM, Bertin FR, Bailey SR. Investigation of breed differences in plasma adrenocorticotropic hormone concentrations among healthy horses and ponies. Vet J 2023; 296-297:105995. [PMID: 37207985 DOI: 10.1016/j.tvjl.2023.105995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/06/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023]
Abstract
Plasma adrenocorticotropic hormone (ACTH) concentration is commonly measured to diagnose pituitary pars intermedia dysfunction (PPID). Several intrinsic and extrinsic factors affect ACTH concentrations, including breed. The objective of this study was to prospectively compare plasma ACTH concentrations among different breeds of mature horses and ponies. Three breed groups comprised Thoroughbred horses (n = 127), Shetland ponies (n = 131) and ponies of non-Shetland breeds (n = 141). Enrolled animals did not show any signs of illness, lameness or clinical signs consistent with PPID. Blood samples were collected 6 months apart, around the autumn equinox and spring equinox, and plasma concentrations of ACTH were measured by chemiluminescent immunoassay. Pairwise breed comparisons within each season were performed on log transformed data using the Tukey test. Estimated mean differences in ACTH concentrations were expressed as fold difference with 95 % confidence intervals (CI). Reference intervals for each breed group per season were calculated using non-parametric methods. In autumn, higher ACTH concentrations were found among non-Shetland pony breeds compared with Thoroughbreds (1.55 fold higher; 95 % CI, 1.35-1.77; P < 0.001), and in Shetland ponies compared with Thoroughbreds (2.67 fold higher; 95 % CI, 2.33-3.08; P < 0.001) and non-Shetland pony breeds (1.73 fold higher; 95 % CI, 1.51-1.98; P < 0.001). In spring, no differences were identified among breed groups (all P > 0.05). Reference intervals were similar among breed groups in spring, but upper limits for ACTH concentrations were markedly different between Thoroughbred horses and pony breeds in autumn. These findings emphasise that breed should be accounted for when determining and interpreting reference intervals for ACTH concentrations among healthy horses and ponies in autumn.
Collapse
Affiliation(s)
- N J Bamford
- Melbourne Veterinary School, The Universtiy of Melbourne, Building 400, Parkville, Victoria 3010, Australia.
| | - A J Stewart
- School of Veterinary Science, The University of Queensland, Building 4114, Gatton, Queensland 4343, Australia
| | - C M El-Hage
- Melbourne Veterinary School, The Universtiy of Melbourne, Building 400, Parkville, Victoria 3010, Australia
| | - F R Bertin
- School of Veterinary Science, The University of Queensland, Building 4114, Gatton, Queensland 4343, Australia
| | - S R Bailey
- Melbourne Veterinary School, The Universtiy of Melbourne, Building 400, Parkville, Victoria 3010, Australia
| |
Collapse
|
4
|
Manfredi JM, Jacob S, Norton E. A one-health lens offers new perspectives on the importance of endocrine disorders in the equine athlete. J Am Vet Med Assoc 2023; 261:153-164. [PMID: 36595370 DOI: 10.2460/javma.22.11.0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Endocrine disorders are associated with joint pain and tendon injury in humans, but the effects in the horse are only starting to be understood. Similar patterns of clinical signs and injury appear to affect horses and humans for both orthopedic and endocrine disorders, supporting the use of a one-health approach to tackle these issues. In this Currents in One Health, we will discuss common equine endocrinopathies, current testing recommendations, dietary management, genetic predispositions, and endocrine disorders' effects on performance. Our aim is to use a one-health lens to describe current comparative research so that veterinarians can employ cutting-edge preventative, diagnostic, and therapeutic recommendations. Identified key gaps in knowledge include whether equine metabolic osteoarthritis exists, if steroid joint injections are safe in horses with endocrine disorders, and if the return to performance percentage improves with concurrent treatment of endocrine and musculoskeletal disorders. Key takeaways include that the relationship between endocrine disorders and musculoskeletal disease in the horse goes beyond laminitis to include lameness, muscle atrophy, suspensory ligament degeneration, osteochondritis dissecans, and potentially metabolic osteoarthritis. Approaches learned from human and equine comparative studies can offer insight into injury recognition and management, thus mitigating the impact of endocrine disorders on performance in both species. Readers interested in an in-depth description of current and future research involving pathophysiology, novel interventions, and multiomic approaches to identify individuals with athletic limitations induced by endocrine disorders are invited to read the companion Currents in One Health by Manfredi et al, AJVR, February 2023.
Collapse
Affiliation(s)
- Jane M Manfredi
- 1Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Sarah Jacob
- 1Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Elaine Norton
- 2Department of Animal and Comparative Biomedical Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ
| |
Collapse
|
5
|
Gris AH, Bianchi RM, Schwertz CI, Piva MM, Richter G, Sonne L, Driemeier D, Pavarini SP. Pituitary pars intermedia dysfunction in horses associated to pituitary adenoma. PESQUISA VETERINÁRIA BRASILEIRA 2023. [DOI: 10.1590/1678-5150-pvb-7117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
ABSTRACT: The clinical syndrome of the pituitary pars intermedia dysfunction (PPID) is the most common endocrinopathy of older horses. This syndrome is characterized by several clinical and pathological changes, which are usually associated with adenomas of the pars intermedia (PI) of the pituitary gland. The aim of this work is to describe five cases of pituitary adenoma of the PI associated with PPID in horses, addressing its clinical and pathological aspects. The horses had a mean of 22 years of age. The main clinical signs were hirsutism and paresis of hind limbs, and at post mortem examination all horses had hirsutism, and a nodule in the pituitary gland, which was histologically characterized as an adenoma of PI (5/5). Furthermore, two horses had gross lesions suggestive of chronic laminitis. Moreover, there was intense parasitism of Sarcocystis neurona (2/5), Strongylus vulgaris (1/5), Parascaris equorum (1/5), Draschia megastoma (1/5), and Klossiella equi (1/5).
Collapse
|
6
|
Kirkwood NC, Hughes KJ, Stewart AJ. Prospective Case Series of Clinical Signs and Adrenocorticotrophin (ACTH) Concentrations in Seven Horses Transitioning to Pituitary Pars Intermedia Dysfunction (PPID). Vet Sci 2022; 9:vetsci9100572. [PMID: 36288186 PMCID: PMC9607114 DOI: 10.3390/vetsci9100572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/29/2022] [Accepted: 10/11/2022] [Indexed: 12/31/2022] Open
Abstract
Simple Summary Pituitary pars intermedia dysfunction (PPID) is a common disease of the geriatric horse population. The most common clinical sign of PPID is hypertrichosis, or a long hair-coat with delayed shedding. Hypertrichosis is the most easily recognized clinical sign of PPID. However, the presence of hypertrichosis is often associated with severe end-stage disease. There is little research investigating sub-clinical or early PPID and the clinical signs associated with these stages of disease. The benefit of being able to recognize early PPID, is that we are able to begin treatment earlier on in disease process, potentially reducing the deleterious consequences of PPID and improving survival. Laboratory tests are available to more accurately diagnose PPID, and these tests include the basal ACTH and TRH-stimulated ACTH tests. Basal ACTH is easy to perform and is recommended in cases where clinical disease is suspected. The TRH-stimulation test improves diagnostic accuracy in early PPID cases. This study documents both test results and clinical signs associated with the transition from subclinical to clinical PPID, so that we are better able to recognize potential early PPID, as well as interpret results in these horses. Abstract Poor recognition of subtle clinical abnormalities and equivocal ACTH concentrations make early diagnosis of PPID difficult. Progressive clinical findings and corresponding ACTH concentrations in horses transitioning to PPID over time have not been documented. Seven horses with ACTH concentrations equivocal for PPID (utilizing locally derived, seasonally adjusted diagnostic-cut off values (DCOV)) and no clinical signs of PPID were selected. Sequential measurement of basal and thyrotropin-releasing hormone (TRH)-stimulated ACTH concentrations and recording of clinical findings occurred from October 2017 to November 2021 in a prospective case series. In two horses, marked hypertrichosis developed. Although 1/11 basal ACTH concentrations were below DCOV in 2018, subsequently all basal ACTH concentrations in these two horses without treatment were greater than DCOV. One horse was treated with pergolide which normalized basal ACTH concentrations. Four horses developed intermittent, mild hypertrichosis, and one horse never developed hypertrichosis. Basal ACTH concentrations in these five horses were greater than DCOV in 63/133 (47.4%) of testing points. TRH-stimulated ACTH concentrations in these five horses were greater than DCOV in 77/133 (57.9%) of testing points, sometimes markedly increased and greater than the assay upper limit of detection (LoD) of 1250pg/mL. TRH-stimulated ACTH concentrations were most frequently positive in late summer and early autumn, with 24/37 (64.9%) of TRH-stimulated ACTH concentrations greater than the DCOV in February and March. Horses transitioning to PPID can have subtle clinical signs and equivocal ACTH concentrations. However, TRH-stimulated ACTH concentrations can be markedly greater than DCOV, especially in late summer and early autumn (February and March) allowing for identification of subclinical and transitional cases.
Collapse
Affiliation(s)
- Naomi C. Kirkwood
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Kristopher J. Hughes
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Allison J. Stewart
- School of Veterinary Science, Gatton Campus, The University of Queensland, Gatton, QLD 4343, Australia
- Correspondence: ; Tel.: +61-754-601-799
| |
Collapse
|
7
|
Pituitary Pars Intermedia Dysfunction (PPID) in Horses. Vet Sci 2022; 9:vetsci9100556. [PMID: 36288169 PMCID: PMC9611634 DOI: 10.3390/vetsci9100556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
Substantial morbidity results from pituitary pars intermedia dysfunction (PPID) which is often underestimated by owners and veterinarians. Clinical signs, pathophysiology, diagnostic tests, and treatment protocols of this condition are reviewed. The importance of improved recognition of early clinical signs and diagnosis are highlighted, as initiation of treatment will result in improved quality of life. Future research should be targeted at improving the accuracy of the diagnosis of PPID, as basal adrenocorticotropic hormone (ACTH) concentration can lack sensitivity and thyrotropin releasing hormone (TRH) used to assess ACTH response to TRH stimulation is not commercially available as a sterile registered product in many countries. The relationship between PPID and insulin dysregulation and its association with laminitis, as well as additional management practices and long-term responses to treatment with pergolide also require further investigation.
Collapse
|
8
|
Abstract
Polyuria and polydipsia are rare, but significant, manifestations of several different diseases of horses. Causes can be endocrine, iatrogenic, psychogenic, infectious, or toxic in nature and can also be due to primary renal disease or diseases of other organs, such as the liver. Although numerous causes of polyuria and polydipsia in horses exist, the most common conditions include chronic kidney disease, pituitary pars intermedia dysfunction, and psychogenic polydipsia with secondary polyuria. Additional testing is dictated by history, other clinical signs, and the results of blood work and/or urinalysis. Prognosis for horses with polyuria and/or polydipsia varies significantly based on the underlying cause.
Collapse
|
9
|
Nitzsche AM, Fey K, Büttner K, Gröf M, Staszyk C. The Gingiva of Horses With Pituitary Pars Intermedia Dysfunction: A Macroscopic Anatomical Evaluation. Front Vet Sci 2022; 8:786971. [PMID: 35146012 PMCID: PMC8821874 DOI: 10.3389/fvets.2021.786971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Pituitary pars intermedia dysfunction (PPID) is a common neurodegenerative disease mainly in horses older than 15 years. The domestic equine population is following the same demographic change as that seen in humans; it is aging and veterinarians are asked to attend to geriatric horses more frequently. Common problems seen regularly in older equines are dental disorders and especially periodontal disease. As a systemic and endocrine disease, associated with delayed wound healing and impaired immune function, PPID should be considered before major dental treatment in aged equines is started. Possible negative effects of PPID on epithelial tissues could also affect the periodontium. Therefore, the aim of the present study was to identify gross changes in the gingiva associated with PPID. Fourteen horses with clinical signs of PPID and adenoma in the pituitary pars intermedia and 13 controls showing neither clinical signs nor PPID-associated histological changes in the pituitary gland were included. PPID-affected horses (26.9 ± 0.73 years) were significantly older than controls (20.0 ± 1.24 years). In the PPID-affected group, significantly more often an irregular and bulky appearance of the gingival texture was observed, as well as an irregular shape of the gingival margin. Furthermore, the sulcus gingivalis of cheek teeth frequently was deeper than 1 mm. These findings indicate a possible association between age, soft tissue alterations, and PPID and suggest a potential predisposition of PPID-affected horses for periodontal diseases.
Collapse
Affiliation(s)
- Anne Maria Nitzsche
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Germany
- *Correspondence: Anne Maria Nitzsche
| | - Kerstin Fey
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Germany
| | - Kathrin Büttner
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Germany
| | - Manuela Gröf
- Faculty of Veterinary Medicine, Institute of Veterinary Pathology, Justus-Liebig-University, Giessen, Germany
| | - Carsten Staszyk
- Faculty of Veterinary Medicine, Institute of Veterinary-Anatomy, -Histology and -Embryology, Justus-Liebig-University, Giessen, Germany
| |
Collapse
|
10
|
Thane K, Uricchio C, Frank N. Effect of early or late blood sampling on thyrotropin releasing hormone stimulation test results in horses. J Vet Intern Med 2022; 36:770-777. [PMID: 35049089 PMCID: PMC8965261 DOI: 10.1111/jvim.16362] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 01/21/2023] Open
Abstract
Background Diagnosis of pituitary pars intermedia dysfunction (PPID) using the thyrotropin‐releasing hormone (TRH) stimulation test requires blood collection 10 minutes after TRH injection; it is unknown if small differences in timing affect test results. Objective To determine whether early or late sampling results in a significant (≥10%) difference in plasma adrenocorticotropic hormone (ACTH) concentration compared to standard 10‐minute sampling. Animals Twenty‐four healthy adult horses with unknown PPID status. Methods In this prospective study, subjects underwent a single TRH stimulation test, with blood collected exactly 9 minutes (early), 10 minutes (standard), and 11 minutes (late) after injection. ACTH was measured by chemiluminescent immunoassay. Two aliquots of the 10‐minute plasma sample were analyzed separately to assess intra‐assay variability. Data were reported descriptively and bias was calculated using Bland‐Altman plots. Significance was set at P = .05. Results Minor variability was observed between the paired 10‐minute sample aliquots (range, 0%‐6%; median 3%). Overall variability of early or late samples compared to the corresponding paired (average) 10‐minute standard concentration ranged from 0% to 92% (median 10%). Seventy‐five percent of horses (18/24) tested had at least 1 early or late reading that differed by ≥10% from its corresponding 10‐minute standard concentration, and 21% of horses (5/24) would have a different interpretation of testing result with either early or late sampling. Incidence of ≥10% variability was independent of PPID status (P = .59). Conclusions and Clinical Importance Precise timing of sample collection is critical to ensure accurate assessment of PPID status given the observation of significant variability associated with minor alterations in timing of sample collection.
Collapse
Affiliation(s)
- Kristen Thane
- Tufts Cummings School of Veterinary Medicine, Department of Comparative Pathobiology, North Grafton, Massachusetts, USA
| | - Cassandra Uricchio
- University of Massachusetts, Department of Veterinary and Animal Sciences, Amherst, Massachusetts, USA
| | - Nicholas Frank
- Tufts Cummings School of Veterinary Medicine, Department of Comparative Pathobiology, North Grafton, Massachusetts, USA
| |
Collapse
|
11
|
Gehlen H, Fisch J, Merle R, Trachsel DS. Preliminary study on the effects of pergolide on left ventricular function in the horses with pituitary pars intermedia dysfunction. J Vet Sci 2021; 22:e64. [PMID: 34553515 PMCID: PMC8460455 DOI: 10.4142/jvs.2021.22.e64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Pituitary pars intermedia dysfunction (PPID), a neurodegenerative disease leading to reduced dopamine production, is a common disease in aged horses. The treatment is based on administration of the dopamine agonist pergolide. This drug has been related to valvular fibrosis in humans, but the cardiovascular effect of this drug has not yet been investigated in horses. OBJECTIVES To determine whether pergolide induces valvular disease in horses or affects the cardiac function. METHODS Standard, tissue Doppler (TDE) and two-dimensional speckle tracking (STE) echocardiography were performed in horses with diagnosed PPID based on adrenocorticotropic hormone dosage. Measurements taken in horses treated with pergolide were compared with those from untreated horses with nonparametric t-tests. Furthermore, measurements from follow-up examinations performed at least three months after the initial exam were compared with a Wilcoxon signed rank test for repeated measurements in each group. RESULTS Twenty-three horses were included. None of the 12 horses under treatment developed valvular regurgitation. Furthermore, no differences in the measurements of the left ventricular systolic or diastolic function could be seen between the group of horses with treatment and those without treatment. Measurements taken in the follow-up exam did not differ compared to those taken in the initial exam in both groups. CONCLUSIONS No changes of the left ventricular function assessed by TDE and STE could be shown in a small population of horses with confirmed PPID. Treatment with pergolide did not affect the ventricular function nor induce valvular disease.
Collapse
Affiliation(s)
- Heidrun Gehlen
- Department of Veterinary Medicine, Equine Clinic: Surgery and Radiology, Freie University Berlin, Berlin 14163, Germany
| | - Judith Fisch
- Department of Veterinary Medicine, Equine Clinic: Surgery and Radiology, Freie University Berlin, Berlin 14163, Germany
| | - Roswitha Merle
- Department of Veterinary Medicine, Institute for Veterinary Epidemiology and Biostatistics, Freie University Berlin, Berlin 14163, Germany
| | - Dagmar S Trachsel
- Department of Veterinary Medicine, Equine Clinic: Surgery and Radiology, Freie University Berlin, Berlin 14163, Germany.
| |
Collapse
|
12
|
Equine pituitary pars intermedia dysfunction: a spontaneous model of synucleinopathy. Sci Rep 2021; 11:16036. [PMID: 34362943 PMCID: PMC8346493 DOI: 10.1038/s41598-021-95396-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022] Open
Abstract
Equine pituitary pars intermedia dysfunction (PPID) is a common endocrine disease of aged horses that shows a similar pathophysiology as Parkinson’s Disease (PD) with increased levels of α-synuclein (α-syn). While α-syn is thought to play a pathogenic role in horses with PPID, it is unclear if α-syn is also misfolded in the pars intermedia and could similarly promote self-aggregation and propagation. Consequently, α-syn was isolated from the pars intermedia from groups of healthy young and aged horses, and aged PPID-afflicted horses. Seeding experiments confirmed the prion-like properties of α-syn isolated from PPID-afflicted horses. Next, detection of α-syn fibrils in pars intermedia via transmission electron microscopy (TEM) was exclusive to PPID-afflicted horses. A bank of fragment peptides was designed to further characterize equine α-syn misfolding. Region 62–87 of equine and human α-syn peptides was found to be most prone to aggregation according to Tango bioinformatic program and kinetics of aggregation via a thioflavin T fluorescence assay. In both species, fragment peptide 62–87 is capable of generating mature fibrils as demonstrated by TEM. The combined animal, bioinformatic, and biophysical studies provide evidence that equine α-syn is misfolded in PPID horses.
Collapse
|
13
|
Pujol R, Tessier C, Manneveau G, De Fourmestraux C. Suspected primary mycotic rhinitis and paranasal sinusitis in seven horses (2013–2019). EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Pujol
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - C. Tessier
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - G. Manneveau
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
- Clinique Équine de Provence Saint‐Cannat France
| | - C. De Fourmestraux
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
| |
Collapse
|
14
|
Tsuchiya T, Noda R, Ikeda H, Maeda M, Sato F. Relationship between endogenous plasma adrenocorticotropic hormone concentration and reproductive performance in Thoroughbred broodmares. J Vet Intern Med 2021; 35:2002-2008. [PMID: 34028083 PMCID: PMC8295711 DOI: 10.1111/jvim.16145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background Pituitary pars intermedia dysfunction (PPID) is an endocrine disorder the clinical signs of which include infertility, but few reports have examined the relationship between PPID and reproductive performance in broodmares. Hypothesis/Objective Broodmares with infertility of unknown etiology were screened for PPID using baseline endogenous plasma ACTH concentrations, and its relationship with subsequent reproductive performance was analyzed. Animals Sixty‐seven Thoroughbred broodmares. Methods Adrenocorticotropic hormone concentrations were measured in autumn. The broodmares were divided into 3 groups based on endogenous plasma ACTH concentration (low, <50 pg/mL; intermediate 50‐100 pg/mL; and high >100 pg/mL) as recommended by the Equine Endocrinology Group. We compared these results with those of other blood tests, clinical examinations, subsequent conception, and frequency of normal delivery. Results The numbers of horses per group (percentage) were 22 (32.8%), 20 (29.9%), and 25 (37.3%). The mean ± SD ages (years) were 11.1 ± 3.4, 12.1 ± 4.5, and 13.0 ± 4.3, with no significant difference among groups. Mean ± SD plasma cortisol concentrations (μg/dL) were 4.0 ± 1.6, 7.1 ± 1.4, and 7.6 ± 1.9, with the intermediate and high ACTH groups having significantly higher results than the low ACTH group (P < .001). Conception rates were 77.3%, 89.5%, and 56.5% and normal delivery rates were 77.2%, 84.2%, and 43.5% with the percentage of each significantly lower in the high ACTH group (P = .02, P = .008, respectively). Conclusions and Clinical Importance The study group of infertile broodmares may include horses with PPID. The reproductive performance of the high ACTH group was significantly lower than the other groups. Early diagnosis and treatment of infertile broodmares by screening plasma ACTH concentrations could help improve reproductive performance.
Collapse
Affiliation(s)
- Takeru Tsuchiya
- Northern Farm Tenei, Fukushima, Japan.,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan
| | - Ryusuke Noda
- Equine Medical Center, Hidaka Horse Breeders Association, Hokkaido, Japan
| | - Hiroki Ikeda
- Equine Medical Center, Hidaka Horse Breeders Association, Hokkaido, Japan
| | - Masaya Maeda
- Equine Medical Center, Hidaka Horse Breeders Association, Hokkaido, Japan
| | - Fumio Sato
- United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan.,Equine Research Institute, Japan Racing Association, Tochigi, Japan
| |
Collapse
|
15
|
Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership. PLoS One 2021; 16:e0244784. [PMID: 33395695 PMCID: PMC7781667 DOI: 10.1371/journal.pone.0244784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/15/2020] [Indexed: 01/04/2023] Open
Abstract
Pituitary pars intermedia dysfunction (PPID) is the most prevalent endocrine disorder of older equids. To date, key research areas likely to have the greatest impact on equine health have not been identified. In human medicine, public and patient involvement is widely used to inform research agendas. This study aimed to engage with veterinary surgeons and horse owners to identify evidence gaps ('uncertainties') and prioritise these into a list of the 10 most important PPID research questions. The James Lind Alliance (JLA) Priority Setting Partnership (PSP) Framework was adapted. Questions about the diagnosis, treatment and prognosis of PPID were gathered via an online survey targeting veterinary surgeons and horse owners with experience of PPID. Thematic analysis was used to form a longlist of collated indicative research questions (CIRQs), defined by the JLA as true 'evidence uncertainties' when not answered by a published, clinically relevant, up-to-date systematic review. In an interim prioritisation survey, questions were ranked by weighted scores creating a shortlist of 25 that were taken forward to the PSP workshop, where participants reached a consensus on the top 10. Useable responses containing ≥1 question were received from 524 respondents (92.6% owners, n = 485; 7.4% veterinary surgeons, n = 39). After screening for relevance, 1,260 individual questions were included in thematic analysis, resulting in 47 CIRQs. Interim prioritisation votes for the CIRQs were received from 360 respondents. The top 10 questions prioritised at the PSP workshop focused on long-term prognosis, diagnostic accuracy, efficacy of pergolide treatment, alternative treatment/management strategies and potential treatment options for poor responders to pergolide. The quantity of questions generated indicates an extensive number of uncertainties regarding the diagnosis, treatment and prognosis of PPID. The top 10 research questions will help to inform key areas for evidence synthesis and knowledge translation, and to direct future research into areas most important to end users involved in caring for and treating animals with PPID.
Collapse
|
16
|
Miller AB, Loynachan AT, Bush HM, Hart KA, Barker VD, Campana-Emard AG, Grubbs ST, Adams AA. Effects of pituitary pars intermedia dysfunction and Prascend (pergolide tablets) treatment on endocrine and immune function in horses. Domest Anim Endocrinol 2021; 74:106531. [PMID: 32942194 DOI: 10.1016/j.domaniend.2020.106531] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/19/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Abstract
It remains unclear how pituitary pars intermedia dysfunction (PPID) and pergolide treatment (Prascend [pergolide tablets]) affect endocrine and immune function in horses. To evaluate these effects, blood was collected regularly from 28 university-owned horses (10 Non-PPID, 9 PPID control [PC], and 9 PPID treatment [PT]) over approximately 15 mo. Pergolide treatment was initiated after Day 0 collections. Analyses included ACTH, insulin, total cortisol, free cortisol, complete blood counts, plasma myeloperoxidase, and cytokine/receptor gene expression in basal whole blood and in vitro stimulations (PMA/ionomycin, heat-inactivated Rhodococcus equi, and heat-inactivated Escherichia coli) of whole blood and peripheral blood mononuclear cells (PBMCs). The results were analyzed using a linear mixed model (SAS 9.4) with significance set at P < 0.05. Significant group (P = 0.0014) and group-by-time (P = 0.0004) effects were observed in resting ACTH such that PT horses differed from Non-PPID horses only at Day 0. PT horses had significantly lower changes in ACTH responses to thyrotropin-releasing hormone stimulation tests than PC horses at non-fall time points only, mid-late February 2018 (P = 0.016) and early April 2018 (P = 0.0172). When PT and PC horses did not differ, they were combined before comparison to Non-PPID horses. No significant group or group-by-time effects were seen in resting insulin, total cortisol, or free cortisol; however, significant time effects were observed in these measures. PPID horses had lower absolute lymphocyte (P = 0.028) and red blood cell (P = 0.0203) counts than Non-PPID horses. In unstimulated whole blood, PPID horses had increased IL-8 expression compared with Non-PPID horses (P = 0.0102). In addition, PPID horses had decreased interferon γ production from PBMCs after stimulation with R. equi (P = 0.0063) and E. coli (P = 0.0057) and showed increased transforming growth factor β expression after E. coli stimulation (P = 0.0399). The main limitations of this study were a limited sample size and an inability to truly randomize the PPID horses into treatment groups. Resting ACTH is likely the best choice for determining successful responses to pergolide. Neither PPID nor pergolide appears to influence insulin, total cortisol, and free cortisol. As measured, systemic immune function was altered in PPID horses, and it is likely that these horses are indeed at increased risk of opportunistic infection. Despite reducing ACTH, pergolide treatment did not appear to influence immune function.
Collapse
Affiliation(s)
- A B Miller
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA.
| | - A T Loynachan
- Veterinary Diagnostic Laboratory, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - H M Bush
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - K A Hart
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - V D Barker
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - A G Campana-Emard
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - S T Grubbs
- Boehringer Ingelheim Animal Health USA, Inc, Duluth, GA, USA
| | - A A Adams
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
17
|
Horn R, Stewart AJ, Jackson KV, Dryburgh EL, Medina-Torres CE, Bertin FR. Clinical implications of using adrenocorticotropic hormone diagnostic cutoffs or reference intervals to diagnose pituitary pars intermedia dysfunction in mature horses. J Vet Intern Med 2020; 35:560-570. [PMID: 33368633 PMCID: PMC7848300 DOI: 10.1111/jvim.16017] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Diagnosis of pituitary pars intermedia dysfunction (PPID) is problematic because of large variations in ACTH concentrations. HYPOTHESIS/OBJECTIVES Compare the test characteristics of baseline and post-thyrotropin-releasing hormone (TRH) stimulation plasma ACTH concentrations in horses using diagnostic cutoff values (DCOVs) and reference intervals (RIs) and determine the clinical consequences of using each method. ANIMALS One hundred six mature horses: 72 control cases and 34 PPID cases. METHODS Prospective case-controlled study. Horses underwent monthly TRH stimulation tests. Diagnostic cutoff values were determined monthly by receiver operating characteristic curves using the Youden index. Reference intervals were determined monthly by a robust method. For each case age, sex and body condition score (BCS) were recorded. RESULTS Baseline ACTH concentrations varied by month (P < .001) with significant "month × age" (P = .003), "month × sex" (P = .003), and "month × BCS" (P = .007) effects. Baseline ACTH concentrations were accurate to diagnose PPID (0.91 ± 0.06) with DCOVs increasing the test sensitivity (0.61 ± 0.21 to 0.87 ± 0.05, P = .002) and RI increasing test specificity (0.85 ± 0.12 to 0.98 ± 0.01, P = .01). Thyrotropin-releasing hormone stimulation improved test accuracy (0.91 ± 0.06 to 0.97 ± 0.03, P = .004). CONCLUSIONS AND CLINICAL IMPORTANCE ACTH concentrations follow a circannual rhythm and vary with physiological factors. As using DCOVs increases the ability to detect mild cases and using RI decreases the risk of unnecessary treatments, ACTH concentrations should be interpreted within a specific clinical context. The TRH stimulation test improves the diagnosis of PPID.
Collapse
Affiliation(s)
- Remona Horn
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Allison J Stewart
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Karen V Jackson
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | | | - Carlos E Medina-Torres
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - François-René Bertin
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| |
Collapse
|
18
|
Bamford NJ, Harris PA, Bailey SR. Circannual variation in plasma adrenocorticotropic hormone concentrations and dexamethasone suppression test results in Standardbred horses, Andalusian horses and mixed-breed ponies. Aust Vet J 2020; 98:616-621. [PMID: 33001453 DOI: 10.1111/avj.13022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/18/2020] [Accepted: 09/04/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To compare circannual plasma concentrations of adrenocorticotropic hormone (ACTH) and seasonal dexamethasone suppression test (DST) results between three different equine breed groups. METHODS Six Standardbred horses, six Andalusian horses and six mixed-breed ponies were followed over a 1-year period, during which time groups were managed identically. Blood samples were collected monthly (around the autumn equinox) or in every second month (other times of the year) for the determination of plasma ACTH concentrations using a chemiluminescent immunoassay. Overnight DSTs were performed quarterly, with suppression of plasma cortisol to below 27 nmol/L at 19 h considered a normal result. RESULTS Seasonal variation in plasma ACTH concentrations was present among all breed groups with, as expected, higher levels detected around the autumn equinox, from February to April (P < 0.001). Plasma ACTH concentrations were different between breed groups in March, with higher levels in Andalusians compared with Standardbreds (P = 0.048) and in ponies compared with Standardbreds (P = 0.010). Suppression of cortisol during the DST was normal for all animals in winter, spring and summer, but five Andalusians and three ponies returned abnormally high results in autumn, compared with zero Standardbreds. CONCLUSION Higher plasma ACTH concentrations and more false-positive DST results were obtained during autumn in ponies and Andalusian horses when compared with Standardbred horses. Potential differences between breeds should be considered when interpreting test results for horses and ponies that are evaluated for pituitary pars intermedia dysfunction. Further work is recommended to establish population-based reference intervals and clinical cut-off values for ACTH in different equine breeds.
Collapse
Affiliation(s)
- N J Bamford
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - P A Harris
- Equine Studies Group, WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire, UK
| | - S R Bailey
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
19
|
Fortin JS, Benskey MJ, Lookingland KJ, Patterson JS, Howey EB, Goudreau JL, Schott HC. Restoring pars intermedia dopamine concentrations and tyrosine hydroxylase expression levels with pergolide: evidence from horses with pituitary pars intermedia dysfunction. BMC Vet Res 2020; 16:356. [PMID: 32977825 PMCID: PMC7517620 DOI: 10.1186/s12917-020-02565-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/11/2020] [Indexed: 12/20/2022] Open
Abstract
Background Pituitary pars intermedia dysfunction (PPID) develops slowly in aged horses as degeneration of hypothalamic dopaminergic neurons leads to proliferation of pars intermedia (PI) melanotropes through hyperplasia and adenoma formation. Dopamine (DA) concentrations and tyrosine hydroxylase (TH) immunoreactivity are markedly reduced in PI tissue of PPID-affected equids and treatment with the DA receptor agonist pergolide results in notable clinical improvement. Thus, we hypothesized that pergolide treatment of PPID-affected horses would result in greater DA and TH levels in PI tissue collected from PPID-affected horses versus untreated PPID-affected horses. To test this hypothesis, pituitary glands were removed from 18 horses: four untreated PPID-affected horses, four aged and four young horses without signs of PPID, and six PPID-affected horses that had been treated with pergolide at 2 µg/kg orally once daily for 6 months. DA concentrations and TH expression levels in PI tissues were determined by high performance liquid chromatography with electrochemical detection and Western blot analyses, respectively. Results DA and TH levels were lowest in PI collected from untreated PPID-affected horses while levels in the pergolide treated horses were similar to those of aged horses without signs of PPID. Conclusions These findings provide evidence of restoration of DA and TH levels following treatment with pergolide. Equine PPID is a potential animal model of dopaminergic neurodegeneration, which could provide insight into human neurodegenerative diseases.
Collapse
Affiliation(s)
- Jessica S Fortin
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, 784 Wilson Road, East Lansing, 48824, MI, USA.
| | - Matthew J Benskey
- Department of Pharmacology and Toxicology, Neuroscience Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Keith J Lookingland
- Department of Pharmacology and Toxicology, Neuroscience Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Jon S Patterson
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, 784 Wilson Road, East Lansing, 48824, MI, USA
| | - Erin B Howey
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, 784 Wilson Road, East Lansing, 48824, MI, USA
| | - John L Goudreau
- Department of Pharmacology and Toxicology, Neuroscience Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.,Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Harold C Schott
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 784 Wilson Road, East Lansing, MI, 48824, USA.
| |
Collapse
|
20
|
Accidental Overdose of Pergolide (Prascend) Followed by Loss of Appetite, Tachycardia, and Behavioral Abnormalities in a Pony Mare. J Equine Vet Sci 2020; 92:103181. [PMID: 32797773 DOI: 10.1016/j.jevs.2020.103181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/14/2020] [Accepted: 06/29/2020] [Indexed: 11/21/2022]
Abstract
A 26-year-old pony mare (ca. 180 kg bodyweight) was presented as an emergency because it had erroneously received 110 times its standard dose of pergolide (Prascend) per os approximately 4 hours earlier. Clinical examination initially was normal except tachycardia of 52 beats/min. The pony was treated symptomatically with paraffin oil and activated charcoal per nasogastric tube to prevent further systemic absorption and accelerate intestinal excretion of the pergolide. Furthermore, the pony received 400 mg of dopamine antagonist azaperone (Stresnil) intramuscularly (i.m.) followed by 80 mg every 6 hours twice i.m. and then 60 mg every 6 hours twice i.m. In addition, 40 mg verapamil (Verapamil-ratiopharm) was given every 4 hours per os for two days, followed by 40 mg every 6 hours for another 5 days. The pony was closely monitored clinically. It remained bright and alert with heart rate returning to normal within one day. The only abnormalities noticed 24 hours after ingestion of the pergolide overdose were a decreased appetite and anxiety, possibly a dopaminergic central nervous effect. Over the next days, appetite returned and anxiety disappeared. Overdosing pergolide is considered very rare and to the authors' knowledge this is the first report with a severe overdose of pergolide (Prascend). As accidental drug overdosing is a common error in medicine, it is important to know about possible side effects and how to react in cases like this.
Collapse
|
21
|
Norton E, McCue ME. Genetics of Equine Endocrine and Metabolic Disease. Vet Clin North Am Equine Pract 2020; 36:341-352. [PMID: 32534851 DOI: 10.1016/j.cveq.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
A role for a genetic contribution to equine metabolic syndrome (EMS) and pars pituitary intermedia dysfunction (PPID) has been hypothesized. Heritability estimates of EMS biochemical measurements were consistent with moderately to highly heritable traits. Further, genome-wide association analyses have identified hundreds of regions of the genome contributing to EMS and candidate variants have been identified. The genetics of PPID has not yet been proven. Continued research for the specific genetic risk factors for both EMS and PPID is crucial for gaining a better understanding of the pathophysiology of both conditions and allowing development of genetic tests.
Collapse
Affiliation(s)
- Elaine Norton
- Veterinary Population Medicine Department, University of Minnesota, 225 Veterinary Medical Center, 1365 Gortner Avenue, St Paul, MN 55108, USA.
| | - Molly E McCue
- Veterinary Population Medicine Department, University of Minnesota, 225 Veterinary Medical Center, 1365 Gortner Avenue, St Paul, MN 55108, USA
| |
Collapse
|
22
|
Horn R, Bertin FR. Evaluation of combined testing to simultaneously diagnose pituitary pars intermedia dysfunction and insulin dysregulation in horses. J Vet Intern Med 2019; 33:2249-2256. [PMID: 31498947 PMCID: PMC6766519 DOI: 10.1111/jvim.15617] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/21/2019] [Indexed: 01/29/2023] Open
Abstract
Background The thyrotropin‐releasing hormone (TRH) stimulation test and the 2‐step insulin sensitivity test are commonly used methods to diagnose, respectively, pituitary pars intermedia dysfunction (PPID) and insulin dysregulation (ID). Objectives To investigate the diagnostic value of combining the TRH stimulation test and the 2‐step insulin sensitivity test to diagnose PPID and ID simultaneously. Animals Twenty‐seven adult horses, 10 control horses without PPID or ID, 5 horses with PPID only, 5 horses with ID only, and 7 horses with PPID and ID. Methods Randomized prospective study. Horses underwent a TRH stimulation test alone, a 2‐step insulin sensitivity test alone, and combined testing with simultaneous TRH and insulin injection in the same syringe. Data were compared by 2‐way repeated measures analysis of variance and 2 1‐sided tests to demonstrate equivalence. Bland‐Altman plots were generated to visualize agreement between combined and independent testing. Results The effect of combined testing on plasma adrenocorticotropic hormone, blood glucose concentration, or percentage decrease in blood glucose concentration was not significantly different from the effect obtained with independent testing. One control horse appeared falsely positive for PPID, 2 PPID‐only horses appeared falsely positive for ID, and 1 PPID and ID horse appeared falsely negative for ID when tests were performed simultaneously. Bland‐Altman plots supported the agreement between combined and independent testing. Conclusions and Clinical Importance Combining the TRH stimulation test and the 2‐step insulin sensitivity test appears to be a useful diagnostic tool for equine practitioners in the field, allowing testing of a horse for both PPID and ID simultaneously.
Collapse
Affiliation(s)
- Remona Horn
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - François-René Bertin
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| |
Collapse
|
23
|
Rendle DI, Doran G, Ireland J, Edwards S. Pharmacokinetics and pharmacodynamics of pergolide mesylate after oral administration in horses with pituitary pars intermedia dysfunction. Domest Anim Endocrinol 2019; 68:135-141. [PMID: 31082785 DOI: 10.1016/j.domaniend.2019.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 01/23/2019] [Accepted: 01/25/2019] [Indexed: 01/11/2023]
Abstract
Published information on the pharmacokinetic and pharmacodynamic properties of pergolide is limited. The aim of this study was to investigate the pharmacokinetic and pharmacodynamic properties of oral pergolide in horses with pituitary pars intermedia dysfunction (PPID). The study design was a nonrandomized clinical trial. Six horses with PPID diagnosed by thyrotropin-releasing hormone (TRH) stimulation tests received pergolide at 4 μg/kg for 18 d. Plasma samples for determination of pergolide and ACTH concentration were collected 0.5 h before and 2 and 12 h after each administration of pergolide. Maximum plasma concentrations after the first oral dose of pergolide (0.104-0.684 ng/mL; median 0.261 ng/mL; interquartile range [IQR] 0.184-0.416 ng/mL) were not significantly different to the maximum steady-state concentration at day 18 (0.197-0.628 ng/mL; median 0.274; IQR 0.232-0.458 ng/mL). Chronic administration was not associated with drug accumulation (R = 1.09) and pergolide concentration reached steady state within 3 d. Throughout, concentrations of pergolide fluctuated considerably, with median plasma peak concentrations more than four times higher than median trough concentrations. Plasma ACTH concentration reduced significantly within 12 h of administration with further reductions occurring up to 10 d after the initiation of treatment. Although there were parallel fluctuations in the concentrations of pergolide and ACTH, timing of ACTH measurement in relation to the administration of pergolide did not have a significant effect. Alterations in the response to TRH were identified at 8 d with no further change being identified at 18 d. A small number of horses were studied. Oral pergolide results in significant suppression of pars intermedia activity within hours. Pergolide and ACTH concentrations fluctuated in tandem although correlation was poor. Fluctuations in pergolide concentration were consistent with a terminal elimination half-life of less than 12 h. To reduce the level of fluctuation of ACTH, twice-daily dosing of pergolide may be more appropriate.
Collapse
Affiliation(s)
- D I Rendle
- School of Animal and Veterinary Sciences, EH Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales 2650, Australia.
| | - G Doran
- School of Agricultural and Wine Sciences, EH Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales 2650, Australia
| | - J Ireland
- Institute of Veterinary Science, University of Liverpool, Chester High Road, Neston CH64 7TE, UK
| | - S Edwards
- School of Animal and Veterinary Sciences, EH Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales 2650, Australia
| |
Collapse
|
24
|
Pijnacker T, Knies M, Galac S, Sanders K, Mol JA, Kooistra HS. TRH-induced secretion of adrenocorticotropin and cortisol in dogs with pituitary-dependent hypercortisolism. Vet Q 2018; 38:72-78. [PMID: 30362899 PMCID: PMC6830985 DOI: 10.1080/01652176.2018.1521537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: In dogs, spontaneous Cushing’s syndrome is most often pituitary-dependent and caused by hypersecretion of adrenocorticotropic hormone (ACTH), resulting in increased adrenocortical glucocorticoid secretion similar to horses. In horses with Cushing’s syndrome (or pituitary pars intermedia dysfunction [PPID]) a thyrotropin-releasing hormone (TRH) stimulation test can be used for diagnosis, as TRH administration results in increased circulating ACTH and cortisol concentrations in affected horses. Objective: The aim of this study was to investigate the effect of TRH administration on the circulating ACTH and cortisol concentrations in dogs with pituitary-dependent hypercortisolism (PDH). Methods: Ten clinically normal control dogs and 10 dogs with PDH, all client owned, underwent a TRH stimulation test with measurement of plasma concentrations of ACTH and cortisol, before and after intravenous administration of 10 μg TRH/kg bodyweight. Results: Plasma ACTH concentration did not rise significantly after TRH stimulation, neither in PDH dogs nor in clinically normal dogs. In contrast, the plasma cortisol concentration did increase significantly after TRH stimulation in both groups (p = .003 in PDH and p < .001 in control). Immunohistochemistry of normal adrenal glands demonstrated the presence of TRH receptors in the whole adrenal cortex. Conclusions: The results of this study demonstrate that the TRH stimulation test should be rejected as a tool to diagnose PDH in dogs. The observed TRH-induced increase in plasma cortisol concentration without a significant rise in plasma ACTH concentration may be explained by a direct effect of TRH on adrenocortical cells mediated by adrenocortical TRH receptors.
Collapse
Affiliation(s)
- Tera Pijnacker
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - Marieke Knies
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - Sara Galac
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - Karin Sanders
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - Jan A Mol
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - Hans S Kooistra
- a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| |
Collapse
|
25
|
PITUITARY PARS INTERMEDIA DYSFUNCTION (EQUINE CUSHING'S DISEASE) IN NONDOMESTIC EQUIDS AT MARWELL WILDLIFE: A CASE SERIES. ONE CHAPMAN'S ZEBRA ( EQUUS QUAGGA CHAPMANI) AND FIVE PRZEWALSKI's HORSES ( EQUUS FERUS PRZEWALSKII). J Zoo Wildl Med 2018; 49:404-411. [PMID: 29900762 DOI: 10.1638/2017-0149.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's disease, is widely reported in middle-aged to older domestic equids but to date reported in only one nondomestic equid, the onager ( Equus hemionus onager). This case series reports clinical, hematological, and pathological findings consistent with PPID in two further equid species: one Chapman's zebra ( Equus quagga chapmani) and five Przewalski's horses ( Equus ferus przewalskii). The case series reports basal adrenocorticotropic hormone (ACTH) testing as a method to diagnose and monitor PPID in zoological equids and the use of pergolide mesylate to reduce basal ACTH concentration and reduce clinical signs associated with PPID. Gross and histopathological examinations of the pituitary gland in four of these cases revealed either pars intermedia adenomas or adenomatous hyperplasia, similar to pathological findings in domestic equids affected by PPID. These findings suggest that clinicians working with nondomestic equids should be aware of this condition and consider screening for it routinely, particularly given that improvements in management and veterinary care for exotic animals are resulting in a more aged captive population. Early diagnosis and treatment of PPID may prevent the development of painful clinical sequelae and therefore improve the welfare of zoo equids.
Collapse
|
26
|
Secombe CJ, Bailey SR, de Laat MA, Hughes KJ, Stewart AJ, Sonis JM, Tan RHH. Equine pituitary pars intermedia dysfunction: current understanding and recommendations from the Australian and New Zealand Equine Endocrine Group. Aust Vet J 2018; 96:233-242. [DOI: 10.1111/avj.12716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 12/25/2022]
Affiliation(s)
- CJ Secombe
- College of Veterinary Medicine, School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - SR Bailey
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences; The University of Melbourne; Werribee VIC Australia
| | - MA de Laat
- Science and Engineering Faculty; Queensland University of Technology; Brisbane QLD Australia
| | - KJ Hughes
- School of Animal and Veterinary Sciences; Charles Sturt University; Wagga Wagga NSW Australia
| | - AJ Stewart
- Equine Specialist Hospital, School of Veterinary Science; The University of Queensland; Gatton QLD Australia
| | - JM Sonis
- Veterinary Associates Equine and Farm, Karaka; Auckland New Zealand
| | - RHH Tan
- Samford Valley Veterinary Hospital; Samford, QLD Australia
- Discipline of Veterinary Clinical Sciences, College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville QLD Australia
| |
Collapse
|
27
|
Madrigal RG, Andrews FM, Rademacher N, McConnico RS, Duplantis D, Eades SC. Large pituitary adenoma in an 8-year-old Arabian stallion. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- R. G. Madrigal
- Equine Health Studies Program; Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge USA
| | - F. M. Andrews
- Equine Health Studies Program; Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge USA
| | - N. Rademacher
- Imaging Section; Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge USA
| | - R. S. McConnico
- Equine Health Studies Program; Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge USA
| | - D. Duplantis
- Equine Health Maintenance; Port Allen Louisiana USA
| | - S. C. Eades
- Equine Health Studies Program; Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge USA
| |
Collapse
|
28
|
Jacob SI, Geor RJ, Weber PSD, Harris PA, McCue ME. Effect of dietary carbohydrates and time of year on ACTH and cortisol concentrations in adult and aged horses. Domest Anim Endocrinol 2018; 63:15-22. [PMID: 29195115 DOI: 10.1016/j.domaniend.2017.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 12/26/2022]
Abstract
Diagnosis of equine pituitary pars intermedia dysfunction (PPID) remains a challenge as multiple factors (stress, exercise, and time of year) influence ACTH and cortisol concentrations. To assess endocrine status in a study designed to evaluate the effects of age and diet on glucose and insulin dynamics, we performed thyrotropin-releasing hormone (TRH) stimulation tests and overnight dexamethasone suppression tests in March, May, August, and October on 16 healthy Thoroughbred and Standardbred mares and geldings. Horses were grouped by age: adult (mean ± SD; 8.8 ± 2.9 yr; n = 8) and aged (20.6 ± 2.1 yr; n = 8). None of the horses showed clinical signs (hypertrichosis, regional adiposity, skeletal muscle atrophy, lethargy) of pituitary pars intermedia dysfunction. Horses were randomly assigned to groups of 4, blocked for age, and fed grass hay plus 4 isocaloric concentrate diets (control, starch-rich, fiber-rich, and sugar-rich) using a balanced Latin square design. Data were analyzed using a multivariable linear mixed regression model. Baseline ACTH was significantly higher in aged horses (mean ± standard error of the mean; 60.0 ± 10.7 pg/mL) adapted to the starch-rich diet compared to adult horses (15.7 ± 12.0 pg/mL) on the same diet (P = 0.017). After controlling for age and diet, baseline ACTH concentrations were significantly increased in October (57.7 ± 7.1 pg/mL) compared to March (13.2 ± 7.1 pg/mL; P < 0.001), May (12.4 ± 7.1 pg/mL; P < 0.001), and August (24.2 ± 7.1 pg/mL; P < 0.001), whereas post-TRH ACTH was higher in August (376.6 ± 57.6 pg/mL) and October (370.9 ± 57.5 pg/mL) compared to March (101.9 ± 57.3 pg/mL; P < 0.001) and May (74.5 ± 57.1 pg/mL; P < 0.001). Aged horses had significantly higher post-dexamethasone cortisol on the starch-rich diet (0.6 ± 0.1 μg/dL) compared to the sugar-rich diet (0.2 ± 0.1 μg/dL; P = 0.021). Post-dexamethasone cortisol was significantly higher in October (0.6 ± 0.1 μg/dL) compared to March (0.3 ± 0.1 μg/dL; P = 0.005), May (0.2 ± 0.1 μg/dL; P < 0.001), and August (0.3 ± 0.1 μg/dL; P = 0.004). Breed did not influence ACTH or cortisol measurements. In conclusion, in addition to age and time of year, diet is a potential confounder as animals on a starch-rich diet may be incorrectly diagnosed with pituitary pars intermedia dysfunction.
Collapse
Affiliation(s)
- S I Jacob
- Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI 48824, USA.
| | - R J Geor
- Massey University College of Sciences, Private Bag 11222, Palmerston North 4442, New Zealand
| | - P S D Weber
- Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI 48824, USA
| | - P A Harris
- Equine Studies Group, WALTHAM Centre for Pet Nutrition, Freeby Lane, Leicestershire, UK
| | - M E McCue
- University of Minnesota College of Veterinary Medicine, 1365 Gortner Avenue, St. Paul, MN 55108, USA
| |
Collapse
|
29
|
Rapson JL, Schott HC, Nielsen BD, McCutcheon LJ, Harris PA, Geor RJ. Effects of age and diet on glucose and insulin dynamics in the horse. Equine Vet J 2018; 50:690-696. [PMID: 29356053 DOI: 10.1111/evj.12812] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/10/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Age and diet may affect insulin sensitivity (SI) but these factors have received limited investigation in horses. OBJECTIVES To measure minimal model parameters during an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT) after adaptation to a forage only diet (HAY) or forage supplemented with either starch/sugar-rich (SS) or oil/fibre-rich (FF) concentrate feeds; and to assess glucose and insulin responses to a standardised meal challenge (SMC, 4 g/kg BW of SS) after diet adaptation in adult and aged mares. STUDY DESIGN Latin square design with eight adult (5-12 years) and nine aged (>19 years) healthy mares. METHODS Diets were fed for 6 weeks, and the FSIGTT and SMC were performed after 31-32 and 41 days on each diet respectively. Data were analysed by a mixed ANOVA for repeated measures. RESULTS Acute insulin response to glucose (AIRg) was greater and SI was lower in aged horses, compared with adults, regardless of diet. Both AIRg and SI were greater in aged mares after adaptation to SS, as compared with HAY. Similar trends, although not statistically significant, were observed after adaptation to SS in adult mares. Peak insulin concentration and area under the insulin vs. time curve during the SMC were greater in aged than adult mares with all diets. Furthermore, area under the glucose vs. time curve was lower after adaptation to SS, when compared with other diets, in both groups. MAIN LIMITATIONS Transient weight loss occurred at the beginning of the study and only one sex was included. Incomplete ingestion of the SMC by four mares was another limitation. CONCLUSIONS Insulin responses to i.v. and enteral nonstructural carbohydrate challenge increase with age in healthy horses, regardless of diet fed.
Collapse
Affiliation(s)
- J L Rapson
- Michigan State University, East Lansing, Michigan, USA
| | - H C Schott
- Michigan State University, East Lansing, Michigan, USA
| | - B D Nielsen
- Michigan State University, East Lansing, Michigan, USA
| | | | - P A Harris
- Equine Studies Group, WALTHAM Centre for Pet Nutrition, Melton Mowbray, Leicestershire, UK
| | - R J Geor
- Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
30
|
Hines MT. Clinical Approach to Commonly Encountered Problems. EQUINE INTERNAL MEDICINE 2018. [PMCID: PMC7158300 DOI: 10.1016/b978-0-323-44329-6.00007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
31
|
Wotman KL, Johnson AL. Ocular Manifestations of Systemic Disease in the Horse. Vet Clin North Am Equine Pract 2017; 33:563-582. [PMID: 29103562 DOI: 10.1016/j.cveq.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Many systemic diseases have ocular manifestations. In some cases, ocular abnormalities are the most obvious or first recognized sign of disease that prompts veterinary evaluation. In other cases, the systemic disease leads to secondary ocular changes that might lead to loss of vision or globe if not addressed. Therefore, recognition of ocular abnormalities that might result from systemic diseases is an essential skill for the equine practitioner. This article provides practitioners with information regarding the most common systemic diseases of horses in North America that have ocular manifestations, organized by ocular signs.
Collapse
Affiliation(s)
- Kathryn L Wotman
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake, Fort Collins, CO 80523-1678, USA.
| | - Amy L Johnson
- Department of Clinical Sciences, Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA 19348, USA
| |
Collapse
|
32
|
Jacob SI, Geor RJ, Weber PSD, Harris PA, McCue ME. Effect of age and dietary carbohydrate profiles on glucose and insulin dynamics in horses. Equine Vet J 2017; 50:249-254. [PMID: 28833406 DOI: 10.1111/evj.12745] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 08/10/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Glucose and insulin dynamics may be different in adult and aged horses. OBJECTIVES To determine the effects of age and dietary carbohydrates on glucose and insulin dynamics in healthy horses. STUDY DESIGN Balanced Latin square with four isocaloric diets: CONTROL (hay plus restricted-starch-and-sugar fortified pellets), STARCH (control plus kibbled corn), FIBER (control plus unmolassed sugar beet pulp/soybean hull pellets) and SUGAR (control plus dextrose powder). METHODS A total of 16 healthy Thoroughbreds and Standardbreds divided into two age groups: ADULT (8.8 ± 2.9 years; n = 8) and AGED (20.6 ± 2.1 years; n = 8). Following dietary adaptation, horses underwent an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT), modified oral sugar test (OST) and dietary meal challenge. Outcome variables included: insulin sensitivity (SI), disposition index (DI), glucose effectiveness (Sg) and acute insulin response to glucose (AIRg) from the FSIGTT; peak glucose, peak insulin, time to peak, area under the curve for glucose (AUCg) and insulin (AUCi) from the OST and dietary meal challenge. Data were analyzed using multivariable linear mixed regression modelling. RESULTS AIRg was higher in AGED (mean [95% confidence interval]; 582.0 [455.0-709.0]) vs. ADULT (358.0 [224.0-491.0]; P = 0.03). ADULT and AGED horses had a higher SI on STARCH (adult: 3.3 [2.3-4.2]; aged: 2.8 [1.9-3.7]) and SUGAR (adult: 3.4 [2.5-4.3]; aged: 4.0 [3.1-4.9]) diets compared with CONTROL (adult: 2.0 [1.1-2.9], P = 0.029 (starch), P = 0.009 (sugar); aged: 1.4 [0.5-2.2], P = 0.009 (starch), P < 0.001 (sugar)). Feeding a STARCH (adult: 21581.0 [15029.0-28133.0]; aged: 35205.0 [29194.0-41216.0]) or SUGAR (adult: 26050.0 [19885.0-32215.0]; aged: 25720.0 [19770.0-31670.0]) meal resulted in postprandial hyperinsulinaemia (AUCi). MAIN LIMITATIONS Study cohort contained two insulin-sensitive breeds and no insulin-resistant breeds. CONCLUSIONS Age and diet should be considered when evaluating glucose and insulin dynamics.
Collapse
Affiliation(s)
- S I Jacob
- Michigan State University College of Veterinary Medicine, East Lansing, Michigan, USA
| | - R J Geor
- Massey University College of Sciences, Palmerston North, New Zealand
| | - P S D Weber
- Michigan State University College of Veterinary Medicine, East Lansing, Michigan, USA
| | - P A Harris
- Equine Studies Group, WALTHAM Centre for Pet Nutrition, Leicestershire, UK
| | - M E McCue
- University of Minnesota College of Veterinary Medicine, St. Paul, Minnesota, USA
| |
Collapse
|
33
|
Lewis SL, Holl HM, Streeter C, Posbergh C, Schanbacher BJ, Place NJ, Mallicote MF, Long MT, Brooks SA. Genomewide association study reveals a risk locus for equine metabolic syndrome in the Arabian horse. J Anim Sci 2017; 95:1071-1079. [PMID: 28380523 DOI: 10.2527/jas.2016.1221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Equine obesity can cause life-threatening secondary chronic conditions, similar to those in humans and other animal species. Equine metabolic syndrome (EMS), primarily characterized by hyperinsulinemia, is often present in obese horses and ponies. Due to clinical similarities to conditions such as pituitary pars intermedia dysfunction (formerly equine Cushing's disease), conclusive diagnosis of EMS often proves challenging. Aside from changes in diet and exercise, few targeted treatments are available for EMS, emphasizing the need for early identification of at-risk individuals to enable implementation of preventative measures. A genomewide association study (GWAS) using Arabian horses with a history of severe laminitis secondary to EMS revealed significant genetic markers near a single candidate gene () that may play a role in cholesterol homeostasis. The best marker, BIEC2-263524 (chr14:69276814 T > C), was correlated with elevated insulin values and increased frequency of laminitis ( = 0.0024 and = 9.663 × 10, respectively). In a second population of Arabian horses, the BIEC2-263524 marker maintained its associations with higher modified insulin-to-glucose ratio (MIRG) values ( = 0.0056) and BCS ( = 0.0063). Screening of the predicted coding regions by sequencing identified a polymorphic guanine homopolymer and 5 haplotypes in the 3' untranslated region (UTR). An 11 guanine (11-G) allele at was correlated with elevated insulin values in the GWAS population ( = 0.0008) and, in the second population, elevated MIRG and increased BCS > 6.5 ( = 0.0055 and = 0.0162, respectively). The BIEC2-263524-C and the 3' UTR -11(G) polymorphisms were correlated at a 98% frequency, indicating strong linkage disequilibrium across this 150-kb haplotype. Assays for these markers could diagnose horses with a genetic predisposition to develop obesity. Additionally, discovery of FAM174A function may improve our understanding of the etiology of this troubling illness in the horse and warrants investigation of this locus for a role in metabolic- and obesity-related disorders of other species.
Collapse
|
34
|
Randleff-Rasmussen PK, Mosca M, Knoerr F, Pin D, Desjardins I. Successful medical treatment of an Aspergillus terreus mycetoma of the nostril/lip in a 16-year-old Fjord pony gelding with pituitary pars intermedia dysfunction. Vet Dermatol 2017; 28:629-e155. [PMID: 28736852 DOI: 10.1111/vde.12471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mycetoma is a chronic, proliferative lesion of cutaneous/subcutaneous tissue characterized by draining tracts and granules in the discharge caused by actinomycetes (actinomycetoma) or filamentous fungi (eumycotic mycetoma). OBJECTIVES This case report describes the unusual finding of a cutaneous mycetoma of the lateral wing of the right nostril in a gelding. ANIMAL A 16-year-old Fjord gelding with suspected pituitary pars intermedia dysfunction (PPID) was presented for evaluation of a nonpainful, firm and raised mass involving the lateral wing of the right nostril and the lip. METHODS AND RESULTS Cytological examination of the mass showed marked pyogranulomatous inflammation and histopathological examination revealed a fungal mycetoma. Fungal culture identified the causative organism as Aspergillus terreus, which is not known for its propensity to cause either dermal granulomas or mycetoma in domestic animals. Further investigation, including a TRH stimulation test, led to a diagnosis of PPID (Cushing's disease), which may have led to immunosuppression of the animal and increased susceptibility to infection. CONCLUSIONS AND CLINICAL IMPORTANCE The horse was treated medically with pergolide for the PPID and oral potassium iodide for the fungal infection, with good therapeutic response and no relapse after five months. Surgical debridement or excision was not performed. To the best of the authors' knowledge, this is the first case report of a cutaneous mycetoma caused by A. terreus in a horse.
Collapse
Affiliation(s)
| | - Marion Mosca
- VetAgro Sup, Veterinary Campus of Lyon, University of Lyon, 69280, Marcy l'Etoile, France
| | - Frédéric Knoerr
- Cabinet Vétérinaire du Vallon, 465 route de la Merlanchonnière, 42740, St Paul en Jarez, France
| | - Didier Pin
- VetAgro Sup, Veterinary Campus of Lyon, University of Lyon, 69280, Marcy l'Etoile, France
| | - Isabelle Desjardins
- VetAgro Sup, Veterinary Campus of Lyon, University of Lyon, 69280, Marcy l'Etoile, France
| |
Collapse
|
35
|
Ireland JL. Demographics, Management, Preventive Health Care and Disease in Aged Horses. Vet Clin North Am Equine Pract 2016; 32:195-214. [PMID: 27449388 DOI: 10.1016/j.cveq.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Gerontology has become increasingly important in equine veterinary medicine, with aged animals representing a significant proportion of the equine population. Horses are defined as geriatric or aged from age 15 years onwards but can have a life span of more than 40 years. Despite a high level of owner concern for the well-being of their geriatric animal, provision of preventive health care may be suboptimal. Owners seem to under-recognize some of the most prevalent diseases identified in geriatric horses. This review focuses on the demographic characteristics of the equine geriatric population and management and preventive care practices of older horses.
Collapse
Affiliation(s)
- Joanne L Ireland
- Epidemiology and Disease Surveillance, Centre for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
| |
Collapse
|
36
|
|
37
|
Restifo MM, Frank N, Hermida P, Sanchez-Londoño A. Effects of withholding feed on thyrotropin-releasing hormone stimulation test results and effects of combined testing on oral sugar test and thyrotropin-releasing hormone stimulation test results in horses. Am J Vet Res 2016; 77:738-48. [DOI: 10.2460/ajvr.77.7.738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
38
|
Mitsui I, Jackson LP, Couëtil LL, Lin TL, Ramos-Vara JA. Hypertrichosis in a Horse with Alimentary T-Cell Lymphoma and Pituitary Involvement. J Vet Diagn Invest 2016; 19:128-32. [PMID: 17459849 DOI: 10.1177/104063870701900125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 13-year-old Quarterhorse mare had a 6-month history of diarrhea, progressive weight loss, and lethargy. At presentation the mare was hirsute, had hyperhidrosis, and abnormal fat distribution in addition to severe diarrhea. A presumptive clinical diagnosis of protein-losing enteropathy and pituitary pars intermedia dysfunction was made. T-cell lymphoma was diagnosed in a rectal biopsy specimen. The owner elected to euthanize the mare because of poor prognosis and the severity of the disease. At necropsy, the mare had hypertrichosis and the pituitary gland was diffusely enlarged. Histologically, neoplastic lymphocytes infiltrated the gastrointestinal mucosa, mesenteric lymph nodes, and the pituitary gland. In addition, there was hyperplasia of the pituitary gland pars intermedia. Pituitary adenoma was not present. Hypertrichosis in this case could have been triggered by a combination of adenomatous hyperplasia of pars intermedia and lymphoma resulting in disruption of the hypothalamic dopaminergic tone or disruption of the hypothalamic thermoregulatory center.
Collapse
Affiliation(s)
- Ikki Mitsui
- Purdue University, School of Veterinary Medicine, Animal Disease Diagnostic Laboratory and Department of Veterinary Pathobiology, 406 South University Street, West Lafayette, IN 47907, USA.
| | | | | | | | | |
Collapse
|
39
|
McFarlane D, Banse H, Knych HK, Maxwell LK. Pharmacokinetic and pharmacodynamic properties of pergolide mesylate following long-term administration to horses with pituitary pars intermedia dysfunction. J Vet Pharmacol Ther 2016; 40:158-164. [DOI: 10.1111/jvp.12339] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/19/2016] [Indexed: 12/01/2022]
Affiliation(s)
- D. McFarlane
- Center for Veterinary Health Sciences; Physiological Sciences; Oklahoma State University; Stillwater OK USA
| | - H. Banse
- Center for Veterinary Health Sciences; Physiological Sciences; Oklahoma State University; Stillwater OK USA
| | - H. K. Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory; School of Veterinary Medicine; University of California; Davis CA USA
| | - L. K. Maxwell
- Center for Veterinary Health Sciences; Physiological Sciences; Oklahoma State University; Stillwater OK USA
| |
Collapse
|
40
|
Irvine KL, Burt K, Hill AJ, Shaw S, Papasouliotis K. Initial analytic quality assessment and method comparison of an immunoassay for adrenocorticotropic hormone measurement in equine samples. Vet Clin Pathol 2016; 45:154-63. [PMID: 26756538 DOI: 10.1111/vcp.12326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Equine pituitary pars intermedia dysfunction (PPID) may be diagnosed by measuring baseline plasma adrenocorticotrophic hormone (ACTH). The Immulite 1000 analyzer uses an automated chemiluminescence enzyme assay, previously validated for measuring equine ACTH. Recently, an automated bench-top immunoassay analyzer (AIA-360), designed for analytes in people, became available for veterinary use. OBJECTIVES Objectives were to evaluate analytic performance of the AIA immunoassay for measuring equine ACTH, and compare the results with those obtained by the Immulite. METHODS Adrenocorticotrophic hormone was measured in plasma samples from 52 clinical cases. For the AIA, within- and between-run coefficients of variation (CV) were assessed, linearity and recovery studies performed, and observed total error (TEobs ) calculated. Correlation and agreement between the 2 analyzers were also evaluated. RESULTS Within-run and between-run CV of the AIA ranged from 2.3% to 4% and 3.5% to 8%, respectively. ACTH recoveries ranged from 89.5% to 115.9%. TEobs at 26.5 pg/mL ACTH was 4.1 pg/mL. The ACTH results (median: 25.9 pg/mL; range: 4.3-276.7 pg/mL) with AIA were significantly lower (P < .0001) than with the Immulite (median: 29.9 pg/mL; range: 10.3-639.0 pg/mL). Correlation between the 2 analyzers was r = 0.882 (P < .0001), with a significant bias for the AIA of -16 pg/mL. The 2 methods were not identical within inherent imprecision. CONCLUSION The AIA is precise for measuring ACTH in horses. Although correlation between the instruments is good, the values obtained by the immunoassays cannot be used interchangeably and should be interpreted using reference intervals established for each analyzer to avoid false negatives. Diagnostic sensitivity and specificity of the AIA-360 should be evaluated before clinical use.
Collapse
Affiliation(s)
- Katherine L Irvine
- School of Veterinary Sciences, University of Bristol, Langford, Bristol, UK.,Diagnostic Laboratories, Langford Veterinary Services, University of Bristol, Bristol, UK
| | - Kay Burt
- School of Veterinary Sciences, University of Bristol, Langford, Bristol, UK
| | - Andrew J Hill
- Equine Centre, Langford Veterinary Services, University of Bristol, Bristol, UK
| | | | - Kostas Papasouliotis
- School of Veterinary Sciences, University of Bristol, Langford, Bristol, UK.,Diagnostic Laboratories, Langford Veterinary Services, University of Bristol, Bristol, UK
| |
Collapse
|
41
|
Miller MA, Moore GE, Bertin FR, Kritchevsky JE. What's New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids. Vet Pathol 2015; 53:390-8. [PMID: 26459516 DOI: 10.1177/0300985815608674] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n = 116) with that in equids ≥20 years of age (n = 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous system (7.9%), cardiovascular system (4.6%), urinary system (4.6%), reproductive system (4.2%), respiratory system (4.2%), integumentary system (4.2%), lymphoid system (2.5%), liver (2.5%), or systemic neoplasia (1.2%). Nervous system disease was more common in the 15- to 19-year group; urinary tract disease was more common in the ≥20-year group. Neoplastic disease, regardless of systemic location, was the basis for death or euthanasia in 18.7% of all equids. Squamous cell carcinoma, lymphoma, and melanoma were the most common malignant neoplasms. PPID was the most common specific diagnosis, based on the postmortem presence of hyperplasia or adenoma, and was the reason for euthanasia in 47.7% of 65 equids with PPID. The most common nonpituitary causes for death or euthanasia in equids with PPID were colic, lameness, cancer, and spinal cord disease. Coexisting conditions in equids with PPID that were not considered the basis for euthanasia included neoplasms, infections, lameness, and recurrent airway obstruction.
Collapse
Affiliation(s)
- M A Miller
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - G E Moore
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - F R Bertin
- Department of Physiology, School of Medicine, McGill University, Montreal, Canada
| | - J E Kritchevsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
42
|
Rendle DI, Hughes KJ, Doran GS, Edwards SH. Pharmacokinetics of pergolide after intravenous administration to horses. Am J Vet Res 2015; 76:155-60. [PMID: 25629913 DOI: 10.2460/ajvr.76.2.155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of pergolide after IV administration to horses. ANIMALS 8 healthy adult horses. PROCEDURES Pergolide mesylate was administered IV at a dose of 20 μg/kg (equivalent to 15.2 μg of pergolide/kg) to each horse, and blood samples were collected over 48 hours. Pergolide concentrations in plasma were determined by means of high-performance liquid chromatography-tandem mass spectrometry, and pharmacokinetic parameters were determined on the basis of noncompartmental methods. RESULTS After IV administration of pergolide, mean ± SD clearance, elimination half-life, and initial volume of distribution were 959 ± 492 mL/h/kg, 5.64 ± 2.36 hours, and 0.79 ± 0.32 L/kg, respectively. CONCLUSIONS AND CLINICAL RELEVANCE With an elimination half-life of approximately 6 hours, twice-daily dosing may be more appropriate than once-daily dosing to reduce peak-trough fluctuation in pergolide concentrations. Further pharmacodynamic and pharmacokinetic studies of pergolide and its metabolites will be necessary to determine plasma concentrations that correlate with clinical effectiveness to determine the therapeutic range for the treatment of pituitary pars intermedia dysfunction.
Collapse
Affiliation(s)
- David I Rendle
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia
| | | | | | | |
Collapse
|
43
|
Spelta CW. Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management. VETERINARY MEDICINE-RESEARCH AND REPORTS 2015; 6:293-300. [PMID: 30101114 PMCID: PMC6067528 DOI: 10.2147/vmrr.s74191] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology has been suggested to initiate the neurodegeneration. While hypertrichosis (formerly known as hirsutism) is considered pathognomic for advanced disease, the antemortem diagnosis of subclinical and early disease has continued to prove difficult. Numerous tests have been used with varying sensitivities and specificities. The overnight dexamethasone suppression test, originally documented to have 100% sensitivity and specificity in horses with advanced disease, has proven to be less valuable in identifying early disease. Basal plasma adrenocorticotropin concentrations have improved sensitivity and specificity when sampled during the autumn months, and α-melanocyte-stimulating hormone, while not yet commercially available, shows promise as a sensitive and specific single sample test. Recent advances in our knowledge include the strong association between laminitis and hyperinsulinemia, both common clinical signs associated with PPID. The pathogenesis of hyperinsulinemia, laminitis, and their association with this disease is a focus of current research. The dopamine agonist pergolide mesylate is still the mainstay of medical management, with studies on oral bioavailability, pharmacokinetics, and long-term survival rates now published.
Collapse
|
44
|
Karikoski NP, Patterson-Kane JC, Singer ER, McFarlane D, McGowan CM. Lamellar pathology in horses with pituitary pars intermedia dysfunction. Equine Vet J 2015; 48:472-8. [PMID: 25869529 DOI: 10.1111/evj.12450] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 04/07/2015] [Indexed: 01/11/2023]
Abstract
REASONS FOR PERFORMING STUDY Hoof lamellar pathology in horses with pituitary pars intermedia dysfunction (PPID) has not been described previously. OBJECTIVES To describe the histomorphometry and pathological lesions in hoof lamellar tissue of animals that had PPID with or without concurrent laminitis, with reference to age-matched controls. We hypothesised that lamellar lesions consistent with laminitis would be associated with PPID, even in animals without current or historical laminitis. STUDY DESIGN Prospective case-control study. METHODS Mid-dorsal hoof histological sections were obtained post mortem from the forelimbs of 16 PPID-affected animals either with (n = 6) or without laminitis (n = 10) and 10 age- and breed-matched controls. Sections were examined by a blinded veterinary pathologist. The length and width of 10 primary epidermal lamellae were measured using image analysis software. The morphology and pathology of primary and secondary epidermal lamellae were then typed or graded in axial, middle and abaxial regions. Fasting serum insulin, plasma adrenocorticotropin and blood glucose concentration were measured from blood samples taken prior to euthanasia. RESULTS All animals with PPID and laminitis had fasting hyperinsulinaemia (median 74.1 miu/l, interquartile range 49.9-349.5 miu/l) whereas PPID animals without laminitis had serum insulin concentrations below the upper limit of the reference range (<20 miu/l). Lamellar pathology in PPID animals with laminitis was variable in severity and unrelated to the reported duration of laminitis (range 2 months-5 years). Most lesions were located abaxially within the lamellar tissue and included increased length and width of the lamellae, chronic abnormal keratinisation, interlamellar epidermal bridging and cell death with more acute lamellar tearing in some cases. The lamellae of PPID animals without laminitis were normal referent to the relevant control group. CONCLUSIONS Whether PPID and hyperinsulinaemia have a causal inter-relationship or not, it may only be the hyperinsulinaemia that is associated with lamellar morphological alteration and pathology consistent with laminitis.
Collapse
Affiliation(s)
- N P Karikoski
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - J C Patterson-Kane
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - E R Singer
- Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - D McFarlane
- Department of Physiological Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - C M McGowan
- Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| |
Collapse
|
45
|
Neutrophil function in healthy aged horses and horses with pituitary dysfunction. Vet Immunol Immunopathol 2015; 165:99-106. [PMID: 25962580 DOI: 10.1016/j.vetimm.2015.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/01/2015] [Accepted: 04/23/2015] [Indexed: 11/23/2022]
Abstract
Immunosuppression leading to opportunist bacterial infection is a well-recognized sequela of equine pituitary pars intermedia dysfunction (PPID). The mechanisms responsible for immune dysfunction in PPID however, are as of yet poorly characterized. Horses with PPID have high concentrations of hormones known to impact immune function including α-melanocyte stimulating hormone (α-MSH) and insulin. α-MSH and related melanocortins have been shown in rodents and people to impair neutrophil function by decreasing superoxide production (known as oxidative burst activity), migration and adhesion. The goal of this study was to determine if neutrophil function is impaired in horses with PPID and, if so, to determine if plasma α-MSH or insulin concentration correlated with the severity of neutrophil dysfunction. Specifically, neutrophil phagocytosis, oxidative burst activity, chemotaxis and adhesion were assessed. Results of this study indicate that horses with PPID have reduced neutrophil function, characterized by decreased oxidative burst activity and adhesion. In addition, chemotaxis was greater in healthy aged horses than in young horses or aged horses with PPID. Plasma insulin: α-MSH ratio, but not individual hormone concentration was correlated to neutrophil oxidative burst activity. In summary, neutrophil function is impaired in horses with PPID, likely due to altered hormone concentrations and may contribute to increased risk of opportunistic infections. Whether regulation of hormone concentration profiles in horses with PPID using therapeutic intervention improves neutrophil function and reduces infections needs to be explored.
Collapse
|
46
|
Mastro LM, Adams AA, Urschel KL. Pituitary pars intermedia dysfunction does not necessarily impair insulin sensitivity in old horses. Domest Anim Endocrinol 2015; 50:14-25. [PMID: 25240230 DOI: 10.1016/j.domaniend.2014.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 07/20/2014] [Accepted: 07/21/2014] [Indexed: 01/03/2023]
Abstract
Equine pituitary pars intermedia dysfunction (PPID) has been associated with reduced insulin sensitivity in comparison with younger adult horses; however, the difference in insulin sensitivity between horses with PPID and aged-matched controls has not been well characterized. The objective of the study was to determine if aged horses with PPID had reduced insulin sensitivity and alterations in the insulin-mediated signaling pathways in the skeletal muscle when compared with healthy aged horses. Isoglycemic hyperinsulinemic clamp procedures were conducted in 12 horses that were classified as either PPID (n = 6; age: 25.0 ± 2.5 yr; mean ± standard deviation) or non-PPID, aged-matched controls (control) (n = 6; age: 25.7 ± 2.0 yr). Blood samples were taken before and during the clamp procedures to measure plasma glucose, insulin, and amino acid concentrations, and 2 muscle biopsies were collected from the gluteus medius muscle, one in the basal state and the second at the end of the clamp procedure (insulin-stimulated state). Plasma insulin concentrations increased ∼9-fold during the clamp compared with basal conditions (P < 0.001) in both groups. During the last 30 min of the clamp, the rate of glucose infusion required to maintain isoglycemia in horses with PPID was similar to that in the control horses (P = 0.67). The plasma concentrations of most indispensible amino acids were lower in the insulin-stimulated state than the basal state (P < 0.05). PPID status did not have an effect on the activation of factors associated with protein synthesis and breakdown; however, factors associated with protein synthesis had increased phosphorylation in the insulin-stimulated state, compared with basal. The results from this study provide evidence that PPID is not always associated with impairments in insulin sensitivity.
Collapse
Affiliation(s)
- L M Mastro
- Department of Animal and Food Sciences, University of Kentucky, Lexington, KY 40546, USA
| | - A A Adams
- Department of Veterinary Science, Gluck Equine Research Center, University of Kentucky, Lexington, KY 40506, USA
| | - K L Urschel
- Department of Animal and Food Sciences, University of Kentucky, Lexington, KY 40546, USA.
| |
Collapse
|
47
|
Gehlen H, May A, Bradaric Z. Comparison of Insulin and Glucose Metabolism in Horses with Pituitary Pars Intermedia Dysfunction Treated Versus Not Treated with Pergolide. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2013.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
48
|
Hebert RC, Thompson DL, Mitcham PB, Lestelle JD, Gilley RM, Burns PJ. Inhibitory Effects of Pergolide and Cabergoline Formulations on Daily Plasma Prolactin Concentrations in Geldings and on the Daily Prolactin Responses to a Small Dose of Sulpiride in Mares. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
49
|
Hebert RC, Thompson DL, Mitcham PB, Lestelle JD. Repeatability of Prolactin Responses to a Small Dose of Sulpiride in Estrogen-Primed Geldings in Spring and in Mares During the Estrous Cycle in Summer. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
50
|
Dunkel B, Wilford SA, Parkinson NJ, Ward C, Smith P, Grahame L, Brazil T, Schott HC. Severe hypertriglyceridaemia in horses and ponies with endocrine disorders. Equine Vet J 2013; 46:118-22. [DOI: 10.1111/evj.12089] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 04/07/2013] [Indexed: 11/27/2022]
Affiliation(s)
- B. Dunkel
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms UK
| | - S. A. Wilford
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms UK
| | | | - C. Ward
- Department of Veterinary Population Medicine; University of Minnesota; USA
| | - P. Smith
- College of Veterinary Medicine; The Ohio State University; USA
- Riviera Equine Internal Medicine & Consulting; Santa Ynez California USA
| | - L. Grahame
- Lisa Grahame Veterinary Surgeon; Letty Green UK
| | - T. Brazil
- Equine Medicine on the Move; Moreton-in-Marsh Gloucestershire UK
| | - H. C. Schott
- Department of Large Animal Clinical Sciences; Michigan State University; USA
| |
Collapse
|