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Journal of veterinary internal medicine2022; 36(3); 1131-1138; doi: 10.1111/jvim.16421

Thromboelastography in obese horses with insulin dysregulation compared to healthy controls.

Abstract: Both obesity and metabolic syndrome are associated with hypercoagulability in people, increasing the risk of cardiovascular disease and thromboembolic events. Whether hypercoagulability exists in obese, insulin-dysregulated horses is unknown. Objective: To determine if coagulation profiles differ between healthy horses and those with obesity and insulin dysregulation. Methods: Fifteen healthy horses (CON) and 15 obese, insulin-dysregulated horses (OBID). Individuals were university or client owned. Methods: Case-control study. Obesity was defined as a body condition score (BCS) ≥7.5/9 (modified Henneke scale). Insulin dysregulation status was assessed by an oral sugar test (OST). Kaolin-thromboelastography and traditional coagulation variables were compared between groups. The direction and strength of the association between coagulation variables and BCS and OST results were determined using Spearman's correlation. Results: Thromboelastography variables MA (OBID: 69.5 ± 4.5 mm; CON: 64.8 ± 4.3 mm; P = .007) and G-value (OBID: 11749 ± 2536 dyn/m ; CON: 9319 ± 1650 dyn/m ; P = .004) were higher in OBID compared to CON. Positive correlations between MA and BCS (R = 0.45, P = .01) and serum insulin (T : R = 0.45, P = .01; T : R = 0.39, P = .03), and G-value and BCS (R = 0.46, P = .01), and serum insulin (T : R = 0.48, P = .007; T : R = 0.43, P = .02; T : R = 0.38, P = .04) were present. Conclusions: Obese, insulin-dysregulated horses are hypercoagulable compared to healthy controls.
Publication Date: 2022-04-16 PubMed ID: 35429197PubMed Central: PMC9151488DOI: 10.1111/jvim.16421Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates whether obesity and insulin dysregulation cause hypercoagulability, or a greater tendency for blood to clot, in horses. The study finds that obese horses with insulin problems have higher blood clotting measurements than healthy horses, suggesting that obesity and insulin dysregulation may increase the risk of cardiovascular disease in horses.

Research Objective

The aim of this study was to determine if there is a difference in coagulation profiles between healthy horses and horses that suffer from obesity and insulin dysregulation (malfunction). The presence of hypercoagulability in these obese, insulin-dysregulated horses was of particular interest, given its potential risk to cardiovascular health.

Methods

  • The study employed a case-control design, comparing 15 healthy horses (labeled CON) against 15 obese insulin-dysregulated horses (OBID).
  • Obesity was defined based on a body condition score (BCS) above or equal to 7.5, measured on a modified Henneke scale – a visual assessment tool for determining a horse’s body fat percentage.
  • The horses’ insulin dysregulation status was assessed by an oral sugar test (OST).
  • The researchers carried out Kaolin-thromboelastography, a method for testing blood clotting, alongside other coagulation variable tests.
  • The results from these tests were used in conjunction with the Spearman’s correlation statistical test to identify any associations between the horses’ BCS and OST results and the coagulation variables.

Results

  • The thromboelastography variables – MA (maximum amplitude, a measure indicating clot strength) and the G-value (a measure of blood’s ability to clot) – were higher in the obese, insulin-dysregulated horses compared to the healthy horses.
  • Positive correlations were found between MA and both BCS and serum insulin, and between G-value and BCS and serum insulin. This implies as the severity of obesity and insulin dysregulation increases, so does the coagulation tendency of the blood.

Conclusions

Based on the higher coagulation readings and the presence of positive correlations between obesity/insulin dysregulation and coagulation factors, the researchers concluded that obese, insulin-dysregulated horses may be hypercoagulable compared to healthy horses. This has potential implications for the cardiovascular health of such horses, and also supports the presence of similar concerns in obese, insulin-dysregulated humans.

Cite This Article

APA
Lovett AL, Gilliam LL, Sykes BW, McFarlane D. (2022). Thromboelastography in obese horses with insulin dysregulation compared to healthy controls. J Vet Intern Med, 36(3), 1131-1138. https://doi.org/10.1111/jvim.16421

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 36
Issue: 3
Pages: 1131-1138

Researcher Affiliations

Lovett, Amy L
  • Department of Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA.
Gilliam, Lyndi L
  • Department of Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA.
Sykes, Benjamin W
  • School of Veterinary Sciences, Massey University, Stillwater, Palmerston North, New Zealand.
McFarlane, Dianne
  • Department of Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA.

MeSH Terms

  • Animals
  • Case-Control Studies
  • Horse Diseases
  • Horses
  • Humans
  • Insulin
  • Obesity / metabolism
  • Obesity / veterinary
  • Thrombelastography / veterinary
  • Thrombophilia / veterinary

Grant Funding

  • Oklahoma State University (OSU) Research Advisory Committee (RAC) 2019

Conflict of Interest Statement

Authors declare no conflict of interest.

References

This article includes 46 references
  1. Durham AE, Frank N, McGowan CM. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019;33:335‐349.
    pubmed: 0
  2. Morange P‐E, Alessi M‐C. Thrombosis in central obesity and metabolic syndrome: mechanisms and epidemiology. Thromb Haemost 2013;110:669‐680.
    pubmed: 0
  3. Frank N, Geor RJ, Bailey SR, Durham AE, Johnson PJ. Equine metabolic syndrome. J Vet Intern Med 2010;24:467‐475.
    pubmed: 0
  4. Wray H, Elliott J, Bailey S. Plasma concentrations of inflammatory markers in previously laminitic ponies. Equine Vet J 2013;45:546‐551.
    pubmed: 0
  5. Holbrook TC, Tipton T, McFarlane D. Neutrophil and cytokine dysregulation in hyperinsulinemic obese horses. Vet Immunol Immunopathol 2012;145:283‐289.
    pubmed: 0
  6. Basinska K, Marycz K, Śmieszek A, Nicpoń J. The production and distribution of IL‐6 and TNF‐α in subcutaneous adipose tissue and their correlation with serum concentrations in Welsh ponies with equine metabolic syndrome. J Vet Sci 2015;16:113‐120.
    pubmed: 0
  7. Vick M, Adams A, Murphy B. Relationships among inflammatory cytokines, obesity, and insulin sensitivity in the horse. J Anim Sci 2007;85:1144‐1155.
    pubmed: 0
  8. Van Rooy MJ, Duim W, Ehlers R. Platelet hyperactivity and fibrin clot structure in transient ischemic attack individuals in the presence of metabolic syndrome: a microscopy and thromboelastography study. Cardiovasc Diabetol 2015;14:86.
    pubmed: 0
  9. Samuels JM, Moore EE, Coleman JR. Obesity is associated with postinjury hypercoagulability. J Trauma Acute Care Surg 2019;87:876‐882.
    pubmed: 0
  10. Kornblith L, Howard B, Kunitake R. Obesity and clotting: BMI independently contributes to hypercoagulability after injury. J Trauma Acute Care Surg 2015;78:30‐38.
    pubmed: 0
  11. Tuovila M, Erkinaro T, Koivukangas V. Thromboelastography values remain hypercoagulative 6 months after obesity surgery: a pilot study. Obes Surg 2018;28:3943‐3949.
    pubmed: 0
  12. Kupcinskiene K, Trepenaitis D, Petereit R. Monitoring of hypercoagulability by thromboelastography in bariatric surgery. Med Sci Monit 2017;23:1819‐1826.
    pubmed: 0
  13. Campello E, Spiezia L, Zabeo E, Maggiolo S, Vettor R, Simioni P. Hypercoagulability detected by whole blood thromboelastometry (ROTEM(R)) and impedance aggregometry (MULTIPLATE(R)) in obese patients. Thromb Res 2015;135:548‐553.
    pubmed: 0
  14. Pivalizza EG, Pivalizza PJ, Weavind LM. Perioperative thromboelastography and sonoclot analysis in morbidly obese patients. Can J Anaesth 1997;44:942‐945.
    pubmed: 0
  15. Hyldahl Laursen S, Andersen PH, Kjelgaard‐Hansen M, Wiinberg B. Comparison of components of biological variation between 3 equine thromboelastography assays. Vet Clin Pathol 2013;42:443‐450.
    pubmed: 0
  16. Machackova K, Boselova M, Vanova I, Drabkova Z, Doubek J. Evaluation of kaolin‐activated thromboelastography and sample stability in healthy horses. Vet Med 2018;63:203‐209.
  17. Scruggs JL, Flatland B, McCormick KA. Biological variation of thromboelastrography variables in 10 clinically healthy horses. J Vet Emerg Crit Care (San Antonio) 2016;26:80‐84.
    pubmed: 0
  18. Thane K, Bedenice D, Pacheco A. Operator‐based variability of equine thromboelastography. J Vet Emerg Crit Care 2017;27:419‐424.
  19. Epstein KL, Brainard BM, Lopes MA. Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor. J Vet Emerg Crit Care (San Antonio) 2009;19:96‐101.
    pubmed: 0
  20. Lemon AV, Goddard A, Hooijberg EH. Effects of storage time and temperature on thromboelastographic analysis in dogs and horses. Vet Clin Pathol 2021;50:9‐19.
    pubmed: 0
  21. Dunkel B, Chan D, Boston R. Association between hypercoagulability and decreased survival in horses with ischemic or inflammatory gastrointestinal disease. J Vet Intern Med 2010;24:1467‐1474.
    pubmed: 0
  22. Mendez‐Angulo JL, Mudge MC, Vilar‐Saavedra P, Stingle N, Couto CG. Thromboelastography in healthy horses and horses with inflammatory gastrointestinal disorders and suspected coagulopathies. J Vet Emerg Crit Care (San Antonio) 2010;20:488‐493.
    pubmed: 0
  23. Mendez‐Angulo JL, Mudge M, Zaldivar‐Lopez S, Vilar‐Saavedra P, Couto G. Thromboelastography in healthy, sick non‐septic and septic neonatal foals. Aust Vet J 2011;89:500‐505.
    pubmed: 0
  24. Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN. Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease. J Vet Emerg Crit Care (San Antonio) 2013;23:504‐516.
    pubmed: 0
  25. Dallap Schaer BL, Wilkins PA, Boston R, Palmer J. Preliminary evaluation of hemostasis in neonatal foals using a viscoelastic coagulation and platelet function analyzer. J Vet Emerg Crit Care 2009;19:81‐87.
  26. Kohnke JR. Feeding and Nutrition: The Making of a Champion. Melbourne, Australia: Birubi Pacific; 1992:163‐166.
  27. Henneke D, Potter G, Kreider J. Relationship between condition score, physical measurements and body fat percentage in mares. Equine Vet J 1983;15:371‐372.
    pubmed: 0
  28. Dugdale AH, Grove‐White D, Curtis GC. Body condition scoring as a predictor of body fat in horses and ponies. Vet J 2012;194:173‐178.
    pubmed: 0
  29. Schuver A, Frank N, Chameroy KA, Elliott SB. Assessment of insulin and glucose dynamics by using an oral sugar test in horses. J Equine Vet 2014;34:465‐470.
  30. nEquine Endocrinology Group [Internet]n. Tufts University; 2020. https://sites.tufts.edu/equineendogroup/n
  31. Hackett E, McCue P. Evaluation of a veterinary glucometer for use in horses. J Vet Intern Med 2010;24:617‐621.
    pubmed: 0
  32. Garcia‐Pereira BL, Scott MA, Koenigshof AM, Brown AJ. Effect of venipuncture quality on thromboelastography. J Vet Emerg Crit Care 2012;22:225‐229.
  33. Mendez‐Angulo J, Mudge M, Couto C. Thromboelastography in equine medicine: technique and use in clinical research. Equine Vet Educ 2012;24:639‐649.
  34. Campello E, Zabeo E, Radu CM. Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events. Thromb Haemost 2015;113:85‐96.
    pubmed: 0
  35. Cowling JC, Zhang X, Bajwa KS. Thromboelastography‐based profiling of coagulation status in patients undergoing bariatric surgery: analysis of 422 patients. Obes Surg 2021;1‐8:3590‐3597.
  36. Faber DR, de Groot PG, Visseren FL. Role of adipose tissue in haemostasis, coagulation and fibrinolysis.. Obes Rev 2009 Sep;10(5):554-63.
  37. Stepanian A, Bourguignat L, Hennou S, Coupaye M, Hajage D, Salomon L, Alessi MC, Msika S, de Prost D. Microparticle increase in severe obesity: not related to metabolic syndrome and unchanged after massive weight loss.. Obesity (Silver Spring) 2013 Nov;21(11):2236-43.
    pubmed: 23512861doi: 10.1002/oby.20365google scholar: lookup
  38. Feige K, Schwarzwald CC, Bombeli T. Comparison of unfractioned and low molecular weight heparin for prophylaxis of coagulopathies in 52 horses with colic: a randomised double-blind clinical trial.. Equine Vet J 2003 Jul;35(5):506-13.
    pubmed: 12875331doi: 10.2746/042516403775600514google scholar: lookup
  39. Reef VB. Diseases of the cardiovascular system. In: Smith BP, Van Metre DC, Pusterla N, eds. Large Animal Internal Medicine. 6th ed. Maryland Heights, MO: Elsevier; 2020:507.
  40. Dolente BA, Beech J, Lindborg S, Smith G. Evaluation of risk factors for development of catheter-associated jugular thrombophlebitis in horses: 50 cases (1993-1998).. J Am Vet Med Assoc 2005 Oct 1;227(7):1134-41.
    pubmed: 16220676doi: 10.2460/javma.2005.227.1134google scholar: lookup
  41. Ertelt A, Barton AK, Schmitz RR, Gehlen H. Metabolic syndrome: is equine disease comparable to what we know in humans?. Endocr Connect 2014 Sep;3(3):R81-93.
    pmc: PMC4068110pubmed: 24894908doi: 10.1530/ec-14-0038google scholar: lookup
  42. Ragno VM, Zello GA, Klein CD, Montgomery JB. From Table to Stable: A Comparative Review of Selected Aspects of Human and Equine Metabolic Syndrome.. J Equine Vet Sci 2019 Aug;79:131-138.
    pubmed: 31405493doi: 10.1016/j.jevs.2019.06.003google scholar: lookup
  43. van Eps AW, Burns TA. Are There Shared Mechanisms in the Pathophysiology of Different Clinical Forms of Laminitis and What Are the Implications for Prevention and Treatment?. Vet Clin North Am Equine Pract 2019 Aug;35(2):379-398.
    pubmed: 31126692doi: 10.1016/j.cveq.2019.04.001google scholar: lookup
  44. Ahammad J, Kurien A, Shastry S, Shah HH, Nayak D, Kamath A, Badagabettu S. Age- and gender-related reference ranges for thromboelastography from a healthy Indian population.. Int J Lab Hematol 2020 Apr;42(2):180-189.
    pubmed: 31889401doi: 10.1111/ijlh.13148google scholar: lookup
  45. Carslake HB, Pinchbeck GL, McGowan CM. Equine metabolic syndrome in UK native ponies and cobs is highly prevalent with modifiable risk factors.. Equine Vet J 2021 Sep;53(5):923-934.
    pmc: PMC8451835pubmed: 33128277doi: 10.1111/evj.13378google scholar: lookup
  46. Rapson JL, Schott HC 2nd, Nielsen BD, McCutcheon LJ, Harris PA, Geor RJ. Effects of age and diet on glucose and insulin dynamics in the horse.. Equine Vet J 2018 Sep;50(5):690-696.
    pubmed: 29356053doi: 10.1111/evj.12812google scholar: lookup

Citations

This article has been cited 3 times.
  1. Espinosa-López EM, Ortiz-Guisado B, Diez de Castro E, Durham A, Aguilera-Tejero E, Gómez-Baena G. Quantitative proteomics unveils potential plasma biomarkers and provides insights into the pathophysiological mechanisms underlying equine metabolic syndrome. BMC Vet Res 2025 Jul 2;21(1):425.
    doi: 10.1186/s12917-025-04879-6pubmed: 40604814google scholar: lookup
  2. Vokes JR, Lovett AL, de Kantzow MC, Rogers CW, Wilkins PA, Sykes BW. Comparison of Citrated Whole Blood to Native Whole Blood for Coagulation Testing Using the Viscoelastic Coagulation Monitor (VCM Vet™) in Horses. Animals (Basel) 2024 Oct 8;14(19).
    doi: 10.3390/ani14192892pubmed: 39409841google scholar: lookup
  3. Robles M, Rousseau-Ralliard D, Dubois C, Josse T, Nouveau É, Dahirel M, Wimel L, Couturier-Tarrade A, Chavatte-Palmer P. Obesity during Pregnancy in the Horse: Effect on Term Placental Structure and Gene Expression, as Well as Colostrum and Milk Fatty Acid Concentration. Vet Sci 2023 Dec 4;10(12).
    doi: 10.3390/vetsci10120691pubmed: 38133242google scholar: lookup