N
Neurological symptoms - PPID
Neuropathic pain
Nitric Oxide NO
Nitroglycerine
NSAIDs
NSC - Non Structural Carbohydrates
Neurological symptoms - PPID
Neuropathic pain
Nitric Oxide NO
Nitroglycerine
NSAIDs
NSC - Non Structural Carbohydrates
Neurological symptoms - PPID
Neurological symptoms associated with advanced stage PPID include ataxia (weakness/inconsistent gait), blindness, seizures and narcolepsy.
In her 2011 paper on PPID, Dianne McFarlane suggests that 6 to 50 % of horses with PPID show signs of neurological disease. Unpublished data found that neurological impairment was seen more commonly in old horses with PPID (27%) than old horses without PPID (5%).
Dianne McFarlane
Equine Pituitary Pars Intermedia Dysfunction
Veterinary Clinics of North America: Equine Practice Vol 27, No. 1, April 2011
However this article for VetGrad suggests that neurological signs are rarely reported in horses with PPID, include blindness, collapse and seizures and are likely caused by the increased size of the pituitary gland exerting pressure on the base of the brain.
Katie Snalune BSc MA VetMB Cert EM (Int.Med.) Cert ES (Soft Tissue) MRCVS - 21/04/2013
Pituitary Pars Intermedia Dysfunction (PPID) in the Horse
Abra Wright also lists neurological signs amongst clinical signs of PPID, including seizures, abnormal vision, blindness, ataxia and
narcolepsy, and again suggests that these may be associated with compression from a macro-adenoma (tumour) - see page 9:
Abra Wright MSc Thesis 2009
Pharmacokinetics of Pergolide in normal mares
Clinical Endocrinology of Companion Animals (2013) suggests that effects from a pituitary adenoma are rare, although blindness has been reported, most likely due to compression of the optic chiasm (optic nerves) by an enlarged pituitary gland. Seizures have been reported rarely but the cause of the seizures has not been linked to PPID. See p 106:
Clinical Endocrinology of Companion Animals - edited by Jacquie Rand, Ellen Behrend, Danielle Gunn-Moore, Michelle Campbell-Ward - 2013
At the 2013 Western Veterinary Conference, Hal Schott II reported that bizarre neurological signs and blindness have been associated with PPID, but said that researchers don't fully understand the connection between these signs and the disease.
Current Diagnostic Options for PPID - Erica Larson - www.thehorse.com - April 2013
Further information on these conditions (not related to PPID):
Diagnosing Equine Ataxia: Go Back to Basics - Stacey Oke, DVM, MSc - www.theHorse.com - Dec 2011
Seizures - Equilibrate
Narcolepsy: more common that you think? - Melissa T Hines - NAVC 2005
Research by Fuchs et al. suggested that ""narcolepsy" of adult horses is not a neurological disorder but rather a REM-sleep deficiency due to recumbent sleep deprivation caused by illness, ethological deficits or husbandry shortcomings."
Fuchs C, Kiefner C, Reese S, Erhard M, Wöhr AC
Narcolepsy: Do Adult Horses Really Suffer from a Neurological Disorder or Rather from a Recumbent Sleep Deprivation/Rapid Eye Movement (REM)-Sleep Deficiency?
Equine Veterinary Journal Volume 48, Issue S50 September 2016 p 9
TLS comment: trauma/blows to the head have been linked to neurodegeneration in humans, and research at UCLA in 2011 found that traumatic brain injury caused degeneration of nigrostriatal dopaminergic neurons and caused the remaining dopaminergic neurons to become more vulnerable to further damage, increasing the risk of Parkinson's disease.
Is it possible that some cases of PPID are caused by blows to the head (not uncommon in horses), and that the neurological symptoms seen are also related to the traumatic brain injury rather than the PPID per se?
Neurological symptoms associated with advanced stage PPID include ataxia (weakness/inconsistent gait), blindness, seizures and narcolepsy.
In her 2011 paper on PPID, Dianne McFarlane suggests that 6 to 50 % of horses with PPID show signs of neurological disease. Unpublished data found that neurological impairment was seen more commonly in old horses with PPID (27%) than old horses without PPID (5%).
Dianne McFarlane
Equine Pituitary Pars Intermedia Dysfunction
Veterinary Clinics of North America: Equine Practice Vol 27, No. 1, April 2011
However this article for VetGrad suggests that neurological signs are rarely reported in horses with PPID, include blindness, collapse and seizures and are likely caused by the increased size of the pituitary gland exerting pressure on the base of the brain.
Katie Snalune BSc MA VetMB Cert EM (Int.Med.) Cert ES (Soft Tissue) MRCVS - 21/04/2013
Pituitary Pars Intermedia Dysfunction (PPID) in the Horse
Abra Wright also lists neurological signs amongst clinical signs of PPID, including seizures, abnormal vision, blindness, ataxia and
narcolepsy, and again suggests that these may be associated with compression from a macro-adenoma (tumour) - see page 9:
Abra Wright MSc Thesis 2009
Pharmacokinetics of Pergolide in normal mares
Clinical Endocrinology of Companion Animals (2013) suggests that effects from a pituitary adenoma are rare, although blindness has been reported, most likely due to compression of the optic chiasm (optic nerves) by an enlarged pituitary gland. Seizures have been reported rarely but the cause of the seizures has not been linked to PPID. See p 106:
Clinical Endocrinology of Companion Animals - edited by Jacquie Rand, Ellen Behrend, Danielle Gunn-Moore, Michelle Campbell-Ward - 2013
At the 2013 Western Veterinary Conference, Hal Schott II reported that bizarre neurological signs and blindness have been associated with PPID, but said that researchers don't fully understand the connection between these signs and the disease.
Current Diagnostic Options for PPID - Erica Larson - www.thehorse.com - April 2013
Further information on these conditions (not related to PPID):
Diagnosing Equine Ataxia: Go Back to Basics - Stacey Oke, DVM, MSc - www.theHorse.com - Dec 2011
Seizures - Equilibrate
Narcolepsy: more common that you think? - Melissa T Hines - NAVC 2005
Research by Fuchs et al. suggested that ""narcolepsy" of adult horses is not a neurological disorder but rather a REM-sleep deficiency due to recumbent sleep deprivation caused by illness, ethological deficits or husbandry shortcomings."
Fuchs C, Kiefner C, Reese S, Erhard M, Wöhr AC
Narcolepsy: Do Adult Horses Really Suffer from a Neurological Disorder or Rather from a Recumbent Sleep Deprivation/Rapid Eye Movement (REM)-Sleep Deficiency?
Equine Veterinary Journal Volume 48, Issue S50 September 2016 p 9
TLS comment: trauma/blows to the head have been linked to neurodegeneration in humans, and research at UCLA in 2011 found that traumatic brain injury caused degeneration of nigrostriatal dopaminergic neurons and caused the remaining dopaminergic neurons to become more vulnerable to further damage, increasing the risk of Parkinson's disease.
Is it possible that some cases of PPID are caused by blows to the head (not uncommon in horses), and that the neurological symptoms seen are also related to the traumatic brain injury rather than the PPID per se?
Neuropathic pain
Dr. Kellon’s Guidelines: When Winter Laminitis Strikes Out of Nowhere - Uckele Health & Nutrition Feb 2017
See:
ALCAR - Acetyl-L-Carnitine, L-Carnitine
Alpha lipoic acid (ALA) (available to Friends of TLS only)
Treatments for neuropathic pain in humans:
Nascimento OJM, Pessoa BL, Orsini M, et al.
Neuropathic Pain Treatment: Still a Challenge.
Neurology International. 2016;8(2):6322. doi:10.4081/ni.2016.6322.
Dr. Kellon’s Guidelines: When Winter Laminitis Strikes Out of Nowhere - Uckele Health & Nutrition Feb 2017
See:
ALCAR - Acetyl-L-Carnitine, L-Carnitine
Alpha lipoic acid (ALA) (available to Friends of TLS only)
Treatments for neuropathic pain in humans:
Nascimento OJM, Pessoa BL, Orsini M, et al.
Neuropathic Pain Treatment: Still a Challenge.
Neurology International. 2016;8(2):6322. doi:10.4081/ni.2016.6322.
Nitric Oxide - NO
Nitric oxide - good or bad?
Nitric oxide (NO) is a signalling molecule produced by many cells in the body, which acts on the circulatory, nervous and immune systems. It acts similar to a neurotransmitter in the nervous system, regulates blood vessel tone and plays a defence role in the immune system. However it is also a free oxygen radical (NOS) and can be toxic to cells. NO is synthesized from the amino acid L-arginine by the action of the enzyme nitric oxide synthase (NOS), and has a half-life of just a few seconds. There are (at least) 3 forms of NOS: eNOS (endothelial), nNOS (neuronal) and iNOS (inducible).
eNOS causes NO to be synthesized by the epithelium (lining cells) of blood vessels to "tell" smooth muscle to relax (vasodilate), leading to increased blood flow.
Journal of Cell Science 117, 2427-2429
eNOS at a glance
William C. Sessa
Recent research suggests that eNOS may be implicated in causing chronic stress induced tumours - eNOS knockout mice did not get tumours from chronic stress. "These results disclose for the first time a pivotal role for eNOS in chronic stress-induced initiation and promotion of tumour growth."
J Cell Mol Med. 2012 Apr;16(4):920-6.
Role of endothelial nitric oxide synthase (eNOS) in chronic stress-promoted tumour growth.
A Barbieri et al.
iNOS causes NO to be synthesized in large amounts as part of the immune response, which can damage cells. Inhibition of iNOS may help in the treatment of inflammatory disease.
Life Sciences 75 (2004) 639 – 653
iNOS-mediated nitric oxide production and its regulation
Fugen Aktan
Clin Exp Immunol. 1998 August; 113(2): 147–156.
Inducible nitric oxide synthase in human diseases
K-D Kröncke, K Fehsel, and V Kolb-Bachofen
Nitric Oxide - www.cvphysiology.com
Curr Vasc Pharmacol. 2012 Jan;10(1):4-18.
The role of nitric oxide on endothelial function.
Tousoulis D, Kampoli AM, Tentolouris C, Papageorgiou N, Stefanadis C.
(Relating to humans) "The vascular endothelium is a monolayer of cells between the vessel lumen and the vascular smooth muscle cells. Nitric oxide (NO) is a soluble gas continuously synthesized from the amino acid L-arginine in endothelial cells by the constitutive calcium-calmodulin-dependent enzyme nitric oxide synthase (NOS). This substance has a wide range of biological properties that maintain vascular homeostasis, including modulation of vascular dilator tone, regulation of local cell growth, and protection of the vessel from injurious consequences of platelets and cells circulating in blood, playing in this way a crucial role in the normal endothelial function. A growing list of conditions, including those commonly associated as risk factors for atherosclerosis such as hypertension, hypercholesterolemia, smoking, diabetes mellitus and heart failure are associated with diminished release of nitric oxide into the arterial wall either because of impaired synthesis or excessive oxidative degradation. The decreased production of NO in these pathological states causes serious problems in endothelial equilibrium and that is the reason why numerous therapies have been investigated to assess the possibility of reversing endothelial dysfunction by enhancing the release of nitric oxide from the endothelium."
Handb Exp Pharmacol. 2006;(176 Pt 1):213-54.
Nitric oxide and the vascular endothelium.
Moncada S, Higgs EA.
Circulation.2006; 113: 1708-1714
Endothelial Nitric Oxide Synthase in Vascular Disease
Ulrich Förstermann, Thomas Münzel
Can nitric oxide help laminitis cases?
J. Nutr. July 2006 vol. 136no. 7 2114S-2121S
Countermeasures for Pasture-Associated Laminitis in Ponies and Horses
Harris P, Bailey SR, Elliott J, Longland A
Equine Vet J. 1996 Jan;28(1):17-28.
Nitric oxide donors as treatment for grass induced acute laminitis in ponies.
Hinckley KA, Fearn S, Howard BR, Henderson IW.
Concluded "Nitric oxide is likely to participate in the multifactorial pathogenesis of equine laminitis."
Nitroglycerine is converted to NO in the body.
Research
Finding EJT, Elliott J, Harris PA, Menzies-Gow NJ
Nitric oxide synthase inhibition reveals differences in the nitric oxide pathway in previously laminitic ponies
Research in Veterinary Science Available online 1 July 2022. https://doi.org/10.1016/j.rvsc.2022.05.012
Keywords: Blood pressure, Equine, Endothelial cells, Laminitis, Nitric oxide
Nitric oxide (NO), a vasodilator, predominates in the balance between vasodilators and vasoconstrictors, maintaining the vasculature in a vasodiluted state. NO is generated from L-arginine by the action of NO synthase (NOS) throughout the body.
Nitric oxide (NO) is a signalling molecule produced by many cells in the body, which acts on the circulatory, nervous and immune systems. It acts similar to a neurotransmitter in the nervous system, regulates blood vessel tone and plays a defence role in the immune system. However it is also a free oxygen radical (NOS) and can be toxic to cells. NO is synthesized from the amino acid L-arginine by the action of the enzyme nitric oxide synthase (NOS), and has a half-life of just a few seconds. There are (at least) 3 forms of NOS: eNOS (endothelial), nNOS (neuronal) and iNOS (inducible).
eNOS causes NO to be synthesized by the epithelium (lining cells) of blood vessels to "tell" smooth muscle to relax (vasodilate), leading to increased blood flow.
Journal of Cell Science 117, 2427-2429
eNOS at a glance
William C. Sessa
Recent research suggests that eNOS may be implicated in causing chronic stress induced tumours - eNOS knockout mice did not get tumours from chronic stress. "These results disclose for the first time a pivotal role for eNOS in chronic stress-induced initiation and promotion of tumour growth."
J Cell Mol Med. 2012 Apr;16(4):920-6.
Role of endothelial nitric oxide synthase (eNOS) in chronic stress-promoted tumour growth.
A Barbieri et al.
iNOS causes NO to be synthesized in large amounts as part of the immune response, which can damage cells. Inhibition of iNOS may help in the treatment of inflammatory disease.
Life Sciences 75 (2004) 639 – 653
iNOS-mediated nitric oxide production and its regulation
Fugen Aktan
Clin Exp Immunol. 1998 August; 113(2): 147–156.
Inducible nitric oxide synthase in human diseases
K-D Kröncke, K Fehsel, and V Kolb-Bachofen
Nitric Oxide - www.cvphysiology.com
Curr Vasc Pharmacol. 2012 Jan;10(1):4-18.
The role of nitric oxide on endothelial function.
Tousoulis D, Kampoli AM, Tentolouris C, Papageorgiou N, Stefanadis C.
(Relating to humans) "The vascular endothelium is a monolayer of cells between the vessel lumen and the vascular smooth muscle cells. Nitric oxide (NO) is a soluble gas continuously synthesized from the amino acid L-arginine in endothelial cells by the constitutive calcium-calmodulin-dependent enzyme nitric oxide synthase (NOS). This substance has a wide range of biological properties that maintain vascular homeostasis, including modulation of vascular dilator tone, regulation of local cell growth, and protection of the vessel from injurious consequences of platelets and cells circulating in blood, playing in this way a crucial role in the normal endothelial function. A growing list of conditions, including those commonly associated as risk factors for atherosclerosis such as hypertension, hypercholesterolemia, smoking, diabetes mellitus and heart failure are associated with diminished release of nitric oxide into the arterial wall either because of impaired synthesis or excessive oxidative degradation. The decreased production of NO in these pathological states causes serious problems in endothelial equilibrium and that is the reason why numerous therapies have been investigated to assess the possibility of reversing endothelial dysfunction by enhancing the release of nitric oxide from the endothelium."
Handb Exp Pharmacol. 2006;(176 Pt 1):213-54.
Nitric oxide and the vascular endothelium.
Moncada S, Higgs EA.
Circulation.2006; 113: 1708-1714
Endothelial Nitric Oxide Synthase in Vascular Disease
Ulrich Förstermann, Thomas Münzel
Can nitric oxide help laminitis cases?
J. Nutr. July 2006 vol. 136no. 7 2114S-2121S
Countermeasures for Pasture-Associated Laminitis in Ponies and Horses
Harris P, Bailey SR, Elliott J, Longland A
Equine Vet J. 1996 Jan;28(1):17-28.
Nitric oxide donors as treatment for grass induced acute laminitis in ponies.
Hinckley KA, Fearn S, Howard BR, Henderson IW.
Concluded "Nitric oxide is likely to participate in the multifactorial pathogenesis of equine laminitis."
Nitroglycerine is converted to NO in the body.
Research
Finding EJT, Elliott J, Harris PA, Menzies-Gow NJ
Nitric oxide synthase inhibition reveals differences in the nitric oxide pathway in previously laminitic ponies
Research in Veterinary Science Available online 1 July 2022. https://doi.org/10.1016/j.rvsc.2022.05.012
Keywords: Blood pressure, Equine, Endothelial cells, Laminitis, Nitric oxide
Nitric oxide (NO), a vasodilator, predominates in the balance between vasodilators and vasoconstrictors, maintaining the vasculature in a vasodiluted state. NO is generated from L-arginine by the action of NO synthase (NOS) throughout the body.
Nitroglycerine
Vet Surg. 2005 Nov-Dec;34(6):604-9.
Effects of topical nitroglycerine patches and ointment on digital venous plasma nitric oxide concentrations and digital blood flow in healthy conscious horses.
Gilhooly MH, Eades SC, Stokes AM, Moore RM.
"CONCLUSIONS: In clinically healthy horses, digital arterial blood flow and digital venous plasma NO concentrations did not change significantly with application of the NTG patches/ointment. These treatments are unlikely to have an effect on the digital vasculature of laminitic horses, however, further investigation is warranted.
CLINICAL RELEVANCE: Although NTG patches have been used as a method of decreasing vasomotor tone and improving digital blood flow in horses with laminitis, this study provides evidence in healthy conscious horses that this treatment is not effective in altering digital blood flow."
Effects of topical nitroglycerine patches and ointment on digital venous plasma nitric oxide concentrations and digital blood flow in healthy conscious horses.
Gilhooly MH, Eades SC, Stokes AM, Moore RM.
"CONCLUSIONS: In clinically healthy horses, digital arterial blood flow and digital venous plasma NO concentrations did not change significantly with application of the NTG patches/ointment. These treatments are unlikely to have an effect on the digital vasculature of laminitic horses, however, further investigation is warranted.
CLINICAL RELEVANCE: Although NTG patches have been used as a method of decreasing vasomotor tone and improving digital blood flow in horses with laminitis, this study provides evidence in healthy conscious horses that this treatment is not effective in altering digital blood flow."
NSAIDs - NonSteroidal Anti-Inflammatory Drugs
NSAID information and data sheets
Bute - Phenylbutazone see under Phenylbutazone
Equioxx (Firocoxib) datasheet
AAVPT monograph - Flunixin (Banamine)
Metacam 15 mg/ml oral suspension (Meloxicam)
Meloxicam EMEA 2002
Always be aware of potential side effects when giving NSAIDs, never give NSAIDs or change the dose without consulting your vet, and never exceed the recommended dose (without close veterinary supervision).
Be very careful when giving any NSAID as there are often adverse interactions between NSAIDs and other medicines and supplements, particularly herbal supplements. For example:
NSAIDs + MSM: in humans, increased bruising and blood in the faeces has been reported anecdotally when Meloxicam was taken at the same time as MSM (Source: Prescriber's Digital Reference Meloxicam).
Do NSAIDs have a role in treating laminitis?
Recent research has suggested that endocrine (hyperinsulinaemic) laminitis may involve little inflammation, and therefore NSAIDs may be useful for their pain-relieving properties only and not help to prevent or treat the laminitis.
TLS comment: In our experience, the pain from endocrine laminitis often appears to be related to misalignment between the pedal/coffin bone and the hoof capsule, and it is realigning the foot and correctly supporting the foot through the solar surface that most significantly reduces pain.
Karikoski NP, McGowan CM, Singer ER, Asplin KE, Tulamo RM, Patterson-Kane JC
Pathology of Natural Cases of Equine Endocrinopathic Laminitis Associated With Hyperinsulinemia
Vet Pathol. 2014 Sep 17
The lamellae of 14 laminitic and hyperinsulinaemic horses and ponies were compared to controls.
"Acute separation originated from the abaxial region, with minimal associated inflammation".
de Laat M, Sillence M, McGowan C, Pollitt C
Insulin-Induced Laminitis - An investigation of the disease mechanism in horses
RIRDC Dec 2011
Melody de Laat suggested that inflammation might be a minor player in hyperinsulinaemic laminitis, and therefore "anti-inflammatory medications may only be useful for their analgesic properties in this form of laminitis, and may not alter progression of the disease."
From www.ecirhorse.org Laminitis
"Phenylbutazone (Bute) and flunixin meglumine (Banamine) are the mainstays in anti inflammatory drugs. A newcomer is firocoxib (Equioxx) which carries a lower risk of gastrointestinal ulceration with short term use. These drugs are reasonable to use for the first 3 to 5 days of an acute laminitis bout but should not be used for longer than this. These drugs are in the class called nonsteroidal anti inflammatories. They are well documented to interfere with healing of bone and soft tissue to the point that many human surgeons now instruct their patients not to use this class of drugs after a surgery."
NSAID use in horses/veterinary medicine
Noble G, Edwards S, Lievaart J, Pippia J, Boston R, Raidal SL
Phamacokinetics and Safety of Single and Multiple Oral Doses of Meloxicam in Adult Horses
Journal of Veterinary Internal Medicine Sept-Oct 2012 Vol 26, Issue 5, pages 1192-1201.
https://doi.org/10.1111/j.1939-1676.2012.00976.x
Equine Vet J Suppl. 2011 Aug;(39):140-4
The effect of nonsteroidal anti-inflammatory drugs on the equine intestine
Marshall JF, Blikslager AT
"While NSAIDs effectively treat the symptoms of colic, there is evidence to suggest that their administration is associated with adverse gastrointestinal effects including right dorsal colitis and inhibition of mucosal barrier healing." "Flunixin meglumine has been shown in the small intestine to inhibit barrier function recovery and increase permeability to lipopolysaccharide (LPS)."
J Vet Intern Med 2005;19:633–643
The Coxib NSAIDs: Potential Clinical and Pharmacologic Importance in Veterinary Medicine
Mary Sarah Bergh and Steven C. Budsberg
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to control acute and chronic pain as well as to manage oncologic and
neurologic diseases in human and veterinary patients. Despite ongoing research and efforts to improve the safety and efficacy of
existing drugs, adverse effects such as gastrointestinal irritation, renal and hepatic toxicity, interference with hemostasis, and
reproductive problems persist. The true incidence of NSAID-induced adverse effects in animals is unknown, but is likely underestimated,
because cats and dogs may be more sensitive than humans to NSAIDs due to alterations in drug metabolism, absorption,
and enterohepatic recirculation. NSAIDs produce both analgesia and toxic adverse effects primarily by inhibiting cyclooxygenase
(COX), thereby decreasing the production of prostaglandins that signal inflammation and pain as well as mediate physiologic
functions such as platelet aggregation, gastric protection, and electrolyte balance in the kidney. The presence of at least 2 COX
isoforms may account for variability in NSAID efficacy and toxicity both within and among species. This paper reviews and
evaluates the published literature on the safety, pharmacology, uses, and complications of a subclass of COX-1–sparing drugs, the
coxibs, in veterinary medicine. Coxibs and other COX-1–sparing drugs provide a clinically useful improvement over traditional
NSAIDs, but data are incomplete and more in vivo species-specific, target-tissue, and clinical studies are needed.
Myths and Truths About Controlling Pain and Inflammation in Horses
Comparing Bute and Firocoxib Safety (AAEP 2010) - The Horse
NSC - Non-Structural Carbohydrates
NSC (non-structural carbohydrate) is a term used by plant scientists.
NSC = WSC (water soluble carbohydrate) and starch.
WSC = ESC (ethanol soluble carbohydrate) plus fructan.
ESC = simple sugars (glucose, fructose, sucrose).
The problem with using the term NSC for horse diets is that ESC and starch are digested before the hind gut, increase blood glucose and therefore blood insulin, and are important for endocrinopathic laminitis, but fructans - which can comprise a large part of WSC - are fermented in the hind gut to volatile fatty acids (VFAs) and do not directly affect blood glucose or insulin levels, and do not appear to play a role in endocrinopathic laminitis (or, when eaten naturally, any form of laminitis). See Do fructans cause laminitis?
NSC (non-structural carbohydrate) is a term used by plant scientists.
NSC = WSC (water soluble carbohydrate) and starch.
WSC = ESC (ethanol soluble carbohydrate) plus fructan.
ESC = simple sugars (glucose, fructose, sucrose).
The problem with using the term NSC for horse diets is that ESC and starch are digested before the hind gut, increase blood glucose and therefore blood insulin, and are important for endocrinopathic laminitis, but fructans - which can comprise a large part of WSC - are fermented in the hind gut to volatile fatty acids (VFAs) and do not directly affect blood glucose or insulin levels, and do not appear to play a role in endocrinopathic laminitis (or, when eaten naturally, any form of laminitis). See Do fructans cause laminitis?
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How does NSC affect insulin and glucose concentrations in horses?
Shepherd ML, Pleasant RS, Crisman MV, Werre SR, Milton SC, Swecker WS Jr
Effects of high and moderate non-structural carbohydrate hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings
J Anim Physiol Anim Nutr (Berl). 2012 Jun;96(3):428-35. doi: 10.1111/j.1439-0396.2011.01159.x. Epub 2011 May 16
Shepherd ML, Pleasant RS, Crisman MV, Werre SR, Milton SC, Swecker WS Jr
Effects of high and moderate non-structural carbohydrate hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings
J Anim Physiol Anim Nutr (Berl). 2012 Jun;96(3):428-35. doi: 10.1111/j.1439-0396.2011.01159.x. Epub 2011 May 16