Fat and Foundered: Equine Metabolic Syndrome

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Fat and FounderedEquine Metabolic Syndrome
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Introduction

• Recent survey of Equine Veterinarians revealed 3
  top causes of laminitis
• Cushings Syndrome (PPID)
• Metabolic Syndrome/Insulin Resistance
• Lush Pasture
• Do you have a horse that is often unexplainably
  foot sore?
• Did you know obesity could be linked to
  laminitis?

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What is it?

• Equine Metabolic Syndrome (EMS)
• Obesity
• Regional fat deposits (regional adiposity)
• Insulin resistance
• Laminitis
• Previously thought of as hypothyroidism
• Long recognized syndrome in horses

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Why Metabolic Syndrome?

• Similarity to horse findings
• Obesity
• Insulin resistance
• High blood glucose
• Differences
• Blood pressure
• triglycerides

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Who is affected?

• Young to middle aged horses
• Mares and geldings
• Morgans, Peruvian Pasos, Pasofinos, Tennessee
  Walkers, European Warmbloods, ponies,
  Saddlebreds, Spanish mustangs, Arabs

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Genetic Predisposition?

• Ossabaw Island Swine
• Abandoned by Spanish colonists 500 y ago
• Thrifty Gene
• Survival method for seasons of feasting famine
• Modern captivity excess food
• ?Metabolic Syndrome

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Thrifty Gene

• Genetics of horses allow for extra fat storage
  for winter
• In nature, horses would eat less in winter and
  lose weight by spring
• In confinement, generous amount of food
  constantly available
• More efficient energy metabolism in previously
  mentioned breeds

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Risk of Obesity

• Fat isnt just repository of stored energy
• Adipocytes produce hormones (endocrine and
  paracrine activity)
• Leptin and Resistin
• Pro-inflammatory cytokines
• Raise total body inflammation
• Lower threshold for disease
• Increased weight
• on lamina

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Obesity ? Laminitis

• Prolonged insulin elevation
• Prolonged glucose elevation
• Alters blood flow
• Experimentally induced obesity increases insulin
  resistance

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EMS Diagnosis

• No definitive test
• Fasting insulin
• Fasting blood glucose
• Glucose tolerance testing
• Tests to R/O Cushings
• Blood Leptin

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EMS Diagnosis

• Best predictors of laminitic events
• Basal insulin levels
• Serum Leptin concentration
• Generalized body condition scoring
• Cresty neck scoring

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EMS Diagnosis
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EMS Diagnosis
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EMS Treatment

• Goal?2 pronged approach
• Induce weight loss
• Reduce caloric intake
• Eliminate cereal grains
• Improve insulin sensitivity
• Diet
• exercise

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EMS Treatment

• Induce weight loss
• Quality grass hay 1.5 BDWT/day then lower to
  1.5 of ideal BDWT/day over 2 weeks
• Access to trace mineral and vitamin block
• Eliminate grain pellets
• No access to pasture
• Have hay analyzed
• Non-structural carbohydrate content lt 10 ideal
• Dairy One forage 800-496-3344 30/sample
• Soak in cold water 30 min reduces NSC 50

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EMS Treatment

• Medical
• Vit E up to 10,000 IU/day
• Levothyroxine 4 scoops/day 3-6 months to induce
  weight loss then taper 4 weeks
• Chromium and Magnesium and Vanadium
• Metformin (Glucophage)insulin sensitizing drug
• Clenbuterol (Ventipulmin) for weight loss
• Traditional management of laminitis

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EMS Treatment

• Exercise is key
• 20-30 minutes trot daily
• 5-6 days/week
• Improve insulin sensitivity in 2 weeks

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What can you do?

• 1-9 scale
• 1dead horse walking
• 5 ideal, feel ribs but dont see them
• 67fleshy, difficult to feel ribs, look for fat
  deposits
• 9morbidly obese, crease on back holds water in
  rain

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BCS 1
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BCS 1
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BCS 2-3
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BCS 4
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BCS 5
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BCS 6
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BCS 7 or 8
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BCS 9
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BCS 9
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What can you do?

• Regular exercise for your horse
• Avoid sweet feeds
• Learn the BCS system
• Recognizea fat horse wont be a happy horse for
  long

• Test insulin on horses w/ previous bout of
  laminitis
• Cautiously introduce horses to lush spring and
  fall pasture

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What about pasture grass?

• Spring/fall or immediately after heavy rain
• Horses consume in large quantities
• CHO overload on intestines
• CHO overload contributes to IR

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Questions?