12+ hours of nothing to eat except hay or pasture. No fasting. Hay or pasture available all the time. This protocol comes from the Virginia Polytechnic pony field study. Results can then be uploaded to the IR calculator (http:// www.freil.com/%7Emlf/IR/ir.html) for interpretation.


The most recently available test is serum leptin, available from Cornell University’s diagnostic laboratory: http://ahdc.vet.cornell. edu/test/list.aspx?Species=&Test_ Name=leptin&TstTyp=&WebDisc=


Leptin is a hormone released by fat cells which in normal horses turns off appetite. However, IR horses are leptin resistant and have elevated levels of this hormone.


Insulin’s job is to trigger the uptake of glucose from the blood into tissues that are dependent on insulin for this function—fat, skeletal muscle and liver. The involvement of liver in horses may be different from other species.


Experiments using infusions of either insulin or glucose in normal horses and ponies have established that the laminitis associated with IR is caused by high insulin, not high glucose.


In humans, insulin resistance in the liver results in high blood glucose from glucose production in the liver. This is why, even with fasting, a human with IR/type II diabetes will have elevated blood glucose (and insulin). On the other hand, fasting a horse with insulin resistance can lead to a false negative test, with insulin and glucose normal.


THERAPY


The most successful therapy for insulin resistance in both humans and horses is exercise and diet control. Exercise primes the muscle to take up glucose by pathways that are independent of insulin, resulting in less work for insulin to do and improved insulin resistance. The effect lasts for about 24 hours.


Feral horses are often insulin resistant but their high level of exercise protects them from problems. Very few domesticated horses cover the 20 miles


Holistic Horse™ • April/May 2012 • Vol.19, Issue 78


a day a feral horse does. Without the protective exercise, susceptible horses are primed to develop problems with IR if their diet is not carefully restricted. Most IR horses need a hay-based diet with combined simple sugars (ESC on hay analysis) and starch of 10% or lower.


So, what does work for insulin resistant horses?


• When possible/not laminitic, exercise, exercise, exercise!


• Diet of hay or hay and beet pulp, with ethanol soluble carbohydrates (ESC = simple sugars) plus starch no higher than 10% • Added flax seed to supply essential fatty acids in a ratio that approximates the naturally found level in grasses • Balanced minerals, preferably based on a hay analysis, with generous magnesium (calcium:magnesium ratio no higher than 2:1) and careful balancing of trace minerals, with supplemental salt and vitamin E


Almost everyone has heard of equine insulin resistance, but few really understand what it is, what causes it, and what to do about it


On the drug front, multiple options exist for people but the only one that actually improves insulin sensitivity is metformin. Metformin has been studied in horses and, while results are somewhat contradictory, it does appear to be a good choice for getting rapid control of IR, at least for a few weeks.


Most herbals used for human type II diabetes are not


appropriate for horses because they raise insulin without really addressing insulin resistance.


Acetyl-L-carnitine is a naturally occurring metabolite that influences a “master switch” enzyme in the cells causing increased glucose utilization and improved glycogen levels. Glycogen is a storage form of glucose that is typically


continued on p. 21 „„ Balanced Nutrition


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✔ Enhances and provides for quality skin and coat


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PO Box 89 • Savannah, MO 64485 • 800.228.1211 • www.kaeco.com • kaeco@stjoelive.com www.holistichorse.com | 9


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