Effect of age and dietary carbohydrate profiles on glucose and insulin dynamics in horses

Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia

BACKGROUND

Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies.

OBJECTIVES

To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR).

STUDY DESIGN

Cross-sectional.

METHODS

Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1-9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms.

RESULTS

Among 167 ponies tested, median (range) age was 9 (4-21) years and BCS was 6 (4-8). Prevalence (95% confidence interval [CI]) of ID was 61 (53-68)%. Factors associated with insulin concentrations (estimate [95% CI]; μIU/mL) 60 min post-OST were: age (1.07 [1.02-1.11]), CNS (≥3/5, 1.52 [1.04-2.23]) and VASo (≥7/9, 1.75 [1.09-2.79]); and 90 min post-OST were: age (1.08 [1.03-1.12]), CNS (≥3/5, 1.80 [1.22-2.64]), VASo (≥7/9, 2.49 [1.52-4.08]) and sex (male, 0.64 [0.45-0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (-1.34 [-2.01 to -0.67]), sex (female, -6.21 [-11.68 to -0.74]) and VASo (≥7/9, -1.74 [-18.89 to -4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68-12.58]), IR (3.66 [1.26-10.61]) and PPID (11.75 [1.54-89.40]).

MAIN LIMITATIONS

Single time-point sampling, laminitis definition and diet analysis.

CONCLUSIONS

Ageing, being female and owner-perceived obesity were associated with ID.

Deciphering reference intervals and clinical decision limits in equine endocrine diagnostic testing

Reference intervals (RIs) and clinical decision limits (CDLs) are frequently established to facilitate interpretation of values of endocrine biomarkers in the diagnosis of disease. Despite their commonplace use in clinical decision-making, these concepts can be confused. Comparing a test result with a RI provides an estimation as to whether or not the individual is healthy, whereas comparison with a CDL facilitates identification of individuals with a particular disease state or at greater risk of adverse clinical outcomes. In practice, there will also be a range of results for which the discriminative ability of the test is insufficient to inform a specific diagnostic decision. Including a range of uncertain test results, or 'grey zone', between positive and negative avoids the constraint of a binary decision in classifying an individual with a test value above (or below) a single cut-off value as diseased. This review will detail the application of both RIs and CDLs, including defining the range of uncertain test results, in the context of equine endocrinology.

Age-Related Differences in Short-Term Transportation Stress Responses of Horses

Transportation of horses on short journeys can lead to an increase in stress. There are known age-associated changes in immune and metabolic responses in horses; however, no research exists evaluating how age may influence these responses to transportation stress. Eleven mares within two age groups, aged (n = 5, 22 ± 1 year) or young (n = 6, 2 ± 1 year), were transported 1 hour and 20 minutes. Peripheral blood and saliva were collected before and after transportation at baseline (2 to 3 weeks prior to transportation), 24 hours pre-transport, 1 hour before loading, 15 minutes, 30 minutes, 1 to 3 hours, 24 hours and 8 days post-transport. Heart rates, rectal temperatures, under the tail temperatures, serum cortisol, plasma ACTH, serum insulin, salivary cortisol and salivary IL-6 were measured. Whole blood gene expression of the cytokines IL-1b, IL-2, IL-6, IL-10, IFNγ, and TNFα were determined through qPCR, and peripheral blood mononuclear cells were isolated, stimulated, and stained to determine IFNγ and TNFα production. Serum cortisol (P < .0001), salivary cortisol (P < .0001) and heart rate (P = .0002) increased in response to transportation with no age differences. Rectal (P = .03) and under the tail temperatures (P = .02) were increased in young versus aged horses. ACTH was higher in aged horses (P = .007) and post-transportation (P = .0001). Aged horses showed a greater increase in insulin compared with young horses (P < .0001). While age does not seem to impact cortisol responses to short-term transportation in horses, it did influence the post transportation insulin response to stress in aged horses.

Fecal Microbiota, Forage Nutrients, and Metabolic Responses of Horses Grazing Warm- and Cool-Season Grass Pastures

Integrating warm-season grasses into cool-season equine grazing systems can increase pasture availability during summer months. The objective of this study was to evaluate effects of this management strategy on the fecal microbiome and relationships between fecal microbiota, forage nutrients, and metabolic responses of grazing horses. Fecal samples were collected from 8 mares after grazing cool-season pasture in spring, warm-season pasture in summer, and cool-season pasture in fall as well as after adaptation to standardized hay diets prior to spring grazing and at the end of the grazing season. Random forest classification was able to predict forage type based on microbial composition (accuracy: 0.90 ± 0.09); regression predicted forage crude protein (CP) and non-structural carbohydrate (NSC) concentrations (p < 0.0001). Akkermansia and Clostridium butyricum were enriched in horses grazing warm-season pasture and were positively correlated with CP and negatively with NSC; Clostridum butyricum was negatively correlated with peak plasma glucose concentrations following oral sugar tests (p ≤ 0.05). These results indicate that distinct shifts in the equine fecal microbiota occur in response different forages. Based on relationships identified between the microbiota, forage nutrients, and metabolic responses, further research should focus on the roles of Akkermansia spp. and Clostridium butyricum within the equine hindgut.

Palatability, glycemic, and insulinemic responses to various carbohydrate formulations: Alternatives for the diagnosis of insulin dysregulation in horses?

BACKGROUND

Oral glycemic challenge (GC) tests are recommended for diagnosis of insulin dysregulation (ID). Various protocols are used, but all have limitations in terms of palatability, ease of use, variable composition, geographic availability, or some combination of these.

HYPOTHESIS/OBJECTIVE

To evaluate newly developed formulations with defined carbohydrate composition for use as oral GCs.

ANIMALS

Thirty-four horses and ponies in various metabolic states.

METHODS

Our objectives were carried out in 2 separate cross-over experiments. First, the palatability and acceptance of various GCs (2 syrups, 1 granulate) offered for free intake were compared to glucose mixed in a chaff-based diet. Subsequently, syrups were administered by syringe and compared to an oral glucose test using naso-gastric tubing (tube OGT) to investigate the glycemic and insulinemic responses. Second, these variables were compared in the best performing GC-formulations (granulate further optimized to pelleted formulation and 1 syrup) and a tube OGT. All GCs were administered with equivalent amounts of 0.5 g glycemic carbohydrates per kg body weight.

RESULTS

Only the GC pellets were consumed completely by all horses (consumption time 5 ± 2 min). When administered by syringe, the GC syrup also was well accepted. The insulin concentrations at 120 min correlated significantly between tube OGT and GC pellets (r = .717; P < .001) or GC syrup (r = .913; P < .001). The new GC syrup and GC pellets discriminate between healthy and ID horses.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

The GC pellets (DysChEq)™ and GC syrup can be used as palatable and well-accepted oral GC tests for assessment of ID in horses.

Predictors of laminitis development in a cohort of nonlaminitic ponies

BACKGROUND

Quantifying risk factors for laminitis development requires improvement.

OBJECTIVES

To identify the most useful physical examination, metabolic and management factors to predict laminitis development in client-owned, nonlaminitic ponies.

STUDY DESIGN

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- (<21.6 µIU/ml), medium- (21.6-45.2 µIU/ml) and high-risk (>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.

MAIN LIMITATIONS

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.

Carbohydrate pellets to assess insulin dysregulation in horses

BACKGROUND

A glycemic challenge test is used for the diagnosis of insulin dysregulation (ID) in horses and ponies. Different forms of the test exist where the administrative route and dose of glucose vary, which makes interpretation of results challenging.

HYPOTHESIS/OBJECTIVES

To evaluate the palatability of, and blood glucose and insulin responses to, carbohydrate pellets fed as an oral glucose test (OGT), and to establish the diagnostic threshold for ID when using the pellets.

ANIMALS

University and privately-owned horses and ponies (n = 157) comprised of 31 breeds and both sexes.

METHODS

Multicenter cohort study. A custom-produced glycemic pellet was offered for free intake at 0.5 g/kg BW soluble carbohydrate and serum insulin and blood glucose concentrations measured before and after (60, 120, and 180 minutes) the pellets were offered. Pellet acceptance and intake time (those that finished within 10 minutes) were determined to assess palatability.

RESULTS

The pellets were palatable to 132/157 animals, and ponies found the pellets more (P = .004) palatable than horses. The median intake time (4 [3-6] minutes) was positively correlated with acceptance grade (r = .51; P < .0001). Consumption of the pellets elicited peak blood glucose (6.6 [5.8-7.8] mmol/L) and serum insulin (40.5 [19-99.8] μIU/mL) responses at 120 minutes. At 120 minutes the optimal cut-off was 83 μIU/mL (95% CI: 70-99 μIU/mL) for the IMMULITE 2000XPi assay.

CONCLUSIONS AND CLINICAL IMPORTANCE

The pellets were palatable and a suitable, novel carbohydrate source for the OGT.

A starch-rich treat affects enteroinsular responses in ponies

OBJECTIVE

To determine the effect of a starch-rich treat, added to the daily diet of ponies for 10 days, on enteroinsular responses to meal consumption.

ANIMALS

10 mixed-breed adult ponies owned by Queensland University of Technology were used in the study. Six ponies were metabolically healthy, and 4 were insulin dysregulated at the start of the study, according to the results of an in-feed oral glucose test.

PROCEDURES

A bread-based treat was offered twice daily for 10 days, adding 0.36 ± 0.04 g/kg body weight (BW) carbohydrates to the daily diet. Before and after treatment, the intestinal capacity for simple carbohydrate absorption was approximated with a modified D-xylose absorption test. Plasma glucagon-like peptide-2 (GLP-2), blood glucose, and serum insulin responses to eating were also measured before and after treatment.

RESULTS

The absorption of D-xylose (area under the curve [AUC]) increased 1.6-fold (P < .001) after 10 days of eating the treat. In addition, while basal (fasted) GLP-2 concentrations were not affected, GLP-2 AUC increased 1.4-fold in response to eating (P = .005). The treat did not change blood glucose or serum insulin concentrations, before, during, or after eating.

CLINICAL RELEVANCE

A small amount of additional carbohydrate each day in the form of a treat can cause a measurable change in the enteroinsular responses to eating.

Effects of Bromocriptine on Glucose and Insulin Dynamics in Normal and Insulin Dysregulated Horses

The objectives of the study were to study the effects of the synthetic ergot alkaloid (EA), bromocriptine, on glucose and lipid metabolism in insulin dysregulated (ID, n = 7) and non-ID (n = 8) mares. Horses were individually housed and fed timothy grass hay and two daily concentrate meals so that the total diet provided 120% of daily DE requirements for maintenance. All horses were given intramuscular bromocriptine injections (0.1 mg/kg BW) every 3 days for 14 days. Before and after 14 days of treatment horses underwent a combined glucose-insulin tolerance test (CGIT) to assess insulin sensitivity and a feed challenge (1 g starch/kg BW from whole oats) to evaluate postprandial glycemic and insulinemic responses. ID horses had higher basal plasma concentrations of insulin (P = 0.01) and triglycerides (P = 0.02), and lower concentrations of adiponectin (P = 0.05) compared with non-ID horses. The CGIT response curve showed that ID horses had slower glucose clearance rates (P = 0.02) resulting in a longer time in positive phase (P = 0.03) and had higher insulin concentrations at 75 min (P = 0.0002) compared with non-ID horses. Glucose (P = 0.02) and insulin (P = 0.04) responses to the feeding challenge were lower in non-ID compared to ID horses. Regardless of insulin status, bromocriptine administration increased hay intake (P = 0.03) and decreased grain (P < 0.0001) and total DE (P = 0.0002) intake. Bromocriptine treatment decreased plasma prolactin (P = 0.0002) and cholesterol (P = 0.10) and increased (P = 0.02) adiponectin concentrations in all horses. Moreover, in both groups of horses, bromocriptine decreased glucose clearance rates (P = 0.02), increased time in positive phase (P = 0.04) of the CGIT and increased insulin concentrations at 75 min (P = 0.001). The postprandial glycemic (P = 0.01) and insulinemic (P = 0.001) response following the oats meal was lower after bromocriptine treatment in all horses. In conclusion, in contrast to data in humans and rodents, bromocriptine treatment reduced insulin sensitivity in all horses, regardless of their insulin status. These results indicate that the physiological effects of EA might be different in horses compared to other species. Moreover, because bromocriptine shares a high degree of homology with natural EA, further investigation is warranted in horses grazing endophyte-infected grasses.

Comparison of insulin sensitivity between healthy neonatal foals and horses using minimal model analysis

The equine neonate is considered to have impaired glucose tolerance due to delayed maturation of the pancreatic endocrine system. Few studies have investigated insulin sensitivity in newborn foals using dynamic testing methods. The objective of this study was to assess insulin sensitivity by comparing the insulin-modified frequently sampled intravenous glucose tolerance test (I-FSIGTT) between neonatal foals and adult horses. This study was performed on healthy neonatal foals (n = 12), 24 to 60 hours of age, and horses (n = 8), 3 to 14 years of age using dextrose (300 mg/kg IV) and insulin (0.02 IU/kg IV). Insulin sensitivity (SI), acute insulin response to glucose (AIRg), glucose effectiveness (Sg), and disposition index (DI) were calculated using minimal model analysis. Proxy measurements were calculated using fasting insulin and glucose concentrations. Nonparametric statistical methods were used for analysis and reported as median and interquartile range (IQR). SI was significantly higher in foals (18.3 L·min^-1· μIU^-1 [13.4–28.4]) compared to horses (0.9 L·min^-1· μIU^-1 [0.5–1.1]); (p < 0.0001). DI was higher in foals (12 × 10³ [8 × 10³−14 × 10³]) compared to horses (4 × 10² [2 × 10²−7 × 10²]); (p < 0.0001). AIRg and Sg were not different between foals and horses. The modified insulin to glucose ratio (MIRG) was lower in foals (1.72 μIU_insulin²/10·L·mg_glucose [1.43–2.68]) compared to horses (3.91 μIU _insulin²/10·L·mg_glucose [2.57–7.89]); (p = 0.009). The homeostasis model assessment of beta cell function (HOMA-BC%) was higher in horses (78.4% [43–116]) compared to foals (23.2% [17.8–42.2]); (p = 0.0096). Our results suggest that healthy neonatal foals are insulin sensitive in the first days of life, which contradicts current literature regarding the equine neonate. Newborn foals may be more insulin sensitive immediately after birth as an evolutionary adaptation to conserve energy during the transition to extrauterine life.

Obesity-Related Metabolic Dysfunction in Dairy Cows and Horses: Comparison to Human Metabolic Syndrome

Obesity has become a serious health problem with frequent occurrence both in human and animal populations. It is estimated that it may affect over 85% of the human population and 70–80% of horses and cows by 2030. Fat cow syndrome (FCS) is a combination of metabolic, digestive, infectious, and reproductive disorders that affects obese periparturient dairy cows, and occurs most frequently in loose-housing systems, where periparturient and dry cows are fed and managed in one group disregarding the lactation stages. Equine metabolic syndrome (EMS) was named after human metabolic syndrome (MetS) and has insulin dysregulation as a central and consistent feature. It is often associated with obesity, although EMS may occur in a lean phenotype as well. Other inconsistent features of EMS are cardiovascular changes and adipose dysregulation. Laminitis is the main clinical consequence of EMS. MetS holds a 30-years old lead in research and represents a clustering of risk factors that comprise abdominal obesity, dyslipidemia, hypertension, and hyperglycemia (impaired fasting glucose or type 2 diabetes mellitus—T2DM), which are associated with doubled atherosclerotic cardiovascular disease risk, and a 5-fold increased risk for T2DM. The main aim of this review is to provide critical information for better understanding of the underlying mechanisms of obesity-related metabolic dysfunction in animals, especially in cows and horses, in comparison with MetS. Human medicine studies can offer suitable candidate mechanisms to fill the existing gap in the literature, which might be indispensable for owners to tackle FCS, EMS, and their consequences.

Effect of Dose and Fasting on Oral Sugar Test Responses in Insulin Dysregulated Horses

The oral sugar test (OST) is frequently used to identify insulin dysregulated (ID) equines. The effect of fasting and varying sugar dose for the OST has been investigated in the pony but little work has been done in the horse. This study aimed to investigate (1) an OST response with access to forage continued until the time of the OST or prevented for 3 hours prior to the OST and (2) responses of ID and non-insulin dysregulated (NID) horses to two different OST doses. Twenty-one mixed-breed horses (14.8 ± 3.2 years; 574.3 ± 83.3 kg) were used in two randomized crossover studies. Seven ID and seven NID horses were used in study A, and eight ID and eight NID in study B. Study A horses underwent an OST (0.15 mL/kg BW) either after a fast (FA) or directly off pasture (FE). Study B horses received either a low (LD; 0.15 mL/kg BW) or high dose (HD; 0.45 mL/kg BW) OST on one occasion each. Blood was collected at basal (T0), and post-60 minute (T60) for later determination of insulin (RIA). Data were analyzed via ANOVA with repeated measures. ID horses had significantly (P < 0.05) greater insulin responses than NID for all OSTs. There was no statistical difference between LD versus HD mean insulin concentrations (T0, T60, delta insulin) for either ID or NID horses. ID had higher T0 (P < 0.01) for FE compared to FA; however, FE and FA did not significantly affect T60 or delta insulins (DI) concentrations.

Use of palm bran (Nopalea cochenillifera (L.) Salm-Dyck) in partial replacement of concentrate in maintenance equine diets - a pilot study

Forage palm is extremely suitable as animal fodder due to its high tolerance to the climatic rigors of the semiarid region and its ability to withstand the harsh physical–chemical limitations of poor soils. Thus, in this study, the effects of the partial replacement (0 %, 5 %, 10 % and 15 % replacement) of a molasses- or oat-based commercial concentrate with forage palm bran (FPB) on the acceptability, apparent digestibility and glycemic response of horses at maintenance were evaluated. The ratio of concentrate to roughage (Tifton 85 hay) was 30:70, and the dry matter (DM) intake was 2 % of body weight (BW). For the preference test, 10 barren Mangalarga Marchador mares were used. The experimental diets were offered simultaneously to determine the consumption preference and the intake ratio. For the digestibility test, four mixed-breed geldings were used and were distributed in a Latin square experimental design (4×4). For the glycemic response, blood samples were collected 30 min before and 30, 60, 90, 120, 180 and 240 min after supplying the feed. The preference test indicated that feed containing 0 % and 5 % FPB was preferred by the animals. Nutrient digestibility coefficients did not differ among the experimental diets. Blood glucose was lower at 180 min in the 7.42 % FPB inclusion diet (R2=0.97); this was estimated using the following equation: Y=115.05-2.75x+0.19x2. It is concluded that the incorporation of up to 15 % of forage palm bran as a substitute for concentrate in the maintenance diet tested did not negatively influence feed intake, nutrient digestibility or glycemic index; however, inclusion values above 5 % reduced diet acceptability.

How to Perform a Nutritional Assessment in a First-Line/General Practice

Inappropriate nutrition is a priority welfare challenge. Nutritional mistakes are common and can lead to adverse events, such as poor growth and performance, colic, laminitis, and obesity. A detailed nutritional assessment involving evaluating the equine patient, current diet/ration, and management is essential in creating an effective nutritional plan. Goal(s) should be established and used to inform the plan. Management or resource barriers should be considered. Effective communication and a team-based approach versus an authoritarian one are likely to enhance the success of the nutritional plan. Developing a plan should be an interactive process, adjusting as needed after intentional monitoring.

Changes Associated with the Peri-Ovulatory Period, Age and Pregnancy in ACTH, Cortisol, Glucose and Insulin Concentrations in Mares

Simple Summary

The reproductive cycle of mares is associated with many hormonal changes, but the effects of this cycle and pregnancy on adrenocorticotropic hormone and insulin concentrations are poorly described, which could limit our ability to diagnose pituitary pars intermedia dysfunction and insulin dysregulation. In this study, healthy mares are followed through their reproductive cycle during the physiologic breeding season, and adrenocorticotropic hormone, cortisol, glucose and insulin concentrations are measured to determine the effects of age, pregnancy and the reproductive cycle on analyte concentrations. No significant effect of age, the reproductive cycle or pregnancy is detected on the cortisol, glucose or insulin concentrations; however, adrenocorticotropic hormone concentrations are significantly increased throughout the peri-ovulatory period and during pregnancy. Therefore, knowledge of a mare’s reproductive cycle might be beneficial when interpreting adrenocorticotropic hormone concentrations.

Abstract

Although there are many hormonal changes associated with reproduction, the effects of ovulation and early pregnancy on adrenocorticotropic hormone (ACTH) and insulin concentrations are poorly described. We hypothesise that both ovulation and early pregnancy will alter ACTH and insulin concentrations in healthy mares. Eighteen mares showing no clinical signs suggestive of, or laboratory findings consistent with, pituitary pars intermedia dysfunction PPID and insulin dysregulation (ID) are enrolled. ACTH, cortisol, insulin and glucose concentrations are measured over their peri-ovulatory period, as determined via ultrasounds and progesterone concentrations. The mares are grouped by age and gestation status, and a two-way repeated-measures ANOVA is used to determine the effects of age and early pregnancy, along with the peri-ovulatory period, on analyte concentrations. No significant effect of age, ovulation or early pregnancy is detected on the mares’ cortisol, insulin or glucose concentrations; however, there is a significant effect of early pregnancy and ovulation on ACTH concentrations (p = 0.04 and p = 0.04 respectively). ACTH concentrations change around ovulation and with early pregnancy. Therefore, knowledge of a mare’s reproductive status might be beneficial when interpreting ACTH concentrations.

The effect of diet-induced obesity and pasture on blood pressure and serum cortisol in Standardbred mares

BACKGROUND

Obesity is associated with insulin resistance, vascular dysfunction and altered cortisol metabolism both in humans and in horses.

OBJECTIVES

Evaluate the effect of weight gain induced by a haylage diet low in nonstructural carbohydrates (NSC) on insulin sensitivity, blood pressure and serum cortisol concentrations.

STUDY DESIGN

In vivo experiment.

METHODS

Nine adult Standardbred mares fed a fat supplemented haylage diet at 250% of the horses' daily metabolisable energy requirements for 22 weeks. Horses were then turned out on pasture for 4 weeks. Insulin sensitivity (SI_CLAMP ) was measured before and after weight gain and after 4 weeks of pasture using the euglycemic hyperinsulinaemic clamp (EHC) method. Body condition score (BCS), blood pressure and serum cortisol were monitored throughout the study. All data were analysed using the linear mixed model procedure. Values of P < 0.05 were considered as statistically different.

RESULTS

All horses became obese during the weight gain period (BCS> 7). Mean arterial blood pressure (MAP) increased during the weight gain period and was significantly higher than initial values at the end of the weight gain period (78 ± 3 mm Hg vs 92 ± 3 mmHg). MAP remained increased on pasture (93 ± 3 mmHg). SI_CLAMP was unaffected by weight gain 0.9 ± 0.1 vs 1.0 ± 0.1 ([mg/kg/min × 10³ ]/[µIU/mL × mmol/L])) but improved after pasture (1.6 ± 0.1 ([mg/kg/min × 10³ ]/ [mU/L]). Serum cortisol concentrations increased during the weight gain period (80 ± 9 nmol/L vs 112 ± 9 nmol/L) and remained increased during pasture.

MAIN LIMITATIONS

Limited number of horses and no control group.

CONCLUSIONS

Obesity was associated with a linear increase in blood pressure and an increase in serum cortisol that was not associated with insulin sensitivity.

Weight loss is linearly associated with a reduction of the insulin response to an oral glucose test in Icelandic horses

BACKGROUND

Insulin dysregulation (ID) goes along with lasting or transient hyperinsulinemia able to trigger equine laminitis, a painful and crippling foot condition. Promoting weight loss through dietary changes and physical activity is currently the main option to prevent this disease. This study aimed at describing the relationship between weight variations and the level of ID as determined by oral glucose tests (OGT). Therefore, the insulin response of 19 Icelandic horses to repeated OGTs was retrospectively analysed considering the variations in their body weight.

RESULTS

There was a strong linear relationship between variations in body weight and variations in the total insulin response to OGT as approximated by the area under the curve of insulin (p < 0.001). As indicated by a weighted least squares model, the insulin response decreased by 22% for 5% weight loss on average. However some horses did not respond to weight loss with a reduction of their insulin response to OGT. Additionally, a high correlation between 120 min serum insulin concentration and total insulin response was observed (r = 0.96, p < 0.001).

CONCLUSIONS

The results corroborate that weight loss is effective against ID and allow for a better quantification of the expected improvement of the insulin response after weight loss. However, it is unclear why some horses did not respond as expected. The high correlation between the 120 min insulin concentration and total insulin response suggests that insulin status can be accurately determined and monitored with only few samples in a practical setting.

Effect of long-term overfeeding of a high-energy diet on glucose tolerance in Shetland pony mares

Background

Overfeeding is associated with obesity and insulin dysregulation (ID), which are both risk factors for equine metabolic syndrome. How chronic overfeeding affects development of these factors is poorly understood.

Objectives

To examine the influence of long‐term high‐energy diet provision on body condition and ID.

Animals

Eleven Shetland pony mares.

Methods

In a 3‐phase study, the high‐energy group (n = 7) was fed 200% of net energy (NE) requirements (hay; concentrate: 36% sugar and starch, 13% fat) for 24 weeks, followed by 17 weeks hay‐only feeding before resuming the high‐energy diet (n = 4) for an additional 29 weeks. Mares were weighed weekly. Oral glucose tolerance tests were performed 3 to 4 times per dietary period. Results were compared with those of a control group (phase 1, n = 4; phases 2 and 3, n = 6) that received 100% NE requirements, using a general linear mixed model with post hoc Bonferroni testing.

Results

The mean body weight of the high‐energy group increased by 27% per high‐energy feeding period. During both feeding periods, area under the curve (AUC) for plasma glucose concentration decreased (P < .01), whereas AUC for plasma insulin concentration increased. Mean basal plasma glucose concentration and peak plasma insulin concentrations were higher (P < .05) in the high‐energy group than in the control group.

Conclusion and Clinical Importance

Feeding a high‐energy diet to healthy nonobese Shetland pony mares led to more efficient glucose metabolism within 5 weeks, followed by significant hyperinsulinemia and obesity. Hyperinsulinemic status was reversed during 17 weeks of hay‐only feeding, regardless of body condition, but returned rapidly after restarting the high‐energy diet.

Chromium propionate increases insulin sensitivity in horses following oral and intravenous carbohydrate administration

Forty-eight Quarter Horse geldings (3 to 8 yr of age) were used to determine the effects of dietary chromium (Cr), in the form of Cr propionate (Cr Prop) on insulin sensitivity. Horses were blocked by age, body condition score, and glucose response to concentrate feeding on day 0 and randomly assigned to treatments. Treatments consisted of 0, 2, 4, or 8 mg Cr/d from Cr Prop. Horses were fed daily a concentrate mix at a rate of 0.2 kg/100 kg body weight (BW) and grass hay at 1.75 to 2.0 kg/100 kg BW. All horses were fed the control diet for 7 d prior to the initiation of the study. After an overnight fast, blood samples from the jugular vein were obtained at 0, 2, and 4 h after concentrate feeding on days 0 and 28 for the determination of glucose, nonesterified fatty acids, and insulin. A glucose tolerance test (GTT) was conducted on day 42. Glucose was infused via jugular vein catheters, and blood samples were collected at various times relative to dosing for glucose and insulin determination. Plasma glucose on day 28 was affected (P < 0.05) by treatment, time, and treatment × time. Horses fed 4 mg Cr/d had lesser (P < 0.05) plasma glucose concentrations than those in the other treatments at 0 h. At 2 h post-feeding glucose concentrations were greater (P < 0.05) in horses fed 0 or 8 mg Cr/d than in those given 4 mg Cr. Horses fed 2 mg Cr/d had lesser (P < 0.05) plasma glucose at 4 h post feeding compared with those fed 0 or 8 mg Cr. Plasma glucose did not differ among horses receiving 2 or 4 mg Cr/d at 2 or 4 h. Serum insulin was affected (P < 0.05) by treatment, time, and treatment × time. Insulin concentrations were greater (P < 0.05) in horses fed 0 or 2 mg Cr/d than in those given 4 or 8 mg Cr at 0 h. At 4 h post-feeding insulin concentrations were greater (P < 0.05) in horses given 0 or 8 mg Cr than in those fed 2 or 4 mg Cr/d. Plasma glucose was affected (P < 0.05) by treatment and time, but not by treatment × time following the GTT. Mean plasma glucose (across sampling times) concentrations were greater (P < 0.05) in controls than in horses fed 2 or 4 mg Cr/d. Glucose concentrations following the GTT did not differ among controls and horses given 8 mg Cr/d. Following glucose infusion, serum insulin concentrations were greater (P < 0.05) in horses fed 2 or 4 mg Cr and tended to be greater in those fed 8 mg Cr/d compared with controls. The results of this study indicate that 2 or 4 mg Cr/d from Cr Prop increased insulin sensitivity in adult horses following oral carbohydrate consumption.

Investigation of the Effects of a Dietary Supplement on Insulin and Adipokine Concentrations in Equine Metabolic Syndrome/Insulin Dysregulation

High insulin concentrations are a common clinical feature of equine metabolic syndrome (EMS) and insulin dysregulation. Hyperinsulinemia can induce laminitis, so reduction of insulin concentrations in response to an oral challenge should decrease risk. In human studies, diets containing a polyphenol (resveratrol) led to improvements in insulin sensitivity. In rodents, the addition of leucine to a resveratrol supplement caused a decrease in the amount of resveratrol needed to achieve a clinical effect. We hypothesize a supplementation with a low dose of a synergistic polyphenol and amino acid blend including leucine (SPB+L) would improve metabolic health in EMS/insulin dysregulated horses. Fifteen EMS/ID horses received a high or low dose of SPB+ L daily for 6 weeks. Insulin during an oral sugar test (OST), body condition score, weight, baseline high-molecular-weight (HMW) adiponectin, triglycerides, nonesterified fatty acids, and tumor necrosis factor alpha were assessed before supplementation (PRE) and after supplementation (POST) via paired Student's t-tests and a repeated-measures mixed-model analysis of variance (significant at P < .05). There were no differences between doses. Horses in the POST group weighed significantly less, had significantly higher baseline HMW adiponectin concentrations, and had significantly lower insulin concentrations at 60- and 75-minute time points (P < .05). Insulin concentrations of the horsesin the POST group, but not in the PRE group, were lower and similar to results from the study conducted three years before the present study (PRIOR) for 0- and 60-minute time points (P < .002). An increased HMW adiponectin level supports increasing insulin sensitivity after supplementation. These results suggest that SPB + L supplementation at either dose leads to improvements in the clinical manifestations of EMS/insulin dysregulation, potentially reducing laminitis risk.

Genome-Wide Association Analyses of Equine Metabolic Syndrome Phenotypes in Welsh Ponies and Morgan Horses

Equine metabolic syndrome (EMS) is a complex trait for which few genetic studies have been published. Our study objectives were to perform within breed genome-wide association analyses (GWA) to identify associated loci in two high-risk breeds, coupled with meta-analysis to identify shared and unique loci between breeds. GWA for 12 EMS traits identified 303 and 142 associated genomic regions in 264 Welsh ponies and 286 Morgan horses, respectively. Meta-analysis demonstrated that 65 GWA regions were shared across breeds. Region boundaries were defined based on a fixed-size or the breakdown of linkage disequilibrium, and prioritized if they were: shared between breeds or across traits (high priority), identified in a single GWA cohort (medium priority), or shared across traits with no SNPs reaching genome-wide significance (low priority), resulting in 56 high, 26 medium, and seven low priority regions including 1853 candidate genes in the Welsh ponies; and 39 high, eight medium, and nine low priority regions including 1167 candidate genes in the Morgans. The prioritized regions contained protein-coding genes which were functionally enriched for pathways associated with inflammation, glucose metabolism, or lipid metabolism. These data demonstrate that EMS is a polygenic trait with breed-specific risk alleles as well as those shared across breeds.

Effect of body condition on intestinal permeability in horses

OBJECTIVE

To investigate effects of body condition on permeability of intestinal mucosa in horses.

ANIMALS

13 horses (7 obese and 6 lean) from 8 to 15 years of age.

PROCEDURES

Body condition score was assessed, and an oral sugar test (OST) was performed to evaluate glucose and insulin dynamics. Horses were allowed a 2-week diet acclimation period and were then euthanized. Tissue samples were collected from the jejunum, ileum, cecum, pelvic flexure, right dorsal colon, and rectum. Mucosal permeability was assessed by measuring transepithelial resistance and lipopolysaccharide (LPS) flux across tissue samples mounted in Ussing chambers.

RESULTS

5 obese horses and 1 lean horse had evidence of insulin dysregulation, whereas 1 obese and 5 lean horses had no abnormalities in results of the OST. Results for the OST were not available for 1 obese horse. Mucosal transepithelial resistance did not differ in any intestinal segment between obese and lean horses. Obese horses had a significantly higher LPS flux across jejunal mucosa, compared with results for lean horses, but there were no significant differences between obese and lean horses for other intestinal segments.

CONCLUSIONS AND CLINICAL RELEVANCE

Obese horses may have had greater paracellular mucosal permeability of jejunal mucosa to LPS, compared with that for lean horses. This finding was consistent with data for the gastrointestinal mucosa of humans and mice and supported the hypothesis that obese horses may be at higher risk from chronic exposure to increased amounts of LPS, compared with the risk for lean horses.

Effects of grazing system, season, and forage carbohydrates on glucose and insulin dynamics of the grazing horse

Rotational grazing is a recommended practice for grazing livestock, but little is known about its benefits with respect to grazing horses. The objective of this study was to investigate the effects of continuous (CON) and rotational (ROT) grazing on forage nutrient composition and whether those concentrations influenced circulating glucose and insulin concentrations in the grazing horse. Twelve mature Standardbred mares were paired by age and weight and randomly assigned to 1 replicate of either a 1.5 ha cool-season grass CON or ROT system for a total of 3 mares in each system. Mares on CON were allowed to graze the entire system at all times, whereas mares on ROT were given access to a 0.4 ha pasture section and stress lot where they were confined during inclement weather and slow forage growth. Blood and feces from horses and forage from each system were sampled over one 24-h period in June, August, and October. Blood was assessed for plasma glucose (GLU) and serum insulin (INS), feces for pH, and forage for nutritional composition. Data were analyzed by ANOVA with repeated measures with significance set at P < 0.05. There were no treatment differences for water and ethanol soluble carbohydrates (WSC and ESC, respectively), starch, ADF, and NDF, but CP was lower in ROT compared to CON (P = 0.04). With respect to month, WSC were highest in June compared to August and October, whereas ESC were highest in June compared to only August. Starch was lower in October than in June and August. Concentrations of ADF and NDF were lowest in October compared to June and August. Crude protein was higher in October than June and August. Plasma GLU and serum INS were affected by season and time of day but not grazing system. For all horses, GLU was highest in August (105.6 ± 1.3 mg/dL), whereas INS was highest in October (0.21 ± 0.02 μg/L; P < 0.0001). Fecal pH only varied by season and was highest in August (7.06; P < 0.0001). Few consistent correlations between grazing systems were found with the exception of INS with ESC (R = 0.32 to 0.39; P < 0.04) and INS and GLU with ADF and NDF in August and October (R = -0.31 to -0.48; P < 0.04). In conclusion, grazing system did not affect the forage carbohydrate concentrations or GLU or INS in horses; however, season did have an effect on both forage nutrient content and glucose metabolism in horses.

ECEIM consensus statement on equine metabolic syndrome

Equine metabolic syndrome (EMS) is a widely recognized collection of risk factors for endocrinopathic laminitis. The most important of these risk factors is insulin dysregulation (ID). Clinicians and horse owners must recognize the presence of these risk factors so that they can be targeted and controlled to reduce the risk of laminitis attacks. Diagnosis of EMS is based partly on the horse's history and clinical examination findings, and partly on laboratory testing. Several choices of test exist which examine different facets of ID and other related metabolic disturbances. EMS is controlled mainly by dietary strategies and exercise programs that aim to improve insulin regulation and decrease obesity where present. In some cases, pharmacologic aids might be useful. Management of an EMS case is a long‐term strategy requiring diligence and discipline by the horse's carer and support and guidance from their veterinarians.

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Background

Equine endocrinopathic laminitis is common and can be associated with an underlying endocrinopathy, such as equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID), pasture consumption, or any combination of these factors.

Objectives

The aim of the study was to improve the risk assessment capabilities of clinicians, and to inform management strategies, for acute endocrinopathic laminitis by prospectively examining the phenotypic, hormonal, and clinical characteristics of the disease in a large cohort.

Animals

Privately owned horses and ponies (n = 301) of any age, sex, or breed diagnosed with laminitis by a veterinarian. A history of laminitis was acceptable.

Methods

This was a prospective cohort study. Veterinarians provided information on each case via an online questionnaire after informed consent from the animal's owner, and all data were de‐identified before analysis. Serum insulin and plasma adrenocorticotrophic hormone concentrations were measured in each case.

Results

Most cases were recruited in spring (109/301; 36.2%). Concurrent EMS and PPID resulted in higher basal insulin concentrations (49 [21.5‐141]; P < .02) than if an animal had a single underlying cause for their laminitis. The insulin concentration was negatively correlated (r² = −0.38; P < .001) with the animal's height, being higher in ponies (33[10‐14]; P < .001) than horses (9.5 [3‐25.7]) and was positively correlated (r² = 0.12; P = .05) with their grade (severity) of laminitis.

Conclusions and Clinical Importance

Horses and ponies with concurrent endocrinopathies have more marked hyperinsulinemia. Higher basal insulin concentrations were associated with more severe lameness.

Glucose and Insulin Response of Aged Horses Grazing Alfalfa, Perennial Cool-Season Grass, and Teff During the Spring and Late Fall

Spring and late fall grazing can lead to metabolic problems in horses (Equus caballus L.) as a result of elevated nonstructural carbohydrates (NSC) in pastures. Therefore, the objectives were to determine the impact of different forage species on blood glucose and insulin concentrations of horses during the spring and late fall. Research was conducted in May (spring) and October (late fall) in St. Paul, MN. Alfalfa (Medicago sativa L.) and mixed perennial cool-season grasses (CSG) were grazed in spring, and CSG and teff (Eragrostis tef [Zucc.] Trotter) were grazed in late fall by six adult horses randomly assigned to a forage in a cross-over design. Jugular catheters were inserted 1 hour before the start of grazing, and horses had access to pasture from 8 AM to 4 PM in the spring and 8 AM to 12 PM in the late fall. Jugular venous blood samples were collected from each horse before being turned out (0 hours) and then at 2 hours intervals after turnout. Plasma and serum samples were collected and analyzed for glucose and insulin, respectively. Corresponding forage samples were taken by hand harvest. Seasons were analyzed separately, and data were analyzed using the MIXED procedure in SAS with P ≤ .05. Teff had lower NSC compared with CSG in the late fall (P ≤ .05) with subsequently lower average glucose, average insulin, and peak insulin in horses grazing teff compared with CSG (P ≤ .05). These results suggest grazing teff could lower the glucose and insulin response of horses during late fall.

Glucose and Insulin Response of Horses Grazing Alfalfa, Perennial Cool-Season Grass, and Teff Across Seasons

Elevated nonstructural carbohydrate (NSC) values in pasture forages can cause adverse health effects in some horses (Equus caballus L.). The objectives of this study were to determine the impact of different forage species on blood glucose and insulin concentrations of horses throughout the grazing season. Research was conducted in July (summer) and September (fall) in St. Paul, MN. Alfalfa (Medicago sativa L.), mixed perennial cool-season grasses (CSG), and teff (Eragrostis tef [Zucc.] Trotter) pastures were grazed by six horses (24 ± 2 years) that were randomly assigned to one of three forage types in a replicated Latin-square design. Jugular catheters were inserted 1 hour before the start of grazing and horses had access to pasture each day from 08:00 to 16:00 hours. Jugular venous blood samples were collected from each horse before being turned out (0 hours) and then at 2-hour intervals following turnout. Plasma and serum samples were collected and analyzed for glucose and insulin, respectively. Corresponding forage samples were taken by hand harvest. Seasons were analyzed separately and data were analyzed using the MIXED procedure in SAS with P ≤ .05. Teff generally had lower (P ≤ .05) equine digestible energy, crude protein, and NSC compared to the other forages. Differences in peak insulin were observed between horses grazing CSG and teff during the fall grazing (P ≤ .05). These results suggest grazing teff could lower the glucose and insulin response of some horses.

Effects of age and diet on glucose and insulin dynamics in the horse

BACKGROUND

Age and diet may affect insulin sensitivity (SI) but these factors have received limited investigation in horses.

OBJECTIVES

To measure minimal model parameters during an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT) after adaptation to a forage only diet (HAY) or forage supplemented with either starch/sugar-rich (SS) or oil/fibre-rich (FF) concentrate feeds; and to assess glucose and insulin responses to a standardised meal challenge (SMC, 4 g/kg BW of SS) after diet adaptation in adult and aged mares.

STUDY DESIGN

Latin square design with eight adult (5-12 years) and nine aged (>19 years) healthy mares.

METHODS

Diets were fed for 6 weeks, and the FSIGTT and SMC were performed after 31-32 and 41 days on each diet respectively. Data were analysed by a mixed ANOVA for repeated measures.

RESULTS

Acute insulin response to glucose (AIRg) was greater and SI was lower in aged horses, compared with adults, regardless of diet. Both AIRg and SI were greater in aged mares after adaptation to SS, as compared with HAY. Similar trends, although not statistically significant, were observed after adaptation to SS in adult mares. Peak insulin concentration and area under the insulin vs. time curve during the SMC were greater in aged than adult mares with all diets. Furthermore, area under the glucose vs. time curve was lower after adaptation to SS, when compared with other diets, in both groups.

MAIN LIMITATIONS

Transient weight loss occurred at the beginning of the study and only one sex was included. Incomplete ingestion of the SMC by four mares was another limitation.

CONCLUSIONS

Insulin responses to i.v. and enteral nonstructural carbohydrate challenge increase with age in healthy horses, regardless of diet fed.