Measuring Insulin

With the Spring grass starting to come through and the risk of clinical laminitis increasing it is time to consider what we can do to protect our equine population from new or repeated bouts of this painful condition. Laminitis often presents as a result of complex metabolic imbalances which are exacerbated by increased grass intake and changes to sugar levels in the grass. This can be in the form of pars pituitary intermedia dysfunction (PPID) also known as Cushings or Equine Metabolic Syndrome (EMS).  There are metabolic blood profiles which can be used to assess for these diseases. Recent studies have shown that of these diagnostic blood tests insulin levels in the blood can be used as a very reliable and strong predictor of future laminitis episodes.

Who to test?

Any horse/pony with:

• History of laminitis
• Undiagnosed or recurring lameness
• Divergent hoof rings
• Overweight
• Regional fat deposits
• Infertility
• Swollen sheath
• Suspicion of metabolic disease such as PPID or EMS

When to test?

Insulin can be measured at any time. The only requirement is that the horse must have been on forage prior to the blood sample being collected ie. not fasted or just had its hard feed.

What do the results mean?

High insulin (hyperinsulinaemia) increases the risk of laminitis. This result can tell us how likely your pony or horse is to get laminitis in the next four years. If the insulin is low (less than 21.6 µIU/ml) they are 6% more likely to get laminitis, if it is medium (between 21.6 and 45.2 µIU/ml) they are 22% more likely and if it is high (more than 45.2 µIU/ml) they are 69% more likely to get laminitis in the following 4 years.

How much does it cost?

For the next 3 months we are offering a reduced price for insulin blood tests. For Spring and Summer 2022, the reduced cost will be £30 per insulin blood test if paid at the time.

Booked the test on your zone visit day and the visit will be just £15 or free if we see 3 or more horses at the same yard.

What can we do?

There are a number of options to bring the insulin back under control. Dietary changes can be instigated along with exercise if the horse/pony is able to. Alongside these changes or if there are limitations due to lameness or logistics there are now several new drugs on the market to normalize blood insulin.

 normalize blood insulin. We can piece all the information together to advise what would be most appropriate going forward to manage the risk of laminitis over the year ahead.

It is essential that we identify horses and ponies with these predispositions early so that medical and environmental management changes can be made prior to them getting laminitis.

There are now several new drugs on the market to normalize blood insulin.

References

Equine Endocrinology Group, ‘Recommendations for the Diagnosis and Treatment of Equine Metabolic Syndrome (EMS)’, 2020

Knowles E.J., Elliott J., Harris P. A., Chang Y. M., Menzies-Gow N. J., ‘Predictors of laminitis development in a cohort of non-laminitic ponies’, Equine Veterinary Journal 2022