b'NEAEP Conference Wrap SPONSORED BYare obese (or even overweight) and, also, that horses with ID might have lamini-tis without obvious lameness. Van Eps said that in one study researchers found radiographic evidence of laminitis in 76% of horses presented for pituitary pars intermedia dysfunction (PPID, aka equine Cushings disease), but half of them had not shown signs of foot pain, and lami-nitis wasnt recognized by the owners. Pituitary pars intermedia dysfunction leads to an overproduction of hormones such as adrenocorticotropic hormone (ACTH) and cortisol, and affected horses can have regional fat deposits and experi-COURTESY CHRISTINA WEESEence muscle wasting, among other signs, but they arent generally obese.Our goal for now (to prevent endo-crinopathic laminitis) is to target ID, he said. Diagnose them early, because this type of laminitis is often well-advancedWestern College of Veterinary Medicine reseracher Dr. Julia Montgomery is collaborating with an before we see any outward clinical signs. engineering firm to create a harness to help horses recover from limb injuries. Dr. Andrew van Eps of Van Eps prefers to test plasma ACTHPenn Vet said it could be helpful for treating supporting limb laminitis cases.concentration for diagnosing PPID: either resting (baseline) or after thyrotropin- one by looking at him. Researchers arefeeding if given in a targeted way shortly releasing hormone (TRH) stimulation (aworking to identify predictors in thebefore meals/turnout, he added. There little more sensitive). With this test vetsgenes, said van Eps. are other options on the horizon for tar-look for overproduction of ACTH, whichTheres a good chance in the futuregeting ID, including a recent paper with the pituitary glandenlarged or affectedthat were going to have some geneticsome exciting preliminary evidence on a by a tumor in PPID horsesnormallymarkers and some genetic tests, he said,drug class that helps to control insulin by makes in relatively small amounts toand potentially breed this out (of theenhancing the clearance of glucose from control adrenal gland function. Vets mustthe blood by the kidneys. We are likely remember seasonal reference rangesto see more medication options become when assessing results. We are likely to seeavailable for horses and ponies with ID in After starting the confirmed-PPID horsemore medicationthe coming years.on Prascend (the FDA-approved pergolideFour on the Floor Another type of drug), you need to test them a monthoptions become avail- horse predisposed to laminitis is one that later and then at least once a year to see ifable for horses andhasnt been bearing weight evenly on all their ACTH is under control, because youfour limbs, usually because of a severe cant control their laminitis if theres anponies with ID in theinjury. Metabolically and mechanically, underlying uncontrolled endocrinopathy. coming years. something happens that causes laminar Van Eps recommends using the oraldamage in the supporting limb.sugar test (OST) to check for equine meta- DR. ANDREW VAN EPS Van Eps says to prevent laminitis in bolic syndrome, another form of ID. Thisthese horses, blood must perfuse the tiny involves collecting a blood sample, fol- horse population). capillaries of the foot in the supporting lowed by administering light corn syrupIn terms of medical treatments for ID,limb. The best way to improve digital orally, and collecting another sample 60 tovan Eps said there are now options thatcapillary perfusion is to cycle weight 90 minutes later. In a new study van Epsmight suit different horses and ponies,off and on that limb. Thats not easy to group showed that the OST can be per- and owners should always consult theiraccomplish in a horse thats shifting its formed immediately after the TRH stimu- vet. Levothyroxine may be a usefulweight to be comfortable, however.lation test as a combined protocol withoutadjunct to weight loss and can help toWe need to improve limb load cycling affecting the results, and this is best wayimprove ID, he told The Horse. Supple- in order to improve perfusion, said van to test for ID and PPID in one visit. ments containing polyphenols such asEps. Weve done some work trying to im-He welcomes vets to contact him withresveratrol may help to improve ID;prove perfusion using various means in any questions about interpreting results. however, there is very limited evidence forthe limb under load, and it doesnt appear Indeed, metabolically, theres a type ofthis in horses at this stage. possible. It looks like we have to provide horse or pony that is prone to developingMetformin can be useful in horses andsome sort of load relief to do that.laminitis, but you cant always identifyponies to reduce the insulin response toHe said vets in Canada are developing TheHorse.com|The HorseFebruary 202033NEAEPWrapUp.indd 33 1/3/20 10:54 AM'