Severe hypertriglyceridaemia in horses and ponies with endocrine disorders.
Authors: Dunkel B, Wilford S A, Parkinson N J, Ward C, Smith P, Grahame L, Brazil T, Schott H C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Severe hypertriglyceridaemia secondary to endocrine disorders in horses and ponies Dunkel and colleagues documented a previously under-recognised association between severe hypertriglyceridaemia (>5.65 mmol/l) and endocrine disease in horses and ponies, specifically pituitary pars intermedia dysfunction (PPID) and type 2 diabetes mellitus. Through a retrospective multi-centre case review of seven animals, the researchers found triglyceride concentrations ranging from 10.5 to 60.3 mmol/l, accompanied by hyperglycaemia in six cases, suspected insulin resistance, and elevated hepatic enzymes; histological examination revealed moderate hepatic lipidosis in two animals despite clinically normal presentations. Six of seven cases were associated with PPID (confirmed via basal ACTH or dexamethasone suppression testing), with five of these animals concurrently diagnosed with type 2 diabetes mellitus. Treatment with pergolide and/or insulin resulted in biochemical improvement in four animals, though response was variable in others; notably, one pony maintained abnormal laboratory values for seven years without apparent clinical detriment. For equine practitioners, these findings suggest that severe hypertriglyceridaemia warrants screening for underlying insulin resistance and endocrine dysfunction rather than investigation of primary lipid metabolism disorders, and that appropriate management of PPID and glucose regulation may resolve triglyceridaemia—though the variable progression and clinical presentation underscore the need for individualised assessment and close biochemical monitoring during treatment.
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Practical Takeaways
- •Investigate endocrine status (ACTH, dexamethasone suppression) in horses and ponies presenting with unexplained weight loss and marked hypertriglyceridaemia, as treatment of underlying pituitary or metabolic disease can resolve lipid abnormalities
- •Monitor serum triglycerides and glucose in horses with pituitary pars intermedia dysfunction or insulin resistance, as severe hypertriglyceridaemia may develop silently without overt clinical signs despite hepatic lipidosis
- •Expect variable treatment responses; biochemical abnormalities may persist long-term without apparent clinical deterioration, but early intervention with pergolide and insulin offers the best chance of normalising lipid profiles
Key Findings
- •7 horses and ponies (3 horses, 4 ponies) presented with severe hypertriglyceridaemia (10.5–60.3 mmol/l) secondary to endocrine disorders, with 6 of 7 animals showing hyperglycaemia
- •6 animals (3 horses, 3 ponies) were diagnosed with pituitary pars intermedia dysfunction, and 5 of these concurrent had type 2 diabetes mellitus
- •Laboratory abnormalities improved in 4 animals treated with pergolide and/or insulin, while 2 ponies had impaired or ineffective treatment responses
- •Despite biochemical evidence of hepatic compromise including moderate hepatic lipidosis in 2 animals, no clinical hepatic disease was observed in any case