Plasma fructosamine concentrations in horses with pituitary pars intermedia dysfunction with and without laminitis.
Authors: Knowles E J, Menzies-Gow N J, Mair T S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Fructosamine and PPID-Associated Laminitis Pituitary pars intermedia dysfunction (PPID) drives persistent hyperglycaemia and represents a significant risk factor for laminitis in older horses, yet the relationship between glycaemic control and laminitis development in PPID cases remains incompletely understood. Knowles and colleagues measured plasma fructosamine concentrations—a marker reflecting average blood glucose over the preceding 2–3 weeks—in PPID-affected horses, stratifying animals by presence or absence of concurrent laminitis to determine whether fructosamine could distinguish between metabolically dysregulated but clinically sound horses and those that had developed laminitic complications. The investigators found elevated fructosamine in PPID horses generally, but critically, horses with PPID and active laminitis demonstrated significantly higher fructosamine concentrations than PPID horses without laminitis, suggesting a threshold effect in glycaemic dysregulation that may precipitate laminitic episodes. This distinction has practical implications for risk stratification: fructosamine measurement could help identify PPID horses at highest laminitis risk and guide intensity of glycaemic management, potentially informing decisions about medication escalation (such as pergolide dosing) or dietary intervention. The finding reinforces that glucose control is not binary in PPID cases, and monitoring medium-term glycaemic trends alongside insulin and glucose values may refine our ability to prevent laminitis in this high-risk population.
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Practical Takeaways
- •Fructosamine testing may be a useful diagnostic marker for identifying horses with PPID at risk of laminitis, offering a non-invasive way to assess glucose control over 2-3 weeks
- •Monitoring fructosamine in PPID cases could help stratify laminitis risk and guide treatment decisions
- •Consider fructosamine alongside other metabolic screening in older horses with suspected PPID to detect subclinical hyperglycaemia before laminitis develops
Key Findings
- •Plasma fructosamine concentration reflects medium-term average blood glucose concentration in horses
- •Fructosamine levels are elevated in horses with active laminitis compared to normal horses
- •PPID is associated with both hyperglycaemia and laminitis risk