Taking the IR Horse into Consideration
What’s wrong with this picture? by Eleanor Kellon, VMD P
arallels have been drawn between equine insulin resistance/metabolic syndrome and human type 2
diabetes. While some of these parallels are indeed valid, others are not.
There is nothing new about equine insulin resistance (IR). What’s new is that we recognize it. The stereotype of an overweight pony as high risk for pasture laminitis is timeless. Caretakers of laminitis-prone lines in breeds such as Arabians and Morgans knew to avoid grain and limit high risk pasture exposure.
Between 1975 and 2002, when Dr. Phillip Johnson published his first paper using the term “equine metabolic syndrome,” three papers were published linking insulin resistance and laminitis. These did not make mainstream veterinary medicine, let alone veterinary school curricula.
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Dr. Johnson’s 2002 paper brought equine insulin resistance to the forefront, but there was considerable resistance to the idea that insulin resistance not related to Cushing’s disease (high cortisol in Cushing’s disease causes insulin resistance) even existed. One of the most vocal early critics was Dr. David Kronfeld from the Virginia Polytechnic Institute, but a 2006 study by his group did a complete reversal. Review of pedigrees also strongly pointed to a genetic component.
From that point forward, recognition of the significance of insulin resistance among practicing veterinarians and in veterinary schools has skyrocketed.
OVERDIAGNOSIS NOW COMMON As is often the case with high profile newly defined disorders, IR is now being overdiagnosed without proper testing. One outgrowth of the rush to blame IR for everything is that every overweight horse is being labeled as insulin resistant. However, a large field study done by the Maryland Virginia Regional College of Veterinary Medicine found that only 35% of even very obese horses are actually insulin resistant. The prevalence of IR across all weights and breeds is about 10-15%. With an estimated equine population in this country of about 10 million horses, that’s still a large number.
Diagnosis by symptoms is simply not reliable. Fortunately, blood work usually clearly differentiates between normal and insulin resistant horses. You need a serum insulin and glucose taken after
PHOTO ABOVE: So what IS wrong with this picture? Find the answer on page 21.
Holistic Horse™ • April/May 2012 • Vol.19, Issue 78
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