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Topic:Equine Metabolic Syndrome

Equine Metabolic Syndrome (EMS) is a condition in horses characterized by a combination of obesity, insulin resistance, and an increased risk of laminitis. This syndrome is often observed in horses with a predisposition to accumulate fat, particularly in specific areas such as the neck, shoulders, and tailhead. Insulin resistance in horses with EMS can lead to elevated insulin levels, which may contribute to the development of laminitis, a painful and potentially debilitating hoof condition. Research on EMS focuses on understanding its pathophysiology, identifying genetic and environmental risk factors, and developing management strategies to mitigate its effects. This page compiles peer-reviewed research studies and scholarly articles that explore the diagnosis, treatment, and management of Equine Metabolic Syndrome, as well as its implications for equine health and welfare.
Effects of body weight reduction on blood adipokines and subcutaneous adipose tissue adipokine mRNA expression profiles in obese ponies.
The Veterinary record    October 7, 2012   Volume 171, Issue 21 528 doi: 10.1136/vr.100911
Ungru J, Blüher M, Coenen M, Raila J, Boston R, Vervuert I.Fifteen obese ponies were used in a body weight (BW) reduction programme (BWRP, daily energy intake: 7.0-8.4 MJ/100 kg BW). A frequently sampled intravenous glucose tolerance test was used to assess insulin sensitivity. Subcutaneous adipose tissue biopsies of the tail head were obtained for mRNA gene expression profiles of adiponectin, retinol-binding protein 4 (RBP4), interleukin 6 (IL-6) and macrophage activation marker (CD68) before and after BWRP. Blood samples were analysed for serum leptin, serum RBP4 and plasma adiponectin. Significant BW losses occurred with 7 MJ DE/100 kg BW. Serum le...
Short-term incubation of equine laminar veins with cortisol and insulin alters contractility in vitro: possible implications for the pathogenesis of equine laminitis.
Journal of veterinary pharmacology and therapeutics    September 3, 2012   Volume 36, Issue 4 382-388 doi: 10.1111/j.1365-2885.2012.01429.x
Keen JA, McGorum BC, Hillier C, Nally JE.This study investigated the effects of cortisol and insulin, hormones that affect both glycaemic status and vascular function, on the in vitro contractility of isolated healthy equine small laminar veins. Small veins (150-500 μm) draining the digital laminae from healthy horses or ponies were investigated by wire myography. Concentration response curves were constructed for noradrenaline (NA), phenylephrine (PE), endothelin-1 (ET-1) and 5-hydroxytryptamine (5-HT) in the presence of either cortisol (10(-6 ) m) or insulin (1000 μIU/mL). Cortisol significantly increased the maximum contractilit...
Evaluation of high-molecular weight adiponectin in horses.
American journal of veterinary research    August 2, 2012   Volume 73, Issue 8 1230-1240 doi: 10.2460/ajvr.73.8.1230
Wooldridge AA, Edwards HG, Plaisance EP, Applegate R, Taylor DR, Taintor J, Zhong Q, Judd RL.To characterize adiponectin protein complexes in lean and obese horses. Methods: 26 lean horses and 18 obese horses. Procedures-Body condition score (BCS) and serum insulin activity were measured for each horse. Denaturing and native western blot analyses were used to evaluate adiponectin complexes in serum. A human ELISA kit was validated and used to quantify high-molecular weight (HMW) complexes. Correlations between variables were made, and HMW values were compared between groups. Results: Adiponectin was present as a multimer consisting of HMW (> 720-kDa), low-molecular weight (180-kDa)...
Interday variation and effect of transportation on indirect blood pressure measurements, plasma endothelin-1 and serum cortisol in Standardbred and Icelandic horses.
Acta veterinaria Scandinavica    June 10, 2012   Volume 54, Issue 1 37 doi: 10.1186/1751-0147-54-37
Söder J, Bröjer JT, Nostell KE.Systemic hypertension is a prominent feature in humans with metabolic syndrome (MS) and this is partly caused by an enhanced endothelin-1 (ET-1) mediated vasoconstriction. There are indications that systemic hypertension might be a feature in equine metabolic syndrome (EMS) but if ET-1 is involved in the development of hypertension in horses is not known. Increased levels of cortisol have also been found in humans with MS but there are no reports of this in horses. Before blood pressure, plasma ET-1 and serum cortisol can be evaluated in horses with EMS, it is necessary to investigate the inte...
Feeding the foal for immediate and long-term health.
Equine veterinary journal. Supplement    May 19, 2012   Issue 41 149-156 doi: 10.1111/j.2042-3306.2011.00522.x
Becvarova I, Buechner-Maxwell V.The nutrition and nutritional status of the mare, as well as foal's nutrient intake from colostrum, milk and creep feed, are critical factors that are known to influence the growth period of the foal. Long-term effects of mare and foal nutrition are not well recognised or understood in the horse but may have the greatest impact on the animal's health and use when mature. Both under- and overfeeding can negatively influence important characteristics such as bone development and neurological function The risk of developing debilitating diseases such as metabolic syndrome may also be increased by...
Seasonal changes in the combined glucose-insulin tolerance test in normal aged horses.
Journal of veterinary internal medicine    May 18, 2012   Volume 26, Issue 4 1035-1041 doi: 10.1111/j.1939-1676.2012.00939.x
Funk RA, Wooldridge AA, Stewart AJ, Behrend EN, Kemppainen RJ, Zhong Q, Johnson AK.Equine metabolic syndrome (EMS) is an increasingly recognized problem in adult horses. Affected horses are often obese and predisposed to the development of laminitis, especially in the spring and summer months. In addition, in the summer and fall months, increases in endogenous insulin concentrations, a marker of EMS, have been reported. Objective: The purpose of this study was to evaluate seasonal changes in results of the combined glucose-insulin tolerance test (CGIT), a diagnostic test for EMS. Methods: Nine healthy, aged horses with no history of laminitis and no clinical signs of EMS. Me...
A Potential Role for Pro-Inflammatory Cytokines in the Development of Insulin Resistance in Horses.
Animals : an open access journal from MDPI    May 2, 2012   Volume 2, Issue 2 243-260 doi: 10.3390/ani2020243
Suagee JK, Corl BA, Geor RJ.Understanding the mechanisms involved in the development of insulin resistance in horses should enable development of effective treatment and prevention strategies. Current knowledge of these mechanisms is based upon research in obese humans and rodents, in which there is evidence that the increased production of pro-inflammatory cytokines by adipose tissue negatively influences insulin signaling in insulin-responsive tissues. In horses, plasma concentrations of the cytokine, tumor necrosis factor-α, have been positively correlated with body fatness and insulin resistance, leading to the hypo...
Diabetes, insulin resistance, and metabolic syndrome in horses.
Journal of diabetes science and technology    May 1, 2012   Volume 6, Issue 3 534-540 doi: 10.1177/193229681200600307
Johnson PJ, Wiedmeyer CE, LaCarrubba A, Ganjam VK, Messer NT.Analogous to the situation in human medicine, contemporary practices in horse management, which incorporate lengthy periods of physical inactivity coupled with provision of nutritional rations characterized by inappropriately high sugar and starch, have led to obesity being more commonly recognized by practitioners of equine veterinary practice. In many of these cases, obesity is associated with insulin resistance (IR) and glucose intolerance. An equine metabolic syndrome (MS) has been described that is similar to the human MS in that both IR and aspects of obesity represent cornerstones of it...
Managing obesity in pasture-based horses.
Compendium (Yardley, PA)    April 11, 2012   Volume 34, Issue 4 E1-E4 
Becvarova I, Pleasant RS.Obesity - a common problem in pasture-based horses - warrants intervention because it is associated with an increased risk for development of laminitis. Treating obesity in pasture-based horses is relatively simple and generally involves reducing caloric intake by using grazing muzzles and/or increasing caloric expenditure through exercise. To prevent recurrence of obesity after weight loss, clients should be educated on how to monitor body condition and to adjust feeding and management programs to maintain proper body condition.
Voluntary feed intake and leptin sensitivity in ad libitum fed obese ponies following a period of restricted feeding: a pilot study.
Journal of animal physiology and animal nutrition    April 5, 2012   Volume 97, Issue 4 624-631 doi: 10.1111/j.1439-0396.2012.01300.x
Van Weyenberg S, Buyse J, Kalmar ID, Swennen Q, Janssens GP.The relation between plasma leptin and daily ad libitum roughage intake was evaluated during a 14-day period in eight obese Shetland ponies. When the feeding strategy was changed from maintenance feeding to ad libitum feeding, feed intake increased the first day, decreased the second day and increased again during the following days to reach a constant level after 8 days. Plasma leptin concentration increased during the first 2 days, but remained constant afterwards. Although the same pattern was found in all ponies, the magnitude of the increase in leptin on day 1 and the resulting decrease i...
Neutrophil and cytokine dysregulation in hyperinsulinemic obese horses.
Veterinary immunology and immunopathology    November 25, 2011   Volume 145, Issue 1-2 283-289 doi: 10.1016/j.vetimm.2011.11.013
Holbrook TC, Tipton T, McFarlane D.Equine metabolic syndrome is characterized by obesity and regional adiposity coupled with evidence of recurrent laminitis. Although inflammation has been well characterized in several experimental models of acute laminitis, the inflammatory events associated with endocrinopathic laminitis are not well documented. The aim of this study was to characterize selected markers of inflammation in horses with clinical evidence of equine metabolic syndrome (EMS). Neutrophil phagocytosis and oxidative burst, as well as endogenous and stimulated cytokine expression were evaluated. A marked increase in ne...
Effects of the insulin sensitizing drug, pioglitazone, and lipopolysaccharide administration on markers of systemic inflammation and clinical parameters in horses.
Veterinary immunology and immunopathology    October 25, 2011   Volume 145, Issue 1-2 42-49 doi: 10.1016/j.vetimm.2011.10.007
Wearn JG, Suagee JK, Crisman MV, Corl BA, Hulver MW, Hodgson DR, Geor RJ, McCutcheon LJ.Equine metabolic syndrome (EMS) is a condition of obese horses characterized by insulin resistance, systemic inflammation, and an increased risk of laminitis. The pathogenesis of EMS is thought, in part, to be due to inflammatory proteins produced by adipose tissue. Reducing inflammation may decrease the incidence of laminitis in horses with EMS. Pioglitazone hydrochloride, a thiazolidinedione, has efficacy to reduce obesity associated inflammation in humans. Eight normal, adult, horses were administered 1mg/kg pioglitazone for 14 days, and eight horses served as controls. Physical examination...
Metformin in equine metabolic syndrome: an enigma or a dead duck?
Veterinary journal (London, England : 1997)    August 31, 2011   Volume 191, Issue 1 17-18 doi: 10.1016/j.tvjl.2011.08.003
Durham AE.No abstract available
Effects of high and moderate non-structural carbohydrate hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings.
Journal of animal physiology and animal nutrition    May 16, 2011   Volume 96, Issue 3 428-435 doi: 10.1111/j.1439-0396.2011.01159.x
Shepherd ML, Pleasant RS, Crisman MV, Werre SR, Milton SC, Swecker WS.The objective of this study was to determine the effects of high and moderate non-structural carbohydrates (NSC) hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings. Eight adult overweight (average BCS 7 [9-point scale]) Arabian geldings were fed each of two orchardgrass hays, high NSC (18% DM) and moderate NSC (12% DM), in a cross over design during two 28-day periods. Body weight and body condition score assessment along with blood sampling to measure insulin, glucose, leptin, and triglyceride concentrations were performed on days 0, 7, 14, 21 and ...
Pharmacokinetics of pioglitazone after multiple oral dose administration in horses.
Journal of veterinary pharmacology and therapeutics    April 16, 2011   Volume 34, Issue 3 252-258 doi: 10.1111/j.1365-2885.2010.01217.x
Wearn JM, Crisman MV, Davis JL, Geor RJ, Hodgson DR, Suagee JK, Ashraf-Khorassani M, McCutcheon LJ.Pioglitazone is a thiazolidinedione class of antidiabetic agent with proven efficacy in increasing insulin sensitivity in humans with noninsulin-dependent diabetes mellitus, a syndrome of insulin resistance sharing similarities with equine metabolic syndrome. The purpose of this study was to determine the pharmacokinetics of pioglitazone in adult horses following multiple oral dose administration. Pioglitazone hydrochloride (1 mg/kg) was administered orally for 11 doses at 24-h intervals, and plasma samples were collected. Initially, a pilot study was performed using one horse; and thereafter ...
Equine metabolic syndrome.
The Veterinary clinics of North America. Equine practice    March 12, 2011   Volume 27, Issue 1 73-92 doi: 10.1016/j.cveq.2010.12.004
Frank N.The concept of an equine metabolic syndrome (EMS) was first proposed in 2002. This concept has developed over time, and EMS was recently described in a consensus statement released by the American College of Veterinary Internal Medicine. In human medicine, metabolic syndrome (MetS) refers to a set of risk factors that predict the risk of cardiovascular disease, including obesity, glucose intolerance and insulin resistance (IR), dyslipidemia, microalbuminuria, and hypertension. EMS shares some of the features of MetS, including increased adiposity, hyperinsulinemia, IR, but differs in that lami...
Prevalence of obesity in a population of horses in the UK.
The Veterinary record    January 17, 2011   Volume 168, Issue 5 131 doi: 10.1136/vr.c6281
Stephenson HM, Green MJ, Freeman SL.No abstract available
Effect of dietary restriction on body condition, composition and welfare of overweight and obese pony mares.
Equine veterinary journal    September 16, 2010   Volume 42, Issue 7 600-610 doi: 10.1111/j.2042-3306.2010.00110.x
Dugdale AH, Curtis GC, Cripps P, Harris PA, Argo CM.Increased prevalence of obesity among UK horses and ponies demands evidence-based advice to promote weight loss. Objective: Restriction of dry matter intake (DMI) to 1% of body mass (BM, 67% [corrected] of predicted maintenance digestible energy [DE] requirements) would promote weight loss without compromise to health. Methods: Five mature (mean ± s.e. 10 ± 2 years), overweight/obese pony mares (BM, 257 ± 20 kg: body condition score [BCS] 6.8/9 ± 0.5) were studied over 12 weeks. Animals were individually housed. Daily provision of a chaff-based, complete diet (measured DE, 8.5 MJ/kg DM) wa...
Severity and outcome of equine pasture-associated laminitis managed in first opinion practice in the UK.
The Veterinary record    September 8, 2010   Volume 167, Issue 10 364-369 doi: 10.1136/vr.c3206
Menzies-Gow NJ, Stevens K, Barr A, Camm I, Pfeiffer D, Marr CM.Data from 107 cases of pasture-associated laminitis were obtained from first opinion practices to study factors associated with severity, survival and return to ridden exercise. There were 43 mares and 64 geldings, with a median age of 11 years. Of the 107 animals, 33 were small ponies, 45 were large ponies/cobs, 17 were small horses and 12 were large horses. Ninety-seven animals were categorised as having laminitis as defined by Cripps and Eustace (1999): 76 had mild (Obel grade 1 or 2) laminitis and 31 had severe (Obel grade 3 or 4) laminitis. Forty-three animals had previously had laminitis...
Pasture management to minimize the risk of equine laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 361-369 doi: 10.1016/j.cveq.2010.04.007
Watts K.The sugar, starch, and fructan content (collectively referred to as nonstructural carbohydrates [NSC]) of pasture plants is dependent on the environmental conditions under which they have grown. Pasture that is stressed by cold, drought, or lack of nutrients can be 2 to 3 times higher in NSC than pasture that grows quickly in warm weather and is adequately watered and fertilized. Horses at risk for laminitis should have access to pasture limited or be removed completely when environmental conditions are conducive to high levels of NSC accumulation.
Current concepts on the pathophysiology of pasture-associated laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 265-276 doi: 10.1016/j.cveq.2010.06.001
Geor RJ.Epidemiologic studies indicate that most laminitis cases occur in horses and ponies kept at pasture, hence the term 'pasture-associated laminitis'. Clinical cases of laminitis most often occur under conditions that favor accumulation of rapidly fermentable nonstructural carbohydrates (fructans, simple sugars, or starches) in pasture, and animals with an equine metabolic syndrome (EMS) phenotype (insulin resistance, abnormal insulin dynamics, +/- obesity) seem to be at highest risk for developing the condition. Although the mechanisms linking consumption of pasture forage with development of la...
Voluntary intake and digestibility of teff hay fed to horses.
Journal of animal science    June 25, 2010   Volume 88, Issue 10 3296-3303 doi: 10.2527/jas.2009-2668
Staniar WB, Bussard JR, Repard NM, Hall MH, Burk AO.The objective of this study was to evaluate nutrient composition, voluntary DMI, and apparent DM digestibility of teff hay cut at 3 different stages of maturity to evaluate its potential as a preserved forage for horses. Six mature Quarter Horse mares (12 +/- 3 yr; 553 +/- 39 kg of BW) were used in a replicated balanced Latin square design with 3 periods and 3 maturities of teff hay. Eragrostis tef ('Tiffany' teff) was planted in May and harvested at the boot, early-heading, or late-heading stage of maturity through the summer. Horses were acclimated to a mixture of maturities of teff hay for ...
Endocrinopathic laminitis.
The Veterinary clinics of North America. Equine practice    June 11, 2010   Volume 26, Issue 2 233-237 doi: 10.1016/j.cveq.2010.04.009
McGowan CM.In laminitis occurring in the field, as opposed to laminitis occurring during hospitalization or severe illness, endocrinopathic laminitis is the predominant form of laminitis. Prevalent causes of endocrinopathic laminitis are ECS and EMS. Exclusion of inflammatory or weight bearing causes of laminitis and focussing on the identification and treatment of underlying endocrine conditions will improve laminitis management strategies.
Laminitis and the equine metabolic syndrome.
The Veterinary clinics of North America. Equine practice    June 9, 2010   Volume 26, Issue 2 239-255 doi: 10.1016/j.cveq.2010.04.004
Johnson PJ, Wiedmeyer CE, LaCarrubba A, Ganjam VK, Messer NT.Although much has been written about laminitis in the context of its association with inflammatory processes, recognition is growing that most cases of laminitis examined by veterinarians in private practice are those associated with pasture grazing, obesity, and insulin resistance (IR). The term 'endocrinopathic laminitis' has been adopted to classify the instances of laminitis in which the origin seems to be more strongly associated with an underlying endocrinopathy, such as either IR or the influence of corticosteroids. Results of a recent study suggest that obesity and IR represent the mos...
The pharmacologic basis for the treatment of endocrinopathic laminitis.
The Veterinary clinics of North America. Equine practice    June 8, 2010   Volume 26, Issue 2 303-314 doi: 10.1016/j.cveq.2010.04.006
Durham A.Although the treatment and management of laminitis in the horse requires a holistic and often multidisciplinary approach from the veterinarian, farrier, and nutritionist, this review focuses on pharmacologic interventions that might have prophylactic benefit, specifically in the horse with laminitis as a result of pituitary pars intermedia dysfunction and equine metabolic syndrome.
Diabetes in the horse: a condition of increasing clinical awareness for differential diagnosis and interpretation of tests.
Equine veterinary journal    April 14, 2010   Volume 41, Issue 9 841-843 doi: 10.2746/042516409x471412
Menzies-Gow N.No abstract available
Equine metabolic syndrome.
Journal of veterinary internal medicine    April 2, 2010   Volume 24, Issue 3 467-475 doi: 10.1111/j.1939-1676.2010.0503.x
Frank N, Geor RJ, Bailey SR, Durham AE, Johnson PJ.No abstract available
Seasonal variation in serum concentrations of selected metabolic hormones in horses.
Journal of veterinary internal medicine    April 2, 2010   Volume 24, Issue 3 650-654 doi: 10.1111/j.1939-1676.2010.0500.x
Place NJ, McGowan CM, Lamb SV, Schanbacher BJ, McGowan T, Walsh DM.Determination of adrenocorticotropic hormone (ACTH) concentration is a commonly used test in the evaluation of endocrine causes of equine laminitis, but the concentration in healthy horses can be high at certain times of year, which alters the specificity of the ACTH test. Objective: To determine if circulating concentrations of ACTH, cortisol, glucose, insulin, and thyroxine vary month to month in healthy horses and in horses with equine metabolic syndrome (EMS). Methods: Nine healthy adult horses were studied on their farm/stable over the course of 1 year. After the diagnosis of EMS, 10 lami...
Effects of exercise training on adiposity, insulin sensitivity, and plasma hormone and lipid concentrations in overweight or obese, insulin-resistant horses.
American journal of veterinary research    March 2, 2010   Volume 71, Issue 3 314-321 doi: 10.2460/ajvr.71.3.314
Carter RA, McCutcheon LJ, Valle E, Meilahn EN, Geor RJ.To determine effects of exercise training without dietary restriction on adiposity, basal hormone and lipid concentrations and glucose and insulin dynamics in overweight or obese, insulin-resistant horses. Methods: 12 overweight or obese (body condition score > or = 7), insulin-resistant (insulin sensitivity < or = 1.2 x 10(-4) L/min/mU) geldings. Methods: 4 horses remained sedentary, and 8 horses were exercised for 4 weeks at low intensity and 4 weeks at higher intensity, followed by 2 weeks of detraining. Prior to and after each training period, frequently sampled IV glucose tolerance ...
Influence of sward structure on daily intake and foraging behaviour by horses.
Animal : an international journal of animal bioscience    March 1, 2010   Volume 4, Issue 3 480-485 doi: 10.1017/S1751731109991133
Fleurance G, Duncan P, Fritz H, Gordon IJ, Grenier-Loustalot MF.The spatial heterogeneity of grasslands determines the abundance and quality of food resources for grazing animals. As plants mature, they increase in mass, which allows greater instantaneous intake rates, but the cell wall concentrations increase too, reducing diet quality. In ruminants, daily intake rates are often constrained by the time needed for the ingesta to pass through the rumen, which is influenced by the rate of digestion. It has been suggested that the digestive constraint should have much less effect on hindgut fermenters such as equids. Horses play an increasing role in the mana...