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Old 07-22-2008, 08:27 AM   #1
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Equine Metabolic Syndrome interesting read

http://www.petalia.com.au/Templates/...y_no=2035#ct-3
Equine Metabolic SyndromeKER




Horsemen have known for decades that obesity is an unhealthy condition in horses. In olden times, overweight horses were not common because they were required to toil all day behind a plough or a herd of sheep or cattle. Their reward for a day’s work was suitable feed, but not enough to become too fleshy. Many wore the badges of hard work; their hides scarred from ill-fitting harnesses or overzealous spurring.

In this age, obese horses are more the rule rather than the exception. Despite admonitions by veterinarians and nutritionists to keep horses in moderate body weight, well-meaning horse owners ply their charges with high-calorie concentrates and hay. More times than not, the result is a plump middle-aged horse that is anything but healthy or athletic. He gasps for breath when subjected to mild exercise, and his limbs bear the brunt of unnecessary pounds.

Now, scientists have uncovered yet another reason to keep mature horses slim and conditioned: equine metabolic syndrome. Because it is a relatively novel discovery, scientists are just beginning to learn the intricacies of this disorder. At first, the veterinary community could not agree on a suitable name. In the past, it has been commonly referred to as peripheral Cushing’s syndrome, pseudo-Cushing’s syndrome, hypothyroidism, and insulin resistance syndrome. A mysterious-sounding moniker evolved as well, syndrome X.

Eventually, researchers agreed on the terminology proposed by the World Health Organization to designate this condition: equine metabolic syndrome.

As the accurate diagnosis of equine metabolic syndrome becomes more widespread, researchers are learning more about the causes, signs, and treatments of the disorder. Insulin Resistance: The Root Top
Equine metabolic syndrome is characterized foremost by insulin resistance, defined as a peculiar physiological response to the ingestion of foods digested to glucose or other sugar molecules.

Abundant in certain feedstuffs commonly fed to horses, glucose causes a normal state of hyperglycaemia or elevated sugar in the blood. Hyperglycaemia prompts the release of insulin from the pancreas, which encourages the removal of glucose from the bloodstream by fat or muscle cells. Once in the cells, glucose can be put to work immediately to fuel exercise or growth, or stored as glycogen or fat for later use.

Insulin resistance implies that either the central tissue (liver) or the peripheral tissues (the skeletal muscle or the fat cells) are relatively insensitive to the action of insulin or that the quantity of insulin released by the pancreas in response to hyperglycaemia is diminished. This leaves glucose circulating in the blood. Because glucose levels do not drop, the pancreas continues to discharge insulin, leading to elevated concentrations of insulin in the bloodstream, known as hyperinsulinemia.

What predisposes a horse to insulin resistance? Top
Little is known on this front but responsibility might rest on genetic, gestational, and environmental factors. In humans, causative factors are well documented: aging, pregnancy, smoking, reduced physical activity, and obesity. In genetically susceptible humans, glucose intolerance can lead to noninsulin-dependent diabetes mellitus.

In the equine model, obesity appears to be related to the onset of metabolic syndrome. One suggested cause is that certain fat cells produce cortisol, among other hormones, which interferes with the ability of insulin to move the glucose into the cell. Because obese horses have more fat cells, more cortisol is produced and there is greater interference with insulin. This explains why weight reduction is effective in increasing insulin sensitivity.

Not all fat horses are insulin resistant. Current beliefs hold that horses whose fat cells produce high levels of leptin as well as cortisol are the ones prone to insulin resistance. Leptin is not causing insulin resistance but is found to be higher in horses that are insulin resistant.

Age and diet may be directly related to the development of equine metabolic syndrome. Age is thought to decrease the horse’s sensitivity to insulin. Meals high in starch and sugar cause significant spikes in blood glucose and insulin, and years of consuming such meals might lead to insulin resistance.

Obesity-Associated Laminitis Top
An overwhelming clinical sign of equine metabolic syndrome is laminitis, but not the disabling, painful disease related to gastrointestinal failure and endotoxemic insults. The laminitis exhibited by these obese, middle-aged horses tends to be mild. On occasion, so minimal are the laminitic episodes that knowledgeable, conscientious horse owners cannot vouch definitively for any clinical signs of lameness.

The hard evidence speaks a different tale, however. Abnormal hoof growth occurs. Dropped soles, unusual growth lines, and separation of the hoof at the white line are frequently observed. More ****ing, however, is the shifting of the pedal bone within the hoof, which is obvious upon radiography.

But what causes the laminitis? Over the years, the cause of laminitis in obese mature horses has been attributed to:
(1) endocrine disorders, namely hypothyroidism or high cortisol production;
(2) aggravation of a pre-existing laminitis caused by endotoxemia (over consumption of grain, for example); and
(3) mechanical inadequacy due to the stress of excessive weight on soft tissues of the leg.

Regardless of the cause, laminitis is the result of changed circulation to the laminae, the interconnected layers of tissue that insure the integrity of the hoof. In obese horses, researchers believe that insulin insensitivity and vascular spasms may incite changes in the endothelial tissue of the laminae. On a physiological level, this concurs with the circulation problems observed in human patients with noninsulin-resistant diabetes mellitus. Despite well- founded theories, a definitive cause for obesity-associated laminitis remains elusive.

Diagnosis Top
At this time, diagnosis of equine metabolic syndrome is based on description and physical characteristics, results of glucose-tolerance testing, and elimination of similar conditions.

Description and physical characteristics. Affected horses are usually between the ages of 8 and 18, though numerous patients have fallen outside this range. Horses and ponies of nearly all breeds have been diagnosed, though Morgans, Peruvian Pasos, Paso Finos, domesticated Spanish Mustangs, and warmbloods appear to be especially predisposed to the syndrome. As a group, ponies tend to become overweight more readily than horses and are often inclined to suffer from laminitis.

What’s more telling than either age or breed of the patient is distribution of exterior body fat. Areas of unusual fat accumulation include the top of the neck (commonly called the crest), over the shoulders, and the rump (including deposits over the croup and just above the tailhead). Significant fat sometimes settles in the sheaths of geldings or around the teats of mares, so much so that they may appear swollen. Affected broodmares show unusual oestrous cycling, which makes them incredibly difficult to get pregnant.

Anecdotal evidence by owners is also instrumental in diagnosing equine metabolic disease. Owners frequently describe their horses as easy keepers, finding it virtually impossible to reduce the weight of these horses by calorie restriction alone. Many report that high-calorie feeds such
as grain are not being fed.

Results of glucose-intolerance testing. Veterinarians often perform an oral or intravenous glucose tolerance test on horses they suspect to be insulin resistant. Following the administration of glucose, insulin and glucose responses are measured and compared against the responses of normal horses. This test should be performed on a fasted animal so glucose from a recent meal does not shade the results of the assessment.

According to some equine nutritionists, the only truly effective method of diagnosing insulin resistance is the 'euglycemic hyperinsulinemic clamp'. The procedure is complicated, time- consuming, and can be expensive. Because of these limitations, veterinarians typically diagnose on clinical signs alone.

Elimination of similar conditions. In the past, veterinarians often misdiagnosed equine metabolic syndrome, suggesting hypothyroidism or Cushing’s syndrome instead.

In humans, hypothyroidism occurs when the thyroid gland fails to produce sufficient thyroid hormone, leading to clinical manifestations of thyroid insufficiency such as low metabolic rate and tendency to gain weight. In horses, neither obesity nor laminitis develops in mature horses from which the thyroid gland has been removed. Thyroid stimulation tests, designed to gauge thyroid function, fail to identify hypothyroidism. Additionally, the thyroid glands from horses affected with equine metabolic syndrome appear normal. Hence, it is clear that the combination of obesity and laminitis are not always ramifications of inadequate thyroid hormone production.

Also mistaken for equine metabolic disease is Cushing’s syndrome. This endocrine disorder involves dysfunction of the pituitary gland pars intermedia. Using tests most commonly administered to verify Cushing’s syndrome (including the dexamethasone suppression test), veterinarians yielded negative results on these obese, laminitic horses. The pituitary glands of these horses also revealed no pathology, leading researchers to believe that Cushing’s syndrome was not to be blamed for the signs.

Misdiagnosis of Cushing’s syndrome is understandable as a few of the clinical symptoms are shared by individuals with equine metabolic syndrome: abnormal distribution of fat, elevated circulating insulin, glucose intolerance, predisposition to laminitis, and infertility. Other clinical features of Cushing’s are not normally documented in horses suffering from metabolic syndrome, notably an excessively shaggy coat that fails to shed and increased drinking and urination.

Prevention and Treatment Top
Diet. Too many horses eat too many groceries; it’s that simple. The objective of all equine feeding programs should be straightforward: provide sufficient feed to satisfy nutrient requirements for growth, maintenance, or work while maintaining optimal body condition. Optimal should not be confused with maximal or obese.

Optimal body condition can be defined as a nutritional state in which the animal’s ribs can be easily felt with gentle palpation but cannot be seen. Horses become overweight because they consume too many calories in relation to the work asked of them. Those that perform mild to moderate work may need little more than good-quality grass hay or pasture and a complete vitamin and mineral supplement, particularly if they are good doers (able to maintain weight easily). This ration, though simple, is considered low in starch; one important step in dodging equine metabolic syndrome.

Mature horses diagnosed with metabolic syndrome should not be given grain, grain mixes with molasses, or unlimited access to pasture. A balancer pellet (concentrated protein, minerals, and vitamins such as Gold Pellet) can be given to provide essential nutrients without unwanted carbohydrates. If a horse requires additional energy, nonstarch alternatives such as corn oil or stabilised rice bran (Equi-Jewel) can be fed.

The feeding of grain in large quantities should be discouraged, especially in young growing horses. Limited grain intake is important at this stage of life. Horses that are overfed as youngsters are the very ones that are likely to obese in midlife and become prone to laminitis. These horses harbour disproportionate quantities of fat within their abdomens, which in turn makes them more susceptible to metabolic syndrome.

Exercise. In addition to changes in diet, an exercise program should be implemented to slim down overweight horses or prevent them from becoming too heavy. Exercise can be provided in numerous ways: riding, driving, ponying, hand walking, lunging, or long-lining. Not only does exercise ward off obesity, research has shown that it improves insulin sensitivity in horses and ponies. A combination of diet changes and increased exercise is the most effective way to increase insulin sensitivity.

Exercise programs must be designed with the individual in mind. A realistic assessment of the horse must be made and appropriate exercise regime chalked out, especially with horses that are old, unfit, or of questionable soundness. If a horse has suffered a mild bout of laminitis, consultation with a veterinarian and farrier is warranted before any exercise is started.

Medication. No medication is suitable for treating metabolic syndrome. The two most commonly used medications for the management of Cushing’s syndrome, pergolide and cyproheptadine, have proven ineffective for treatment of metabolic syndrome. Both medications have a tendency to limit pancreatic insulin secretion, which only adds to the problem.

Equine metabolic syndrome has emerged on the veterinary scene as a health threat to middle-aged, obese horses. Though deep understanding of the disease has not occurred, a diet and near-daily exercise program that emphasizes moderate body condition may be just enough to elude this dangerous disease.

Last edited by PeggySue; 07-22-2008 at 09:11 AM.
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Old 07-22-2008, 09:42 AM   #2
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Quote:
. . Those that perform mild to moderate work may need little more than good-quality grass hay or pasture and a complete vitamin and mineral supplement, particularly if they are good doers (able to maintain weight easily). This ration, though simple, is considered low in starch; one important step in dodging equine metabolic syndrome.
. . .
Thanks for posting this. After listening to multiple equine nutrition lectures and visiting with several equine nutritionists, I wholeheartedly support the above: horses that perform moderate work don't need tons of grain and do best on good hay or pasture and a good vitamin and mineral supplement.
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Old 07-22-2008, 09:48 AM   #3
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Originally Posted by fishing_trex View Post
Thanks for posting this. After listening to multiple equine nutrition lectures and visiting with several equine nutritionists, I wholeheartedly support the above: horses that perform moderate work don't need tons of grain and do best on good hay or pasture and a good vitamin and mineral supplement.

If we could just get all horse owners to realize this we could save them LOTS and LOTS of money!! Also Ration balancers are great for most everyday horses that don't' do a lot of work and cheaper then most other options running about 50 cents a day
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Old 07-22-2008, 10:09 AM   #4
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If we could just get all horse owners to realize this we could save them LOTS and LOTS of money!! Also Ration balancers are great for most everyday horses that don't' do a lot of work and cheaper then most other options running about 50 cents a day
I know a guy who has a dozen draft horses. They were all way overweight (two were literally off the body condition scoring chart!). He did away with the grain, feeds them only a supplement and hay/grass, and he has cut his feed bill in half or more. And his horses are far healthier as a result. All of our local equine vets are recommending this feeding strategy.
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Old 07-22-2008, 10:32 AM   #5
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It is wonderful to hear the vets are finally catching on so many dont' have a clue when it comes to feeding!!!


I was shocked when I set up a diet for my friends horse and the vet agreed with it becasue it was grain free but then he went on to add a bunch of stuff that is pushing the horse toxic I am scared...
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Old 07-22-2008, 10:53 AM   #6
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I was shocked when I set up a diet for my friends horse and the vet agreed with it becasue it was grain free but then he went on to add a bunch of stuff that is pushing the horse toxic I am scared...
By "then he went on" do you mean your friend or the vet? (I suspect your friend).

There are SO many things out there that companies pedal around that are supposed to help a horse grow feet, get shiny, etc. etc. People see that their horses' hooves aren't perfect or that they don't shine and immediately start feeding a supplement for the feet, and another for the coat, and another for condition X, then condition Y, and so on. I have a riding buddy that, for several years, fed 10 different supplements, all at the same time! Add to that -- she never had her hay tested or her feed evaluated -- she didn't even know what the horses were/were not getting-- Eek!

I'm not saying all supplements are bad -- many are warranted and in many cases, absolutely necessary. It depends on the horse and the horse's job. I'm just saying it's so easy to feed a supplement for this or that, and then to end up feeding so many that often, it's just throwing money into the manure pile.
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Old 07-22-2008, 11:27 AM   #7
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That's a good article, thanks for posting that. I don't think I'll try grain on my horse, shes so laid-back she'd be fat as a corn fed hog on grain.

My horse has never been fed grain and stays really healthy on hay, minerals,graze and a few carrots and apples.
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Old 07-22-2008, 11:48 AM   #8
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Originally Posted by fishing_trex View Post
By "then he went on" do you mean your friend or the vet? (I suspect your friend).

There are SO many things out there that companies pedal around that are supposed to help a horse grow feet, get shiny, etc. etc. People see that their horses' hooves aren't perfect or that they don't shine and immediately start feeding a supplement for the feet, and another for the coat, and another for condition X, then condition Y, and so on. I have a riding buddy that, for several years, fed 10 different supplements, all at the same time! Add to that -- she never had her hay tested or her feed evaluated -- she didn't even know what the horses were/were not getting-- Eek!

I'm not saying all supplements are bad -- many are warranted and in many cases, absolutely necessary. It depends on the horse and the horse's job. I'm just saying it's so easy to feed a supplement for this or that, and then to end up feeding so many that often, it's just throwing money into the manure pile.
The vet added Sho Glo, Sho Hoof in addition to the Progressive Pro Advantage Grass Formula and the horse is breaking out worse after ten days I am seeing right off a Vitamin A and Se toxice levels ... but you have a vet or me who do you believe??
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