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Equine veterinary journal2022; 55(1); 12-23; doi: 10.1111/evj.13572

Predictors of laminitis development in a cohort of nonlaminitic ponies.

Abstract: Quantifying risk factors for laminitis development requires improvement. Objective: To identify the most useful physical examination, metabolic and management factors to predict laminitis development in client-owned, nonlaminitic ponies. Methods: Prospective cohort study. Methods: Physical examination, metabolic and management data were collected from a pony cohort 6 monthly for up to 4 years. Ponies were monitored for the development of laminitis. Metabolic data included basal plasma concentrations of ACTH ([ACTH]), adiponectin ([adiponectin]), triglycerides and glucose. Serum insulin concentrations ([insulin]) were measured in the unfasted basal state ([insulin]T0) and 60 minutes ([insulin]T60) after administration of corn syrup (0.3ml/kg). Separate multivariable Cox proportional-hazards models were developed for physical, management/signalment and metabolic data and later combined into two final models. Low-, medium- and high-laminitis risk categories were defined based on basal or T60 [insulin]. Results: Overall, 374 ponies (age 5-32 years) and 891 pony-years were included in the main analysis. Laminitis incidence (95% confidence interval (CI)) was 4.8 (3.5-6.5) cases/100 pony-years. Laminitis development was associated with numerous univariable factors. Significant (P < .05) factors retained in the final multivariable models included [insulin]T0, [insulin]T60, [adiponectin] and divergent hoof growth. [ACTH] was not independently associated with laminitis. Based on [Insulin]T0, low- (45.2 µIU/ml) categories encompassed 70, 20 and 10% of the population and had estimated 4-year laminitis incidences (95%CI) of 6 (2-9)%, 22 (10-33)% and 69 (48-82)% respectively. Based on [Insulin]T60 the low- (<53.4 µIU/ml), medium- (53.4-153 µIU/ml) and high-risk (≥153 µIU/ml) categories comprised 60, 30 and 10% of the population and had estimated 4-year laminitis incidences (95%CI) of 3 (0-6)%, 20 (10-29)% and 73 (52-84)% respectively. Conclusions: Results may not apply to different insulin assays, geographical regions, breeds or management types. Conclusions: [Insulin]T0 or [insulin]T60 best quantify the risk of future laminitis development in nonlaminitic ponies. Unassigned: A quantificação dos fatores de risco para o desenvolvimento de laminite requere mais estudos. Objective: Identificar os fatores de exame físico, níveis metabólicos e de manejo mais úteis para predizer o desenvolvimento de laminite em pôneis não laminíticos de proprietários privados. Unassigned: Coorte prospectivo. Methods: Exame físico e dados metabólicos e de manejo foram coletados de um coorte de pôneis a cada seis meses por um máximo de quatro anos. Os pôneis foram monitorados para o desenvolvimento de laminite. Dados metabólicos incluíram: concentração basal de ACTH ([ACTH]), adiponectina ([adiponectina]), triglicérides e glicose. A concentração sérica de insulina ([insulina]) foi mensurada no estado basal sem jejum ([insulina]T0) e 60 minutos ([insulina]T60) após a administração de xarope de milho (0.3ml/kg). Modelos separados de riscos proporcionais de Cox multivariável foram desenvolvidos para dados de exame físico, manejo/identificação dos animais e metabólicos, que depois foram combinados em dois modelos finais. As categorias para o risco de desenvolvimento de laminite foram classificadas como baixa, média e alta, levando em consideração o nível basal ou T60 de insulina. Results: 374 pôneis (idades entre 5 e 32 anos) e um total de 891 anos acumulados foram incluídos na análise. A incidência de laminite (95% de intervalo de confiança (IC)) foi 4.8 (3.5-6.5) casos/100 anos. O desenvolvimento de laminite foi associado com inúmeros fatores invariáveis. Os fatores significantes (p<0.05) retidos no modelo de análise multivariável final foram: [insulina] T0, [insulina] T60, [adiponectina], e crescimento de casco divergente. [ACTH] não foi independentemente associado com laminite. Baseado nas categorias de [insulina] T0, as categorias de baixo (45.2 µIU/ml) risco foram compostas por 70, 20 e 10% da população e tiveram uma estimativa de 4 anos de incidência de laminite (95% CI) de 6 (2-9)%, 22 (10-33)% e 69 (48-82%), respectivamente. Baseado na [insulina] T60, as categorias de risco baixa (<53.4 µIU/ml), média (53.4-153 µIU/ml) e alta (≥153 µIU/ml) foram compostas por 60, 30 e 10% da população e tiveram uma estimativa de 4 anos de incidência (95% CI) de 3 (0-6)%, 20 (10-29)% e 73 (52-84)%, respectivamente. PRINCIPAIS LIMITAÇÕES: Esses resultados podem não ser aplicáveis com outras metodologias de mensuração de insulina, e outras regiões geográficas, raças ou tipos de manejo. CONCLUSÕES: [Insulina] T0 ou [insulina] T60 são os fatores que melhor quantificam o risco de futuro desenvolvimento de laminite em pôneis não laminíticos.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2022-04-01 PubMed ID: 35263471PubMed Central: PMC10084125DOI: 10.1111/evj.13572Google Scholar: Lookup
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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 investigates factors that could predict the development of laminitis, a disease affecting the feet of hooved animals, in nonlaminitic ponies. The study uses physical examination, metabolic markers and management considerations alongside a specific procedure involving insulin testing.

Objective and Methodology

  • The primary objective of this study was to determine key physical, metabolic, and management indicators that can predict the onset of laminitis in nonlaminitic, client-owned ponies.
  • The researchers conducted a prospective cohort study where they collected physical examination and metabolic data from the ponies every 6 months over a span of 4 years.
  • The ponies were supervised for the development of laminitis. Metabolic data collected included basal plasma concentrations of ACTH (Adrenocorticotropic Hormone), adiponectin, triglycerides, and glucose.
  • Insulin concentration was also measured in two states: in the non-fasting basal state and 60 minutes after corn syrup administration, denoted as [insulin]T0 and [insulin]T60 respectively.
  • Potential risk factors were evaluated using multiple Cox proportional-hazards models, and eventual results were generated by combining two final models.

Results and Findings

  • The study involved a total of 374 ponies, aged between 5 to 32 years, over 891 pony-years.
  • The occurrence of laminitis was found to be around 4.8 cases per 100 pony-years, showing a strong association with multiple univariable factors.
  • The most significant factors contributing to laminitis were found to be [insulin]T0, [insulin]T60, adiponectin, and irregular hoof growth. The study revealed that ACTH was not independently related to laminitis.
  • Based on the initial measurements of insulin concentration, the ponies were categorized into low-, medium- and high-risk groups. The groups constituted 70%, 20%, and 10% of the population respectively.
  • The predicted 4-year laminitis occurrence rates for the three risk groups were 6%, 22%, and 69%, respectively.

Conclusions and Limitations

  • The study concludes that the measurements of [Insulin]T0 or [Insulin]T60 are the most reliable indicators of the risk of future development of laminitis in nonlaminitic ponies.
  • However, the researchers acknowledge that their findings may not be applicable to different methodologies of insulin measurement, geographical regions, breeds, or management styles.

Cite This Article

APA
Knowles EJ, Elliott J, Harris PA, Chang YM, Menzies-Gow NJ. (2022). Predictors of laminitis development in a cohort of nonlaminitic ponies. Equine Vet J, 55(1), 12-23. https://doi.org/10.1111/evj.13572

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 1
Pages: 12-23

Researcher Affiliations

Knowles, Edward J
  • The Royal Veterinary College, Hatfield, UK.
  • Bell Equine Veterinary Clinic, Mereworth, UK.
Elliott, Jonathan
  • The Royal Veterinary College, Hatfield, UK.
Harris, Patricia A
  • WALTHAM Centre for Pet Nutrition, Waltham on the Wolds, UK.
Chang, Yu-Mei
  • The Royal Veterinary College, Hatfield, UK.
Menzies-Gow, Nicola J
  • The Royal Veterinary College, Hatfield, UK.

MeSH Terms

  • Horses
  • Animals
  • Foot Diseases / epidemiology
  • Foot Diseases / veterinary
  • Foot Diseases / etiology
  • Horse Diseases / chemically induced
  • Horse Diseases / epidemiology
  • Adiponectin
  • Prospective Studies
  • Insulin
  • Adrenocorticotropic Hormone

Grant Funding

  • MARS Petcare
  • The Royal Veterinary College from the Mellon Trust

Conflict of Interest Statement

EJ Knowles is employed by CVS Ltd and provides diagnostic laboratory services through Axiom Veterinary Laboratories. He has received fees for speaking/CPD material from Boehringer Ingelheim. PA Harris is employed by MARS Petcare UK.

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Citations

This article has been cited 10 times.
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