​Can you contribute to a study on quality of life for horses with PPID?
The Royal Veterinary College is looking for owners who are planning to test their horse for PPID, or who have had their horse tested for PPID in the last 2-4 weeks, to take part in a 2 year study, with a 10 minute online questionnaire to complete every 3 months. The PPID test doesn't have to have been positive to join the research. The research runs until September 2026, so plenty of time to join.
To join the research, your horse must be aged 10+ and have been tested for PPID within the last:
4 weeks if the test result was positive but no treatment is planned, or negative/equivocal, or
2 weeks if the test result was positive and treatment with pergolide has started within the last 2 weeks, or treatment with pergolide hasn't started yet but is planned.
You must be aged 18+ and be based in the UK (owners and professionals welcome). Your data will be anonymised but you must be happy for the research team to contact you and for your answers to be used in the research.
The purpose of the study is to assess, monitor and quantify the impact of the long-term effect of PPID on the quality of life of a horse/pony and owner's well-being. The data collected will contribute to research into how treatment with pergolide and other long-term changes affect the quality of life of horses with PPID.
Click this link (or the image above) to apply to participate in the study.

November 2023 - Senvelgo, an oral solution of velagliflozin, an SGLT-2 inhibitor, has now been licenced for the treatment of cats in the UK and Europe.  Will a licenced SLGT-2 inhibitor product for horses follow??

New (or that we've only recently noticed!) feeds that might be suitable for horses with laminitis, ID or PPID:

Dengie Meadow Lite with Herbs
A low calorie blend of oat straw and meadow grass with DE of 5 MJ/kg, 3% sugar (ESC/simple sugars) and 0.5% starch as fed (but note the low protein at only 5% as fed).  Can be added to bucket feed to encourage chewing and slow fast eaters, and used as a forage replacer [NB as this is a straw based product it will be particularly important to feed a good balancer to provide protein, minerals and vitamins, e.g. Spillers Lite + Lean, and with only 5% protein additional protein may be needed in addition to a balancer, depending on the quantities fed].

Baileys Natural Meadow Cobs
Can be used as a forage replacer for horses with poor or missing teeth (old horses, horses with EOTRH).  Sugar and starch combined are a little high for horses with laminitis or insulin dysregulation, at 10% (7.8% sugar and 2.2% starch on an as fed basis so probably around 11.1% dry matter if the moisture content is around 10%), but the energy content is low for a grass-based product at 6 MJ/kg as fed (around 6.7 MJ/kg DM if the moisture content is around 10%).  The cobs must be soaked before feeding.  

The recording of a webinar with Rossdales vets Lucy Grieve and Emily Floyd and Dengie Horse Feeds nutritionist Katie Williams from 17 May 2022.
​

Vet Edd Knowles, currently at Bell Equine, completed his PhD at the RVC in 2021.  His research showed that testing insulin, both resting and after an oral sugar test using Karo Light corn syrup, was the best way to identify ponies that would develop laminitis.  Other factors identified by Knowles that can help identify horses at risk of laminitis include level of exercise, body condition score/body fat and hoof changes - although hoof changes (related to laminitis such as divergent hoof rings) will follow laminitis, not precede it.

Knowles' research was published in the EVJ September 2021 special issue for BEVA 2021 clinical research abstracts:
​Knowles EJ, Elliott J, Harris PA, Menzies-Gow NJ
Predictors of laminitis development in non-laminitic ponies
Equine Veterinary Journal August 2021 Vol 53 Issue S55 Clinical Research Abstracts of the BEVA Congress 2021​ p21-22.  https://doi.org/10.1111/evj.31_13492

and as a full paper in the EVJ in March 2022:
​Knowles EJ, Elliott J, Harris PA, Chang YM, Menzies-Gow NJ.
Predictors of laminitis development in a cohort of non-laminitic ponies.
Equine Vet J. 2022 Mar 9. doi: 10.1111/evj.13572. Epub ahead of print. PMID: 35263471.

374 ponies were monitored for up to 4 years (giving 891 pony years - 891 pony years/374 ponies = an average of 2.4 years that a pony was followed for).  The ponies were considered non-laminitic when they entered the study.  Every 6 months blood was collected for measurement of basal ACTH, adiponectin, triglycerides, glucose and basal non-fasted insulin (T0), and an oral sugar test was carried out 60 minutes (T60) after administering 0.3 ml/kg bodyweight (rather than the standard 0.15 or 0.45 ml/kg) Karo Light corn syrup.  Insulin was measured using a Tosoh AIA-360 Fluorescence Enzyme Immunoassay.

4.8 ponies developed laminitis per 100 pony years, or per 100 ponies/year.  The ponies were divided into 3 groups - low, medium and high risk of laminitis depending on their basal T0 and 60 minutes after Karo Light corn syrup (T60) insulin results.

Measured factors that were associated with the development of laminitis included basal insulin, insulin 60 minutes after giving Karo Light corn syrup, adiponectin, and evidence of divergent hoof growth.  Divergent hoof rings are a sign of chronic laminitis - at The Laminitis Site we have only seen divergent hoof rings where there is palmar rotation and usually (at least at some point) dorsal rotation and signs of compression in the toe wall/coronary band, therefore we would argue that seeing divergent hoof rings shows that a pony has already had laminitis, and is not predictive of future laminitis.  Seeing divergent hoof rings means that x-rays should be taken to assess and guide the realignment of rotation/misalignment between pedal bone and hoof capsule.

ACTH was not associated with laminitis.

The 3 risk groups were:
Low: non-fasted basal insulin <21.6 uIU/ml, 70% of the population were in this group, so 261.8/374 ponies, incidence of laminitis was 6% in this group over 4 years.
Medium: non-fasted basal insulin 21.6-45.2 uIU/ml, 20% of the population were in this group, so 74.8/374 ponies, incidence of laminitis was 22% in this group over 4 years.
High: non-fasted basal insulin >45.2 uIU/ml, 10% of the population were in this group, so 37.4/374 ponies, incidence of laminitis was 69% in this group over 4 years.


Under Main limitations the abstract says "Results may not apply to different insulin assays...".

Questions:
How does the Tosoh AIA-360 Fluorescence Enzyme Immunoassay compare e.g. to Immulite 2000 results?  Was this assay validated for equine insulin?  
What did the ponies eat before their basal non-fasted insulin blood collections?

Listen to The Humble Hoof's podcast Laminitis: Treatment and Prevention with Dr Alicia Nolfi.  Dr Nolfi discusses laminitis treatment, and the importance of preventative care.

Laminitis: Treatment and Prevention Podcast

The link between insulin dysregulation, obesity and laminitis in horses - Prof. Simon Bailey, University of Melbourne

Webinar: How to provide a good life for horses: friends, freedom and forage
Hosted by World Horse Welfare on 26 May 2021

The Latest on EMS, PPID & Laminitis
Webinar by Jamie Prutton from Liphook Equine Hospital and Tracey Hammond from Dengie Horse Feeds on 31 March 2021, hosted by Dengie Horse Feeds

Dengie brought out a new Laminitis Guide in March 2020, which features photos taken by The Laminitis Site of some of the many laminitis cases that TLS has helped.  Dengie very kindly provided The Laminitis Site with Dengie feed vouchers as a thank you - for which rescued laminitic pony Dolly will be very pleased, as she loves Dengie HiFi molasses free!