Pituitary Lesions, Obesity, and Mesenteric Lipomas in Insulin-Resistant Horses

Newkirk, Kim M.; Chameroy, Kelly A.; Tadros, Elizabeth M.; Rohrbach, Barton W; Frank, Nicholas

doi:10.4236/ojvm.2014.49022

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…A B Although no scientific evidence of the association between obesity and pedunculated lipoma has been proven, Frank [6] has observed that pedunculated lipomas are more common in horses with metabolic alterations. Another author also found a higher frequency of this disease in horses presenting insulin resistance and diffuse pars intermedia hyperplasia [14]. The mare reported in this study had a high BCS, however no metabolic profile was performed.…”

Section: Discussionsupporting

confidence: 58%

Small Intestine Strangulating Obstruction by Mesenteric Pedunculated Lipoma in a Criollo Mare

Souza

Rafael

Mousquer

et al. 2020

Acta Scientiae. Vet.

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Background: The abdominal lipomas are benign tumors of hyperplastic growth that originate from mesenteric adipose tissue, most commonly in the small intestine. Pedunculated lipoma strangulation occurs when the pedicle wraps around an intestinal loop and its mesentery, obstructing the intestinal lumen and blood supply of the affected segment. The aim of the present study is to report a case of a Criollo mare presenting a strangulating obstruction of the jejunum and ileum by a pedunculated lipoma, focusing the discussion in the causes and epidemiology of this alteration.Case: A 24-year-old Criollo mare with a body condition score 8 out of 9 was referred to a Veterinary Clinical Hospital of the Federal University of Pelotas (HCV-UFPel) presenting acute abdominal pain. At the hospital, the mare was presenting mild signs of abdominal discomfort. At the initial clinical exam, the mare had an increased heart and respiratory rates, normal body temperature, hyperemic mucous membranes, capillary refil time of 3 s and absent gut sounds in all four quadrants during auscultation. Mild dehydration was present, increased fibrinogen and serum lactate. Rectal palpation revealed distention of the small intestine by gas, during abdominal ultrassonography the small intestinal wall thickness was found increased. Peritoneal lactate was 11 mmol/L and protein was 6 mg/dL. Due to the clinical findings during the exam, an exploratory celiotomy was performed. Necrosis of the final third of jejunum and the entire extension of ileum was found. Examining the compromised intestinal portion, it was observed a linear structure strangulating two segments of the small intestine. Taking into account the extensive area of irreversible necrosis and the advanced age of the patient, euthanasia was performed. The mare was then referred for necropsy and findings confirmed the strangulation of the final portion of the jejunum and all the extension of the ileum caused by a mesenteric pedunculated lipoma.Discussion: Increased mesenteric fat can predispose horses to the development of mesenteric lipomas. Although there is no scientific evidence of the association of mesenteric lipoma and obesity, it has been observed that pedunculated lipomas are more common in horses with metabolic alterations, for example, Criollo breed, that is potentially predisposed to develop metabolic disturbances. Elderly horses are at the highest risk of colic by mesenteric lipoma, as well as geldings, however, others authors describe that females are more commonly affected. Horses considered of short stature are more predisposed when compared to jumping or race horses. Pedunculated lipoma occurs in 18% of all cases of treated colic and is found more frequently in the small intestine when compared to the smaller colon. In most cases, surgery is indicated and resection of the pedicle and the affected segment may be necessary, however, in this case, the extensive area of intestinal necrosis and the impossibility of externalization of the affected segment lead the decision to proceed with euthanasia. In conclusion, the mare of the present study had an advanced age and a high body condition score, which the authors’ believe were two predisposing factors that increased the risk of it developing a mesenteric lipoma. Considering that, further epidemiologic studies should be conducted to better understand this relation.

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Section: Discussionsupporting

confidence: 58%

Small Intestine Strangulating Obstruction by Mesenteric Pedunculated Lipoma in a Criollo Mare

Souza

Rafael

Mousquer

et al. 2020

Acta Scientiae. Vet.

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“…Abnormal ultrasound appearance of the mesenteric fat has also been described in some inflammatory bowel condition such as Crohn's disease (Maconi et al, 2008). To the authors' knowledge, there is no currently published evidence of a clear link between obesity/increased body mass and increased risk of abdominal lipoma/lipomatosis in horses (Newkirk et al, 2014). However, in the aforementioned study, insulin‐resistant horses and horses with diffuse pituitary hyperplasia (both more likely to suffer from endocrinopathies) were more likely to have incidental lipomas detected on post‐mortem examination compared with controls, and further research is required in this area.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasonographic identification of mesenteric lipomatosis in a Shetland mare with recurrent colic episodes

Lesca

Fairburn

Fitzharris

et al. 2022

Equine Veterinary Education

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An obese 17-year-old Shetland pony mare with a history of recurrent colic episodes was presented for investigation of colic signs of a few hours' duration associated with marked tachycardia. Transabdominal ultrasonography identified a large amount of multilobulated tissue that was hypoechoic to the adjacent retroperitoneal fat within the caudal and ventral abdomen; this could be seen extending dorsally into the mid-abdomen between intestinal structures. At exploratory laparotomy, a lipoma at the mesenteric attachment of the mid-jejunum (considered likely to have caused intermittent extraluminal compression) as well as excessively thick layers of fat in the mesentery of both small and large intestine (compatible with lipomatosis) were identified. The lipoma was removed. Post-operative recovery was uneventful. A strict diet was enforced, resulting in marked weight loss over the 12-week post-surgery period. Follow-up abdominal ultrasound examination identified a reduction in the thickness of the retroperitoneal fat layer and the abnormal multilobulated tissue. This is the first case report detailing the ultrasonographic findings in a case of extensive mesenteric lipomatosis in a pony and describing the ultrasonographic improvement following a weight loss programme.

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“…A retrospective study conducted to assess the short-term survival rate of colic in a group of 300 horses and ponies that underwent exploratory laparotomy identified that 13% of those animals required surgical intervention due to intestinal strangulation by pedunculated lipoma, and the short-term survival rate of those 39 animals was 64.1% [ 43 ]. Interestingly, a recent study that evaluated associations between pituitary lesions, obesity and the presence of mesenteric lipomas in insulin-resistant horses found that whilst insulin-resistant horses had a higher frequency of mesenteric lipomas, there was no association between obesity and the frequency of mesenteric lipomas [ 44 ]. This finding combined with our finding in the current study that mesenteric fat scores were not associated with BCS would perhaps suggest that mesenteric fat scores as opposed to BCS may be associated with the frequency of mesenteric lipomas and may be an area for future study.…”

Section: Discussionmentioning

confidence: 99%

EQUIFAT: A novel scoring system for the semi-quantitative evaluation of regional adipose tissues in Equidae

Morrison

Harris²,

Maltin

et al. 2017

PLoS ONE

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Anatomically distinct adipose tissues represent variable risks to metabolic health in man and some other mammals. Quantitative-imaging of internal adipose depots is problematic in large animals and associations between regional adiposity and health are poorly understood. This study aimed to develop and test a semi-quantitative system (EQUIFAT) which could be applied to regional adipose tissues. Anatomically-defined, photographic images of adipose depots (omental, mesenteric, epicardial, rump) were collected from 38 animals immediately post-mortem. Images were ranked and depot-specific descriptors were developed (1 = no fat visible; 5 = excessive fat present). Nuchal-crest and ventro-abdominal-retroperitoneal adipose depot depths (cm) were transformed to categorical 5 point scores. The repeatability and reliability of EQUIFAT was independently tested by 24 observers. When half scores were permitted, inter-observer agreement was substantial (average κw: mesenteric, 0.79; omental, 0.79; rump 0.61) or moderate (average κw; epicardial, 0.60). Intra-observer repeatability was tested by 8 observers on 2 occasions. Kappa analysis indicated perfect (omental and mesenteric) and substantial agreement (epicardial and rump) between attempts. A further 207 animals were evaluated ante-mortem (age, height, breed-type, gender, body condition score [BCS]) and again immediately post-mortem (EQUIFAT scores, carcass weight). Multivariable, random effect linear regression models were fitted (breed as random effect; BCS as outcome variable). Only height, carcass weight, omental and retroperitoneal EQUIFAT scores remained as explanatory variables in the final model. The EQUIFAT scores developed here demonstrate clear functional differences between regional adipose depots and future studies could be directed towards describing associations between adiposity and disease risk in surgical and post-mortem situations.

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Pituitary Lesions, Obesity, and Mesenteric Lipomas in Insulin-Resistant Horses

Cited by 5 publications

References 24 publications

Small Intestine Strangulating Obstruction by Mesenteric Pedunculated Lipoma in a Criollo Mare

Small Intestine Strangulating Obstruction by Mesenteric Pedunculated Lipoma in a Criollo Mare

Ultrasonographic identification of mesenteric lipomatosis in a Shetland mare with recurrent colic episodes

EQUIFAT: A novel scoring system for the semi-quantitative evaluation of regional adipose tissues in Equidae

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