References
Equine Review
Abstract
Introduction: This edition of the Equine Review looks at thromboelastography in obese horses, the effect of omeprazole and sulcrafate on gastrointestinal injury and perioperative lung ultrasound changes on horses underdoing general anaesthesia.
Equine metabolic syndrome (EMS) is a collection of risk factors for endocrinopathic laminitis that consist of obesity, regional adiposity and insulin dysregulation (ID). Adipose tissue dysregulation and interplay between proinflammatory and prothrombotic states is established in people, but it is unknown if this exists in horses. Thromboelastography is a global assessment of haemostasis which can identify both hypo and hypercoagulable states. Lovett et al (2022) investigated whether coagulation profiles differ between healthy horses and those with obesity and insulin dysregulation. Horses were confirmed as having EMS by using the oral sugar test. A total of 15 horses were in each group (healthy vs those with EMS). Thromboelastography was performed as well as a standard coagulation profile. Maximal amplitude (MA) and G-values were higher when horses had EMS.
There were positive correlations between these values with serum insulin and with body condition score. A higher MA and G-value were reflective of larger final clot strength and stability; the authors concluded that obese, insulin-dys-regulated horses are hypercoagulable compared to healthy controls. The hypercoagulable state of obese human patients is a consequence of complicated interactions of adipose tissue dysregulation, oxidative stress and chronic systemic inflammation. Mechanisms include increased tissue factor release from adipocytes, enhanced biosynthesis of fibrinogen and clotting factors by the liver and increased hepatic expression of plasminogen activator inhibitor-1 leading to hypofibrinolysis.
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