Morphometric, metabolic, and inflammatory markers across a cohort of client-owned horses and ponies on the insulin dysregulation spectrum

Ragno, Valentina M; Klein, Colby D; Sereda, Nicole S; Uehlinger, Fabienne D; Zello, Gordon A.; Robinson, Katherine A.; Montgomery, Julia B.

doi:10.1016/j.jevs.2021.103715

Cited by 5 publications

(3 citation statements)

References 58 publications

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“…However, triglycerides are not necessarily different between normal and hyperinsulinemic horses ( Frank et al , 2006 ). In ponies, a high cresty/fatty neck score is positively associated with triglycerides with no differences between normal weight and obese ponies ( Ragno et al , 2021 ). Triglycerides were not of value in predicting endocrinopathic laminitis ( Fitzgerald et al , 2019b ).…”

Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Kellon¹,

Gustafson²

2023

Open Vet J

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Background: Sodium-Glucose CoTransporter-2 [SGLT2] inhibitors, the -flozin group of drugs, which block glucose reuptake in the renal proximal tubule, are being increasingly used off-label to treat horses with refractory hyperinsulinemia. After two years of use by animals in our group, a horse on canagliflozin was incidentally noted to be hyperlipemic. Case Description: We have been following a cohort of equines (n=20) treated with SGLT2 inhibitors due to refractory hyperinsulinemia. The animals are owned by members of the Equine Cushing’s and Insulin Resistance Group (ECIR) and treated by their attending veterinarians. The index case was a 23 year old gelding with a 2 year history of recurring laminitis that began canagliflozin therapy to control hyperinsulinemia which was no longer responsive to metformin. Between 6-10 weeks post therapy, significant weight loss was noticed. Two days later he was hospitalized with colic symptoms and hyperlipemia but was bright, alert and eating well throughout. Canagliflozin was discontinued and triglycerides returned to normal reference values within 10 days. Subsequent study of 19 other horses on SGLT2 inhibitors revealed varying degrees of hypertriglyceridemia, all asymptomatic. Conclusion: While this class of drugs holds great promise for cases of refractory hyperinsulinemia and laminitis that do not respond to diet or metformin therapy, hypertriglyceridemia is a potential side effect. In our experience, animals remained asymptomatic and eating well. Further study of hypertriglyceridemia in horses on SGLT2 inhibitors and the possible mitigating effect of diet is indicated. To our knowledge, this is the first published report of hypertriglyceridemia with SGLT2 inhibitor treatment in equines.

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Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Kellon¹,

Gustafson²

2023

Open Vet J

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“…An in-feed OST or the use of other commercial glucose mixtures have not been evaluated in this species. Blood biomarkers (cytokines, amino acids and extracellular microvesicles) as well as metabogenomic and lipidomic profiles and their role in the pathogenesis of EMS/ID are being evaluated in horses [52,53]. No data are available for donkeys.…”

Section: Insulin Dysregulationmentioning

confidence: 99%

Metabolic and Endocrine Insights in Donkeys

Mendoza,

Toribio,

Perez-Ecija

2024

Animals

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Donkey medicine is gaining attention due to their increased use as companion animals, in shows, asinotherapy, etc. The increasing demand and unique aspects call for specialized care, requiring new information (physiology, infectious disorders, pharmacology, etc.). Since obesity is common in this species, hyperlipemia, metabolic syndrome and insulin dysregulation (ID) are common disorders in donkeys, in some cases with high mortality, either directly (multiorgan dysfunction) or indirectly due to poor quality of life (chronic laminitis). Donkeys have long-life expectancy and are often afflicted with pituitary pars intermedia dysfunction (PPID), a neurodegenerative and endocrine disease. Hyperlipemia is diagnosed based on high plasma triglyceride concentration in association with clinical findings and laboratory abnormalities from affected tissues (liver, kidney and pancreas). The measurement of resting serum insulin and plasma ACTH concentrations is the first step in ID and PPID diagnosis. In donkeys with clinical signs of ID (obesity or recurrent laminitis) or PPID (hypertrichosis, regional adiposity, laminitis and weight loss), where these hormones are in the normal or non-diagnostic range (donkey-specific cut-off values and reference ranges need to be established), dynamic tests are recommended (oral sugar test or thyrotropin-releasing hormone, respectively). Equine treatment protocols apply to donkeys, although pharmacological studies for most drugs, except pergolide, are lacking.

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“…13,14 In a weight loss study where very obese ponies lost an average of 11.4% bodyweight, BCS was not significantly altered, although belly girth (an objective morphometric measurement) did decrease as it was suggested internal fat was lost. 13 Similarly the cresty neck score (CNS), 15 although it may correlate with measures of insulin dysregulation, 16 is subjectively assessed on a 6-point scale so is not as sensitive to small changes as a neck circumference measurement; and may be more of a feature in particular breeds.…”

Section: Introductionmentioning

confidence: 99%

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

Potter

Erdody

Bamford

et al. 2023

Equine Veterinary Journal

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BackgroundThere 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.ObjectivesTo derive a body condition index (BCI), based on objective morphometric measurements, that correlates with % body fat.Study designRetrospective cohort study.MethodsMorphometric 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.ResultsThe 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 limitationsFurther work may be required to adapt the BCI to a method that is more applicable for Shetlands and miniature ponies.ConclusionsThis 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.

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Morphometric, metabolic, and inflammatory markers across a cohort of client-owned horses and ponies on the insulin dysregulation spectrum

Cited by 5 publications

References 58 publications

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Metabolic and Endocrine Insights in Donkeys

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

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