The oral glucose test predicts laminitis risk in ponies fed a diet high in nonstructural carbohydrates

Meier, Alexandra; Laat, Melody A. de; Reiche, Dania; Pollitt, C. C.; Walsh, Donald M.; McGree, James; Sillence, Martin N.

doi:10.1016/j.domaniend.2017.10.008

Cited by 74 publications

(113 citation statements)

References 25 publications

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“…There is an increasing body of evidence that hyperinsulinaemia is directly correlated with laminitis risk, and the results of the present study are consistent with this premise. The small odds ratio for the relationship between recurrence risk and insulin concentration can be explained by the fact that the variability in insulin was large (almost 900 μIU/mL) and the odds ratio represents the change in odds per μIU/mL of insulin, without consideration of where in the range of insulin concentrations an increase might occur.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Laat

Reiche

Sillence

et al. 2019

Veterinary Internal Medicne

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Background Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. Objectives To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. Animals Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). Methods This prospective cohort study collected data on veterinary‐diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non‐endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow‐up data were collected at regular intervals to determine whether the laminitis recurred in the 2‐year period after diagnosis. Results The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2‐year study period increased with basal, fasted serum insulin concentration ( P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0‐20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely ( P = .05) to recur sooner. Conclusions and clinical importance Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Laat

Reiche

Sillence

et al. 2019

Veterinary Internal Medicne

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“…Endocrinopathic laminitis is associated with hyperinsulinemia and is a frequent sequelae to 2 common equine endocrinopathies: equine metabolic syndrome (EMS) and pituitary pars intermedia dysfunction (PPID) . Increased adiposity (generalized or regional, or both) is also a risk factor for the disease .…”

Section: Introductionmentioning

confidence: 99%

“…Hyperinsulinemia can be transient and occur in response to carbohydrate consumption, or it can be persistent, as indicated by basal (resting) hyperinsulinemia, which might result from, or induce, tissue resistance to insulin . Resting hyperinsulinemia, insulin resistance, and abnormal insulin responses to oral carbohydrate can all occur in an insulin‐dysregulated horse or pony (alone or in combination), and any uncontrolled hyperinsulinemia increases an individual's risk of laminitis …”

Section: Introductionmentioning

confidence: 99%

“…15,16 Resting hyperinsulinemia, insulin resistance, and abnormal insulin responses to oral carbohydrate can all occur in an insulin-dysregulated horse or pony (alone or in combination), and any uncontrolled hyperinsulinemia increases an individual's risk of laminitis. 9,17 Given the number of potential underlying causative factors, or combinations thereof, it is important to gain an increased understanding of the complex interplay among these contributing factors in endocrinopathic laminitis. These data would then aid in the understanding, diagnosis, and management of what is currently a challenging condition for practitioners to treat and prevent.…”

mentioning

confidence: 99%

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Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Laat

Sillence

Reiche

2019

Veterinary Internal Medicne

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Background Equine endocrinopathic laminitis is common and can be associated with an underlying endocrinopathy, such as equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID), pasture consumption, or any combination of these factors. Objectives The aim of the study was to improve the risk assessment capabilities of clinicians, and to inform management strategies, for acute endocrinopathic laminitis by prospectively examining the phenotypic, hormonal, and clinical characteristics of the disease in a large cohort. Animals Privately owned horses and ponies (n = 301) of any age, sex, or breed diagnosed with laminitis by a veterinarian. A history of laminitis was acceptable. Methods This was a prospective cohort study. Veterinarians provided information on each case via an online questionnaire after informed consent from the animal's owner, and all data were de‐identified before analysis. Serum insulin and plasma adrenocorticotrophic hormone concentrations were measured in each case. Results Most cases were recruited in spring (109/301; 36.2%). Concurrent EMS and PPID resulted in higher basal insulin concentrations (49 [21.5‐141]; P < .02) than if an animal had a single underlying cause for their laminitis. The insulin concentration was negatively correlated (r 2 = −0.38; P < .001) with the animal's height, being higher in ponies (33[10‐14]; P < .001) than horses (9.5 [3‐25.7]) and was positively correlated (r 2 = 0.12; P = .05) with their grade (severity) of laminitis. Conclusions and Clinical Importance Horses and ponies with concurrent endocrinopathies have more marked hyperinsulinemia. Higher basal insulin concentrations were associated with more severe lameness.

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“…The pathophysiology of endocrinopathic laminitis is complex and still inadequately understood, notably because at this stage we are unable to reconcile how metabolic dysfunction during endocrine disease manifests as lamellar deterioration. However, the growing body of research around endocrinopathic laminitis is at least united, a position somewhat unusual in science, in supporting that hyperinsulinaemia is predictive of laminitis risk . Being insulin‐dysregulated is a fundamental component of EMS, a syndrome that also incorporates an increased risk of laminitis, increased adiposity (regional and/or general) that may be difficult to manage, dyslipidaemia, and altered adipokine concentrations, particularly hypoadiponectinaemia.…”

mentioning

confidence: 99%

Science in brief: Progress in endocrinopathic laminitis research: Have we got a foothold?

Laat

2019

Equine Veterinary Journal

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The oral glucose test predicts laminitis risk in ponies fed a diet high in nonstructural carbohydrates

Cited by 74 publications

References 25 publications

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Science in brief: Progress in endocrinopathic laminitis research: Have we got a foothold?

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