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New Stall-Side Equine Insulin Test


Wellness Ready Insulin Test. Photo: EquiManagment.com

Wellness Ready is the first and only point-of-care equine insulin diagnostic test available to equine practitioners. It allows veterinarians to measure a horse’s insulin levels at the point of care in a matter of minutes rather than collecting blood, shipping it, and waiting a week or more for test results. Metabolic disorders like Equine Metabolic Syndrome (EMS) and insulin resistance are on the rise in the horse population, and veterinarians and horse owners are searching for solutions to prevent these conditions from developing into laminitis, the second leading cause of death among horses.


EQUINE METABOLIC SYNDROME

Equine Metabolic Syndrome (EMS) is a disorder associated with inappropriate blood insulin levels (insulin dysregulation), increased fat deposition, and reduced ability to lose weight. When affected horses consume meals high in specific carbohydrates, their bodies produce higher-than-normal insulin levels and are slow to return to baseline values. These clinical signs were previously referred to as Hypothyroidism, Peripheral Cushing’s Disease, Pre-Laminitic Syndrome, or Syndrome X.


The breeds most affected by EMS utilize glucose very efficiently to ensure that they have plenty of energy reserves when food is scarce. When these "easy keepers" are in an environment where they have access to an abundance of pasture and carbohydrates and do not get as much exercise as they would in their ancestral habitat, they can easily consume too many calories.


One of the most severe consequences of EMS is laminitis which can result in the devastating separation of the hoof from the underlying coffin bone. Laminitis is extremely painful and can cause permanent and life-threatening damage. Laminitis can happen for various reasons, but EMS lowers the threshold for laminitis and makes it easier to develop.


Most horses with EMS are obese, with a body condition score (BCS) of 6 or higher (out of 9) and a "cresty" neck with fat deposits over their ribs and tailhead regions. It's important to note that insulin dysregulation can also occur in thinner horses, and not all horses with an increased BCS have EMS.


For an excellent video on how you can learn to assess and monitor your horse's BCS, watch this webinar from the University of Georgia: https://kaltura.uga.edu/media/t/1_qhek7n8d


Friesian horse with a Body Condition Score of 8

INSULIN RESISTANCE

Insulin resistance is the accepted term for increased blood glucose in combination with normal to increased blood insulin levels. Insulin resistance is often an early warning of other metabolic-related diseases, including colic and laminitis, and endocrine-related problems, such as Cushing's DisIn a normally functioning system, glucose in the bloodstream is transported into the cells by the action of insulin. In the case of insulin resistance, this glucose transport function is impaired, resulting in increased glucose inside the circulatory system and decreased glucose within the cells. This excess of glucose in the circulatory system signals the pancreas to secrete even more insulin to return blood glucose to normal. The result is an increase in insulin and glucose in the circulatory system and a decrease in glucose in the tissue, thus the term insulin resistance. Signs of insulin resistance include:

  • Abnormal weight gain or weight loss.

  • Increased or excessive water consumption

  • Loss of stamina and muscle tone

  • Tendency to develop laminitis or colic

  • Abdominal bloating

  • Increased blood triglyceride levels


ABOUT WELLNESS READY

Wellness Ready helps veterinarians identify and manage horses with metabolic and insulin-related issues. The unique feature of the Wellness Ready Stall Side Insulin Test is that you get results within minutes at a price similar to the typically used test, which requires the blood sample to be shipped to a lab and can take a week or more for results. Veterinarians can screen horses for risk based on their physical signs, conduct diagnostics within minutes and develop an immediate action plan to reduce the horse's risk. In some cases, a week might be critical to avoiding the onset of laminitis.



References:


Durham, AE, Frank, N, McGowan, CM, et al. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med. 2019; 33: 335– 349. https://doi.org/10.1111/jvim.15423


Bertin, F. R., & de Laat, M. A. (2017). The diagnosis of equine insulin dysregulation. Equine veterinary journal, 49(5), 570–576. https://doi.org/10.1111/evj.12703


Emily H. Berryhill, Naomi S. Urbina, Sam Marton, William Vernau, and Flavio H. Alonso. Validation and method comparison for a point-of-care lateral flow assay measuring equine whole bod insulin concentrations Journal of Veterinary Diagnostic Investigation. 2022.





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