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They found that high concentrations of insulin stimulated the cells to proliferate. Furthermore, this effect could be prevented using an antibody that specifically blocks only the IGF-1 receptor. Further downstream effects within the cells were also shown. The changes seemed to occur mainly at very high concentrations of insulin.

Similar concentration levels can be seen in ponies and horses with insulin dysregulation linked to Equine Metabolic Syndrome, but are not commonly seen in normal horses who are considered to be at lower risk of laminitis. Further work is under way to determine exactly how these cellular changes induced by sustained high insulin concentrations might cause laminitis. However, it seems that targeting the IGF-1 receptor may be an option for developing new drugs to prevent and treat laminitis. The effect of insulin on equine lamellar basal epithelial cells mediated by the insulin-like growth factor-1 receptor.

Baskerville C. Role of obesity Obesity is no longer seen as a sole cause of EMS but rather a commonly associated feature that, when present, can exacerbate ID. Role of genetics The expression of EMS is the result of a complex interaction between genetics and the environment. Pretest considerations Acute stress can affect insulin and glucose concentrations via activation of the adrenocortical axis and by catecholamine release. Basal testing 6. Insulin An indication of ID can be based on finding resting or basal hyperinsulinemia. Glucose Measuring resting plasma glucose in horses with suspected ID is generally uninformative although warrants inclusion for identification of occasional cases of diabetes mellitus.

Triglycerides Horses and ponies affected by EMS often suffer from dyslipidemia, 12 , and hypertriglyceridemia has been found to be a significant predictor of laminitis in ponies with cutoff values from 0. Dynamic testing Dynamic tests provide additional information on the relationship between insulin and glucose and are generally more sensitive than basal testing for identification of ID. Intravenous challenge tests Parenteral delivery of exogenous glucose, insulin, or both has the advantage of decreasing variability associated with gastrointestinal transit and absorption but also omits some possibly important elements of ID including incretin effects.

Key laboratory testing recommendations The specific methodology used to quantify analytes such as insulin has a marked effect on results and should always be considered, especially when considering diagnostic criteria from published studies. Dietary energy restriction Nutritional strategies for management of obesity primarily rely on energy restriction through limiting the total replace with DMI. Welfare considerations Safe rates of BM loss are not well defined.

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Key dietary recommendations An ideal target for weight loss in obese horses is between 0. Exercise programs Exercise improves insulin sensitivity and reduces inflammation in people, even in the absence of weight loss. Key exercise recommendations Exercise recommendations are opinions extrapolated from medical research and clinical experience; relative gait and HR ranges are based on horse and pony exercise physiology research.

Key pharmacologic recommendations Drug treatment of EMS should never be used as a substitute for diet and exercise interventions.


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Laminitis detection All horses with EMS must be monitored frequently for the earliest clinical signs of laminitis, which are often seen when the horse is turned in tight circles on a hard surface or transitions from soft to hard ground. Obesity control Although diet and exercise recommendations might appear relatively straightforward, they can often be limited by poor compliance from horse owners and other practical barriers to implementation.

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Endocrine monitoring Body mass reduction is expected to improve ID, , , and laboratory testing is recommended to support the weight loss program and to confirm the degree of success in improving ID. Key monitoring recommendations Monitoring and support are crucial elements of EMS management because of poor compliance rates. Insulin tolerance in laminitic ponies.

Can J Comp Med. Glucose tolerance and insulin sensitivity in ponies and Standardbred horses. Equine Vet J.

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Johnson PJ. The equine metabolic syndrome peripheral Cushing's syndrome. Equine metabolic syndrome. Frank N, Tadros EM.

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Insulin dysregulation. J Am Vet Med Assoc. Weight loss resistance: a further consideration for the nutritional management of obese Equidae. Vet J. Am J Vet Res.

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Cardiovascular findings in ponies with equine metabolic syndrome. Prevalence and risk factors for hyperinsulinaemia in ponies in Queensland, Australia. Aust Vet J. Prevalence and risk factors for hyperinsulinaemia in clinically normal horses in central ohio. Adiposity, plasma insulin, leptin, lipids, and oxidative stress in mature light breed horses.

Domest Anim Endocrinol. Breed differences in insulin sensitivity and insulinemic responses to oral glucose in horses and ponies of moderate body condition score. Equine Vet J Suppl. Changes in skeletal muscle GLUT4 content and muscle membrane glucose transport following 6 weeks of exercise training. The effect of exercise training on insulin sensitivity and fat and muscle tissue cytokine profiles of old and young standardbred mares. J Equine Vet Sci.

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Effect of age, season, body condition, and endocrine status on serum free cortisol fraction and insulin concentration in horses. Glycemic and insulinemic responses are affected by age of horse and method of feed processing. Effects of age and diet on glucose and insulin dynamics in the horse. Aging effect on plasma metabolites and hormones concentrations in riding horses.

Open Vet J. Plasma concentrations of inflammatory markers in previously laminitic ponies. Leptin secretion in horses: effects of dexamethasone, gender, and testosterone. Leptin in horses: tissue localization and relationship between peripheral concentrations of leptin and body condition.

J Anim Sci. Prevalence of obesity in a population of horses in the UK. Vet Rec. Obesity prevalence and associated risk factors in outdoor living domestic horses and ponies. Prevalence of obesity in riding horses in Scotland.

The body condition score of leisure horses competing at an unaffiliated championship in the UK. Body condition score, morphometric measurements and estimation of body weight in mature Icelandic horses in Denmark. Acta Vet Scand. Demographics, management, and welfare of nonracing horses in Prince Edward Island.

Can Vet J. Prevalence of obesity in the equine population of Saskatoon and surrounding area. Prevalence of overconditioning in mature horses in southwest Virginia during the summer. Assessing the seasonal prevalence and risk factors for nuchal crest adiposity in domestic horses and ponies using the Cresty Neck Score. BMC Vet Res. Appl Anim Behav Sci. Prevalence and risk factors for overweight horses at premises in Sweden assessed using official animal welfare control data.

Seasonal variation in serum concentrations of selected metabolic hormones in horses. Seasonal and annual influence on insulin and cortisol results from overnight dexamethasone suppression tests in normal ponies and ponies predisposed to laminitis. Evaluation of the effects of pregnancy on insulin sensitivity, insulin secretion, and glucose dynamics in Thoroughbred mares.

Seasonal variation in results of diagnostic tests for pituitary pars intermedia dysfunction in older, clinically normal geldings. Relationships among body condition, insulin resistance and subcutaneous adipose tissue gene expression during the grazing season in mares. PLoS One. Seasonal and pulsatile dynamics of thyrotropin and leptin in mares maintained under a constant energy balance.

Equine serum lipids: serum lipids and glucose in Morgan and Thoroughbred horses and Shetland ponies.


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Insulin secretion and carbohydrate metabolism during pregnancy in the mare. J Reprod Fertil.