Incidence and risk factors for recurrence of endocrinopathic laminitis in horses.
Abstract: Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. Objective: To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. Methods: Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). Methods: This prospective cohort study collected data on veterinary-diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non-endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow-up data were collected at regular intervals to determine whether the laminitis recurred in the 2-year period after diagnosis. Results: The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2-year study period increased with basal, fasted serum insulin concentration (P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0-20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely (P = .05) to recur sooner. Conclusions: Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2019-04-10 PubMed ID: 30972832PubMed Central: PMC6524073DOI: 10.1111/jvim.15497Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Clinical Study
- Clinical Symptoms
- Diagnosis
- Disease Diagnosis
- Disease Etiology
- Disease Management
- Endocrine System
- Epidemiology
- Equine Diseases
- Equine Health
- Horses
- Insulin
- Lameness
- Longitudinal Study
- Metabolic Health
- Observational Study
- Pony
- Recurrent Airway Obstruction
- Risk Factors
- Veterinary Medicine
- Veterinary Research
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research study provides an analysis of the recurrence of endocrinopathic laminitis in privately owned horses and ponies. It identifies hyperinsulinemia and prior instances of laminitis as significant risk factors for the reoccurrence of the disease.
Research Objectives and Methodology
- The primary aim of the study was to pinpoint the incidence as well as risk factors linked to the recurrence of endocrinopathic laminitis in horses and ponies.
- 317 horses and ponies experiencing acute laminitis were investigated in the study. Out of these, 276 instances of endocrinopathic laminitis were pursued till the termination of the study.
- It was a prospective cohort study, in which data was recorded for 2 years on veterinary-diagnosed incidents of acute laminitis.
- Each case was categorized as endocrinopathic or non-endocrinopathic laminitis based on the information collected via a questionnaire completed by each animal’s vet.
- The study regularly collected follow-up data in order to find out whether the laminitis recurred within the 2-year duration post-diagnosis.
Results and Findings
- The recurrence rate for endocrinopathic laminitis was found to be 34.1% during the study.
- The risk of recurrence in the 2-year period of the study increased with the basal, fasted serum insulin concentration, with the probability of recurrence amplifying notably as the insulin concentration rose past the normal range (0-20 μIU/mL) to beyond the normal threshold (approximately 45 μIU/mL).
- A previous diagnosis of laminitis (prior to the initiation of the study) was also found to increase the risk of recurrent laminitis.
- Cases having a higher Obel grade of laminitis were more likely to experience a recurrence sooner.
Conclusions and Implications
- The study concluded that hyperinsulinemia and a previous diagnosis of laminitis are significant risk factors for the recurrence of endocrinopathic laminitis.
- This knowledge can be leveraged by clinicians to proactively address these factors, in order to potentially reduce the risk of laminitis recurrence.
Cite This Article
APA
de Laat MA, Reiche DB, Sillence MN, McGree JM.
(2019).
Incidence and risk factors for recurrence of endocrinopathic laminitis in horses.
J Vet Intern Med, 33(3), 1473-1482.
https://doi.org/10.1111/jvim.15497 Publication
Researcher Affiliations
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.
- Animal Health, Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.
MeSH Terms
- Animals
- Cohort Studies
- Endocrine System Diseases / complications
- Endocrine System Diseases / veterinary
- Female
- Foot Diseases / epidemiology
- Foot Diseases / etiology
- Foot Diseases / veterinary
- Hoof and Claw
- Horse Diseases
- Horses
- Hyperinsulinism / veterinary
- Incidence
- Male
- Prospective Studies
- Recurrence
- Risk Factors
Grant Funding
- Boehringer Ingelheim
Conflict of Interest Statement
Authors declare no conflict of interest.
References
This article includes 40 references
- Mitchell CF, Fugler LA, Eades SC. The management of equine acute laminitis.. Vet Med (Auckl) 2015;6:39-47.
- Bertin FR, de Laat MA. The diagnosis of equine insulin dysregulation.. Equine Vet J 2017 Sep;49(5):570-576.
- Tadros EM, Fowlie JG, Refsal KR, Marteniuk J, Schott HC 2nd. Association between hyperinsulinaemia and laminitis severity at the time of pituitary pars intermedia dysfunction diagnosis.. Equine Vet J 2019 Jan;51(1):52-56.
- Frank N, Tadros EM. Insulin dysregulation.. Equine Vet J 2014 Jan;46(1):103-12.
- Coleman MC, Belknap JK, Eades SC, Galantino-Homer HL, Hunt RJ, Geor RJ, McCue ME, McIlwraith CW, Moore RM, Peroni JF, Townsend HG, White NA, Cummings KJ, Ivanek-Miojevic R, Cohen ND. Case-control study of risk factors for pasture-and endocrinopathy-associated laminitis in North American horses.. J Am Vet Med Assoc 2018 Aug 15;253(4):470-478.
- Menzies-Gow NJ, Katz LM, Barker KJ, Elliott J, De Brauwere MN, Jarvis N, Marr CM, Pfeiffer DU. Epidemiological study of pasture-associated laminitis and concurrent risk factors in the South of England.. Vet Rec 2010 Oct 30;167(18):690-4.
- Menzies-Gow NJ, Harris PA, Elliott J. Prospective cohort study evaluating risk factors for the development of pasture-associated laminitis in the United Kingdom.. Equine Vet J 2017 May;49(3):300-306.
- Welsh CE, Duz M, Parkin TDH, Marshall JF. Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records.. Prev Vet Med 2017 Jan 1;136:11-18.
- Potter SJ, Bamford NJ, Harris PA, Bailey SR. Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia.. Aust Vet J 2017 Oct;95(10):370-374.
- de Laat MA, Sillence MN, Reiche DB. Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis.. J Vet Intern Med 2019 May;33(3):1456-1463.
- Obel N. Studies on the Histopathology of Acute Laminitis. 1948.
- Copas VE, Durham AE. Circannual variation in plasma adrenocorticotropic hormone concentrations in the UK in normal horses and ponies, and those with pituitary pars intermedia dysfunction.. Equine Vet J 2012 Jul;44(4):440-3.
- Banse HE, McCann JP, McFarlane D. Comparison of two immunoassays for measurement of serum insulin in horses. J Vet Intern Med 2013;27:649‐649.
- Warnken T, Huber K, Feige K. Comparison of three different methods for the quantification of equine insulin.. BMC Vet Res 2016 Sep 9;12(1):196.
- Mc Gowan TW, Pinchbeck GP, Mc Gowan CM. Evaluation of basal plasma α-melanocyte-stimulating hormone and adrenocorticotrophic hormone concentrations for the diagnosis of pituitary pars intermedia dysfunction from a population of aged horses.. Equine Vet J 2013 Jan;45(1):66-73.
- Henneke DR, Potter GD, Kreider JL, Yeates BF. Relationship between condition score, physical measurements and body fat percentage in mares.. Equine Vet J 1983 Oct;15(4):371-2.
- Carter RA, Geor RJ, Burton Staniar W, Cubitt TA, Harris PA. Apparent adiposity assessed by standardised scoring systems and morphometric measurements in horses and ponies.. Vet J 2009 Feb;179(2):204-10.
- Frank N, Geor RJ, Bailey SR, Durham AE, Johnson PJ. Equine metabolic syndrome.. J Vet Intern Med 2010 May-Jun;24(3):467-75.
- Borer KE, Bailey SR, Menzies-Gow NJ, Harris PA, Elliott J. Effect of feeding glucose, fructose, and inulin on blood glucose and insulin concentrations in normal ponies and those predisposed to laminitis.. J Anim Sci 2012 Sep;90(9):3003-11.
- Knowles EJ, Harris PA, Elliott J, Menzies-Gow NJ. Use of the oral sugar test in ponies when performed with or without prior fasting.. Equine Vet J 2017 Jul;49(4):519-524.
- Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr 1974;19:716‐723.
- Hosmer DW, Lemeshow S. Applied Logisitic Regression. 2005.
- Menzies-Gow NJ. Laminitis epidemiology data: still severely lacking….. Vet J 2011 Sep;189(3):242.
- Meier A, Reiche D, de Laat M, Pollitt C, Walsh D, Sillence M. The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies.. PLoS One 2018;13(9):e0203655.
- Meier AD, de Laat MA, Reiche DB, Pollitt CC, Walsh DM, McGree JM, Sillence MN. The oral glucose test predicts laminitis risk in ponies fed a diet high in nonstructural carbohydrates.. Domest Anim Endocrinol 2018 Apr;63:1-9.
- McGowan CM, Frost R, Pfeiffer DU, Neiger R. Serum insulin concentrations in horses with equine Cushing's syndrome: response to a cortisol inhibitor and prognostic value.. Equine Vet J 2004 Apr;36(3):295-8.
- de Laat MA, McGree JM, Sillence MN. Equine hyperinsulinemia: investigation of the enteroinsular axis during insulin dysregulation.. Am J Physiol Endocrinol Metab 2016 Jan 1;310(1):E61-72.
- Karikoski NP, McGowan CM, Singer ER, Asplin KE, Tulamo RM, Patterson-Kane JC. Pathology of Natural Cases of Equine Endocrinopathic Laminitis Associated With Hyperinsulinemia.. Vet Pathol 2015 Sep;52(5):945-56.
- Lynden J, Ogden J, Hollands T. Contracting for care - the construction of the farrier role in supporting horse owners to prevent laminitis.. Equine Vet J 2018 Sep;50(5):658-666.
- van Eps AW. Therapeutic hypothermia (cryotherapy) to prevent and treat acute laminitis.. Vet Clin North Am Equine Pract 2010 Apr;26(1):125-33.
- McFarlane D, Paradis MR, Zimmel D, Sykes B, Brorsen BW, Sanchez A, Vainio K. The effect of geographic location, breed, and pituitary dysfunction on seasonal adrenocorticotropin and α-melanocyte-stimulating hormone plasma concentrations in horses.. J Vet Intern Med 2011 Jul-Aug;25(4):872-81.
- Secombe CJ, Tan RHH, Perara DI, Byrne DP, Watts SP, Wearn JG. The Effect of Geographic Location on Circannual Adrenocorticotropic Hormone Plasma Concentrations in Horses in Australia.. J Vet Intern Med 2017 Sep;31(5):1533-1540.
- Wood S, Loudon A. Clocks for all seasons: unwinding the roles and mechanisms of circadian and interval timers in the hypothalamus and pituitary.. J Endocrinol 2014 Aug;222(2):R39-59.
- Longland AC, Byrd BM. Pasture nonstructural carbohydrates and equine laminitis.. J Nutr 2006 Jul;136(7 Suppl):2099S-2102S.
- Carter RA, Treiber KH, Geor RJ, Douglass L, Harris PA. Prediction of incipient pasture-associated laminitis from hyperinsulinaemia, hyperleptinaemia and generalised and localised obesity in a cohort of ponies.. Equine Vet J 2009 Feb;41(2):171-8.
- Luthersson N, Mannfalk M, Parkin TDH, Harris P. Laminitis: risk factors and outcome in a group of Danish horses. J Equine Vet 2017;53:68‐73.
- Rohrbach BW, Stafford JR, Clermont RS, Reed SM, Schott HC 2nd, Andrews FM. Diagnostic frequency, response to therapy, and long-term prognosis among horses and ponies with pituitary par intermedia dysfunction, 1993-2004.. J Vet Intern Med 2012 Jul-Aug;26(4):1027-34.
- Pollitt CC, Daradka M. Hoof wall wound repair.. Equine Vet J 2004 Apr;36(3):210-5.
- Pollitt CC. Equine laminitis. Clin Tech Equine Pract 2004;3:34‐44.
- Pollard D, Wylie CE, Verheyen KLP, Newton JR. Assessment of horse owners' ability to recognise equine laminitis: A cross-sectional study of 93 veterinary diagnosed cases in Great Britain.. Equine Vet J 2017 Nov;49(6):759-766.
Citations
This article has been cited 8 times.- Go YY, Hazard NW, Balasuriya UBR, Chapman AM, Fitton NS, Kenéz Á, Andrews FM. Clinical evaluation of the Immulite® 1000 chemiluminescent immunoassay for measurement of equine serum insulin.. Front Vet Sci 2023;10:1018230.
- Moss A, Leise B, Hackett E. Stress response as a contributing factor in horses with laminitis.. J Vet Sci 2023 Mar;24(2):e33.
- de Tonnerre DJ, Medina Torres CE, Stefanovski D, Robinson MA, Kemp KL, Bertin FR, van Eps AW. Effect of sirolimus on insulin dynamics in horses.. J Vet Intern Med 2023 Mar;37(2):703-712.
- Pratt-Phillips S, Munjizun A. Impacts of Adiposity on Exercise Performance in Horses.. Animals (Basel) 2023 Feb 14;13(4).
- Sillence M, Meier A, de Laat M, Klee R, Reiche D. Demographic, morphologic, hormonal and metabolic factors associated with the rate of improvement from equine hyperinsulinaemia-associated laminitis.. BMC Vet Res 2022 Jan 18;18(1):49.
- Ribitsch I, Oreff GL, Jenner F. Regenerative Medicine for Equine Musculoskeletal Diseases.. Animals (Basel) 2021 Jan 19;11(1).
- Meier A, McGree J, Klee R, Preuß J, Reiche D, de Laat M, Sillence M. The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting.. BMC Vet Res 2021 Jan 7;17(1):16.
- Rahnama S, Vathsangam N, Spence R, Medina-Torres CE, Pollitt CC, de Laat MA, Bailey SR, Sillence MN. Effects of an anti-IGF-1 receptor monoclonal antibody on laminitis induced by prolonged hyperinsulinaemia in Standardbred horses.. PLoS One 2020;15(9):e0239261.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists