Kentucky equine practitioner Dr. Vern Dryden has built a career on treating laminitis, often with headline-making, client-lauding success. But two years ago, he expanded his practice beyond equine veterinary podiatry to focus his efforts not just on treating laminitis, but also preventing it.
But from that day, the vet and owner are building a record of insulin results, which will help Dryden and other veterinarians who treat the horse understand its hormonal status.
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| Wellness Ready tests are self-contained kits that provide a digital readout of the horse's insulin level--while the veterinarian is still with the owner. |
Laminitis is beginning a new chapter–the chapter of proactive testing, whether early in the lameness phase or early enough to prevent hoof pain before it starts. Prevention takes effort, first of all, and information, most of all. For an estimated 90 percent of laminitis cases (1), the root problem is a hormone-disrupting condition, usually Equine Metabolic Syndrome (EMS).
EMS horses tend to be overweight, with fat deposits in certain areas (“regional adiposity”), and a cresty neck. Many are ponies and Morgans but they also increasingly include Arabians, Quarter horses, Andalusians, and warmbloods.
It is important to know that EMS is being diagnosed in virtually all breeds of horses; moreover, neither old age nor obesity is a prerequisite.
This video introduces you to Wellness Ready and some of the veterinarians using it in the field.
Laminitis prevention begins with insulin level testing
What all EMS cases have in common is a change in the horse’s ability to regulate insulin, the all-important regulatory hormone secreted by the pancreas. The cresty neck and fat pads are external signs of a systemic hormone imbalance.
When insulin dysregulation (ID) is determined to be a problem, as in an EMS horse–and previously unmeasured, as is so often the case–laminitis is a risk. Veterinarians often need to know if a horse is likely to have elevated insulin before prescribing some therapeutic medications or procedures that may be contraindicated in an EMS horse, such as corticosteroids contained in joint injections for performance horses.
Waiting several days for traditional insulin test results might require delaying the use of therapeutic medications, rescheduling competition and training, and avoiding stressful events like transport
The drive to prevent laminitis in as many horses as possible, and to insure equine welfare, has led to suggestions that insulin testing should be part of a pre-purchase exam for a mature horse, and a standard test in an annual wellness exam, as well.
How do insulin tests help identify a horse at risk for laminitis?
Insulin testing is easy enough for a veterinarian to do, but most are not likely to do the test on healthy horses until or unless health or soundness changes are seen. This may mean that no recent insulin numbers are posted in a horse’s medical history for comparison.
While there is still no test to predict laminitis itself, the Wellness Ready quick response insulin test kit helps vets identify horses whose Equine Metabolic Syndrome puts them at risk for related health problems, which include obesity and laminitis.
The problem is finding horses before they become obese, fat-lumpy, or cresty necked. Before they start changing their posture, shortening their strides, and showing signs of bruising in their hoof trimmings.
Officially known as HAL, or hyperinsulinemia-associated laminitis, the EMS form of laminitis might also be called grass founder, easy-keeper disease, insulin laminitis or other names. No matter what you call it, it is just as painful for the horse.
While HAL is the most common type of laminitis, by far, it is important to differentiate HAL from the three other primary “pathways” of laminitis (sepsis, support limb and road founder), when saying that a horse has had or does have laminitis. Dr. Vern Dryden has seen–and treated–them all.
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A horse with laminitis will benefit from follow-up insulin testing over the course of the rehabilitation, but preventing a horse from developing laminitis may only be possible with accurate and serial insulin testing to determine if EMS is the problem, and knowing if the insulin levels are fluctuating or are back to normal.
“We needed a better way and now we have one,” Dryden explained over and over again this spring, as horses across America were reacting to the perennial surge in insulin levels so often associated with spring grass turnout.
Insulin testing is becoming the norm
Horse owners raised eyebrows and sputtered, “What does that have to do with his sore feet?” as he prepared to run a test. But when they found out that the little plastic cube meant an insight would be available in minutes instead of days, their skepticism turned to relief.
Dryden is particularly observant of any insulin changes around the changes in seasons, or any adverse health events that affect the horse.
This video explains the mission of Wellness Ready to help horses with EMS and prevent laminitis:
Test kits are now familiar tools
Dryden’s new business, Wellness Ready, is shepherding laminitis prevention and EMS diagnostics into the world of time-sensitive stallside medicine, where it is so badly needed. Across the realm of veterinary medicine, a lineup of stallside tests is changing both how horse health is monitored and how long it takes to obtain a result needed to initiate an intervention or treatment.
In the last year, self-initiated coronavirus test kits for humans have made many Americans familiar with at-home testing and the benefit of instant results for their own health.
Horse owners are increasingly aware that obesity carries many health risks for a horse, including the possibility of endocrine disease like EMS and laminitis. But it is still up to the veterinarian to say, “Let’s not guess. Let’s test the insulin so we know.”
A diagnosis of EMS is not just a snicker about a horse being an “easy keeper” or needing to go on a diet. It is a stern warning. A potentially dire prediction. And a call to action, armed with numbers gathered at each visit: recent diet and exercise history, physical exam and body condition score, hoof inspection for signs of laminitis, and endocrine testing (2).
The call is now easier than ever to answer, thanks to Wellness Ready testing kits. Armed with fast results to analyze and symptoms to evaluate, an action plan for an EMS horse can begin immediately, so laminitis is never the next call that horse owner will make to a vet.
Who's behind the Wellness Ready test kit?
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| Wellness Ready founders Patrick Lawless, PhD and Vern Dryden, DVM, CJF |
Wellness Ready was co-founded by veterinarian Vern Dryden and researcher Patrick Lawless, PhD, who is the firm’s CEO. Dr Lawless is also founder of Thrive Animal Health, manufacturer of Equithrive & Petthrive brand veterinary nutraceuticals.
Wellness Ready test kits are available to veterinarians through major US veterinary product distributors such as Vetcove.com, Covetrus, and MWI. The company is located in Lexington, Kentucky.
Wellness Ready is also available in Canada, Australia, Japan, the United Kingdom, and a growing number of other countries.
Please visit wellnessready.com or call (800) 236-7821.
References:
1. Morgan, R., Keen, J. and McGowan, C. (2015), Equine metabolic syndrome. Veterinary Record, 177: 173-179. https://doi.org/10.1136/vr.103226 (Open Access)
2. Durham AE, Frank N, McGowan CM, et al. European College of Equine Internal Medicine (ECEIM) consensus statement on equine metabolic syndrome. J Vet Intern Med. 2019;33:335–349. https://doi.org/ 10.1111/jvim.15423 (Open Access)
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