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.
Potter K, Stevens K, Menzies-Gow N.A retrospective treated versus untreated study (study 1) and multicentre prospective cohort study (study 2) were undertaken to determine the prevalence of, and risk factors associated with, acute laminitis in horses treated with corticosteroids. All old treated with corticosteroids January-December 2014 (study 1) and January 2015-February 2017 (study 2) by two first opinion and referral hospitals in UK were included. Additionally, an untreated animal was identified for each treated animal (study one). Signalment, body condition (study 2 only), relevant medical history, primary condition, corti...
van Eps AW, Burns TA.Laminitis is a consequence of primary disease processes elsewhere in the body. The key pathophysiologic events are insulin dysregulation in endocrinopathic laminitis, ischemia in supporting limb laminitis, and inflammation in sepsis-related laminitis. These apparently disparate mechanisms converge to cause lamellar attachment failure through epithelial cell adhesion loss and stretch, possibly mediated by common growth factor signaling pathways. Tissue damage through mechanical distraction, inflammation, pain, and a proliferative epithelial healing response are features of acute laminitis regar...
Meier A, de Laat M, Reiche D, Fitzgerald D, Sillence M.A previous six-week (wk) study demonstrated the potential of the sodium-glucose linked transport inhibitor velagliflozin as a novel treatment for equine insulin dysregulation. The present study examined the safety and efficacy of velagliflozin over 16 wk. of treatment, and over 4 wk. of withdrawal. Twenty-four insulin dysregulated ponies were selected, based on their hyper-responsiveness to a diet challenge meal containing 3.8 g non-structural carbohydrates (NSC)/kg bodyweight (BW). Ponies with serum insulin > 90 μIU/mL either 2 or 4 h after feeding were enrolled, and randomly allocated...
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 ...
Blaue D, Schedlbauer C, Starzonek J, Gittel C, Brehm W, Einspanier A, Vervuert I.The objective of this study was to illuminate the changes in serum NEFA concentrations during a combined glucose-insulin test (CGIT) and basal serum triacylglycerides (TGs) with increasing BW in Shetland ponies and warmblood horses. Therefore, basal blood samples were taken during fasting and a CGIT was performed in 19 healthy equines (10 Shetland ponies, 9 warmblood horses) (t0). After one (t1) and two (t2) year(s) of receiving 200% of their maintenance metabolizable energy requirement, procedures were repeated in the same equines. Sixteen of 19 equines had no signs of insulin dysregulation c...
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...
Finding EJT, Lawson C, Elliott J, Harris PA, Menzies-Gow NJ.Microvesicles are small (up to 1 μm) vesicles found in plasma and other bodily fluids. They are recognised as part of the normal system of inter-cellular communication but altered numbers are also used as biomarkers of disease. Microvesicles have not been studied in detail in the horse but may be relevant to diseases such as laminitis. Identification of equine cell specific microvesicles was performed by developing a panel of cross reactive antibodies to use in flow cytometry to detect microvesicles of platelet, leucocyte and endothelial origin in plasma from healthy ponies and those predis...
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...
Frank N.Equine athletes are affected by 2 major endocrine/metabolic disorders, insulin dysregulation (ID) and pituitary pars intermedia dysfunction. ID is a risk factor for laminitis in horses, which poses the greatest threat to performance because of the damage that it causes to hoof structures. This article includes an in-depth discussion of ID and other risk factors for laminitis that are grouped together as equine metabolic syndrome. As horses age, the risk of pituitary pars intermedia dysfunction increases, and this endocrine disorder may exacerbate preexisting ID and further increase the risk of...
Lindåse S, Müller C, Nostell K, Bröjer J.Information about the effect of nonstructural carbohydrates (NSCs) in forage on the postprandial glucose and insulin response in horses is scarce. This is of interest as postprandial hyperinsulinemia in horses is a risk factor for laminitis. In addition, insulin sensitivity (IS) differs between breeds. The aim was to evaluate the postprandial glucose and insulin response to haylage diets with different NSC content in horses of 2 different breeds and to evaluate the relationship between the postprandial insulin response and measures of IS derived from a frequently sampled intravenous glucose to...
Jacob SI, Murray KJ, Rendahl AK, Geor RJ, Schultz NE, McCue ME.Metabolomics, the study of small-molecule metabolites, has increased understanding of human metabolic diseases, but has not been used to study equine metabolic syndrome (EMS). Objective: (1) To examine the serum metabolome of Welsh Ponies with and without insulin dysregulation before and during an oral sugar test (OST). (2) To identify differences in metabolites in ponies with insulin dysregulation, obesity, or history of laminitis. Methods: Twenty Welsh Ponies (mean ± SD; 13.8 ± 9.0 years) classified as non-insulin dysregulated [CON] (n = 10, insulin 60 mU/L) at 75 minutes ...
Jocelyn NA, Harris PA, Menzies-Gow NJ.The oral sugar test (OST) is used to identify equine insulin dysregulation (ID); however only a dose of 0.15 mL/kg bwt corn syrup has been evaluated. Objective: To determine the effect of varying the dose of corn syrup on insulin and glucose response to the OST and the test's ability to distinguish between ponies with a history of laminitis (PL) and without laminitis (NL). Methods: Randomised crossover experiment. Methods: After an overnight fast, in a three-way randomised crossover study with a 7-day washout, 0.15, 0.3 or 0.45 mL/kg bwt corn syrup was administered orally to eight ponies (5 PL...
Jaqueth AL, Iwaniuk ME, Burk AO.It has been estimated in the United States and abroad that 20%-51% of the equine population suffers from over-conditioning or obesity. The objective of this study was to evaluate the prevalence of over-conditioning in the equine population in Maryland, to characterize weight control measures used, and to ascertain how control measures impact the operation. Over-conditioning was defined as a body condition score of 4 or 5 on a 5-point scale. All licensed horse operators in Maryland were invited to participate in an online survey. A total of 93 farm operators completed the survey with 238 ponies...
Cantarelli C, Dau SL, Stefanello S, Azevedo MS, De Bastiani GR, Palma HE, Brass KE, De La Côrte FD.Owing to the high prevalence of obesity in Crioulo horses, information allowing early diagnosis of equine metabolic syndrome (EMS) and prevention of the associated laminitis is of great value. The aim of this study was to evaluate the occurrence of EMS and the response to an oral sugar test (OST) in obese Crioulo horses. Twenty-two Crioulo horses were allocated into 3 groups according to their body condition score (BCS out of 9) and presence or absence of laminitis as follows: CON (6/22), BCS < 7; OB (8/22), BCS ≥ 7; and LAM (8/22), BCS ≥7 with clinical and/or radiographic signs of lam...
Martin EM, Messenger KM, Sheats MK, Jones SL.Pro-inflammatory cytokines including tumor necrosis factor α (TNFα), IL-1β, IL-6, and IL-8 are potent immune mediators that exacerbate multiple equine diseases such as sepsis and laminitis. Unfortunately, safe and effective cytokine-targeting therapies are lacking in horses; therefore, novel mechanisms of inhibiting cytokine production are critically needed. One potential mechanism for inhibiting cytokine synthesis is elevation of intracellular cyclic AMP (cAMP). In human leukocytes, intracellular cAMP production is induced by activation of E-prostanoid (EP) receptors 2 and 4. These recepto...
Faramarzi B, Lee D, May K, Dong F.There is a need for evidence-based scientific research to address the question of the effectiveness of acupuncture in improving clinical signs of laminitis in horses. The objective of this study was to compare lameness levels before and after 2 acupuncture treatments in horses with chronic laminitis. Twelve adult horses with chronic laminitis received 2 acupuncture treatments 1 week apart. The points were treated using dry needling, hemo-acupuncture, and aqua-acupuncture. Lameness level was objectively evaluated using an inertial sensor-based lameness evaluation system (Lameness Locator), as w...
Lewis SL, Holl HM, Streeter C, Posbergh C, Schanbacher BJ, Place NJ, Mallicote MF, Long MT, Brooks SA.Equine obesity can cause life-threatening secondary chronic conditions, similar to those in humans and other animal species. Equine metabolic syndrome (EMS), primarily characterized by hyperinsulinemia, is often present in obese horses and ponies. Due to clinical similarities to conditions such as pituitary pars intermedia dysfunction (formerly equine Cushing's disease), conclusive diagnosis of EMS often proves challenging. Aside from changes in diet and exercise, few targeted treatments are available for EMS, emphasizing the need for early identification of at-risk individuals to enable imple...
Pazinato FM, Curcio BDR, Fernandes CG, Santos CA, Feijó LS, Varela AS, Nogueira CEW.The objective of this study was to assess the placental vasculature and microcotyledons in pregnant mares with chronic laminitis. Twenty-six pregnant mares were enrolled in the study, 13 had chronic laminitis (Laminitis Group) and 13 were healthy mares (Healthy Group). Arterial systolic pressure and heart rate were measured in the last 30 days of gestation. After foaling, the fetal membranes were grossly evaluated and samples were harvested for histopathologic examination. All mares had digitalized images taken from chorioallantois for histomorphometry analyses (software-NIH ImageJ). Images we...
Spriet M, Espinosa P, Kyme AZ, Stepanov P, Zavarzin V, Schaeffer S, Katzman SA, Galuppo LD, Beylin D.Positron emission tomography (PET) is a highly sensitive, noninvasive imaging technique for quantifying biological functions of tissues. However, at the time of this study, PET imaging applications had not been reported in the horse. The aim of this exploratory study was to determine whether a portable high-resolution PET scanner could be used to image the equine distal limb. Images of the front feet and fetlocks of three research horses, with known lesions localized to the distal front limbs, were acquired under general anesthesia after administration of 18 F-fluorodeoxyglucose (18 F-FDG), wi...
Morgan RA, Keen JA, Walker BR, Hadoke PW.Endocrinopathic laminitis (EL) is a vascular condition of the equine hoof resulting in severe lameness with both welfare and economic implications. EL occurs in association with equine metabolic syndrome and equine Cushing's disease. Vascular dysfunction, most commonly due to endothelial dysfunction, is associated with cardiovascular risk in people with metabolic syndrome and Cushing's syndrome. We tested the hypothesis that horses with EL have vascular, specifically endothelial, dysfunction. Healthy horses (n = 6) and horses with EL (n = 6) destined for euthanasia were recruited. We studied v...
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...
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...
Durham AE.Aging horses may be at particular risk of endocrine disease. Two major equine endocrinopathies, pituitary pars intermedia dysfunction and equine metabolic syndrome, are commonly encountered in an aging population and may present with several recognizable signs, including laminitis. Investigation, treatment, and management of these diseases are discussed. Additionally, aging may be associated with development of rarer endocrinopathic problems, often associated with neoplasia, including diabetes mellitus and other confounders of glucose homeostasis, as well as thyroid, parathyroid, and adrenal d...
Reisinger N, Dohnal I, Nagl V, Schaumberger S, Schatzmayr G, Mayer E.One of the most important hoof diseases is laminitis. Yet, the pathology of laminitis is not fully understood. Different bacterial toxins, e.g. endotoxins or exotoxins, seem to play an important role. Additionally, ingestion of mycotoxins, toxic secondary metabolites of fungi, might contribute to the onset of laminitis. In this respect, fumonsins are of special interest since horses are regarded as species most susceptible to this group of mycotoxins. The aim of our study was to investigate the influence of fumonisin B₁ (FB₁) on primary isolated epidermal and dermal hoof cells, as well as ...
Jordan VJ, Ireland JL, Rendle DI.It is accepted among equine practitioners that glucocorticoid treatment is a risk factor for the development of laminitis. However, there is little published evidence of a link between glucocorticoids and laminitis. Objective: To determine whether horses receiving oral prednisolone are at increased risk of laminitis. Methods: Retrospective case-control study. Methods: Clinical records of horses registered with the ambulatory service at Liphook Equine Hospital between January 2001 and November 2014 were reviewed retrospectively to identify horses that had received treatment with oral prednisolo...
Hatazoe T, Kawaguchi H, Hobo S, Misumi K.Equine pituitary pars intermedia dysfunction (PPID) generally occurs in older horses showing hirsutism, delayed molting, weight loss, polydipsia, polyuria, laminitis, and reproductive disorders (in broodmares), but there have been no reports on stallions. This report presents a case of a 21-year-old Thoroughbred stallion that developed hirsutism and experienced delayed molting. There were no abnormal findings for semen quality or the stallion's sexual desire. The horse was diagnosed with PPID based on dexamethasone suppression test and plasma levels of adrenocorticotropic hormone. It was then ...
Reisinger N, Schaumberger S, Nagl V, Hessenberger S, Schatzmayr G.Laminitis is one of the most common diseases in horses. It is not only painful for the animal, but also has a significant financial impact on the equine industry. This multifactorial disease affects the connective tissue of the hoof. However, the pathogenesis of laminitis is still not fully understood. Endotoxins, also known as lipopolysaccharides (LPS), and bacterial exotoxins seem to play an important role during the development of laminitis. The aim of our study was to investigate the effect of increasing LPS concentrations (0, 2.5, 5, 10, and 100 μg/mL) on cell viability of isolated epide...
Campolo A, de Laat MA, Keith L, Gruntmeir KJ, Lacombe VA.Insulin dysregulation is common in horses although the mechanisms of metabolic dysfunction are poorly understood. We hypothesized that insulin signaling in striated (cardiac and skeletal) muscle and lamellae may be mediated through different receptors as a result of receptor content, and that transcriptional regulation of downstream signal transduction and glucose transport may also differ between tissues sites during hyperinsulinemia. Archived samples from horses treated with a prolonged insulin infusion or a balanced electrolyte solution were used. All treated horses developed marked hyperin...
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...
Spelta CW.Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology has been suggested to initiate the neurodegeneration. While hypertrichosis (formerly known as hirsutism) is considered pathognomic for advanced disease, the antemortem diagnosis of subclinical and early disease has continued to prove difficult. Numerous tests have been used with varying sensitivities and specificities. The overnight dexamethasone suppression test, originally do...
Fontaine GL, Belknap JK, Allen D, Moore JN, Kroll DL.To study expression of interleukin-1beta (IL-1beta) in the digital laminae of horses in the prodromal stage of experimentally induced laminitis. Methods: 8 healthy adult horses with no signs of laminitis. Methods: Black walnut extract was administered via nasogastric tube to 4 horses, and water was administered to the remaining 4 (controls). Complete blood counts and physical examinations were performed every 30 minutes after administration of black walnut extract or water. General anesthesia was induced when total WBC count decreased by 30% in horses given the black walnut extract and 3 hours...
Potter K, Stevens K, Menzies-Gow N.A retrospective treated versus untreated study (study 1) and multicentre prospective cohort study (study 2) were undertaken to determine the prevalence of, and risk factors associated with, acute laminitis in horses treated with corticosteroids. All old treated with corticosteroids January-December 2014 (study 1) and January 2015-February 2017 (study 2) by two first opinion and referral hospitals in UK were included. Additionally, an untreated animal was identified for each treated animal (study one). Signalment, body condition (study 2 only), relevant medical history, primary condition, corti...
Reisinger N, Schaumberger S, Nagl V, Hessenberger S, Schatzmayr G.Laminitis is one of the most common diseases in horses. It is not only painful for the animal, but also has a significant financial impact on the equine industry. This multifactorial disease affects the connective tissue of the hoof. However, the pathogenesis of laminitis is still not fully understood. Endotoxins, also known as lipopolysaccharides (LPS), and bacterial exotoxins seem to play an important role during the development of laminitis. The aim of our study was to investigate the effect of increasing LPS concentrations (0, 2.5, 5, 10, and 100 μg/mL) on cell viability of isolated epide...
Craig DR, Shivy DR, Pankowski RL, Erb HN.Obstructive esophageal disorders in 61 horses included feed or foreign body impaction (27 horses), strictures (18 horses), perforations (11 horses), and diverticula (5 horses). Horses with feed impaction were treated nonsurgically (25 horses) or by esophagotomy (2 horses). Survival to discharge was 78%, and 37% of these had persistent chronic obstruction at home. Long-term survival was 52%. Long-term survival of nine horses treated nonsurgically for esophageal strictures was 22%; for nine horses treated surgically it was 44%. Long-term survival of horses treated nonsurgically was significantly...
Moore JN, Garner HE, Berg JN, Sprouse RF.Cecal fluid from two adult horses was assayed by the limulus amebocyte lysate system for endotoxin before and after carbohydrate overload of the gastrointestinal tract. There were increases in cecal fluid endotoxin concentrations at the 3-, 6-, and 12-hour samplings when compared with base-line values. Concomitant cecal fluid lactate concentrations and pH values increased and decreased, respectively. Both horses subsequently developed clinical signs of acute laminitis.
Delesalle C, van de Walle GR, Nolten C, Ver Donck L, van Hemelrijck A, Drinkenburg W, de Bosschere H, Claes P, Deprez P, Lefere L, Torfs S....Increased plasma (5-HT) concentrations are reported in horses predisposed to develop laminitis and after i.v. infusion of endotoxins. In the equine jejunum contractile 5-HT1A-like receptors show tachyphylaxia upon prolonged activation with 5-HT. Therefore, increased systemic 5-HT release in colic horses could play a possible role in the pathophysiology of ileus. Objective: To investigate possible increased systemic release of 5-HT in colic horses with compromised bowel and to identify the source of 5-HT overload. Methods: Concentrations of 5-HT were determined in plasma and peritoneal fluid (P...
Haffner JC, Eiler H, Hoffman RM, Fecteau KA, Oliver JW.Sustained dexamethasone administration to horses results in insulin resistance, which may predispose them to laminitis. A single dose of dexamethasone is commonly used as a diagnostic aid, yet the effect of a single dose of dexamethasone on glucose homeostasis in horses is not well defined. The objective of this study was to characterize the change in glucose dynamics over time in response to a single dose of dexamethasone. A combined glucose-insulin tolerance test (CGIT) was performed on 6 adult geldings before and at 2, 24, and 72 h postdexamethasone (40 microg/kg of BW, i.v.); a minimum of ...
van der Kolk JH, Heinrichs M, van Amerongen JD, Stooker RC, in de Wal LJ, van den Ingh TS.To determine size and weight of the pituitary gland and associations between pituitary gland size and weight and sex and age in horses without clinical signs associated with pituitary pars intermedia adenoma (PPIA) and horses and ponies with PPIA. Methods: Pituitary glands from 100 horses without clinical signs of PPIA and 19 horses and 17 ponies with PPIA. Methods: Pituitary glands were weighed, measured, and examined histologically by use of H&E stain. Masson trichrome and periodic acid-Schiff staining were used, when appropriate. Histologic lesions in the pars intermedia, pars distalis,...
Kawasako K, Higashi T, Nakaji Y, Komine M, Hirayama K, Matsuda K, Okamoto M, Hashimoto H, Tagami M, Tsunoda N, Taniyama H.To evaluate the histologic diversity of epidermal laminae in hooves from horses without clinical signs of laminitis. Methods: Formalin-fixed samples of stratum internum obtained from the mid region of the dorsal aspect of the hoof wall from the forelimbs of 35Thoroughbred cadavers (including foals [n = 9], yearlings [5], 2 year olds [6], racing horses [5], and mares [10]). Methods: Paraffin-embedded laminar tissues were stained with H&E for the evaluation of architectural variety of primary epidermal laminae (PEL) and secondary epidermal laminae (SEL). For detection of cytokeratin (CK) express...
Eckert RE, Sharief Y, Jones SL.Equine laminar tissues do not contain resident neutrophils and have less superoxide dismutase (SOD) activity than other equine tissues, which makes them inherently more vulnerable to damage induced by reactive oxygen species (ROS) produced by neutrophils that enter the tissues. In the advanced clinical stages of acute laminitis, pathologic events in affected feet include a breakdown in the basement membrane, neutrophil infiltration, and platelet-neutrophil aggregates in laminar dermal veins, highlighting the contribution of neutrophils to the pathophysiology of the disease. The aim of this stu...
Cassimeris L, Armstrong C, Burger QC, Stokes S, van Eps A, Galantino-Homer H.The euglycemic hyperinsulinemic clamp model (EHC) of equine endocrinopathic laminitis induces rapid loss of lamellar tissue integrity, disrupts keratinocyte functions, and induces inflammation similar to natural disease. Continuous digital hypothermia (CDH) blocks tissue damage in this experimental model, allowing identification of specific genes or molecular pathways contributing to disease initiation or early progression. Archived lamellar tissues (8 horses, 48 h EHC treatment, including CDH-treated front limbs) were used to measure relative expression levels of genes encoding keratin 17 (KR...
Gomez DE, Leclere M, Arroyo LG, Li L, John E, Afonso T, Payette F, Darby S.This study describes the clinicopathological findings, diagnostic approach, treatment, and factors associated with non-survival of diarrheic horses admitted to 4 Canadian university teaching hospitals between 2015 and 2019. A total of 300 horses, ≥1-year-old, with acute diarrhea were included and represented 1.6% (300/18 481; range: 0.7 to 3%) of admissions during that period, 70% of the horses survived to discharge. Testing for enteropathogens was limited to a single fecal culture for Salmonella spp. in most cases. An enteropathogen was identified in 14% (42/300) of the horses, but in the h...
Geor R, Frank N.Obesity, insulin resistance, hyperinsulinemia and hypertriglyceridemia are components of an equine metabolic syndrome phenotype associated with increased laminitis risk in horses. Links between these conditions and laminitis must still be elucidated, but human medicine provides candidate mechanisms for future study, including inflammation associated with obesity, vascular compromise induced by insulin resistance, and endothelial dysfunction. Just as metabolic syndrome has been linked to cardiovascular disease in humans, studies are now required to determine the exact mechanisms responsible for...
Baxter GM.Clinical data from 12 cases of equine laminitis characterized by distal displacement of the distal phalanx (P3) were reviewed. Clinical features of horses that survived the syndrome were compared with the nonsurvivors to obtain prognostic indicators. Animals affected included 8 Quarter Horses, 2 Welsh ponies, 1 Thoroughbred, and 1 Arabian. Eight of the animals were females (67%), 2 were stallions, and 2 were geldings. The mean age of affected animals was 8.6 years (2 to 14 years), and the mean body weight was 442 kg. The survivors weighed less than the nonsurvivors (384 kg vs 473 kg, respectiv...
McCue PM.Equine Cushing's disease (ECD) is a chronic progressive disease of the intermediate pituitary gland of older horses. Horses with Cushing's disease often have other health problems, such as laminitis, chronic infections, pseudolactation, and other issues. Diagnosis of ECD is usually based on clinical signs and endocrine tests. Medical management of affected horses is usually a long-term or lifelong commitment. The goal of this article is to review the pathophysiology of ECD, outline diagnostic tests, and present treatment options.
Wijnberg ID, Hardeman LC, van der Meij BR, Veraa S, Back W, van der Kolk JH.Therapeutic reduction of the activity of the deep digital flexor (DDF) muscle may play a role in treatment of laminitic horses. Clostridium botulinum toxin type A induces reduced muscle activity and has a spasmolytic effect in horses. In this study, the effectiveness of 200 IU C. botulinum toxin type A on reduction of DDF muscle activity was measured in seven healthy, sound, adult Royal Dutch sport horses. C. botulinum toxin type A was injected using ultrasound and electromyographic (EMG) guidance. The effectiveness was assessed by interference pattern analysis (IPA) and motor unit action pote...
Cohen ND, Carter GK.Steroid hepatopathy was diagnosed in a horse with glucorticoid-induced hyperadrenocorticism on the basis of anamnesis, serum biochemical data, and histologic findings of hepatic biopsy. Initially, clinical signs of polyuria, polydypsia, and muscular degeneration were seen. The horse developed laminitis during hospitalization.
de la Rebière G, Franck T, Deby-Dupont G, Salciccia A, Grulke S, Péters F, Serteyn D.As heparins are sometimes used to prevent equine laminitis, the interactions between equine neutrophil myeloperoxidase (MPO), unfractionated (UFH) and fractionated low molecular weight (LMWH) heparins and digital endothelium have been investigated. The effects of the heparins on purified equine MPO activity were tested by immunocapture followed by enzymatic detection. Endothelium-MPO interactions were assessed by measuring total and active MPO uptake by arterial and venous digital endothelial cells in culture with or without the addition of heparins. A dose-dependent MPO inhibition by UFH and ...
Yin C, Pettigrew A, Loftus JP, Black SJ, Belknap JK.In the septic horse prone to laminitis, a similar activation of the innate immune system appears to occur as reported in the septic human prone to organ failure. Because oxidant injury plays a central role in organ failure occurring due to an overzealous innate immune response in human sepsis, this study was performed to determine whether there was evidence of oxidant stress in the laminar tissue in the early stages of laminitis. 4-Hydroxy-2-nonenal (4-HNE), a lipid aldehyde that forms due to lipid peroxidation occurring during episodes of oxidant stress, readily forms adducts with cellular pr...
Wooldridge AA, Waguespack RW, Schwartz DD, Venugopal CS, Eades SC, Beadle RE.Hyperinsulinemia causes laminitis experimentally and is a risk factor for naturally occurring laminitis. The aim of this study was to investigate the effects of insulin on laminar vascular relaxation and to induce insulin-associated vascular dysfunction in vitro. Relaxation responses of isolated laminar arterial and venous rings to acetylcholine and insulin were evaluated. To alter vascular function in response to insulin, all vessel rings were incubated with insulin or vehicle, submaximally contracted, administered insulin again and relaxation responses recorded. Laminar arteries were also in...
Stewart AJ, Pettigrew A, Cochran AM, Belknap JK.The liver and lung are not only described as "target organs" in sepsis in most species, but are purported to be sources of circulating inflammatory mediators central to the systemic inflammatory response syndrome (SIRS). As we have recently reported an inflammatory response in the laminar tissue in laminitis similar to that described in "target organs" in human sepsis, we investigated the inflammatory response of the lung and liver in the black walnut extract (BWE) model of equine laminitis to determine (1) if a similar systemic inflammatory response occurs in this laminitis model as described...
French K, Pollitt CC, Pass MA.Experiments were performed to establish the pharmacokinetics of triamcinolone acetonide and the effects of the glucocorticoid on glucose metabolism in horses. The pharmacokinetics after intravenous (i.v.) dosing was best described by a three-compartment open model. There was rapid distribution from the central compartment followed by two phases of elimination. The half-life of the rapid elimination phase was 83.5 min and of the slower phase was 12 h. The term (Vss/Vc)-1was 12.3 indicating extensive distribution into the tissues. Triamcinolone acetonide given i.v. or intramuscularly (i.m. ) ind...
Jeffcott LB, Field JR.Hyperlipaemia is an important condition in ponies, not just because of the seriousness of the clinical signs and biochemical changes involved, but because of the distress it causes owners and breeders that have had animals suffer from it. Hyperlipaemia occurs most commonly in fat ponies in late pregnancy and is rarely seen in larger horses. The syndrome has similarities with conditions in other species but the definitive aetiologies are not yet known. The condition in ponies is undoubtedly related to stress. The biochemical mechanisms involved in equine hyperlipaemia are considered and an hypo...
Faramarzi B, Lee D, May K, Dong F.There is a need for evidence-based scientific research to address the question of the effectiveness of acupuncture in improving clinical signs of laminitis in horses. The objective of this study was to compare lameness levels before and after 2 acupuncture treatments in horses with chronic laminitis. Twelve adult horses with chronic laminitis received 2 acupuncture treatments 1 week apart. The points were treated using dry needling, hemo-acupuncture, and aqua-acupuncture. Lameness level was objectively evaluated using an inertial sensor-based lameness evaluation system (Lameness Locator), as w...
Kellon EM, Gustafson KM.Sodium-Glucose CoTransporter-2 (SGLT2) inhibitors, the -flozin group of drugs, which block glucose reuptake in the renal proximal tubule, are being increasingly used off-label to treat horses with refractory hyperinsulinemia. After 2 years of use by animals in our group, a horse on canagliflozin was incidentally noted to be hyperlipemic. We have been following a cohort of equines (n = 20) treated with SGLT2 inhibitors due to refractory hyperinsulinemia. The animals are owned by members of the Equine Cushing's and Insulin Resistance Group and treated by their attending veterinarians. The index ...
Lindåse S, Müller C, Nostell K, Bröjer J.Information about the effect of nonstructural carbohydrates (NSCs) in forage on the postprandial glucose and insulin response in horses is scarce. This is of interest as postprandial hyperinsulinemia in horses is a risk factor for laminitis. In addition, insulin sensitivity (IS) differs between breeds. The aim was to evaluate the postprandial glucose and insulin response to haylage diets with different NSC content in horses of 2 different breeds and to evaluate the relationship between the postprandial insulin response and measures of IS derived from a frequently sampled intravenous glucose to...
Hansen N, Buchner HH, Haller J, Windischbauer G.To evaluate using strain gauges, a hoof cast with heel wedge, and a therapeutic shoe with unsupported toe for their effectiveness in redistribution of load from the dorsal hoof wall. Methods: In vitro biomechanical study. Methods: Twenty forelimb specimens. Methods: Rosette strain gauges were placed on the dorsal and lateral hoof wall of 20 normal shaped hooves. Limbs were loaded vertically using a tensile testing machine with a 1 Hz sinusoidally cycling load up to 3000 N during 15 seconds. Mean values of principal strain and direction at 2500 N load were calculated for 3 experimental conditio...
Peroni JF, Harrison WE, Moore JN, Graves JE, Lewis SJ, Krunkosky TM, Robertson TP.Equine laminitis purportedly involves haemodynamic dysfunction at the level of the laminar vasculature. However, to date, no studies have been performed characterising the function of laminar arteries and veins during the prodromal stages of equine laminitis. Objective: That the prodromal stages of laminitis are associated with contractile dysfunction of the equine laminar vasculature. Objective: To assess contractile function of laminar arteries and veins to phenylephrine (PE) and 5-hydroxytryptamine (5-HT). Methods: Horses were administered black walnut heartwood extract (BWHE) or water (con...
Rugh KS, Garner HE, Sprouse RF, Hatfield DG.Systemic arterial hypertension is associated with equine laminitis, a disease precipitated by gross over-ingestion of carbohydrates. We examined the hearts from nine chronically hypertensive (161 +/- 11/99 +/- 6 mmHg) laminitic ponies and nine normotensive (128 +/- 2/76 +/- 3 mmHg) ponies postmortem for signs of left ventricular hypertrophy. The hypertensive ponies had hearts which were significantly larger (7.77 +/- 0.26 g/kg bodyweight (BW) vs. 5.67 +/- 0.22 g/kg BW), as well as increased combined left ventricle and septum weight (4.99 +/- 0.21 g/kg BW vs. 3.67 +/- 0.20 g/kg BW) and left ven...
Basile RC, Rivera GG, Del Rio LA, de Bonis TC, do Amaral GP, Giangrecco E, Ferraz G, Yoshinari NH, Canola PA, Queiroz Neto A.Lyme borreliosis is a disease transmitted by ticks to mammals, especially in horses and humans. Caused by a spirochete Borrelia burgdorferi, it can result in lameness, arthritis, carditis, dermatitis and neurological signs. Anaphylactoid reactions are severe responses caused by direct action of substances (drugs, toxins), which can pose risks to life. Still poorly documented in horses, these reactions are caused by the effects of inflammatory mediators such as histamine, kinins and arachidonic acid metabolites. The last two are the most clinically relevant for the species. Methods: The simulta...
