Tuesday 20 June 2017
Archie's 2 week progress
As part of the weight wise scheme we encourage owners to body condition score and weigh tape their horse every 2 weeks. An update from Archie's owner, Fran, shows that Archie is certainly aiming for his slimmer of the month award. We have a fantastic loss of 14kg already, over half way to our first goal weight. Well done Archie and Fran!
Archie's Weigh In
Weigh tapes are a fantastic tool, they allow us to follow trends in our horses' weight quickly and simply. They are accurate to within 10% of your horse's body weight, a fact which must be taken into consideration. Of course if your horse holds deposits of fat at the tail head, then they could feasibly lose weight by mobilising these fat pads, without alterations being seen on the weigh tape.
When using a weigh tape here are some points to remember.
1. Always use a scientifically calibrated tape that has separate horse and pony measurements.
2. Make sure your horse is standing squarely.
3. Try and take a measurement at the same time of day on each occassion.
4. Position the tape from the lowest point of the wither to behind the elbow, this is often a diagonal line.
5. Pull the tape snug and make sure your fingers aren't underneath.
6. Make a note of your horse's weight every 2-4 weeks and plot it on a chart.
When using a weigh tape here are some points to remember.1. Always use a scientifically calibrated tape that has separate horse and pony measurements.
2. Make sure your horse is standing squarely.
3. Try and take a measurement at the same time of day on each occassion.
4. Position the tape from the lowest point of the wither to behind the elbow, this is often a diagonal line.
5. Pull the tape snug and make sure your fingers aren't underneath.
6. Make a note of your horse's weight every 2-4 weeks and plot it on a chart.
Correct positioning of a weigh tape.
Archie came to visit us at the practice to make use of the weigh bridge, this is a large scale suitable for horses and ponies of all sizes. We were pleased to find that the weigh bridge weight for Archie was 530kg, only a 5kg difference from his weigh tape measurement at the time. Great news!
Blood Results - A bit of a surprise.
Within a couple of days we received the results from Archie's free seasonal ACTH test for Cushings disease and his insulin and glucose levels from his dynamic insulin response test. The reason for performing these tests was to evaluate Archie's current laminitis risk status, as discussed in our earlier blog post.
Due to the excellent management by Archie's owner, Fran, we found that Archie had normal glucose and insulin levels following his meal of glucose powder in chaff. Indicating that Archie is regulating his insulin levels appropriately, when faced with sugars, such as those found in grass.
The fact that Archie is carrying larger fat deposits than normal, but is currently regulating his insulin efficiently indicates that the current feed restrictions and management practices are working to tell Archie's body that he is in a negative energy balance and he needs to metabolise those fat stores.
Insulin resistance occurs naturally in the majority of UK native breeds, as they gain body fat they become more insulin resistant, leading to higher circulating levels of the hormone insulin. High insulin levels trigger the body to store fat in deposits rather than break it down. This would allow these native breeds to store fat whilst grass was available and therefore to survive through cold winters with poor sparse grazing. However our local native breeds are far from facing exteme feed shortages or snow covered fells, this cycle of insulin resistance triggering further fat deposition, causing increasing insulin resistance, is a difficult cycle to break. High levels of the circulating hormone insulin can directly trigger laminitis in otherwise healthy horses (De Laat et al, 2010).
The second part of Archie's results revealed a bit of a surprise. Archie's ACTH value was 41pg/ml, normal being <29pg/ml for this time of year. This indicates that Archie has evidence of Pars Pituitary Intermedia Dysfunction, more commonly referred to as Cushing's disease.
Archie is currently not showing symptoms of Cushing's disease. We know the disease is very common in horses over 15 years of age and we believe it starts to occur quite some time before it is detectable on ACTH tests. In horses that show symptoms of Cushing's disease, but have a normal ACTH reading a more sensitive test known as a TRH stimulation tests can be performed to pick up early cases.
The symptoms of Cushings disease are mild to start with and include a loss of topline muscle, a pot belly appearance and fat deposits in the hollow above the eye. Delayed hair shedding or long guard hairs are often seen. Increased drinking, sweating and lethargy can develop. The disease causes suppression of the immune system leading to increased worm burdens, gum disease, delayed healing of wounds or corneal ulcers and recurrent respiratory infections. The disease can also lead to hyperinsulinaema and laminitis. Horses can develop both Cushing's disease and Equine Metabolic Syndrome, the combination of which leads to a high laminitis risk.
As Archie is full of beans and not showing current symptoms of the disease he will be monitored with a follow up blood test during the Autumn, when testing of ACTH is even more accurate. Archie's owner will be monitoring him closely for any of the clinical signs mentioned and when neccesary Archie will be able to start treatment with pergolide tablets to restore normal ACTH levels and counteract the symptoms of disease. The diagnosis does not alter Archie's current management or his ability to continue with rehabilitation and return to eventing.
Reference
De Laat et al (2010) Equine laminitis: induced by 48 hour hyperinsulinaemia in standardbred horses. Equine veterinary journal 42 129-135
Due to the excellent management by Archie's owner, Fran, we found that Archie had normal glucose and insulin levels following his meal of glucose powder in chaff. Indicating that Archie is regulating his insulin levels appropriately, when faced with sugars, such as those found in grass.
The fact that Archie is carrying larger fat deposits than normal, but is currently regulating his insulin efficiently indicates that the current feed restrictions and management practices are working to tell Archie's body that he is in a negative energy balance and he needs to metabolise those fat stores.
Insulin resistance occurs naturally in the majority of UK native breeds, as they gain body fat they become more insulin resistant, leading to higher circulating levels of the hormone insulin. High insulin levels trigger the body to store fat in deposits rather than break it down. This would allow these native breeds to store fat whilst grass was available and therefore to survive through cold winters with poor sparse grazing. However our local native breeds are far from facing exteme feed shortages or snow covered fells, this cycle of insulin resistance triggering further fat deposition, causing increasing insulin resistance, is a difficult cycle to break. High levels of the circulating hormone insulin can directly trigger laminitis in otherwise healthy horses (De Laat et al, 2010).
Welsh ponies and other native breeds such as these, are naturally insulin resistant.
The second part of Archie's results revealed a bit of a surprise. Archie's ACTH value was 41pg/ml, normal being <29pg/ml for this time of year. This indicates that Archie has evidence of Pars Pituitary Intermedia Dysfunction, more commonly referred to as Cushing's disease.
Archie is currently not showing symptoms of Cushing's disease. We know the disease is very common in horses over 15 years of age and we believe it starts to occur quite some time before it is detectable on ACTH tests. In horses that show symptoms of Cushing's disease, but have a normal ACTH reading a more sensitive test known as a TRH stimulation tests can be performed to pick up early cases.
The symptoms of Cushings disease are mild to start with and include a loss of topline muscle, a pot belly appearance and fat deposits in the hollow above the eye. Delayed hair shedding or long guard hairs are often seen. Increased drinking, sweating and lethargy can develop. The disease causes suppression of the immune system leading to increased worm burdens, gum disease, delayed healing of wounds or corneal ulcers and recurrent respiratory infections. The disease can also lead to hyperinsulinaema and laminitis. Horses can develop both Cushing's disease and Equine Metabolic Syndrome, the combination of which leads to a high laminitis risk.
As Archie is full of beans and not showing current symptoms of the disease he will be monitored with a follow up blood test during the Autumn, when testing of ACTH is even more accurate. Archie's owner will be monitoring him closely for any of the clinical signs mentioned and when neccesary Archie will be able to start treatment with pergolide tablets to restore normal ACTH levels and counteract the symptoms of disease. The diagnosis does not alter Archie's current management or his ability to continue with rehabilitation and return to eventing.
Reference
De Laat et al (2010) Equine laminitis: induced by 48 hour hyperinsulinaemia in standardbred horses. Equine veterinary journal 42 129-135
Wednesday 7 June 2017
Archie's First Weight Wise Visit
What to expect at your first weight wise visit.
Firstly it is important for those who have received a glucose feed for dynamic insulin resistance testing, that blood is drawn at 2 hours from the feed being consumed. Therefore that was the first step in Archie's visit.
Archie was graded as a condition score of 4 in the first section, 3 in the mid section and 4 over his rump.
The next step was to record his body weight with a weight tape. Weight tapes are a useful tool for measuring trends in your horse's weight. They are accurate to within 10% of body weight. On the weight tape Archie was recorded as a body weight of 525kg.
An initial target to work towards was set as 500kg. As this target is approached, Archie's body condition score will be evaluated. Aiming for a score of 2-3 in all sections. On occassion, target's will then need to be adjusted for that individual. Condition scoring is a vital part of weight management and often of more value than a numerical weight measurement.
As a feed intake of 2%-2.5% of bodyweight will maintain a horse at their current weight, in the instance where weight reduction is required then a feed intake of 1.5% can be used under veterinary guidance. Archie will therefore be aiming at a dry weight feed intake of 7.9kg per 24 hour period. This is made up of grazing time, soaked hay and a small amount of fibre based feed.
Grazing time of 8 hours on summer grass equates to approximately 7.5kg dry matter and 76MJ caloric content. With a grazing muzzle used for the duration in a small paddock size this can be reduced by 25% to a dry intake of 5.6kg, leaving Archie with a 2.3kg allowance for the dry weight of his hay and dry weight of his low sugar, high fibre hard feed. Luggage scales work perfectly for weighing hay nets and feed buckets.
Archie's owner, Fran, has already instituted several great methods for helping with weight loss;
With the Weight Wise program Archie will receive a veterinary evaluation every 6 to 8 weeks. Archie's owner Fran will body condition score and weigh tape Archie every 2 weeks and the data will be plotted on an electronic Weight Wise graph at his next visit.
Firstly it is important for those who have received a glucose feed for dynamic insulin resistance testing, that blood is drawn at 2 hours from the feed being consumed. Therefore that was the first step in Archie's visit.
Secondly a body condition score was determined in three sections. We use the Caroll and Huntington scoring system, scoring out of 5. The ideal body condition score being between 2 and 3. We use half scores to allow greater accuracy.
| Score |
Section 1
Neck, withers and shoulder. |
Section 2 Back and ribs |
Section 3 Tail head and pelvis |
0
|
Ewe neck which is slack and narrow at the base. Bone structure easily visible. | Individual ribs and vertebrae visible and easily felt. Tissue either side of backbone sunken. | Rump is sunken – angular pelvis and tight skin – deep cavity under the tail. |
1
|
Ewe neck still narrow and slack. Bone structure well defined. | Ribs and vertebrae visible. | Rump sunken but skin is supple. Hip bones visible. Deep depression under the tail. |
2
|
Neck narrow and firm blending smoothly ith the body. Withers rounded over the top. | Ribs just visible, backbone well covered, vertebrae still felt. | Fat around tail head – rump flat either side of backbone – slight cavity under the tail. |
3
|
Firm neck with some fat deposits, no crest. Some fat behind the shoulder. | Ribs covered but still felt, no gutter along back. | Fat around the tail, rump rounded, no gutter along backbone. |
4
|
Wide firm neck with a slight crest. Filling of fat along withers and behind shoulder. | Need firm pressure to feel ribs, gutter along the back to the tail. | Pelvis only felt with firm pressure, gutter along backbone to tailhead. |
5
|
Very wide and firm crest, bulging fat over withers and shoulder. | Cannot feel the ribs, deep gutter along the back. | Cannot feel pelvis, deep gutter along backbone. |
Archie was graded as a condition score of 4 in the first section, 3 in the mid section and 4 over his rump.
The next step was to record his body weight with a weight tape. Weight tapes are a useful tool for measuring trends in your horse's weight. They are accurate to within 10% of body weight. On the weight tape Archie was recorded as a body weight of 525kg.
An initial target to work towards was set as 500kg. As this target is approached, Archie's body condition score will be evaluated. Aiming for a score of 2-3 in all sections. On occassion, target's will then need to be adjusted for that individual. Condition scoring is a vital part of weight management and often of more value than a numerical weight measurement.
As a feed intake of 2%-2.5% of bodyweight will maintain a horse at their current weight, in the instance where weight reduction is required then a feed intake of 1.5% can be used under veterinary guidance. Archie will therefore be aiming at a dry weight feed intake of 7.9kg per 24 hour period. This is made up of grazing time, soaked hay and a small amount of fibre based feed.
Grazing time of 8 hours on summer grass equates to approximately 7.5kg dry matter and 76MJ caloric content. With a grazing muzzle used for the duration in a small paddock size this can be reduced by 25% to a dry intake of 5.6kg, leaving Archie with a 2.3kg allowance for the dry weight of his hay and dry weight of his low sugar, high fibre hard feed. Luggage scales work perfectly for weighing hay nets and feed buckets.
Archie's owner, Fran, has already instituted several great methods for helping with weight loss;
- Grazing muzzle.
- Using grass that has been previously grazed.
- Soaking hay for 12 hours, draining and rinsing away sugar water.
- Bedding on shavings to avoid eating straw.
- Using a trickle net to make hay last longer when stabled over night.
Laminitis Risk Analysis
Although there are numerous benefits to maintaining a healthy body weight, our prime concern as equine practitioners is to prevent laminitis from occuring. With a proactive approach to the nationwide problem of horse obesity, we hope to make changes to reduce the prevalence of laminitis, a painful, debilitating and at times, fatal disease.
"If you always do what you've always done, you'll always get what you've always got" Henry Ford
So, instead of reacting to cases of laminitis, let's be proactive and prevent them from occurring in the first place.
Studies have shown that up to 90% of laminitis cases have underlying endocrine disease. Both Cushing's disease (PPID) and Equine Metabolic Syndrome (EMS) can lead to hyperinsulinaemia, an over-secretion of the hormone insulin. We now know that these spikes in insulin are directly linked to laminitis. When healthy horses are exposed to insulin infusions over a few days, laminitis will develop (De Laat et al, 2010).
Therefore we can use simple blood tests to perform a laminitis risk analysis BEFORE laminitis develops. Horse's can then have their management adapted depending on their current risk level.
An ACTH blood test will evaluate for Cushing's disease. In borderline cases this diagnosis may be confirmed with a TRH stimulation test.
An oral-glucose challenge test is a dynamic test for insulin resistance, seen with Equine Metabolic Syndrome. This test is easy to perform, involving holding the horse off feed over night, feeding a chaff meal containing 1g/kg body weight of glucose powder, then a blood sample 2 hours later to evaluate insulin levels. This process mimics the horse's response to exposure to carbohydrates and sugars in the grass. Both tests can easily be performed within one veterinary visit, they are quick and non-invasive.
We recommend that both tests are carried out as part of the Weight Wise program. Archie had blood drawn and submitted to the laboratory for laminitis risk analysis. Stay tuned to find out his results and what they mean.
Reference
De Laat et al (2010) Equine laminitis: induced by 48 hour hyperinsulinaemia in standardbred horses. Equine veterinary journal 42 129-135
"If you always do what you've always done, you'll always get what you've always got" Henry Ford
So, instead of reacting to cases of laminitis, let's be proactive and prevent them from occurring in the first place.
Studies have shown that up to 90% of laminitis cases have underlying endocrine disease. Both Cushing's disease (PPID) and Equine Metabolic Syndrome (EMS) can lead to hyperinsulinaemia, an over-secretion of the hormone insulin. We now know that these spikes in insulin are directly linked to laminitis. When healthy horses are exposed to insulin infusions over a few days, laminitis will develop (De Laat et al, 2010).
Therefore we can use simple blood tests to perform a laminitis risk analysis BEFORE laminitis develops. Horse's can then have their management adapted depending on their current risk level.
An ACTH blood test will evaluate for Cushing's disease. In borderline cases this diagnosis may be confirmed with a TRH stimulation test.
An oral-glucose challenge test is a dynamic test for insulin resistance, seen with Equine Metabolic Syndrome. This test is easy to perform, involving holding the horse off feed over night, feeding a chaff meal containing 1g/kg body weight of glucose powder, then a blood sample 2 hours later to evaluate insulin levels. This process mimics the horse's response to exposure to carbohydrates and sugars in the grass. Both tests can easily be performed within one veterinary visit, they are quick and non-invasive.
We recommend that both tests are carried out as part of the Weight Wise program. Archie had blood drawn and submitted to the laboratory for laminitis risk analysis. Stay tuned to find out his results and what they mean.
Reference
De Laat et al (2010) Equine laminitis: induced by 48 hour hyperinsulinaemia in standardbred horses. Equine veterinary journal 42 129-135
Sunday 4 June 2017
Thursday Night Fright
Looking back, there had been clues! A weight tape had been used, the hay had been decidedly wet recently after soaking in water all day and a grazing muzzle had made an appearance. Then, on Thursday night, Archie finished his tea and waited patiently for a hay net that never arrived!
Twelve hours without food! TWELVE!
Much to Archie's surprise, a night without food was OK after all, he was still alive and kicking when the sun came up.
Twelve hours without food! TWELVE!
Much to Archie's surprise, a night without food was OK after all, he was still alive and kicking when the sun came up.
The next morning, breakfast was decidedly weird, chaff with glucose powder. 1g of glucose powder per kilo of body weight to be exact.
Then two hours later, the vet arrived!
The Weight Wise Program
Weight
Wise
Are
you worried about the laminitis risk?
Is
your horse looking poor?
Why
not join the Barn Equine Surgery's Weight Wise Scheme, just like Archie!
Included
with Weight Wise:
- A free starter pack including
- A weight tape
- A weight chart
- A guide to body condition scoring
- A discount voucher
Book
two Weight Wise appointments and get the third visit fee free! **
Weight
Wise appointments are available on our Zone Visit scheme.
A
Weight Wise appointment involves a veterinary examination and
evaluation of your nutritional management.
A
nutrition plan will be tailored to your individual horse and we will
set targets to work towards.
We
will follow your progress every 6-8 weeks and at each visit you will
be provided with a weight graph electronically to map your
achievements.
Blood
testing can highlight laminitis risk and track metabolic improvement
achieved through Weight Wise.
The
seasonal Free ACTH lab fee can be incorporated into your visit, as
can dynamic insulin resistance testing.*
Together
we can stamp out laminitis.
*Cushing's
Disease and Equine Metabolic Syndrome account for 90% of laminitis
cases.
Dynamic
testing with an in-feed oral glucose challenge will involve prior
planning with your vet, so please let us know if you would like to
do this at Weight Wise Visit 1 when you book.
**Your
third Weight Wise visit fee will be free of charge if booked on your
zone visit day or a £15 visit discount can be applied to a standard
visit fee at your convenience.
Of
course you can incorporate your other veterinary needs into your
Weight Wise appointments.
Friday 2 June 2017
Meet Archie
Gorgeous Archie has had a bit of a rough year. In January Archie underwent colic surgery and unfortunately developed some complications with the healing of his incision. This meant that poor Archie was on strict box rest for 3 months, followed by a gradual re-introduction to a small turn out paddock. Three weeks ago Archie and his owner, Fran, received the all clear to start ridden work at walk.
Through no fault of his own, this prolonged time away from exercise has meant that Archie became overweight. Archie has kindly volunteered to become our Weight Wise ambassador. I know a lot of our clients will be following our Weight Wise management program to help their horses drop those extra pounds, to reduce the risk of health complications including lipoma related colic, joint stress and of course insulin dysregulation and laminitis.
Archie is going to share the ups and downs of his weight loss journey, hopefully as an inspiration to others, or possibly to receive as much sympathy as possible!
Archie is an 18 year old Welsh Cob Cross. Archie is owned by Fran, one of the team of staff at The Barn Equine Surgery. No stranger to veterinary involvement, Archie can spot a vet at 50 paces. Ever the gentleman, Archie tolerates his veterinary staff with fantastic manners, if not the occassional look of disdain. As you can tell, Archie is a firm favourite at the practice and I know he will be pleased to help other horses and ponies on their Weight Wise journeys.
Stay tuned to find out how Archie got on with his first Weight Wise visit!
www.barnequine.co.uk
Through no fault of his own, this prolonged time away from exercise has meant that Archie became overweight. Archie has kindly volunteered to become our Weight Wise ambassador. I know a lot of our clients will be following our Weight Wise management program to help their horses drop those extra pounds, to reduce the risk of health complications including lipoma related colic, joint stress and of course insulin dysregulation and laminitis.
Archie is going to share the ups and downs of his weight loss journey, hopefully as an inspiration to others, or possibly to receive as much sympathy as possible!
Stay tuned to find out how Archie got on with his first Weight Wise visit!
www.barnequine.co.uk
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