EMS (Yr 4) Flashcards
what does EMS stand for?
equine metabolic syndrome
what does insulin do?
released in response to high glucose in blood to drive it into cells
if the target cells fail to respond to insulin, what happens?
hyperinsulinaemia
what is EMS?
collection of risk factors for endocrinopathic laminitis
what are the factors associated EMS?
obesity (predisposition)
laminitis (clinical effect)
insulin resistance/dysregulation (pathophysiology)
what are the risk factors for EMS?
obesity
genetics
what are the genetic predispositions for EMS?
ponies at increased risk
(certain familial links)
what is the insulin dysregulation driven by in EMS cases?
inappropriate feeding of too much carbohydrates leading to hyperinsulinaemia
what is the relationship between insulin and laminitis?
prolonged hyperinsulinaemia will induce laminitis in clinically normal ponies/horses
what are the grades of laminitis?
1 - shifting lameness/standing
2 - lame, can lift one leg and be able to stand
3 - lame, too painful to lift leg
4 - no walking, lying down
what is done to diagnose EMS?
measure resting insulin (to confirm hyperinsulinaemia)
what tube is needed to test resting insulin?
plain, red top tube
what dynamic testing can be done for EMS?
oral glucose/sugar test (fast, then measure insulin, then feed, measure again 2 hours later)
other than hyperinsulinaemia, what changes are seen with EMS?
hypertriglyceridaemia
mild basal cortisol elevation
high blood pressure
what is the difference between EMS and PPID?
EMS is younger horses than PPID
EMS don’t have hypertrichosis (hirsute)
EMS are negative for PPID on basal ACTH
