Tuesday, June 12, 2007
Report from the ACVIM Conference
This past week the American College of Veterinary Internal Medicine held their annual meeting, this year in Seattle Wash. Beth and I went and met up with some great friends from our days at Cornell. Eric and Patty Peterson and DL Step. It's hard to believe everyone is so respectable now. Many nights out, great food and way to many adult beverages. Thank God this is the home port for Starbucks coffee. This is a very unique meeting in that unlike most Veterinary meetings this one concentrates on recent advancements and ongoing research projects. There are some review sessions...but not many. What I find to be the most useful are the research abstracts that are presented every 15 minutes for several days. This year there was a focus on glucose and insulin interactions. While this may seem really dull.....let me point out how this may effect your horse. For years now we have been working on a condition in the horse called EMS-equine Metabolic Syndrome. This is the overweight horse that frequently has laminitis. They are also known as the "easy keeper". So how do these horses get so fat on just an air sandwich?. The key is what is known as insulin resistance. In these horses they produce insulin, just like other horses in response to glucose intake ( grain/grass/hay) but their body doesn't react to the insulin and the excess glucose is stored in fat cells. They typiaclly show what is called "regional adiposity" those large visible fat pads, dimples, cresty necks and swollen sheaths. They are also VERY prone to having grass/pasture laminitis. A new way to diagnose this disease was presented at this meeting. It is called the CGIT for the Combined Glucose Insulin Test. You administer IV glucose and then Insulin and measure the blood glucose level over time with a hand held glucometer. Once the condition is confirmed you then treat by taking them off ALL grain and severely restrict access to pasture. By using a grazing muscle or putting them on a dirt lot you take the glucose away....only allowing fair quality hay....and not much of that. It was also reported that you can treat the severe ones with THYROL (thyroxine) at super physiologic levels . This was shown to increase Insulin sensitivity two fold. You do the CGIT every 4 months until normal. More than likely there is a genetic component involved in Metabolic Syndrome since many of these horses were overweight at a young age. Natures response to the high sugar content in spring and summer grasses is the lack of food in the winter, a time when most horses should lose the summer excess, but everyone feeds extra grain in the winter. This really potentiates the Insulin Resistance. Now that we have a reliable test and a good treatment plan ,we should be able to prevent a lot of these from developing catastrophic laminitis. There is just way to much info for me to present here, so I'll add posts about the newest data as it fits in. It was a ton of fun, but it's always good to be home.
Me, Eric and DL