Arthrospira platensis enriched with Cr(III), Mg(II), and Mn(II) ions improves insulin sensitivity and reduces systemic inflammation in equine metabolic affected horses.

Equine metabolic syndrome (EMS) is a critical endocrine condition in horses, characterized by hyperinsulinemia, hyperlipidemia, and insulin resistance, posing a significant threat to their health. This study investigates the efficacy of supplementing EMS-affected horses with Arthrospira platensis enriched with Cr(III), Mg(II), and Mn(II) ions using biosorption process in improving insulin sensitivity and glucose tolerance, reducing inflammation, and mitigating obesity-related fat accumulation. Our results demonstrate that Arthrospira supplementation reduces baseline insulin and glucose levels, contributing to decreased adipose tissue inflammation. Furthermore, Arthrospira supplementation results in a decrease in body weight and improvements in overall body condition scores and cresty neck scores. Additionally, administration of Arthrospira leads to reduced levels of triglycerides and aspartate aminotransferase, indicating a decrease in hepatic adiposity and inflammation. These findings suggest that Arthrospira, enriched with essential micro- and macroelements, can be an advanced feed additive to enhance insulin sensitivity, promote weight reduction, and alleviate inflammatory processes, thereby improving the overall condition of horses affected by EMS. The use of Arthrospira as a feed additive has the potential to complement conventional management strategies for EMS.

Use of FreeStyle Libre for continuous glucose monitoring in adult horses.

OBJECTIVES: To evaluate the feasibility of using the FreeStyle Libre (a continuous glucose monitoring system [CGMS]) for instantaneous continuous monitoring of interstitial glucose in adult horses and examine the applicability and accuracy of this system in horses submitted to combined glucose-insulin test (CGIT). DESIGN: Laboratory measurements and continuous glucose monitoring system (CGMS) readings were analyzed using a 2 × 2 factorial statistical model with repeated measures over time. This analysis assessed the effects of the test (factor 1), group (factor 2), and their interactions (test × group, test × time, and group × time). Pearson's correlation analysis was applied to blood glucose values. Mean comparisons were conducted using the t-test, and agreement between techniques was assessed via the Bland-Altman method, with a 95% confidence interval. SETTING: Field study on private horse farms in association with a veterinary school. ANIMALS: Ten healthy stallions were assigned to one of two groups based on their body condition scores (BCS). Group 1 (G1, n = 5) consisted of nonobese horses with a BCS of 5 or 6, while Group 2 (G2, n = 5) consisted of obese horses with a BCS of 7 or higher. INTERVENTIONS: A CGMS sensor was attached to the dorsolateral aspect of the proximal one third of each horse's neck. Laboratory blood glucose measurements and CGMS interstitial glucose readings were compared at different time points for up to 7 days after sensor fixation. Obese horses were also submitted to CGIT on Day 4. MEASUREMENTS AND MAIN RESULTS: A comparative analysis of glucose measurements obtained in G1 and G2 horses using the CGMS and enzymatic methods revealed significant group × time interactions (P < 0.001) and time effects (P < 0.001). No interactions were detected between group (P = 0.45), test (P = 0.62), group and test (P = 0.28), or time and test (P = 0.92). In G1 and G2, tests were significantly correlated (r = 0.84 and P = 0.00) at all time points (T0-T5). Agreement between the glucose values obtained using different methods was excellent despite a small time delay in CGMS detection of rapid changes in blood glucose. CONCLUSIONS: It was concluded that the CGMS can be used for indirect assessment of glycemic status (ie, based on interstitial glucose measurements) in nonobese and obese adult horses submitted to CGIT.

Can Nigerian horse owners effectively estimate body condition and cresty neck scores?

A horse's body condition impacts every aspect of its life, including reproduction, performance, and health. Obesity and equine metabolic syndrome (EMS) are common in Nigeria; hence, early identification of a horse's obesity status by the owner is key to avoiding associated health issues such as EMS. Our study aimed to determine whether horse owners could effectively estimate their horses' body condition scores (BCSs) and cresty neck scores (CNSs). A total of 50 adult sedentary West African Barb horses owned by 50 different people were enrolled in the study. Body condition scores (BCSs) and cresty neck scores (CNSs) were assessed on scales of 1-9 and 0-5, respectively, by an experienced veterinarian and owners. The latter had no veterinary background, received no prior education, and assessed their horses based on provided visual aids and descriptions. The BCS estimates of the experienced veterinarian and owners were slightly in agreement (k=0.209), while there was moderate agreement (k=0.547) between the CNS estimates of the experienced veterinarian and the owners. The proportion of obesity based on the experienced veterinarian's estimation (32%) was higher than that of the owners (18%). The proportion of nuchal crest adiposity based on the experienced veterinarian's (38%) estimation was slightly lower than that of the owners (42%). A larger proportion of the owners underestimated their horses' BCSs and CNSs. We conclude that owners cannot effectively estimate their horses' BCSs and CNSs. It is imperative that they are informed about the health issues associated with obesity and are taught how to effectively estimate BCS and CNS.

Effect of phenylbutazone on insulin secretion in horses with insulin dysregulation.

BACKGROUND: Phenylbutazone is often prescribed to manage pain caused by hyperinsulinemia-associated laminitis, but in diabetic people nonsteroidal anti-inflammatory drugs increase insulin secretion and pancreatic activity. HYPOTHESIS/OBJECTIVES: Investigate the effect of phenylbutazone administration on insulin secretion in horses. It was hypothesized that phenylbutazone will increase insulin secretion in horses with insulin dysregulation (ID). ANIMALS: Sixteen light breed horses, including 7 with ID. METHODS: Randomized cross-over study design. Horses underwent an oral glucose test (OGT) after 9 days of treatment with phenylbutazone (4.4 mg/kg IV q24h) or placebo (5 mL 0.9% saline). After a 10-day washout period, horses received the alternative treatment, and a second OGT was performed. Insulin and glucose responses were compared between groups (ID or controls) and treatments using paired t test and analyses of variance with P < .05 considered significant. RESULTS: In horses with ID, phenylbutazone treatment significantly decreased glucose concentration (P = .02), glucose area under the curve (2429 ± 501.5 vs 2847 ± 486.1 mmol/L × min, P = .02), insulin concentration (P = .03) and insulin area under the curve (17 710 ± 6676 vs 22 930 ± 8788 µIU/mL × min, P = .03) in response to an OGT. No significant effect was detected in control horses. CONCLUSION AND CLINICAL IMPORTANCE: Phenylbutazone administration in horses with ID decreases glucose and insulin concentrations in response to an OGT warranting further investigation of a therapeutic potential of phenylbutazone in the management of hyperinsulinemia-associated laminitis beyond analgesia.

Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia.

BACKGROUND: Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. OBJECTIVES: To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). STUDY DESIGN: Cross-sectional. METHODS: Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1-9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms. RESULTS: Among 167 ponies tested, median (range) age was 9 (4-21) years and BCS was 6 (4-8). Prevalence (95% confidence interval [CI]) of ID was 61 (53-68)%. Factors associated with insulin concentrations (estimate [95% CI]; µIU/mL) 60 min post-OST were: age (1.07 [1.02-1.11]), CNS (≥3/5, 1.52 [1.04-2.23]) and VASo (≥7/9, 1.75 [1.09-2.79]); and 90 min post-OST were: age (1.08 [1.03-1.12]), CNS (≥3/5, 1.80 [1.22-2.64]), VASo (≥7/9, 2.49 [1.52-4.08]) and sex (male, 0.64 [0.45-0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (-1.34 [-2.01 to -0.67]), sex (female, -6.21 [-11.68 to -0.74]) and VASo (≥7/9, -1.74 [-18.89 to -4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68-12.58]), IR (3.66 [1.26-10.61]) and PPID (11.75 [1.54-89.40]). MAIN LIMITATIONS: Single time-point sampling, laminitis definition and diet analysis. CONCLUSIONS: Ageing, being female and owner-perceived obesity were associated with ID.

Development of a body condition index to estimate adiposity in ponies and horses from morphometric measurements.

BACKGROUND: There is a high prevalence of obesity in ponies and pleasure horses. This may be associated with equine metabolic syndrome and an increased risk of laminitis. Body condition scoring (BCS) systems are widely used but are subjective and not very sensitive. OBJECTIVES: To derive a body condition index (BCI), based on objective morphometric measurements, that correlates with % body fat. STUDY DESIGN: Retrospective cohort study. METHODS: Morphometric measurements were obtained from 21 ponies and horses in obese and moderate body condition. Percentage body fat was determined using the deuterium dilution method and the BCI was derived to give the optimal correlation with body fat, applying appropriate weightings. The index was then validated by assessing inter-observer variation and correlation with % body fat in a separate population of Welsh ponies; and finally, the correlation between BCI and BCS was evaluated in larger populations from studies undertaken in Australia, the United Kingdom and the United States. RESULTS: The BCI correlated well with adiposity in the ponies and horses, giving a Pearson r value of 0.74 (P < 0.001); however, it was found to slightly overestimate the % body fat in leaner animals and underestimate in more obese animals. In field studies, the correlation between BCI and BCS varied particularly in Shetlands and miniature ponies, presumably due to differences in body shape. MAIN LIMITATIONS: Further work may be required to adapt the BCI to a method that is more applicable for Shetlands and miniature ponies. CONCLUSIONS: This BCI was able to provide an index of adiposity which compared favourably with condition scoring in terms of accuracy of estimating adiposity; and was more consistent and repeatable when used by inexperienced assessors. Therefore, this may be a useful tool for assessing adiposity; and may be more sensitive than condition scoring for tracking weight gain or weight loss in individual animals.

The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin-dysregulated horses.

BACKGROUND: A single dose of metformin administered 1 h prior to oral glucose challenge was previously shown to reduce insulinaemic responses in horses with experimentally-induced insulin dysregulation (ID). Targeted administration could be useful for controlling post-prandial hyperinsulinaemia in horses with naturally-occurring ID. OBJECTIVES: The objective was to compare the insulinaemic and glycaemic responses to oral sugar testing (OST) performed at different intervals after a single dose of metformin in horses with naturally-occurring ID. We hypothesised that pre-treatment with one dose of metformin would significantly decrease the insulinaemic response to OST. STUDY DESIGN: Randomised cross-over in vivo experiment. METHODS: Eight university-owned adult horses with naturally-occurring ID underwent OST 1, 2 and 6 h following a single oral dose of metformin (30 mg/kg) or 1 h after placebo (240 mL water) with a 7-day washout between treatments over a period of 3 weeks. Plasma insulin, C-peptide and glucose concentrations were measured at 0, 60 and 90 min after 0.45 mL/kg light corn syrup and the effect of treatment (and the interval since dosing) examined using a mixed effects linear regression model. RESULTS: Metformin treatment had no significant effect on plasma glucose, insulin or C-peptide concentrations at any time point compared with placebo (p > 0.05). For OST 1 h post metformin, median (IQR) plasma insulin was 91.3 (62.4-114.9) µIU/mL at 60 min versus 76.2 (59.1-134.5) for placebo (p = 0.8) and 62.7 (31.4-109.7) at 90 min versus 51.8 (29.2-126.3) for placebo (p = 0.9). MAIN LIMITATIONS: Small sample size may limit identification of more subtle decreases in insulin concentration with metformin pre-dosing. The results of this study are relevant only for one pre-treatment dose (30 mg/kg) which limits extrapolation to predictions about the effects of longer-term metformin administration on insulin and glucose dynamics in the horse. CONCLUSIONS AND CLINICAL IMPORTANCE: The results do not support the use of targeted metformin treatment to reduce post-prandial hyperinsulinaemia in horses with naturally-occurring ID.

Effect of 5'-adenosine monophosphate-activated protein kinase agonists on insulin and glucose dynamics in experimentally induced insulin dysregulation in horses.

BACKGROUND: 5'-adenosine monophosphate-activated protein kinase (AMPK) agonists, particularly resveratrol (RES), have not been extensively evaluated for their effect on insulin dysregulation (ID) in horses. OBJECTIVES: Evaluate the effects of treatment with RES (10 mg/kg PO q12h), metformin (MET; 30 mg/kg PO q12h), and aspirin (ASP; 20 mg/kg PO q24h) on experimentally induced ID. ANIMALS: Thirty-three healthy, adult, light-breed horses. METHODS: Unblinded, placebo-controlled, experimental trial evaluating effects of AMPK agonists (RES, MET, and ASP) on experimentally induced ID. Horses were randomly assigned to a treatment group (RES, MET/ASP, RES/ASP, RES/MET/ASP, or placebo [CON]) after induction of ID with dexamethasone (0.08 mg/kg PO q24h for 7 days). Frequently sampled insulin-modified IV glucose tolerance tests (FSIGTT) and oral sugar tests (OST) were performed at baseline, 7 days after ID, and ID plus 7 days of treatment. Minimal model and OST variables were compared between (1-way ANOVA) and within (1-way ANOVA for repeated measures) groups over time to determine effects of treatment on ID. RESULTS: Administration of dexamethasone for 14 days resulted in significantly altered insulin and glucose dynamics (SI, DI, basal [glucose], and [insulin]) and produced clinical signs of laminitis in 5 out of 33 (15%) of horses included in the study. Combination therapy with RES, MET, and ASP did not significantly improve insulin and glucose dynamics in horses with experimentally induced ID. CONCLUSIONS AND CLINICAL IMPORTANCE: Metabolic testing before glucocorticoid administration should be considered in horses with clinical signs of metabolic syndrome.

Relationships between total adiponectin concentrations and obesity in native-breed ponies in England.

BACKGROUND: Equine metabolic syndrome is a collection of risk factors associated with an increased risk of endocrinopathic laminitis. All affected animals display insulin dysregulation and some may show adiponectin dysregulation and/or excessive adiposity. However, the relationship between obesity and hypoadiponectinaemia in equids remains unclear. OBJECTIVES: To investigate the relationship between obesity and circulating plasma total adiponectin (TA) concentrations in native-breed ponies in England. STUDY DESIGN: Secondary data analysis. METHODS: Data collected for three previous studies were retrospectively analysed and cohorts were pooled where possible (maximum sample size: n = 734 ponies). Correlations between [TA], age, and morphometric measures were assessed using Spearman's correlation coefficient. [TA] was compared between animals of different body condition score (BCS) classification (ideal-weight, overweight, and obese), breed, and body shape using Kruskal-Wallis with Dunn's post hoc tests, and sex using Mann-Whitney U test. The proportions of obese and ideal-weight ponies with basal hyperinsulinaemia and/or hypoadiponectinaemia were compared using a Chi-square test of homogeneity and post hoc z-test. Logistic regression was used to identify factors that may discriminate ponies with hypoadiponectinaemia. RESULTS: [TA] was weakly positively correlated with BCS, height, weight, and weight:height ratio (Spearman's ρ = 0.14-0.29, p < 0.05). There were significant differences in [TA] in ponies with different BCS group classification, body shape, and breed. A greater percentage of obese (54.6%) than ideal-weight ponies (33.1%, p < 0.001) had both normal [TA] and [basal insulin], and a greater percentage of ideal-weight (38.6%) than obese ponies (16.5%, p < 0.001) showed hypoadiponectinaemia. Weight:height and BCS group were significant variables in a logistic regression of hypoadiponectinaemia but model fit and predictive accuracy were poor. MAIN LIMITATIONS: Retrospective study design, only native-breed ponies included. CONCLUSIONS: Morphometric measures such as BCS do not closely reflect [TA]. Circulating [TA] and [basal insulin] should be determined in all animals with predisposing factors, regardless of obesity status.

Insulin dysregulated horses metabolic responses to forage pellets.

Hyperinsulinemia-associated laminitis (HAL) is the primary concern for insulin dysregulated (ID) equids and their insulin response to the consumption of oral, nonstructural carbohydrates (NSC) has been shown to be a risk predictor for HAL development. This randomized, crossover study's objective was to examine the insulinemic responses to 3 forage pellets (1 g/kg BW) (timothy hay, TH, 9.5 % CP & 10 % NSC DM; alfalfa hay, AH, 16.3 % CP & 9.8 % NSC DM; timothy-alfalfa hay; TAH, 17.2 % CP & 9.8 % NSC DM) along with a positive (dehulled oats; OG, 14.7 % CP & 59.7 % NSC DM) and negative dietary challenge control (low-NSC; LNSC, 12.8 % CP & 5.4 % NSC DM) of ID (n = 8; 16.1 ± 2.2 yr; 565.4 ± 99.1 kgs.) and non-ID (NID; n = 7; 17.0 ± 2.8 yr; 583.6 ± 57.9 kgs.) horses. ID horses had higher positive incremental area under the curve for insulin (IAUCi) (ID: 890 ± 925 µIU/mL*minute vs. NID: 225 ± 228 µIU/mL*minute), peak (ID: 101.5 ± 80.72 µIU/mL vs. NID: 25.7 ± 7.2 µIU/mL), and delta (ID: 45.5 ± 77.1 µIU/mL vs. NID: 4.9 ± 5.3 µIU/mL) insulin for all forage pellets compared to NID (p < 0.01). ID horses IAUCi for the forage pellets was not different compared to the LNSC (218 ± 327 µIU/mL*minute) but was different from OG (10,522 ± 4,565 µIU/mL*minute). ID horses' lack of an augmented insulinemic response to the low NSC forage pellets (fed in small amounts) indicates that they could be a safe feedstuff for ID animals.

Comparison of one novel and four established diagnostic tests for insulin dysregulation in ponies.

Several tests have been advocated for diagnosis of insulin dysregulation (ID). Tests using simple sugars may not reflect the response to naturally ingested carbohydrates. This study aimed to evaluate agreement between the oral glucose test (OGT), the oral sugar test (OST), a novel oral test using a proprietary cereal (WEET), the IV combined glucose-insulin tolerance test (CGIT) and fasted basal insulin (FI) for diagnosis of ID. Each of the five tests above was performed on a group of six normal and six insulin dysregulated mixed-breed ponies in a randomised crossover study. Area under the curve (AUC) and maximum concentration of insulin from OGT, OST and WEET showed strong to very strong bivariate correlations (r = 0.85-0.94, and r = 0.87-0.92, respectively; P ≤ 0.001) and were significantly different between tests (associated with dose of carbohydrate) and between CGIT-positive and -negative ponies. Dichotomous results showed substantial agreement between OST and both WEET (κ = 0.65; P = 0.02) and OGT (κ = 0.67; P = 0.01) and between CGIT and both OST (κ = 0.63; P = 0.03) and OGT (κ = 0.67; P = 0.01), and no agreement between FI, which had low sensitivity, and all other tests (κ = 0.15 - 0.31; P > 0. 05). Palatability of WEET was variable, resulting in one pony being excluded for analysis of WEET data. Further work on development of an oral test using a more palatable feedstuff and appropriate cut-offs or diagnostic thresholds for tests of ID is warranted.

Diagnosis of equine endocrinopathies: The value of measuring blood glucose during an oral glucose test.

Blood glucose concentration is often measured during an oral glucose test (OGT), but is not thought to aid in diagnosing insulin dysregulation (ID) or pituitary pars intermedia dysfunction (PPID). The aim of this retrospective study was to investigate whether the change in blood glucose concentration during an OGT aligned with indicators of equine metabolic syndrome or PPID, including serum insulin and plasma ACTH concentrations, clinical observations, age, sex, breed type and the test dose. The cohort included 149 horses, miniature horses, and ponies that had undergone an in-feed OGT and clinical examination between 2015 and 2021. The animals were diagnosed as either metabolically healthy, insulin-dysregulated, having PPID or both endocrinopathies. The mean ± standard error increase in blood glucose during the OGT was 3.41 ± 0.21 mM, and this change showed a weak positive correlation with the increase in serum insulin concentration (r = 0.36; P 0.001), body condition score (BCS; r = 0.26; P = 0.002) and cresty neck score (CNS; r = 0.38; P 0.001). The median [interquartile range] increase in blood glucose for miniature horses (5.25 [2.98-6.5] mM), was more than twice that seen in full-sized horses (2.4 [1.33-3.45] mM; P = 0.03). In metabolically healthy animals the increase in blood glucose during an OGT (+2.2 [1-3.5] mM) was smaller (P 0.001) than in animals with ID (+3.8 [2.73-5.33] mM), or both endocrine diseases (+6.1 [3.6-6.85] mM). There was an effect of the dose of dextrose on the blood glucose response, with higher doses yielding larger responses (P 0.001). The variability in these data support that basal and post-prandial blood glucose responses to an OGT are not appropriate as stand-alone diagnostic markers of ID or PPID. However, the association between blood glucose and CNS supports the use of CNS when evaluating animals for ID.

Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: A randomized, placebo-controlled, double-blind, study.

BACKGROUND: Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease postprandial hyperinsulinemia in ID horses are needed. OBJECTIVES: Compare short-term effects of canagliflozin vs placebo on glucose and insulin responses to an oral sugar test (OST) as well as the effects on body weight and triglyceride concentrations in horses with ID. ANIMALS: Sixteen privately-owned ID horses. METHODS: A single-center, randomized, double-blind, placebo-controlled, parallel design study. The horses were randomized (ratio 1:1) to either once daily PO treatment with 0.6 mg/kg canagliflozin or placebo. The study consisted of an initial 3-day period for obtaining baseline data, a 3-week double-blind treatment period at home, and a 3-day follow-up period similar to the initial baseline period but with continued double-blind treatment. Horses were subjected to an 8-sample OST in the morning of the third day on both visits. RESULTS: Maximal geometric least square (LS) mean insulin concentration (95% confidence interval [CI]) during the OST decreased after 3 weeks of canagliflozin treatment compared with placebo (83.2; 55.4-125.0 vs 215.2; 143.2-323.2 µIU/mL). The geometric LS mean insulin response (insulin AUC0-180 ) for canagliflozin-treated horses was >66% lower compared with placebo. Least square mean body weight decreased by 11.1 (4-18.1) kg and LS mean triglyceride concentrations increased by 0.99 (0.47-1.5) mmol/L with canagliflozin treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Canagliflozin is a promising drug for treatment of ID horses that requires future studies.

Development of a Web App to Convert Blood Insulin Concentrations among Various Immunoassays Used in Horses.

The measurement of the blood insulin concentration, and comparison to cut-offs, is essential in diagnosing insulin dysregulation, a common equine endocrinopathy. However, different insulin assays provide disparate results. We aimed to ease comparison between assays by compiling original and published data into a web app to convert insulin measurements from one assay to another. Data were available for ADVIA Centaur insulin chemiluminescent immunoassay (CLIA), Beckman Coulter insulin radioimmunoassay (RIA), Immulite 1000 CLIA, Immulite 2000 CLIA, Immulite 2000 XPi CLIA, Mercodia equine insulin enzyme-linked immunosorbent assay (ELISA), and Millipore porcine insulin RIA. Linear models were fitted for 13 assay pairs using non-decreasing splines, and integrated into this app. Assay comparisons including data from several studies showed a lower performance. This indicates technical variation between laboratories, which has not been described before, but is relevant when diagnostic measurements and cut-offs are provided by different laboratories. Nevertheless, the models' overall high performance (median r2 = 0.94; range 0.57-1.00) supports their use to interpret results from diagnostic insulin measurements when the reference assay is unavailable, and to compare values obtained from different assays.

Evaluation of field-testing protocols to diagnose insulin dysregulation in ponies using a Bayesian approach.

Field tests and their association with laminitis have not been evaluated in large cohorts. The objectives of this study were to evaluate the performance of basal insulin (BI), the oral sugar test (OST) and the insulin tolerance test (ITT) to diagnose ID and investigate their association with laminitis. Insulin dysregulation status was determined in 146 ponies using BI (insulin concentration >20 µIU/mL), an OST (insulin concentration >65 µIU/mL at 60 or 90 min after oral administration of 0.45 mL/kg corn syrup) and an ITT (< 50% reduction in glucose concentration 30 min after intravenous administration of 0.1 IU/kg insulin). Laminitis was identified using modified-Obel scores. A Bayesian approach was used to define the characteristics of the tests and receiver operating characteristic curves were used to assess their association with laminitis. All tests were well tolerated and laminitis was diagnosed in 9% of ponies. Insulin dysregulation was diagnosed in 15% of ponies using BI, 38% using the OST and 54% using the ITT with 11% of ponies positive for all three tests. The sensitivities and specificities of BI, the OST and the ITT to diagnose ID were 0.52 (95% confidence interval [CI], 0.35-0.79) and 0.97 (95% CI, 0.91 - 1.00), 0.84 (95% CI, 0.70 - 0.94) and 0.60 (95% CI, 0.49 - 0.71), and 0.85 (95% CI, 0.68-0.96) and 0.88 (95% CI, 0.75 - 0.97), respectively. Only BI and the OST were associated with laminitis (P = 0.003 and 0.015, respectively).

Equine Metabolic Syndrome: A Complex Disease Influenced by Multifactorial Genetic Factors.

Equine metabolic syndrome (EMS) has become an important issue in modern veterinary medicine and is linked to the common, extremely painful, most-of-the-time performance-terminating hoof laminitis. The growing knowledge in the field of genetic background, inducing environmental factors, diagnosis, treatment and maintenance of affected equines led us to summarise the available information to be used not only for scientific purposes but for fieldwork. In horses, the clinical presentation of EMS includes: obesity or local fat deposition, bilateral lameness or hoof rings attributed to ongoing or previous (pasted) laminitis with the key feature of the occurrence of insulin dysregulation, disturbing the homeostasis within insulin, glucose and lipid metabolism. The management of EMS is based on dietary and fitness discipline; however, intensive research is ongoing in the field of regenerative medicine to develop modern and promising therapies.

Occurrence of equine metabolic syndrome, clinical manifestations, and associated risk factors in Nigeria.

Insulin dysregulation (ID) is central to the pathophysiology of equine metabolic syndrome (EMS), putting the horse at risk of laminitis. There is a paucity of information on the status of EMS in Nigeria. This study aimed to determine the occurrence of EMS, clinical manifestations, and associated risk factors in Nigeria. A cross-sectional study was carried out. Selected horses underwent an insulin 2-step response test to ascertain insulin dysregulation; a physical examination was carried out to diagnose laminitis and obesity. Risk factors were assessed using a questionnaire. The overall prevalence of EMS was 43.10%. Breed and sex were significantly associated with EMS, but age was not. Horses diagnosed with laminitis showed two signs of laminitis, namely, divergent hoof rings and widened white lines. Risk factors significantly associated with the prevalence of EMS were as follows: being a West African Barb horse (60.00%), being a stallion (67.86%), being a leisure horse (67.86%), only walking horses during exercise (68.00%), exercising horses once every 5 months (82.76%), tethering horses to a stake in the ground (67.86%), obesity (92.86%), and abnormal neck crest (83.33%). The risk of ID remains higher in obese horses. However, some of the horses with ID were not obese, indicating that there are other possible underlying causes of EMS.

Prevalence and risk factors for laminitis within the Norwegian pony breed Nordlandshest/Lyngshest.

BACKGROUND: Laminitis is a systemic condition resulting in debilitating pain and structural changes within the feet, and hence has major welfare implications. Causes include endocrine and systemic inflammatory conditions. Ponies are frequently affected, and observations in the field suggest that occurrence of laminitis is also common in Norwegian breeds. The aim of this study was to estimate the prevalence and risk factors for laminitis within the Norwegian pony breed Nordlandshest/Lyngshest. RESULTS: The study was a cross-sectional study based on questionnaires sent to members of the Norwegian Nordlandshest/Lyngshest breed association. Questionnaires were received for 504 animals, of which 464 records were eligible and included in analyses. The population comprised 71 stallions, 156 geldings, and 237 mares, with an age between 1 and 40 years (median and interquartile ranges: 12 (6-18) years). The estimated 3-year period prevalence of laminitis was 8.4% (95% confidence interval (CI95): 6.0-11.3%), whereas lifetime prevalence was 12.5% (CI95: 9.6-15.9%). Mares had a significantly higher period- and lifetime prevalence of laminitis than male horses, and horses 10 years and older had a significantly higher prevalence than younger horses. The lifetime prevalence of laminitis was 3.2% in horses 9 years and younger, whereas from 17.3-20.5% in older horses. Multivariable logistic regression analysis identified age, sex, and regional adiposity as significantly (P < 0.05) associated with the 3-year period outcome of laminitis: Horses older than 9 years had a three-fold increase in the likelihood of having laminitis compared to the younger horses (Odds Ratio (OR)10-14 years = 3.37 (CI95 = 1.19-9.50), OR15-19 years = 3.06 (CI95 = 1.04-9.05), and OR>20 years = 2.70 (CI95 = 0.90-8.02). Mares were more than twice as likely (OR = 2.44 (CI95 = 1.17-5.12) to have laminitis compared to male horses, and horses with regional adiposity had increased odds (OR = 2.35 (CI95 = 1.15-4.82) of laminitis compared to horses without regional adiposity. CONCLUSIONS: Laminitis appears to be a considerable welfare issue in the Norwegian pony breed Nordlandshest/Lyngshest. The identified risk factors age, sex, and regional adiposity highlight the need for improved owner education and awareness of strategies to reduce laminitis risk.

Comparison of a modified 2-step insulin response test performed with porcine zinc insulin and an oral glucose test to detect hyperinsulinemic Icelandic horses.

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.

The effects of obesity and insulin dysregulation on mare reproduction, pregnancy, and foal health: a review.

Obesity is a growing welfare concern in modern equine populations and predisposes horses to disturbances in energy metabolism such as insulin dysregulation. However, equine metabolic syndrome has only been recognized in recent decades. Functioning energy metabolism is pivotal to normal body homeostasis and affects essentially all organ systems, including reproduction. Previous literature suggests that obesity has an effect not only on the reproductive processes in mares but also on offspring health, predisposing the offspring to later-onset orthopedic and metabolic problems. This review focuses on the effects of obesity, insulin dysregulation and hyperinsulinemia on the reproductive functions of mares and the implications on foal health before and after birth. The points of interest are the cyclicity and ovarian function, uterine environment, gestation, the postpartum period, and the newborn foal. The aim is to review the current state of knowledge, and identify outstanding questions that could stimulate future research. This topic is important not only from the equine industry and production perspective but is also relevant for the welfare of future populations and individuals.