Factors associated with survival, laminitis and insulin dysregulation in horses diagnosed with equine pituitary pars intermedia dysfunction.
Abstract: 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 suppression test, thyrotropin-releasing hormone stimulation test or necropsy. Clinical and clinicopathologic characteristics of PPID and therapeutic responses were investigated. Laminitis was diagnosed by radiographic or histologic changes and ID was diagnosed based on endogenous insulin, an oral glucose test or a 2-step insulin-response test. Results: Being a pony, having a higher body condition score and pergolide administration were associated with survival. The clinical presentation of PPID changed with latitude and climate, with anhidrosis and polyuria/polydipsia more commonly recognised at lower latitudes. Laminitis was diagnosed in 89.9% of cases and ID was present in 76.5% of cases in which they were investigated. Conclusions: Despite the sample size, the lack of uniform testing at all locations (primary or referral cases) and the incompleteness of data sets limited the power of the statistical analyses. Conclusions: PPID can present with variable signs at different latitudes and climates, and ID should be investigated in equids diagnosed with PPID. Adequate body condition and administration of pergolide are fundamental in PPID management.
© 2018 EVJ Ltd.
Publication Date: 2018-12-03 PubMed ID: 30417404DOI: 10.1111/evj.13041Google Scholar: Lookup
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- Journal Article
Summary
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This study provides insights into Equine Pituitary Pars Intermedia Dysfunction (PPID), a common endocrine disorder in horses, as it manifests in different latitudes and climates across Australia. It indicates that survival is associated with the horse being a pony, a higher body condition score, and administration of pergolide, whilst laminitis and insulin dysregulation are common complications in diagnosed cases.
Study Overview
- The study is a retrospective investigation into 274 equine cases of PPID from eight different institutions across Australia.
- The primary diagnostic methods used included assessments of endogenous ACTH levels, overnight dexamethasone suppression tests, thyrotropin-releasing hormone stimulation tests, or autopsy.
- The clinical and clinicopathologic features of PPID, along with treatment responses, were examined as part of the analysis.
Findings
- The research found peculiar patterns in the clinical presentation of PPID that varied with latitude and climate.
- Two conditions, anhidrosis (unable to sweat) and polyuria/polydipsia (increased urination and thirst) were identified as being more common in lower latitude regions.
- The research discovered laminitis in a dominating 89.9% of cases and insulin dysregulation in 76.5% of the cases where they were investigated.
Survival Prognosis
- The horse’s breed (specifically being a pony), having a higher body condition score, and pergolide treatment were associated with a higher survival rate in cases of PPID.
Limitations and Conclusions
- Although the sample size was considerable, the study had limitations that impacted the power of the statistical analysis. These limitations were mainly due to inconsistent testing across locations (for primary or referral cases) and the incompleteness of data sets.
- The research establishes that PPID can manifest with variable signs depending on climate and region. It also emphasizes that insulin dysregulation should always be investigated in equids diagnosed with PPID.
- Appropriate and careful management of body condition and the administration of pergolide are crucial aspects of PPID management.
Cite This Article
APA
Horn R, Bamford NJ, Afonso T, Sutherland M, Buckerfield J, Tan RHH, Secombe CJ, Stewart AJ, Bertin FR.
(2018).
Factors associated with survival, laminitis and insulin dysregulation in horses diagnosed with equine pituitary pars intermedia dysfunction.
Equine Vet J, 51(4), 440-445.
https://doi.org/10.1111/evj.13041 Publication
Researcher Affiliations
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia.
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, Australia.
- Gisborne Veterinary Clinic, Gisborne, Victoria, Australia.
- Hobart Equine Practice, Hobart, Tasmania, Australia.
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
- Samford Valley Veterinary Hospital, Samford, Queensland, Australia.
- School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
MeSH Terms
- Animals
- Australia / epidemiology
- Female
- Foot Diseases / epidemiology
- Foot Diseases / pathology
- Foot Diseases / veterinary
- Hoof and Claw / pathology
- Horse Diseases / epidemiology
- Horse Diseases / pathology
- Horses
- Inflammation / epidemiology
- Inflammation / etiology
- Inflammation / veterinary
- Insulin / metabolism
- Male
- Pituitary Diseases / diagnosis
- Pituitary Diseases / epidemiology
- Pituitary Diseases / pathology
- Pituitary Diseases / veterinary
- Pituitary Gland, Intermediate / pathology
- Retrospective Studies
- Risk Factors
Citations
This article has been cited 19 times.- Pratt-Phillips S, Munjizun A. Impacts of Adiposity on Exercise Performance in Horses.. Animals (Basel) 2023 Feb 14;13(4).
- Zapf AM, Fey K, Büttner K, Gröf M, Staszyk C. Periodontal structures in horses with pituitary pars intermedia dysfunction: A histological evaluation.. Front Vet Sci 2023;10:1114445.
- Kirkwood NC, Hughes KJ, Stewart AJ. Prospective Case Series of Clinical Signs and Adrenocorticotrophin (ACTH) Concentrations in Seven Horses Transitioning to Pituitary Pars Intermedia Dysfunction (PPID).. Vet Sci 2022 Oct 17;9(10).
- Kirkwood NC, Hughes KJ, Stewart AJ. Pituitary Pars Intermedia Dysfunction (PPID) in Horses.. Vet Sci 2022 Oct 10;9(10).
- Williams NJ, Furr M, Navas de Solis C, Campolo A, Davis M, Lacombe VA. Investigating the Relationship Between Cardiac Function and Insulin Sensitivity in Horses: A Pilot Study.. Front Vet Sci 2022;9:899951.
- Hinrichsen SL, Yuen KY, Dryburgh EL, Bertin FR, Stewart AJ. Short-Term Effects of Temperature and Thyrotropin-Releasing Hormone Stimulation on Adrenocorticotropin Stability in Horses.. Animals (Basel) 2022 Jan 28;12(3).
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- Hicks GR, Fraser NS, Bertin FR. Changes Associated with the Peri-Ovulatory Period, Age and Pregnancy in ACTH, Cortisol, Glucose and Insulin Concentrations in Mares.. Animals (Basel) 2021 Mar 20;11(3).
- Townsend KS, Johnson PJ, LaCarrubba AM, Martin LM, Ericsson AC. Exodontia associated bacteremia in horses characterized by next generation sequencing.. Sci Rep 2021 Mar 18;11(1):6314.
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- Hu K, Stewart AJ, Yuen KY, Hinrichsen S, Dryburgh EL, Bertin FR. The effect of freeze-thaw cycles on determination of immunoreactive plasma adrenocorticotrophic hormone concentrations in horses.. J Vet Intern Med 2020 May;34(3):1350-1356.
- Leschke DH, Muir GS, Hodgson JK, Coyle M, Horn R, Bertin FR. Immunoreactive insulin stability in horses at risk of insulin dysregulation.. J Vet Intern Med 2019 Nov;33(6):2746-2751.
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- Hodge E, Kowalski A, Torcivia C, Lindborg S, Stefanovski D, Hart K, Frank N, van Eps A. Effect of thyrotropin-releasing hormone stimulation testing on the oral sugar test in horses when performed as a combined protocol.. J Vet Intern Med 2019 Sep;33(5):2272-2279.
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