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Grob AJ, Delarocque J, Feige K, Warnken T. Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin. Vet J 2024; 306:106172. [PMID: 38909714 DOI: 10.1016/j.tvjl.2024.106172] [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: 12/21/2023] [Revised: 05/22/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024]
Abstract
In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of the initial blood glucose concentration at 30 min after insulin administration in insulin sensitive horses. Compared to RHI, porcine zinc insulin (PZI) is veterinary-approved and therefore easier accessible for many practitioners. The aim of this study was to compare the insulin and glucose dynamics during a standard ITT with RHI to an ITT performed with PZI. Twelve Icelandic horses were subjected to an ITT with RHI (ITT-RHI) and with PZI (ITT-PZI) at same dosages in a randomised crossover design. The insulin and glucose dynamics that resulted from these tests were compared, and the consistency of classification into insulin-sensitive and IR categories was evaluated. No complications were observed with the use of either RHI or PZI in ITT. A good correlation of the test results was observed (r = 0.88; P < 0.001). The blood glucose concentrations and the percentage reduction in glucose concentration did not differ significantly between the two tests (P = 0.053), but four out of twelve horses were classified as IR in the ITT-RHI whereas with the ITT-PZI seven out of twelve horses were classified as IR with the 50 % glucose reduction from baseline. Based on the Youden index, when using the ITT-PZI, an adjusted cut-off value for blood glucose reduction of 40 % at 30 min resulted in better test performance. With consideration for the seemingly weaker effect of PZI and the adjusted cut-off value, PZI can be an appropriate substitute to RHI in an ITT.
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Affiliation(s)
- A J Grob
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, Hannover 30559, Germany.
| | - J Delarocque
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, Hannover 30559, Germany
| | - K Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, Hannover 30559, Germany
| | - T Warnken
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, Hannover 30559, Germany; Boehringer Ingelheim Vetmedica GmbH, Binger Straße 173, Ingelheim am Rhein 55263, Germany
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Frers F, Delarocque J, Huber K, Feige K, Warnken T. Comparison of a modified 2-step insulin response test performed with porcine zinc insulin and an oral glucose test to detect hyperinsulinemic Icelandic horses. Vet J 2023; 298-299:106012. [PMID: 37348701 DOI: 10.1016/j.tvjl.2023.106012] [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: 09/23/2022] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
Both, oral and intravenous (IV) testing protocols, are recommended and still used to detect insulin dysregulation (ID) in equids. However, IV tests mainly focus on peripheral insulin resistance (IR), while oral tests assess hyperinsulinemia (HI), which are different aspects of ID. The objective of this study was to describe if horses with HI also demonstrate IR and consequently can be detected by a modified 2-step insulin response test (2-step IRT) performed with a veterinary approved porcine zinc insulin (PZI). Twelve Icelandic horses were subjected to an OGT and 2-step IRT in a crossover study. Serum insulin concentrations during the OGT revealed that six horses were hyperinsulinemic (HI) while six were not (NON-HI). To describe the glucose response to IV injected PZI, the decline of plasma glucose concentration within the first 30 min was analyzed. Glucose reduction was similar in horses with and without HI during the 2-step IRT over time. Additionally, none of the horses reached a glucose reduction of ≥ 50% at 30 min. The results of the present study indicated that a comparable insulin mediated glucose uptake may be observed in horses with and without HI during a modified 2-step IRT. While six out of twelve horses were identified as HI by the OGT, all twelve horses were identified as IR by the modified 2-step IRT performed with PZI underlining the importance, but difficulty in choosing the right diagnostic tool in clinical settings to assess ID.
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Affiliation(s)
- F Frers
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany.
| | - J Delarocque
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany
| | - K Huber
- Institute of Animal Science, Faculty of Agricultural Sciences, University of Hohenheim, Fruwirthstr. 35, 70599 Stuttgart, Germany
| | - K Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany
| | - T Warnken
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany
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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.
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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
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Juśkiewicz J, Fotschki B, Jaworska J, Siemieniuch M. Investigations of the maintenance system of the Konik Polski horse and its effects on fecal microbiota activity during the winter and summer seasons. Anim Sci J 2021; 92:e13603. [PMID: 34318561 DOI: 10.1111/asj.13603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022]
Abstract
Gastrointestinal microbiota play a key role in the nutrients digestion and hence maintaining animal health and welfare. The diet offered to the animals in captivity may differ considerably from that on natural pastures. In a stabled maintenance system, horses have a limited choice of habitat and feed. Time spend for feeding is relevant for equine welfare because the reduction of the time devoted for foraging may be responsible for inducing gastric inflammation and ulceration. Therefore, in the present study, it was hypothesized that fecal bacterial fermentative processes differ between free-roaming and stabled Konik Polski Horses (KPHs) with respect to microbial enzymatic activity, and thus the fecal concentration of short-chain fatty acids (SCFA), which can be further utilized for assessing the feeding behavior and welfare in free-roaming versus stabled horses. The SCFA concentration and profile, as well as the extracellular and intracellular activities of selected bacterial enzymes, were characterized in horse feces collected during the winter and summer feeding seasons. The results showed higher enzymatic activity and SCFA production in the feces excreted by free-roaming versus stabled horses, especially during summer. An increase in pasture plant diversity may be beneficial for the gastrointestinal microbiota and hence for maintaining health and welfare.
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Affiliation(s)
- Jerzy Juśkiewicz
- Biological Function of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Bartosz Fotschki
- Biological Function of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Joanna Jaworska
- Gamete and Embryo Biology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Marta Siemieniuch
- Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland.,Research Station of the Institute of the Animal Reproduction and Food Research, Polish Academy of Sciences, Ruciane-Nida, Poland
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Haseler CJ, Jarvis GE, McGovern KF. Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Equine Vet J 2020; 53:895-901. [PMID: 33174264 DOI: 10.1111/evj.13361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. OBJECTIVES To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses. STUDY DESIGN Retrospective observational cohort study. METHODS Clinical records of horses registered with one large UK equine practice were reviewed retrospectively to identify all horses receiving intrasynovial TA treatment between 1 January 2007 and 31 December 2017. A total of 1510 horses were selected and records investigated for incidence of laminitis over a 4-month period following treatment. For each TA-treated horse, an untreated horse, individually matched by age, sex, date of treatment and client type, was selected from the clinical records. Untreated horses were then investigated for laminitis over the same 4-month period. Data were analysed in a 2 × 2 contingency table using Fisher's exact test. RESULTS A total of 489 horses were lost to follow-up and 55 horses were excluded, leaving 966 treated and matched, untreated horses. The incidence of laminitis over the 4-month study period in both groups was identical: 3/966 horses (0.31%) (95% C.I. [0.08%, 0.91%]), equivalent to 0.93 cases per 100 horses per year (P > .9). MAIN LIMITATIONS Retrospective study; large proportion (489/1510) of horses lost to follow-up; large proportion of study population were racehorses; selection method resulted in disproportionate selection of horses born before 2013; similar incidence between groups may reflect existing risk-based selection by clinicians. CONCLUSIONS intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
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Affiliation(s)
- Callum J Haseler
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.,Westover Veterinary Centre, Hainford, UK
| | - Gavin E Jarvis
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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Paula L, Lera K, Schuh B, Silva F, Nascimento EMD, Pagliosa G. Laminite endocrinopática em equinos com síndrome metabólica: características clínicas, tratamento e evolução em três pacientes ˗ relato de caso. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Laminite endocrinopática designa os casos de laminite cuja etiologia está associada a uma endocrinopatia. Cavalos com síndrome metabólica equina (SME) apresentam adiposidade regional e obesidade. Existe uma correlação positiva entre obesidade e resistência à insulina. Este relato descreve três casos de laminite endocrinopática em cavalos com SME. Os pacientes apresentaram escore de condição corporal (ECC) variando de 8 a 9 (escala de 1 a 9), sensibilidade ao teste de pinçamento do casco e claudicação de grau 3 ou 4 (escala de 1 a 4). Não havia histórico de cólica recente, trauma ou excesso de exercício. O tratamento incluiu medicação anti-inflamatória não esteroidal, repouso na baia, restrição energética para perda de peso, revestimento e bandagem dos membros, conforme a necessidade de cada paciente. A restrição alimentar ajudou no tratamento da SME e reduziu o ECC. Tratamento medicamentoso, casqueamento e bandagem diminuíram o grau de claudicação. Conclui-se que o tratamento anti-inflamatório não esteroidal, a restrição energética, o repouso em baia, o casqueamento e a bandagem do casco são eficazes no tratamento da laminite endocrinopática em cavalos com síndrome metabólica equina.
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Pharmacokinetics of Metformin in Combination With Sitagliptin in Adult Horses After Enteral Administration. J Equine Vet Sci 2018; 72:84-88. [PMID: 30929789 DOI: 10.1016/j.jevs.2018.10.017] [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] [Received: 04/17/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 01/12/2023]
Abstract
Insulin dysregulation (ID) is a common metabolic disorder in horses. Recently, incretin hormone release has been suggested to be involved in ID in horses. In human medicine, metformin and sitagliptin are commonly used in combination for metabolic syndrome. This combination could be useful in treating ID in horses. However, no pharmacokinetics data have been reported in this species. The objective of the present study was to establish the plasma concentration-time profile and to derive pharmacokinetics data for a combination of metformin and sitagliptin in horses after enteral administration. Six healthy adult Purebred Spanish horses were used. A metformin (15 mg/kg) plus sitagliptin (1.5 mg/kg) preparation was administered by intragastric route (IG) as an enteral solution. Blood samples were collected from 0 to 48 hours after IG drug administration. Plasma concentrations of metformin and sitagliptin were measured using high performance liquid chromatography methods. The t½λz for metformin was 2.9 hours and for sitagliptin 21 hours. The Cmax was 442 ± 84 mg/L within 0.9 hours for metformin and 94 ± 14 mg/L within 1.3 hours for sitagliptin. No adverse effects were observed, and the combination of metformin and sitagliptin was well tolerated. Therefore, these results suggest that metformin plus sitagliptin might be a combination to consider in horses with ID. Additional studies are needed to establish the effectiveness and tolerance in equids affected by endocrine disorders.
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Glucose and Insulin Response of Horses Grazing Alfalfa, Perennial Cool-Season Grass, and Teff Across Seasons. J Equine Vet Sci 2018; 68:33-38. [PMID: 31256885 DOI: 10.1016/j.jevs.2018.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/20/2018] [Accepted: 04/30/2018] [Indexed: 11/23/2022]
Abstract
Elevated nonstructural carbohydrate (NSC) values in pasture forages can cause adverse health effects in some horses (Equus caballus L.). The objectives of this study were to determine the impact of different forage species on blood glucose and insulin concentrations of horses throughout the grazing season. Research was conducted in July (summer) and September (fall) in St. Paul, MN. Alfalfa (Medicago sativa L.), mixed perennial cool-season grasses (CSG), and teff (Eragrostis tef [Zucc.] Trotter) pastures were grazed by six horses (24 ± 2 years) that were randomly assigned to one of three forage types in a replicated Latin-square design. Jugular catheters were inserted 1 hour before the start of grazing and horses had access to pasture each day from 08:00 to 16:00 hours. Jugular venous blood samples were collected from each horse before being turned out (0 hours) and then at 2-hour intervals following turnout. Plasma and serum samples were collected and analyzed for glucose and insulin, respectively. Corresponding forage samples were taken by hand harvest. Seasons were analyzed separately and data were analyzed using the MIXED procedure in SAS with P ≤ .05. Teff generally had lower (P ≤ .05) equine digestible energy, crude protein, and NSC compared to the other forages. Differences in peak insulin were observed between horses grazing CSG and teff during the fall grazing (P ≤ .05). These results suggest grazing teff could lower the glucose and insulin response of some horses.
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Mendoza FJ, Toribio RE, Perez-Ecija A. Donkey Internal Medicine—Part I: Metabolic, Endocrine, and Alimentary Tract Disturbances. J Equine Vet Sci 2018. [PMCID: PMC7111315 DOI: 10.1016/j.jevs.2018.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Metabolic and endocrine disturbances are common in donkeys. This species has an inherent ability to thrive with limited and poor-quality roughage. Donkeys are extremely efficient in energy storage and mobilization, which predisposes to hyperlipemia, obesity, and metabolic syndrome. The prevalence of dyslipidemias is higher in donkeys than other equids, which is more evident under stressful conditions. Diagnosis of endocrine and metabolic disorders in donkeys should be based on species-specific information considering that differences in a multitude of variables compared with horses have been demonstrated. Protocols to assess endocrine disorders (e.g., pituitary pars intermedia dysfunction, metabolic syndrome, and thyroid illness) are unavailable, and extrapolation from horse data can be misleading. Treatment guidelines for these conditions in donkeys are currently not reported. On the other hand, the typical stoic and hardy behavior of donkeys can hinder prompt diagnosis of gastrointestinal problems, specifically colic, which is commonly caused by dental issues in this species. Moreover, subclinical gastric ulcer syndrome appears to be a common pathology in this species, especially in working donkeys. Donkeys are different to horses. Numerous physiological and clinic-pathologic idiosyncrasies are reported in horses. Data published for horses should not be extrapolated for donkeys. Specific reference ranges, doses, and protocols have to be used for donkeys.
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Affiliation(s)
- Francisco J. Mendoza
- Departamento de Medicina y Cirugia Animal, Universidad de Cordoba, Campus Rabanales, Cordoba, Spain
- Corresponding author at: Dr Francisco J. Mendoza, Department of Animal Medicine and Surgery University of Cordoba, 14014 Cordoba, Spain.
| | - Ramiro E. Toribio
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - Alejandro Perez-Ecija
- Departamento de Medicina y Cirugia Animal, Universidad de Cordoba, Campus Rabanales, Cordoba, Spain
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Lane HE, Burns TA, Hegedus OC, Watts MR, Weber PS, Woltman KA, Geor RJ, McCutcheon LJ, Eades SC, Mathes LE, Belknap JK. Lamellar events related to insulin‐like growth factor‐1 receptor signalling in two models relevant to endocrinopathic laminitis. Equine Vet J 2017; 49:643-654. [DOI: 10.1111/evj.12663] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/04/2017] [Indexed: 12/20/2022]
Affiliation(s)
- H. E. Lane
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
| | - T. A. Burns
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
| | - O. C. Hegedus
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
| | - M. R. Watts
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
| | - P. S. Weber
- Department of Large Animal Clinical Sciences College of Veterinary Medicine Michigan State University East Lansing Michigan USA
| | - K. A. Woltman
- Department of Large Animal Clinical Sciences College of Veterinary Medicine Michigan State University East Lansing Michigan USA
| | - R. J. Geor
- Department of Large Animal Clinical Sciences College of Veterinary Medicine Michigan State University East Lansing Michigan USA
| | - L. J. McCutcheon
- Department of Large Animal Clinical Sciences College of Veterinary Medicine Michigan State University East Lansing Michigan USA
| | - S. C. Eades
- Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge Louisiana USA
| | - L. E. Mathes
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
- Department of Veterinary Biosciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
| | - J. K. Belknap
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
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Welsh CE, Duz M, Parkin TDH, Marshall JF. Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records. Prev Vet Med 2016; 136:11-18. [PMID: 28010903 DOI: 10.1016/j.prevetmed.2016.11.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not initial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully.
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Affiliation(s)
- Claire E Welsh
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK.
| | - Marco Duz
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Timothy D H Parkin
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK
| | - John F Marshall
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK
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Lindåse S, Nostell K, Bröjer J. A modified oral sugar test for evaluation of insulin and glucose dynamics in horses. Acta Vet Scand 2016; 58:64. [PMID: 27766982 PMCID: PMC5073908 DOI: 10.1186/s13028-016-0246-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background An oral sugar test (OST) using Karo® Light Corn Syrup has been developed in the USA as a field test for the assessment of insulin dysregulation in horses but the syrup is not available in Scandinavian grocery stores. The aim of the study was to compare the results of a modified OST between horses with equine metabolic syndrome (EMS) and healthy horses using a Scandinavian commercially available glucose syrup (Dansukker glykossirap). In addition, the effect of breed and the repeatability of the test were evaluated. In the present study, clinically healthy horses (7 Shetland ponies, 8 Icelandic horses, 8 Standardbred horses) and 20 horses of various breeds with EMS underwent the modified OST test. The Icelandic horses and Shetland ponies underwent the OST twice. Insulin and glucose data from the OST were used to calculate peak insulin concentration (PeakINS), time to peak insulin concentration (T-peakINS), area under the curve for insulin (AUCINS) and glucose (AUCGLU) as well as whole body insulin sensitivity index (ISICOMP). Results Compared to the healthy group, the EMS group had 6–7 times higher geometric mean for PeakINS and AUCINS and 8 times lower geometric mean for ISICOMP. The EMS group had a delayed T-peakINS compared to the healthy group. There was no effect of breed in the group of healthy horses on PeakINS, T-peakINS, AUCINS, AUCGLU and ISICOMP. Coefficient of variation for repeated tests was 19.8, 19.0 and 17.6 % for PeakINS, AUCINS and ISICOMP respectively. Conclusions The results of the present study demonstrate that the modified OST appears to be a practical and useful diagnostic tool for assessment of insulin dysregulation in the horse. However, to make it possible to establish the most appropriate sampling interval and to evaluate the accuracy of the modified OST, further studies in horses with a variable degree of insulin resistance are needed, where results from the modified OST are compared with quantitative measurements for IS.
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Marr CM, Mair TS. EVE and EVJ online collection of equine endocrinology: recent and future directions; a great start, but still a long way to go. Equine Vet J 2016; 46:97-8. [PMID: 24329585 DOI: 10.1111/evj.12217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Dunbar LK, Mielnicki KA, Dembek KA, Toribio RE, Burns TA. Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light-Breed Horses. J Vet Intern Med 2016; 30:885-91. [PMID: 27013065 PMCID: PMC4913564 DOI: 10.1111/jvim.13934] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/26/2016] [Accepted: 02/29/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Several tests have been evaluated in horses for quantifying insulin dysregulation to support a diagnosis of equine metabolic syndrome. Comparing the performance of these tests in the same horses will provide clarification of their accuracy in the diagnosis of equine insulin dysregulation. OBJECTIVES The aim of this study was to evaluate the agreement between basal serum insulin concentrations (BIC), the oral sugar test (OST), the combined glucose-insulin test (CGIT), and the frequently sampled insulin-modified intravenous glucose tolerance test (FSIGTT). ANIMALS Twelve healthy, light-breed horses. METHODS Randomized, prospective study. Each of the above tests was performed on 12 horses. RESULTS Minimal model analysis of the FSIGTT was considered the reference standard and classified 7 horses as insulin resistant (IR) and 5 as insulin sensitive (IS). In contrast, BIC and OST assessment using conventional cut-off values classified all horses as IS. Kappa coefficients, measuring agreement among BIC, OST, CGIT, and FSIGTT were poor to fair. Sensitivity of the CGIT (positive phase duration of the glucose curve >45 minutes) was 85.7% and specificity was 40%, whereas CGIT ([insulin]45 >100 μIU/mL) sensitivity and specificity were 28.5% and 100%, respectively. Area under the glucose curve (AUCg0-120 ) was significantly correlated among the OST, CGIT, and FSIGTT, but Bland-Altman method and Lin's concordance coefficient showed a lack of agreement. CONCLUSIONS Current criteria for diagnosis of insulin resistance using BIC and the OST are highly specific but lack sensitivity. The CGIT displayed better sensitivity and specificity, but modifications may be necessary to improve agreement with minimal model analysis.
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Affiliation(s)
- L K Dunbar
- Ohio State University College of Veterinary Medicine, Columbus, OH
| | - K A Mielnicki
- Ohio State University College of Veterinary Medicine, Columbus, OH
| | - K A Dembek
- Ohio State University College of Veterinary Medicine, Columbus, OH
| | - R E Toribio
- Ohio State University College of Veterinary Medicine, Columbus, OH
| | - T A Burns
- Ohio State University College of Veterinary Medicine, Columbus, OH
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Kaczmarek K, Janicki B, Głowska M. Insulin resistance in the horse: a review. JOURNAL OF APPLIED ANIMAL RESEARCH 2015. [DOI: 10.1080/09712119.2015.1091340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Smith S, Harris PA, Menzies-Gow NJ. Comparison of the in-feed glucose test and the oral sugar test. Equine Vet J 2015; 48:224-7. [DOI: 10.1111/evj.12413] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/01/2015] [Indexed: 01/13/2023]
Affiliation(s)
- S. Smith
- The Royal Veterinary College; London UK
| | - P. A. Harris
- WALTHAM Centre for Pet Nutrition; Waltham on the Wolds Leicestershire UK
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18
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Hofberger S, Gauff F, Licka T. Suspensory ligament degeneration associated with pituitary pars intermedia dysfunction in horses. Vet J 2015; 203:348-50. [DOI: 10.1016/j.tvjl.2014.12.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 12/29/2014] [Accepted: 12/30/2014] [Indexed: 11/28/2022]
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Newkirk KM, Chameroy KA, Tadros EM, Rohrbach BW, Frank N. Pituitary Lesions, Obesity, and Mesenteric Lipomas in Insulin-Resistant Horses. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojvm.2014.49022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sojka-Kritchevsky JE, Johnson PJ. Current status and future directions: Equine pituitary pars intermedia dysfunction and equine metabolic syndrome. Equine Vet J 2013; 46:99-102. [DOI: 10.1111/evj.12194] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - P. J. Johnson
- Veterinary Medicine and Surgery; University of Missouri; Columbia USA
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21
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Frank N, Geor R. Current best practice in clinical management of equine endocrine patients. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- N. Frank
- Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton Massachusetts USA
- Division of Medicine; School of Veterinary Medicine and Science; University of Nottingham; Leicestershire UK
| | - R. Geor
- Large Animal Clinical Sciences; Michigan State University; East Lansing USA
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22
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Marr CM, Mair TS. EVEandEVJonline collection of equine endocrinology: Recent and future directions; a great start but still a long way to go. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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