Severe hypertriglyceridaemia in horses and ponies with endocrine disorders.

REASONS FOR PERFORMING THE STUDY: Severe hypertriglyceridaemia in horses and ponies with endocrine disorders has been reported anecdotally but has not been documented in the literature. OBJECTIVES: To describe historical and clinicopathological findings as well as progression and outcome in horses and ponies with severe hypertriglyceridaemia (serum triglyceride concentration >5.65 mmol/l) secondary to an endocrine disorder that were otherwise apparently healthy. METHODS: Cases from 6 participating institutions were identified and case details extracted from the medical records. RESULTS: Case details of 3 horses and 4 ponies were available. Presenting complaints included weight loss despite good appetite in 4 animals, while in 3 hypertriglyceridaemia was identified incidentally. All animals were bright and alert and showed a normal or increased appetite. Serum triglyceride concentrations ranged from 10.5 to 60.3 mmol/l. Other abnormalities included hyperglycaemia in 6 animals, suspected insulin resistance and mild to severe increases in hepatic enzyme activities. In 2 animals, moderate hepatic lipidosis was confirmed histologically. Three horses and 3 ponies were diagnosed with pituitary pars intermedia dysfunction based on clinical signs and basal adrenocorticotropic hormone (ACTH) concentrations or dexamethasone suppression test results. In 5 of these, type 2 diabetes mellitus was also confirmed, while one pony suffered from type 2 diabetes mellitus without concurrent pituitary pars intermedia dysfunction. Laboratory abnormalities improved in 4 animals with treatment (pergolide and/or insulin), in one horse specific treatment was not attempted, and in 2 ponies treatment was impaired by the owner or only partly effective. In one of the latter cases, biochemical abnormalities persisted for 7 years without apparent ill effects. CONCLUSIONS AND POTENTIAL RELEVANCE: Horses and ponies may develop severe hypertriglyceridaemia secondary to endocrine disorders that are associated with insulin resistance. Hypertriglyceridaemia can resolve with treatment of the endocrinopathy. Although biochemical evidence of hepatic compromise was present, clinical abnormalities were not noted in these animals.

Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.

REASONS FOR PERFORMING STUDY: Ex vivo evidence suggests that cyclo-oxygenase (COX) 2-preferential inhibitor nonsteroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, have a less detrimental effect on intestinal healing than flunixin meglumine (FM). Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal (SSI) lesions is unknown. OBJECTIVES: To compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM. STUDY DESIGN: Randomised prospective study. METHODS: Cases presenting to the Royal Veterinary College Equine Referral Hospital and Bell Equine Veterinary Clinic during 2010 and 2011 in which an SSI lesion was identified at exploratory laparotomy were eligible for inclusion. Horses received either 1.1 mg/kg bwt FM or 0.6 mg/kg bwt meloxicam i.v. q. 12 h. Clinical outcomes and clinical and laboratory parameters associated with endotoxaemia were compared between groups. RESULTS: Sixty cases were enrolled, 32 horses received FM and 28 received meloxicam. There was no difference in signalment, physical examination or surgical factors between groups. The overall survival to discharge was 81%; there was no difference in survival (P = 0.14) or incidence of post operative ileus (P = 0.25) between groups. There was no significant difference between the plasma lipopolysaccharide (LPS) concentrations at 0 h (P = 0.18) or 48 h (P = 0.60); however, there was a significant difference between neutrophil count at 48 h (P<0.05) and at 96 h (P<0.01) with significantly greater cell numbers in horses receiving meloxicam compared with FM. Blinded pain score evaluation showed that more horses receiving meloxicam showed gross signs of pain than those treated with FM (P = 0.04). CONCLUSIONS: Nonsteroidal anti-inflammatory drug choice did not affect major clinical outcomes in horses with SSI lesions but had some effects on signs of pain. This study provides no evidence to recommend one NSAID treatment above another based on survival or the incidence of ileus; however, evaluation of a larger number of cases is required.