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.
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
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
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!
Treatment Goals Improve insulin sensitivity via: Weight loss Exercise Reduction in carbohydrate (NSC) consumption Continue to monitor weight carefully Repeat insulin: glucose testing
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
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.
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
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
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
Treatment for Cushing’s There is no cure Pergolide (Prascend®) Cyproheptadine
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
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!