Laminitis is a complex and painful condition affecting the hooves of horses, characterized by inflammation and damage to the laminae, the soft tissue structures that secure the hoof wall to the coffin bone. This condition can lead to severe lameness and, in chronic cases, permanent structural changes within the hoof. Factors contributing to laminitis include metabolic disorders, excessive intake of carbohydrates, and mechanical overload, among others. The condition is diagnosed through clinical signs, radiographic imaging, and sometimes histopathological examination. Management strategies often involve dietary modifications, pain relief, and corrective hoof care. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, risk factors, diagnostic approaches, and management strategies for laminitis in horses.
Mlyneková E, Zaťko S, Halo M, Imrich I, Halo M.This study aimed to examine the seasonal dynamics of non-structural carbohydrates in pasture and their relationship to metabolic indicators in horses with a history of laminitis. Thirty Hucul mares were divided into a laminitis group (LG, = 15) and a control group (CG, = 15). Insulin, glucose, fructosamines concentrations and body weight were monitored during four sampling periods (S0-S3), while pasture variables were analyzed during three periods (S1-S3). The concentration of water-soluble carbohydrates was highest in May (126.8 g/kg DM) and measured lower in October (57.9 g/kg DM), while s...
Johnson A, Karam B, Schroeder O, McKaig L, Loesch K.A 12-month-old miniature horse filly was presented because of laminitis, suspected lymphangitis, and pyrexia. Although the filly's initial physical examination and diagnostic tests suggested an infectious etiology, ultrasonographic findings were suspicious for generalized steatitis. This was confirmed histopathology. The filly experienced full recovery with continued resolution of clinical signs at 18 mo after presentation. This case included aspects similar to those of previously reported clinical presentations, as well as long-term follow-up in a breed that is not overrepresented, providing...
McGuire CJ, Knowles EJ, Harris PA, Menzies-Gow NJ.Circulating insulin concentrations are used to quantify risk of laminitis in currently non-laminitic ponies. Basal serum activin A (AA) concentration has previously been positively correlated with serum insulin concentrations 60 minutes (T60) following an oral sugar test (OST) in ponies with equine metabolic syndrome. Therefore, circulating AA might be a useful marker for insulin dysregulation (ID) and laminitis risk. Objective: To explore the relationship between circulating AA concentrations at baseline (T0) and T60 in ponies that developed laminitis within six months and non-laminitic ponie...
Zamith Cunha R, Gobbo F, Morini M, Zannoni A, Mainardi C, D'arpe L, Gramenzi A, Chiocchetti R.A growing body of evidence indicates that the endocannabinoid system (ECS) is essential for controlling the homeostasis of the skin and that the ECS is modified in the presence of skin disease. It is plausible to expect that the lamellar junction of the hoof expresses cannabinoid receptors and that their expression could be affected by lamellar disease. The goal of this study was to characterise the cannabinoid receptor type 1 (CB1R) and type 2 (CB2R) and the G protein-coupled receptor 55 (GPR55) within the dermo-epidermal junction of the hooves of healthy and laminitic horses. The expression ...
Kaufman KL, Suagee-Bedore JK, Johnson SE, Ely KM, Ghajar SJ, McIntosh BM.Forage is essential for equine health and performance, but intake of elevated pasture nonstructural carbohydrates (NSC) may exacerbate metabolic disorders. This study aimed to investigate the influence of laminitis history on metabolic and morphometric responses in grazing horses. Twelve non-pregnant mares (15 ± 3.4 yrs) were selected based on previous diagnosis of laminitis (PRELAM; n=6) or not (NOLAM; n=6). Horses were maintained on 8.5-ha pasture. Weekly pasture samples were clipped at random for nutrient analysis. Monthly blood samples were collected and analyzed for glucose and insulin c...
Tuniyazi M, Tang R, Hu X, Zhang N.Laminitis is a serious health condition that can cause severe pain and lameness in horses. Due to lack of understanding of laminitis, treatments often fail to achieve the desired results. In recent years, we have begun to recognize that laminitis may involve a complex interaction between local and systemic inflammation. Dysbiosis of the gut microbiota has been linked in the development of systemic inflammation, and our previous findings suggest that the development of laminitis is closely linked to the production of harmful metabolites of the gut microbiota. In addition, it was found that loca...
Lopes MAF, Hollenbach E, Schliewert EC, Murphy MA, Corrêa F.A mare was admitted for progressive swelling of the neck, lethargy and anorexia. Radiography revealed perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy revealed pharyngeal and tracheal roof collapse, and a small laceration on the trachea. Treatment with antimicrobials, fluids, and flunixin was initiated. To prevent exacerbation of the emphysema, temporary tracheostomy was performed. Clipping for the tracheostomy revealed a hoofprint mark on the ventral neck. Subsequent endoscopies revealed laceration of the esophagus and guttural pouch septum communicating with the visceral ...
Menzies-Gow NJ, Knowles EJ.Laminitis is a common and painful condition of the equine foot and approximately 90% of cases are associated with insulin dysregulation (ID) that is a central feature of the common endocrine disorder equine metabolic syndrome (EMS) and occurs in a subset of animals with pituitary pars intermedia dysfunction. Additional features of EMS include obesity, altered circulating concentrations of adipokines (particularly adiponectin and leptin) and hypertriglyceridaemia. Obesity, ID, hypoadiponectinaemia, hyperleptinaemia and an altered plasma lipid profile are also features of human metabolic syndrom...
Galinelli NC, Bamford NJ, de Laat MA, Sillence MN, Harris PA, Bailey SR.Insulin dysregulation in horses is characterised by hyperinsulinaemia and/or tissue insulin resistance and is associated with increased risk of laminitis. There is growing evidence in other species that dopamine attenuates insulin release from the pancreas; however, this has yet to be examined in horses. The present study aimed to identify whether there are cells capable of producing or responding to dopamine within the equine gastrointestinal mucosa and pancreas. Tissue samples were collected from the stomach, small and large intestines, and pancreas of six mature horses following euthanasia....
Pratt-Phillips S.Obesity is an important health concern in horses, along with humans and companion animals. Adipose tissue is an inflammatory organ that alters the insulin-signaling cascade, ultimately causing insulin dysregulation and impaired glucose metabolism. These disruptions can increase the risk of metabolic disease and laminitis in horses and may also impact energy metabolism during exercise. A single bout of exercise, along with chronic exercise conditioning, increases insulin sensitivity and glucose disposal via both contraction- and insulin-mediated glucose uptake pathways. Regular exercise also in...
Storms N, de la Rebière G, Franck T, Mouithys Mickalad A, Sandersen C, Ceusters J, Serteyn D.Laminitis is a pathology of the equine digit ultimately leading to a failure of the dermo-epidermal interface. Neutrophil activation is recognized as a major factor in SIRS-associated laminitis and has recently been described in induced endocrinopathic laminitis evidenced by the presence of myeloperoxidase (MPO). Neutrophil extracellular traps (NET) are released with neutrophil activation. This study aimed to investigate the presence and activity of MPO and NET in the lamellar tissue of equids presented with naturally occurring laminitis. Samples of lamellar tissue of five horses and five donk...
Kemp KL, Skinner JE, Bertin FR.Phenylbutazone is often prescribed to manage pain caused by hyperinsulinemia-associated laminitis, but in diabetic people nonsteroidal anti-inflammatory drugs increase insulin secretion and pancreatic activity. Objective: Investigate the effect of phenylbutazone administration on insulin secretion in horses. It was hypothesized that phenylbutazone will increase insulin secretion in horses with insulin dysregulation (ID). Methods: Sixteen light breed horses, including 7 with ID. Methods: Randomized cross-over study design. Horses underwent an oral glucose test (OGT) after 9 days of treatment ...
Paraschou G, Xue C, Egan R, Bolfa P.Lymphoma is a common neoplasm in horses but is reported much less commonly in donkeys. In this case report, we describe the macroscopic, microscopic and immunohistochemical features of a multicentric lymphoma with intestinal and bone marrow involvement. Methods: A geriatric female donkey with history of chronic lameness was found dead. Post-mortem examination revealed advanced emaciation, periodontal disease, left front foot laminitis and multiple, soft, white to yellow tan intestinal transmural masses, up to 12 cm in diameter. Cytology suggested a round cell intestinal neoplasm. The femur of...
Weckman MJ, Karikoski NP, Raekallio MR, Box JR, Kvist L.Equine metabolic syndrome (EMS) is a common welfare problem in horses worldwide. It is characterized by insulin dysregulation (ID), predisposition to laminitis and often obesity. EMS is multifactorial by nature, with both the environment and genetics contributing to the phenotype. Environmental factors, such as feeding and exercise, can be controlled, thus forming the basis for treatment and prevention. Genetic factors, by contrast, are less well-known and not easily controllable. The aim of this study was to identify potential genetic loci influencing ID/EMS in Finnhorses. A single-breed (Fin...
Khaledi KA, Mirshahi A, Sardari K, Azizzadeh M, Ghasemi S.The Turkmen horse is one of the oldest breeds in the world with unique characteristics in agility, endurance and jump, being publicly acclaimed. Laminitis affects the limbs and decreases athletic performance. Radiographic evaluation is essential to confirm the sinking diagnosis in every breed of a horse suffering from laminitis. Since no information about distal phalanx radiographic measurements in this breed has been reported, the current study was designed and conducted. In the present study, 24 clinically sound registered Turkmen horses of both sexes (15 mares and nine stallions) were selec...
Clark BL, Norton EM, Bamford NJ, Randhawa IAS, Kemp KL, McCue ME, Bertin FR, Stewart AJ.Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. Objective: To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). Methods: Cross-sectional. Methods: Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an ...
Macon EL, Harris P, McClendon M, Perron B, Adams A.Hyperinsulinemia-associated laminitis (HAL) is the primary concern for insulin dysregulated (ID) equids and their insulin response to the consumption of oral, nonstructural carbohydrates (NSC) has been shown to be a risk predictor for HAL development. This randomized, crossover study's objective was to examine the insulinemic responses to 3 forage pellets (1 g/kg BW) (timothy hay, TH, 9.5 % CP & 10 % NSC DM; alfalfa hay, AH, 16.3 % CP & 9.8 % NSC DM; timothy-alfalfa hay; TAH, 17.2 % CP & 9.8 % NSC DM) along with a positive (dehulled oats; OG, 14.7 % CP & 59.7 % NSC DM) and negative dietary cha...
Pinnell EF, Hostnik LD, Watts MR, Timko KJ, Thriffiley AA, Stover MR, Koenig LE, Gorman OM, Toribio RE, Burns TA.5'-adenosine monophosphate-activated protein kinase (AMPK) agonists, particularly resveratrol (RES), have not been extensively evaluated for their effect on insulin dysregulation (ID) in horses. Objective: Evaluate the effects of treatment with RES (10 mg/kg PO q12h), metformin (MET; 30 mg/kg PO q12h), and aspirin (ASP; 20 mg/kg PO q24h) on experimentally induced ID. Methods: Thirty-three healthy, adult, light-breed horses. Methods: Unblinded, placebo-controlled, experimental trial evaluating effects of AMPK agonists (RES, MET, and ASP) on experimentally induced ID. Horses were randomly ...
Gomez DE, Dunkel B, Renaud DL, Arroyo LG, Schoster A, Kopper JJ, Byrne D, Toribio RE.Clinicopathological findings and their association with the outcome and development of laminitis in horses with acute diarrhoea has not been investigated in a multicentre study across different geographic regions. Objective: Describe and compare clinicopathologic findings of diarrhoeic horses between different geographic regions, survival rates and factors associated with non-survival and laminitis. Methods: Multicentre retrospective case series. Methods: Information from horses with acute diarrhoea presenting to participating institutions between 2016 and 2020 was collected, and clinicopathol...
Bourebaba L, Kępska M, Qasem B, Zyzak M, Łyczko J, Klemens M, Mularczyk M, Marycz K.Equine metabolic syndrome (EMS) is a steadily growing endocrine disorder representing a real challenge in veterinary practice. As a multifactorial condition, EMS is characterized by three main metabolic abnormalities including insulin resistance, increased adiposity or obesity and hoof laminitis. Adipose tissue dysfunction is recognized as a core pathophysiological determinant of EMS, as it strongly participates to lipotoxicity and systemic metaflammation, both of which have been closely linked to the development of generalized insulin resistance. Besides, sex hormone binding globulin (SHBG) i...
de Laat MA, Fitzgerald DM, Harris PA, Bailey SR.High plasma concentrations of insulin can cause acute laminitis. Ponies and horses with insulin dysregulation (ID) exhibit marked hyperinsulinemia in response to dietary hydrolyzable carbohydrates. Glucagon-like peptide-1 (GLP-1), an incretin hormone released from the gastrointestinal tract, enhances insulin release, and is increased postprandially in ponies with ID. The aim of this study was to determine whether blocking the GLP-1 receptor reduces the insulin response to a high glycemic meal. Five adult ponies were adapted to a cereal meal and then given two feed challenges 24 h apart of a me...
Fortin-Trahan R, Sjolin E, Lack A, de Arbina CL, McFadden-Bennett A, Wang L, Baird JD, Rikihisa Y, Arroyo LG.Potomac horse fever (PHF) is characterized by fever, depression, anorexia, ileus, diarrhea, and occasionally, laminitis. The disease is caused by infection with and/or . Equids of all ages may be affected; however, the condition has not been well-characterized in foals. This report describes clinical signs, laboratory findings, and treatment of 2 foals diagnosed with PHF in southwestern Ontario. Feces submitted for an equine PCR panel tested positive for spp. and were subsequently confirmed to be (Case 1) and (Case 2). Both foals recovered following hospitalization and intensive care. Key ...
Jayathilake WMNK, de Laat MA, Furr M, Risco C, Lacombe VA.Hyperinsulinemia is the key feature of equine metabolic syndrome (EMS) which leads to debilitating sequelae. Hyperinsulinemia-associated laminitis (HAL) is one of the major sequelae of EMS, although the pathophysiological mechanisms are not well elucidated. Using an equine model, we hypothesized that expression of inflammatory markers would be increased in digital lamellae and striated muscle following prolonged hyperinsulinemia. Healthy Standardbred horses (5.4 ± 1.9 years) were alternately assigned to a prolonged euglycemic-hyperinsulinemic clamp (pEHC) or control group (n = 4 per group...
Gomez DE, Arroyo LG, Schoster A, Renaud DL, Kopper JJ, Dunkel B, Byrne D, Toribio RE.An international description of the diagnostic approaches used in different institutions to diagnose acute equine diarrhoea and the pathogens detected is lacking. Objective: To describe the diagnostic approach, aetiological agents, outcome, and development of laminitis for diarrhoeic horses worldwide. Methods: Multicentre retrospective case series. Methods: Information from horses with acute diarrhoea presenting to participating institutions between 2016 and 2020, including diagnostic approaches, pathogens detected and their associations with outcomes, were compared between institutions or geo...
Al-Ansari AS, Golding E, Walshe N, Mooney CT, Duggan V.Equine obesity combined with insulin dysregulation (ID) is a major risk factor associated with laminitis. Some pony breeds appear to be at increased risk. However, little is known regarding the prevalence of obesity or hyperinsulinaemia as evidence of ID in Irish ponies. Objective: To investigate the prevalence of obesity and associated endocrine/metabolic disease conditions in Connemara ponies and to determine if hyperinsulinaemia in these ponies could be predicted by morphometric or metabolic markers. Methods: Cross-sectional study. Methods: The study population included registered Connemara...
Reiser V, Reiser A, Licka TF.To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. Methods: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). Methods: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial ch...
Larsen CD, Wilkinson TE, Roberts GD, Guess SC, Mattoon JS, Sanz MG.To evaluate the radiographic thickness of the dorsal hoof wall in normal draft horse feet. Methods: 33 adult draft horses with no history of laminitis, no clinically obvious lameness, and visibly unremarkable front feet were included. Methods: This was a prospective, descriptive study of clinically normal draft horses' front feet. Lateromedial radiographs were acquired of the front feet. A ratio of the dorsal hoof wall thickness to the length of the distal phalanx (DHWP3 ratio) was calculated. Results: The dorsal hoof wall thickness to length of the distal phalanx was calculated as 0.33 ± 0.0...
Barnabé MA, Elliott J, Harris PA, Menzies-Gow NJ.The hormones insulin and adiponectin are commonly measured in equids because of their involvement in endocrinopathic laminitis. These are currently measured in serum/plasma, although jugular venipuncture can cause stress in some animals and may be impossible in needle-shy individuals. However, both hormones can be measured in saliva in other species. Objective: To determine whether [insulin] and [total adiponectin] are detectable in equine saliva using automated assays and whether saliva collection is associated with changes in stress indicators. Additionally, the correlation between serum and...
Lindåse S, Nostell K, Forslund A, Bergsten P, Bröjer J.Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease postprandial hyperinsulinemia in ID horses are needed. Objective: Compare short-term effects of canagliflozin vs placebo on glucose and insulin responses to an oral sugar test (OST) as well as the effects on body weight and triglyceride concentrations in horses with ID. Methods: Sixteen privately-owned ID horses. Methods: A single-center, randomized, double-blind, placebo-controlled, parallel design study. The horses were randomi...
Ward AB, Harris PA, Argo CM, Watson CA, Burns NM, Neacsu M, Russell WR, Grove-White D, Morrison PK.Native ponies are at increased risk of obesity and metabolic perturbations, such as insulin dysregulation (ID), a key risk factor for endocrinopathic laminitis. Management and feeding practices can be adapted to maintain healthy body condition and support metabolic health, but owners may inadvertently provide their ponies with inappropriate management leading to obesity and exacerbating risk of metabolic disease. Adoption of preventative weight management approaches (WMAs), including regular monitoring of body condition, providing appropriate preserved forage, promoting seasonal weight loss, a...
Durham AE, Frank N, McGowan CM, Menzies-Gow NJ, Roelfsema E, Vervuert I, Feige K, Fey K.Equine metabolic syndrome (EMS) is a widely recognized collection of risk factors for endocrinopathic laminitis. The most important of these risk factors is insulin dysregulation (ID). Clinicians and horse owners must recognize the presence of these risk factors so that they can be targeted and controlled to reduce the risk of laminitis attacks. Diagnosis of EMS is based partly on the horse's history and clinical examination findings, and partly on laboratory testing. Several choices of test exist which examine different facets of ID and other related metabolic disturbances. EMS is controlled ...
Steelman SM, Chowdhary BP, Dowd S, Suchodolski J, Janečka JE.The nutrition and health of horses is closely tied to their gastrointestinal microflora. Gut bacteria break down plant structural carbohydrates and produce volatile fatty acids, which are a major source of energy for horses. Bacterial communities are also essential for maintaining gut homeostasis and have been hypothesized to contribute to various diseases including laminitis. We performed pyrosequencing of 16S rRNA bacterial genes isolated from fecal material to characterize hindgut bacterial communities in healthy horses and those with chronic laminitis. Results: Fecal samples were collected...
Garber A, Hastie P, Murray JA.Gastrointestinal microbiota play a crucial role in nutrient digestion, maintaining animal health and welfare. Various factors may affect microbial balance often leading to disturbances that may result in debilitating conditions such as colic and laminitis. The invention of next-generation sequencing technologies and bioinformatics has provided valuable information on the effects of factors influencing equine gut microbiota. Among those factors are nutrition and management (e.g., diet, supplements, exercise), medical substances (e.g., antimicrobials, anthelmintics, anesthetics), animal-related ...
Frank N, Tadros EM.Abnormalities of insulin metabolism include hyperinsulinaemia and insulin resistance, and these problems are collectively referred to as insulin dysregulation in this review. Insulin dysregulation is a key component of equine metabolic syndrome: a collection of endocrine and metabolic abnormalities associated with the development of laminitis in horses, ponies and donkeys. Insulin dysregulation can also accompany prematurity and systemic illness in foals. Causes of insulin resistance are discussed, including pathological conditions of obesity, systemic inflammation and pituitary pars intermedi...
Karikoski NP, Horn I, McGowan TW, McGowan CM.Endocrinopathic causes of laminitis may be a common underlying causative pathogenesis in first-opinion or field cases presenting with laminitis, as opposed to laminitis produced in inflammatory research models. This study aimed to determine whether evidence of an underlying endocrinopathy was present in horses presented for laminitis to a first-opinion/referral veterinary teaching hospital. A second aim was to compare the signalment of horses and ponies with laminitis with the equine hospital population during the same period. All horses presenting for laminitis at Helsinki University Equine T...
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...
Ayala I, Martos NF, Silvan G, Gutierrez-Panizo C, Clavel JG, Illera JC.No detailed comparative data are available on the hormonal parameters of horses suffering from a number of diseases. The aim of our study was to measure concentrations of cortisol, adrenocorticotropic hormone (ACTH), serotonin, adrenaline and noradrenaline in horses with various diseases and following surgery, to assess the response of the HPA axis and adrenal medulla. Blood samples were obtained from six groups of horses comprising a total of 119 animals as follows: laminitis, acute abdominal syndrome (AAS), castration surgery, acute diseases, chronic diseases and healthy controls. Serum horm...
Menzies-Gow NJ, Harris PA, Elliott J.Certain individuals appear to be predisposed to recurrent pasture-associated laminitis. Previous studies have predominantly investigated risk factors only after disease occurrence. Objective: To investigate risk factors for pasture-associated laminitis prior to disease occurrence. Methods: Prospective cohort study. Methods: Non-laminitic ponies aged ≥7 years were recruited. Body condition score (BCS), height, weight, crest height and thickness were measured and an overnight dexamethasone suppression test performed. Plasma or serum adiponectin, leptin, triglyceride, basal insulin, insulin pos...
Schnabel LV, Fortier LA, McIlwraith CW, Nobert KM.Stem cells are commonly used in equine practice to treat musculoskeletal disorders including tendonitis, osteoarthritis, and more recently laminitis. As the field of regenerative medicine continues to advance, equine practitioners need contemporary information regarding the choice of stem cell type and recommendations regarding clinical implementation of stem cell therapies. Clinicians must also be aware of the limitation in current knowledge regarding stem cells, and the impending regulatory laws that may limit the use of equine stem cells in clinical patients.
Horn R, Bamford NJ, Afonso T, Sutherland M, Buckerfield J, Tan RHH, Secombe CJ, Stewart AJ, Bertin FR.Pituitary pars intermedia dysfunction (PPID) is a commonly described endocrine disorder in higher latitudes of the Northern hemisphere but the description of the disease at lower latitudes and in the Southern hemisphere is limited. Objective: Document the clinical features of PPID at different Australian latitudes and climates, and investigate factors associated with survival, laminitis and insulin dysregulation (ID). Methods: Retrospective study of 274 equids from eight institutions across Australia. Methods: A diagnosis of PPID was based on endogenous ACTH, overnight dexamethasone suppressio...
van Weeren PR, Back W.Musculoskeletal disorders are the most prevalent health problem in aging horses. They are not life threatening, but are painful and an important welfare issue. Chronic joint disease (osteoarthritis) and chronic laminitis are the most prevalent. Treating osteoarthritis in the elderly horse is similar to treating performance horses, but aims at providing a stable situation with optimal comfort. Immediate medical treatment of flare-ups, long-term pain management, and adaptation of exercise and living conditions are the mainstays of treatment. Laminitis in the geriatric horse is related often to p...
Johnson RJ, Rivard C, Lanaspa MA, Otabachian-Smith S, Ishimoto T, Cicerchi C, Cheeke PR, Macintosh B, Hess T.Fructose is a simple sugar present in honey and fruit, but can also exist as a polymer (fructans) in pasture grasses. Mammals are unable to metabolize fructans, but certain gram positive bacteria contain fructanases and can convert fructans to fructose in the gut. Recent studies suggest that fructose generated from bacteria, or directly obtained from the diet, can induce both increased intestinal permeability and features of metabolic syndrome, especially the development of insulin resistance. The development of insulin resistance is driven in part by the metabolism of fructose by fructokinase...
Suagee JK, Corl BA, Crisman MV, Pleasant RS, Thatcher CD, Geor RJ.Obesity and hyperinsulinemia increase the risk of laminitis in horses and ponies. In mares, obesity also has been associated with increased circulating concentrations of the proinflammatory cytokine, tumor necrosis factor (TNF)-α. The association of other proinflammatory cytokines with body condition score (BCS) and insulin requires further determination. Objective: Plasma concentrations of TNF, interleukin (IL)-1β, IL-6, and serum amyloid A (SAA) will positively correlate with BCS or insulin or both in horses. Furthermore, inflammatory protein concentrations will correlate with age and vari...
Tadros EM, Fowlie JG, Refsal KR, Marteniuk J, Schott HC.Hyperinsulinaemia is the suspected component of insulin dysregulation having the strongest association with laminitis and occurs variably in equids with pituitary pars intermedia dysfunction (PPID). Objective: We hypothesised that magnitude of hyperinsulinaemia correlates with laminitis severity in PPID-affected equids. Furthermore, we hypothesised that owners can be unaware of chronic endocrinopathic laminitis. Methods: Cross-sectional study. Methods: Serum insulin concentrations, owner-reported laminitis history and radiographic evidence of laminitis were determined in 38 client-owned horses...
Katz LM, Bailey SR.With the increasing number of studies being published on the different experimental models used to induce and study acute laminitis, the pathophysiological events associated with these various models (i.e. starch overload, oligofructose overload, black walnut extract and hyperinsulinaemia) can be compared more realistically. Within this review, the mechanisms for metabolic vs. inflammatory laminitis are discussed, and the question of how pasture laminitis may fit into any of the proposed mechanisms is addressed.
Morgan RA, McGowan TW, McGowan CM.To determine the prevalence of hyperinsulinaemia in a population of ponies in Queensland, Australia, and identify associated factors. Methods: Breeders or traders of ponies within a 100 km radius of Gatton, Queensland, were recruited for study using an internet database. Clinical and management details were obtained, including body condition score, fat deposition and history or evidence of laminitis. Blood samples were analysed for serum insulin and triglyceride concentrations and plasma adrenocorticotrophic hormone (ACTH) and leptin concentrations following short-term removal from pasture and...
Pollitt CC.The equine hoof capsule protects the softer, more sensitive, structures within. Failure of the connection between hoof and bone (suspensory apparatus of the distal phalanx or SADP) results in the crippling lameness of laminitis. Active basal cell proliferation occurs principally in tubular hoof and proximal and distal lamellae. The remaining lamellae are virtually non-proliferative and the hoof wall moves past the stationary distal phalanx, by controlled activation and inhibition of constituent proteases. The lamellar corium derives most of its blood supply from the branches of the terminal ar...
Johnson PJ, Wiedmeyer CE, Messer NT, Ganjam VK.There is growing recognition that obesity is common and represents a significant detriment to the health of companion animals in a manner similar to that by which it is affecting the human population. As is the case for other species, obesity appears to promote insulin resistance in horses and it is through this pathophysiological process that many of the adverse medical consequences of obesity are being characterized. Equine medical conditions that have been described in the context of obesity and insulin resistance differ from those in humans. Chronic human conditions that have been attribut...
Sanchez LC, Robertson SA.Currently, approaches to pain control in horses are a mixture of art and science. Recognition of overt pain behaviours, such as rolling, kicking at the abdomen, flank watching, lameness or blepharospasm, may be obvious; subtle signs of pain can include changes in facial expression or head position, location in the stall and response to palpation or human interaction. Nonsteroidal anti-inflammatory drugs (i.e. phenylbutazone, flunixin meglumine and firocoxib), opioids (i.e. butorphanol, morphine and buprenorphine) and α2 -adrenergic agonists (i.e. xylazine, detomidine, romifidine and medetomid...
Geor RJ, Harris P.Insulin resistance (IR) and hyperinsulinemia increase risk for development of laminitis in horses and ponies. Obesity also has been associated with heightened risk for laminitis, likely by means of development of IR. Dietary factors, particularly the nonstructural carbohydrate (NSC) load, modulate risk for laminitis in these animals by means of exacerbation of IR or gastrointestinal disturbances that trigger the condition. Specific dietary management strategies to lessen risk for laminitis include caloric restriction to promote weight loss and improve insulin sensitivity in obese animals and s...
Estell KE, Young A, Kozikowski T, Swain EA, Byrne BA, Reilly CM, Kass PH, Aleman M.Klebsiella spp. are implicated as a common cause of bacterial pneumonia in horses, but few reports describe clinical presentation and disease progression. Objective: To describe the signalment, clinicopathologic data, radiographic and ultrasonographic findings, antimicrobial susceptibility, outcome, and pathologic lesions associated with Klebsiella spp. pneumonia in horses. Methods: Forty-six horses from which Klebsiella spp. was isolated from the lower respiratory tract. Methods: Retrospective study. Medical records from 1993 to 2013 at the William R. Pritchard Veterinary Medical Teaching Hos...
Jeffcott LB, Field JR, McLean JG, O'Dea K.The existence of an innate insulin insensitivity in ponies was investigated and compared with the situation in larger breeds of horse. Ponies that were fat or had previously suffered laminitis were found to be far more intolerant to oral glucose loading (1 g/kg bodyweight [bwt]) than normal ponies or Standardbreds. These ponies also exhibited a far greater response in plasma insulin levels after glucose loading. Insulin response tests (0.4 iu/kg bwt insulin intravenously) showed only a minimal and very protracted response in both the fat and laminitic groups. The relevance of these findings in...
Respondek F, Myers K, Smith TL, Wagner A, Geor RJ.Obesity and insulin resistance are risk factors for laminitis in horses and ponies, and diet can play an important role in modulating these risk factors. Dietary supplementation with prebiotic fibers, such as short-chain fructo-oligosaccharides (scFOS), has resulted in improvement of insulin sensitivity in obese dogs and rodents. Thus, we hypothesized that scFOS may reduce insulin resistance in obese horses and designed a study to evaluate the effect of dietary supplementation with scFOS on insulin sensitivity. Eight mature Arabian geldings (BW = 523.0 ± 56.5 kg) with an average BCS of 8 were...
Ayoub C, Arroyo LG, MacNicol JL, Renaud D, Weese JS, Gomez DE.The association of microbiota with clinical outcomes and the taxa associated with colitis in horses remains generally unknown. Objective: Describe the fecal microbiota of horses with colitis and investigate the association of the fecal microbiota with the development of laminitis and survival. Methods: Thirty-six healthy and 55 colitis horses subdivided into laminitis (n = 15) and non-laminitis (n = 39, 1 horse with chronic laminitis was removed from this comparison) and survivors (n = 27) and nonsurvivors (n = 28). Methods: Unmatched case-control study. The Illumina MiSeq platform tar...
Kullmann A, Holcombe SJ, Hurcombe SD, Roessner HA, Hauptman JG, Geor RJ, Belknap J.Recent research suggested that prophylactic digital cryotherapy (ICE) improved lameness scores, diminished histological changes and early laminar inflammatory signalling in horses following oligofructose administration. In clinical practice, horses at risk for sepsis-associated laminitis receive ICE. Evidence to support this practice is lacking. Objective: To determine factors associated with development of laminitis in horses diagnosed with colitis, including ICE. Methods: Multicentre retrospective case series. Methods: Medical records for horses admitted to 2 university hospitals diagnosed w...
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...
Karikoski NP, Patterson-Kane JC, Singer ER, McFarlane D, McGowan CM.Hoof lamellar pathology in horses with pituitary pars intermedia dysfunction (PPID) has not been described previously. Objective: To describe the histomorphometry and pathological lesions in hoof lamellar tissue of animals that had PPID with or without concurrent laminitis, with reference to age-matched controls. We hypothesised that lamellar lesions consistent with laminitis would be associated with PPID, even in animals without current or historical laminitis. Methods: Prospective case-control study. Methods: Mid-dorsal hoof histological sections were obtained post mortem from the forelimbs ...
Clutterbuck AL, Harris P, Allaway D, Mobasheri A.The extracellular matrix (ECM) of connective tissue is constantly being remodelled to allow for growth and regeneration. Normal tissue maintenance requires the ECM components to be degraded and re-synthesised in relatively equal proportions. This degradation is facilitated by matrix metalloproteinases (MMPs) and their proteolytic action is controlled primarily by the tissue inhibitors of metalloproteinases (TIMPs). Both MMPs and TIMPs exist in a state of dynamic equilibrium, with a slight excess of one or the other depending on the need for either ECM breakdown or synthesis. Long-term disrupti...
Frank N, Elliott SB, Chameroy KA, Tóth F, Chumbler NS, McClamroch R.Pituitary pars intermedia dysfunction (PPID) is a risk factor for pasture-associated laminitis, which follows a seasonal pattern. Objective: Hormonal responses to season differ between PPID and unaffected horses. Methods: Seventeen horses aged 8-30 years (14 horses ≥ 20 years of age). Methods: Longitudinal observational study. Blood was collected monthly from August 2007 until July 2008 after pasture grazing and again after overnight stall confinement. Blood hormone and metabolite concentrations were measured and pasture grass samples were analyzed to determine carbohydrate content. Analysis...
Durham AE, Rendle DI, Newton JE.Laminitis in equids is a very common debilitating disease, and insulin resistance (IR) and hyperinsulinaemia are increasingly recognised as important predisposing factors. Pharmacological modification of IR and hyperinsulinaemia might reduce the risk of laminitis. Objective: Metformin, a drug commonly prescribed for treatment of human IR, may also decrease IR in equids. Methods: Eighteen horses and ponies with IR and recurrent laminitis were treated with 15 mg/kg bwt metformin per os q. 12 h. Each animal served as its own control by comparing pre- and post treatment proxies for IR, insulin sen...
