Equine Endocrine Disorders slides


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Dr. Ryan's presentation from Badger Veterinary Hospital's Caring for Your Geriatric Horse client education seminar on February 13, 2013.

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Equine Endocrine Disorders slides

  1. 1. Equine Endocrine Disorders Clare Ryan, DVM, PhD, DACVIM Badger Veterinary Hospital Client Education Seminar February 7, 2013
  2. 2. Equine Metabolic Syndrome Horses with:  insulin resistance  obesity and/or  regional adiposity  prior or current laminitis.  Are often “easy keepers.” Typical age of onset is 10-20 years. Pony breeds, Morgans, Paso Finos, and Norwegian Fjords most common. Arabians, Quarter Horses, Thoroughbreds, Saddlebreds, Tennessee Walking Horses and Warmbloods have also been diagnosed.
  3. 3. Equine Metabolic Syndrome Clinical signs:  Laminitis – often begins in the spring with rapid growth of grass  Abnormal reproductive cycling in obese mares  General obesity and/or regional adiposity (fat deposits)  Cresty neck, fat deposits around the tailhead, sheath and above the eyes, with occasional subcutaneous masses on the trunk
  4. 4. Testing Insulin/Glucose ratio  EMS horses are “insulin- resistant”, so insulin levels are elevated Leptin Oral Sugar Test:  feed Karo syrup, measure insulin and glucose Combined Glucose-Insulin Test:  Give IV dextrose and insulin, measure glucose and insulin
  5. 5. Treatment Weight loss  Restrictive diet  Dry lot or grazing muzzle  No access to rapidly growing/ spring* grass  No grain or specially formulated low calorie supplement  Levothyroxine (Thyro-L, thyroid supplement) *can happen any time of year!
  6. 6. Treatment Goals Improve insulin sensitivity via:  Weight loss  Exercise  Reduction in carbohydrate (NSC) consumption Continue to monitor weight carefully Repeat insulin: glucose testing
  7. 7. Equine Pars Pituitary Intermedia Dysfunction (PPID ) PPID or “Cushing’s syndrome” A dysfunction of the pituitary gland resulting in increased levels of cortisol. Different disease process than dogs or humans
  8. 8. Equine Cushing’s Disease The age of onset is 7-42 years of age. Over 85% of the horses are > than 15 years of age. Ponies and Morgans have a high incidence of the disease but all breeds can be affected.
  9. 9. Equine Cushing’s Disease Clinical signs vary depending on the stage of disease but include:  Hirsutism- failure to shed a long curly hair coat.  Increased drinking and urination;  intake of water over 25- 30L/day; consistently wet stall  Laminitis  Lethargy or docile attitude  Increased sweating  Ravenous appetite
  10. 10. Equine Cushing’s Disease Clinical signs (continued):  Muscle mass atrophy (sway- backed or pot- bellied appearance)  Regional adiposity  Recurrent infections:  sole abscesses, tooth root infections, sinusitis, and skin disease  Infertility  Blindness  Seizures
  11. 11. Testing For Cushing’s Dexamethasone supression test:  Injection of dexamethasone given, measure cortisol in 19 hours  Seasonal variation ACTH  Single sample  Seasonal variation TRH stimulation test  If screening tests are normal but Cushing’s still suspected
  12. 12. Treatment for Cushing’s There is no cure Pergolide (Prascend®) Cyproheptadine
  13. 13. Supportive Care Keep adequate body condition Monitor clinical signs closely Retest to assess drug dose, progression of disease Management of feet with appropriate farrier care
  14. 14. Does this sound like your horse? Early diagnosis and treatment is the best way to prevent laminitis and other complications. Call to get more information about testing and treating your horse.  Spring is the best time to test!
  15. 15. Questions?
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