presence of critically-illness-related corticosteroid insufficiency or pancreatic insufficiency in horses is related to poor survival
Stewart, Allison
(2018).
Endocrine response to illness in sick horses.
Diss. (sammanfattning/summary)
Uppsala :
Sveriges lantbruksuniv.,
Acta Universitatis Agriculturae Sueciae, 1652-6880
; 2018:59
ISBN 978-91-7760-258-3
eISBN 978-91-7760-259-0
[Doctoral thesis]
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5MB |
Abstract
Endocrinological responses are under tight physiological control in healthy animals, with homeostatic adaptions made for diet, exercise and illness. Transient adrenal dysfunction with inadequate cortisol production, known as relative adrenal insufficiency (RAI), is a major component of critical illness–related corticosteroid insufficiency (CIRCI), which involves dysfunction of the entire HPA axis. Recognition and treatment of CIRCI improves human survival rates. Whereas a low-dose ACTH stimulation test appears to be the most sensitive method of diagnosing CIRCI in people, published doses for this test in horses were considerably higher, and the lowest dose of ACTH that will maximally stimulate the adrenal glands of horses was unknown. Critical illness is also associated with peripheral tissue insulin resistance and hyperglycaemia in many species, but insulin and glucose dynamics in spontaneously sick adult horses remains to be investigated.
The overall aim was to document changes in cortisol, ACTH, insulin and glucose in sick horses; determine if adrenal or pancreatic dysfunction occurred, and which parameters were correlated with non-survival. A secondary aim was to validate the low-dose ACTH stimulation test in healthy adult horses and neonatal foals and then determine if CIRCI could be identified in sick horses.
A dose of synthetic ACTH of 0.1 µg/kg in healthy adult horses and 0.25 µg/kg in neonatal foals resulted in maximal adrenal stimulation. In sick horses, cortisol, ACTH and ACTH/cortisol ratios were higher in non-survivors at admission. ACTH/cortisol ratios were higher in horses with systemic inflammatory response syndrome (SIRS) and those with an ischemic gastrointestinal lesion, suggesting adrenal dysfunction. Although horses with ischemic lesions had higher basal cortisol, they failed to respond to ACTH stimulation, further indicating adrenal dysfunction. RAI/CIRCI was diagnosed in 21% of sick horses and is associated with a poorer prognosis. Horses presenting with hyperglycaemia and corresponding relative hypoinsulinemia (suggestive of endocrine pancreas dysfunction) had a worse prognosis.
Authors/Creators: | Stewart, Allison | ||||||||||||
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Title: | Endocrine response to illness in sick horses | ||||||||||||
Subtitle: | presence of critically-illness-related corticosteroid insufficiency or pancreatic insufficiency in horses is related to poor survival | ||||||||||||
Alternative abstract: |
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Series Name/Journal: | Acta Universitatis Agriculturae Sueciae | ||||||||||||
Year of publishing : | 22 October 2018 | ||||||||||||
Depositing date: | 22 October 2018 | ||||||||||||
Number: | 2018:59 | ||||||||||||
Number of Pages: | 138 | ||||||||||||
Papers/manuscripts: |
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Place of Publication: | Uppsala | ||||||||||||
Publisher: | Department of Clinical Sciences, Swedish University of Agricultural Sciences | ||||||||||||
ISBN for printed version: | 978-91-7760-258-3 | ||||||||||||
ISBN for electronic version: | 978-91-7760-259-0 | ||||||||||||
ISSN: | 1652-6880 | ||||||||||||
Language: | English | ||||||||||||
Additional Information: | Projects: I – II Birmingham Racing Commission. Project III Hoof Development and Rehabilitation Gift Fund donated by the family of Hall W. Thompson Projects IV – V: American College of Veterinary Emergency and Critical Care research award and the Morris Animal Foundation: Veterinary Student Scholar Program | ||||||||||||
Publication Type: | Doctoral thesis | ||||||||||||
Full Text Status: | Public | ||||||||||||
Agris subject categories.: | L Animal production > L73 Animal diseases | ||||||||||||
Subjects: | (A) Swedish standard research categories 2011 > 4 Agricultural Sciences > 403 Veterinary Science > Clinical Science | ||||||||||||
Keywords: | endocrinology, horses, adrenal, equine, inflammation, colic, CIRCI, cortisol, adrenocorticotropic hormone, ACTH stimulation, SIRS, insulin dysregulation, pancreas | ||||||||||||
URN:NBN: | urn:nbn:se:slu:epsilon-e-5081 | ||||||||||||
Permanent URL: | http://urn.kb.se/resolve?urn=urn:nbn:se:slu:epsilon-e-5081 | ||||||||||||
ID Code: | 15720 | ||||||||||||
Faculty: | VH - Faculty of Veterinary Medicine and Animal Science | ||||||||||||
Department: | (VH) > Dept. of Clinical Sciences | ||||||||||||
Deposited By: | Allison Stewart | ||||||||||||
Deposited On: | 23 Oct 2018 07:50 | ||||||||||||
Metadata Last Modified: | 09 Sep 2020 14:17 |
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