horses

Adipobiology (The Study of Fat in the Body): An Emerging Field

What exactly does stored fat do to a horse's body? It wreaks serious havoc on at least 11 vital body functions. Nat Messer, DVM, Dipl. ABVP, an associate professor of equine medicine and surgery at the University of Missouri (UM), presented a compelling discussion of the relatively new field of adipobiology--the study of fat and its causes and effects. He discussed a paper submitted by Philip Johnson, BVSc(Hons), MS, Dipl. ACVIM, Dipl. ECEIM, MRCVS, professor of veterinary medicine and surgery at UM.

Excess body fat (both subcutaneous fat, such as the squishy stuff around a horse's tailhead, and visceral fat that accumulates near various internal organs) isn't just an unsightly way to store extra calories. Researchers are learning that fat--or adipose tissue as it's scientifically called--is much more active biochemically in many species than was previously thought (particularly visceral fat), noted Johnson in his paper. Fat produces more than 100 substances (collectively called adipokines or adipocytokines) that can affect:

• Lipid and glucose homeostasis (normal fat and glucose balance in the body);
• Inflammation;
• Hemostasis (control of bleeding);
• Osteogenesis (bone production);
• Hematopoiesis (formation and development of blood cells);
• Complement activities (complement is a sequence of proteins in the blood that work to help the animal respond to inflammatory and infectious challenges);
• Reproduction;
• Angiogenesis (development of blood vessels in tissue);
• Blood pressure; and
• Feeding behavior.

In horses, adipokine-mediated alteration of these body functions can cause or contribute to chronic inflammation, metabolic problems such as insulin resistance and possibly pituitary pars intermedia dysfunction (Cushing's disease), circulatory (blood vessel) compromise, and increased risk of laminitis. Also, hyperglycemia (high blood sugar, which is common in horses with severe metabolic syndrome) has been shown to generate oxidative stress--the production of oxygen free radicals that can damage many kinds of tissues.

"In fact, adipokines have recently been claimed to represent the 'missing link' between IR (insulin resistance) and cardiovascular disease in humans," said Johnson. For example, he noted that the branch of the coronary artery passing through an area of fat storage is the one most likely to develop arthrosclerosis (progressive narrowing and hardening of the artery, which can lead to a heart attack or stroke). Local effects of hormones produced by that fat deposit have been implicated as the cause.

Obesity and Insulin Resistance

Even if a horse is fat, if he is insulin- resistant, the cells in his body that depend on insulin for glucose uptake (generally skeletal muscle cells, as well as liver and fat cells) are actually starved for energy--the glucose they should be getting from food metabolism. "Decreased movement of glucose into the cell through glucose transporters (GLUT-4 in this case) in the cell membrane ... is the first step that is defective in human insulin resistance," explained Johnson. This can occur when fatty acids in skeletal muscle directly inhibit insulin activation of glucose-transport activity, he noted.

Not all obese horses develop insulin resistance, and not all insulin-resistant horses are obese, noted Messer. "But IR- associated medical problems are more likely to develop in concert with obesity in individuals born with IR," he said. "Obesity may be an 'add-on' risk factor."

Obesity and Laminitis

"Compelling experimental data have been published to suggest that glucose is essential for the health and strength of the equine hoof-lamellar interface," noted Johnson. "Hemidesmosomes (HD) represent the important attachment link between keratinocytes (hoof wall cells) and the underlying lamellar basement membrane (attaching the coffin bone to the hoof wall). Keratinocyte glucose starvation (from the aforementioned decreased movement of glucose into the cells) may weaken HD, which leads to separation of the keratinocyte from the basement membrane. Situations associated with cell- glucose starvation, such as IR, might increase the risk for laminitis."

He noted that it remains to be seen whether hoof keratinocytes depend (to any extent) on insulin for their glucose supply; this information is currently unknown.

In obese horses insulin resistance might also contribute to widespread inflammation and, thus, vasoconstriction (narrowing of the blood vessels), which is the case in human metabolic syndrome, Johnson added. "By so doing, IR may, in turn, promote the risk of laminitis. The equine hoof-lamellar microvasculature is extremely sensitive to vasoconstrictors (anything that constricts blood vessels)," he explained. Therefore, adipokine-induced vasoconstriction would pose another pathway for causing laminitis in obese horses.

Glucocorticoids and Obesity

Additionally, glucocorticoids have been implicated as a cause of both laminitis and IR. "Our team has been interested in the role that glucocorticoids (corticosteroid drugs or hormones that are involved in carbohydrate metabolism and the body's response to stress) might play in terms of risk of laminitis," Johnson commented. "Newer work in humans suggests that glucocorticoids play a critical role in the development of visceral obesity and metabolic syndrome.

"Glucocorticoids also cause expansion of adipose tissues in the body," he noted. "If present in sufficient quantity (as in the obese state), locally generated cortisol (often called stress hormone) will both stimulate further local adipogenesis (fat deposition) and contribute to IR.

"Circumstances under which individuals might be influenced by the action of excess glucocorticoids include Cushing's syndrome, the administration of synthetic glucocorticoids for therapeutic purposes, and stress," he wrote.

Treating Obesity

Unfortunately, "Obesity in horses is often desirable to owners," said Messer.

"There clearly exists a need for objective criteria by which horses might be 'scored' in terms of whole-body adiposity (such as the body mass index used in human medicine)," Johnson noted.

He added that a major goal of adiposity research focuses on identifying therapeutic strategies that effectively reduce the ratio of pro-inflammatory (inflammation- causing), insulin-desensitizing adipokines to anti-inflammatory, insulin-sensitizing adipokines. Owners need to control obesity now by properly managing horses' diets and increasing exercise levels.

Messer summarized his presentation quite succinctly: "You've seen what fat cells can do today. Until we get rid of excessive fat cells, we'll have all kinds of problems."

Obesity and Insulin Resistance

Nicholas Frank, DVM, PhD, Dipl. ACVIM, associate professor of large animal clinical sciences at the University of Tennessee, discussed the causes, clinical signs, and management of insulin resistance in horses, and its link to laminitis.

"Insulin resistance can be defined as failure of tissues to respond appropriately to insulin," said Frank. "Insulin is secreted by the pancreas to move glucose (sugar from digestion of food) into tissues when it's readily available (after meals)."

There are three types of insulin resistance. "Compensated IR is the most common form; this is when the pancreas secretes more insulin to achieve the same effect (hyperinsulinemia)," he explained. "Uncompensated IR is when pancreatic beta cells (the source of insulin) fail, so blood glucose concentrations rise and insulin levels are variable; this is fairly rare. An extremely rare event is Type 2 diabetes mellitus (caused by insufficient production of insulin or by resistance of target tissues to the effects of insulin), which describes advanced pituitary pars intermedia dysfunction (PPID, or Cushing's). This results in hyperglycemia (high blood sugar) and glucosuria (sugar in the urine)."

Insulin resistance is a part of equine metabolic syndrome (EMS). Said Frank, "There are three criteria for identifying the horse with EMS: Insulin resistance, prior (founder lines) or current laminitis, and general obesity or regional adiposity (areas of abnormal fat deposition such as a cresty neck or fat pads near the tailhead). It has a genetic predisposition--the 'easy keeper,' or the horse that could stay fat on fresh air, is more likely to have EMS."

Insulin Resistance and Laminitis

There are three theories on why insulin resistance might contribute to laminitis:

1. It decreases the amount of glucose getting into hoof tissue cells, which could starve them and hamper their function.

2. Insulin resistance causes decreased peripheral vasodilation (contraction of blood vessels at the extremities, such as in the hoof). Decreased blood flow to the foot means less nutrition for the tissues and likely less healthy tissues.

3. When adipose tissues reach their capacity for fat storage, they can become stressed and release cytokines, causing a pro-inflammatory state. This could lower a horse's threshold for laminitis. Thus, a smaller trigger could cause laminitis--less of a carbohydrate overdose, for example.

Whatever its mechanism of action might be, insulin resistance has been linked to laminitis. Frank described a study of a Virginia pony herd that found insulin sensitivity could even predict laminitis: "Measuring their insulin sensitivity predicted laminitis would occur in 13 ponies, and it actually developed in 11 (85%). This was the first paper saying insulin sensitivity had something to do with laminitis."

The Role of Obesity in IR

"Not all obese individuals are insulin- resistant, and not all IR-affected horses are obese. But IR-associated medical problems are more likely to develop in concert with obesity in individuals born with IR," said Messer. "Thus, obesity may be an 'add-on' risk factor," much as obesity in humans contributes to diabetes.

"The obese 'easy keeper' is poorly defined scientifically," Frank said. "Presumably this characteristic is inherited as a difference in metabolism where the horse is able to maintain weight on fewer calories--he's evolutionarily adapted to live on less food in harsh conditions. When you take this adapted horse and put him on a high-carbohydrate diet (including good pasture), he tends to become obese. Grain can make it even worse.

The theory of how obesity contributes to insulin resistance is as follows, he said: "The accumulation of lipids (fat molecules or diacylg lycerol) in cells alters the normal signaling events within the cell. Skeletal muscle is the most susceptible to this. The theory is that as animal gets more obese, intracellular lipids interfere with insulin activity. Insulin resistance develops as lipids disrupt insulin receptors. Initially this is a reversible process, but chronic IR causes irreversible damage."

Hold the Grain, Please

Management of insulin resistance might lower the risk of laminitis, and one of the cornerstones of management is diet. "Think of these horses as being in a prediabetic state," Frank said. "They need to exercise more and take in less sugar."

He made these recommendations:

• Take obese horses off sweet feed, they don't need it anyway.
• Consider a grazing muzzle.
• Don't overfeed them.
• Feed hay lower in nonstructural carbohydrates (NSC; forage testing labs can tell you a hay's NSC content).
• Induce weight loss by feeding hay initially at 2% of the horse's current body weight, decreasing to 1.5% of current body weight, then finally dropping to 1.5% of ideal body weight.
• Consider pergolide treatment in horses with EMS to stave off PPID.
• Exercise horses to decrease weight.

If an insulin-resistant horse develops laminitis, Frank recommended the following management practices:

• Take the horse off pasture entirely-- remove some horses permanently, but most temporarily.
• Keep the horse in a dry lot.
• Hand-walk him for exercise once his feet are stabilized.
• If he's obese, feed low-sugar hay.
• If he's lean, feed hay plus a low-NSC feed.
• Consider strategic use of levothyroxine (generally used as replacement therapy in reduced or absent thyroid function) for three to six months in obese horses. However, "We are not treating hypothyroidism!" he stated. "That condition is extremely rare in horses. We are using it to accelerate metabolism (to decrease body weight)."

Frank said in an ongoing study, horses in a dry lot and given levothyroxine (Thyro-L; Lloyd Inc., Shenandoah, Iowa) lost an average of 62 kg, compared to 25 kg lost by horses in a dry lot without evothyroxine.

Take-Home Messages

The following facts should be considered if you have a horse that is showing signs of becoming overweight or having insulin resistance.

• Not all obese horses have EMS, and not all horses with EMS are obese.
• Diet and exercise are the main management and prevention strategies. Owners should avoid feeding concentrates and control affected or at-risk horses' exposure to pasture.
• Levothyroxine can be given to reduce body weight and increase insulin sensitivity for three to six months.

Cushing's Disease: Challenges of Diagnosis and Treatment

We know Cushing's disease (or pituitary pars intermedia dysfunction--PPID--as it's more scientifically called), simply put, is an "old-horse disease" that results in metabolism disturbances and an abnormally heavy hair coat. But when it comes to testing and treatment, there are about as many opinions as there are people to ask. Luckily, Harold Schott, DVM, PhD, Dipl. ACVIM, professor of large animal clinical sciences at Michigan State University (MSU), discussed the challenges of PPID diagnosis and treatment.

"Owners have really pushed us to learn more about this disease," he began. "Unfortunately, I might not leave you with a totally clear picture, because a lot of what we know is still based on experience rather than scientific data."

Pituitary pars intermedia dysfunction describes altered activity of the pars intermedia lobe of the pituitary gland. Schott first described the prevalence of PPID clinical signs seen in various studies: hirsutism (excessive haircoat) 47-100% of affected horses; muscle wasting, 35-88%; chronic laminitis, 24-82%; polyuria/polydipsia (excessive urination and chronic, excessive thirst/intake of fluid), 17-76%; hyperhidrosis (excessive sweating), 14-67%; abnormal fat deposition, 9-67%; chronic infections, 27-48%; lethargy, 43-82%; neurological signs, including seizures, 6-50%

"My subjective impression is that age at onset of clinical signs is important; the younger ones (at onset) do worse," said Schott.

"Laminitis is the clinical problem we deal with the most," he commented. "It's our main reason for looking at these horses. Here's take-home message #1: Evaluation for PPID is warranted in horses more than 15 years old that develop insidious (gradual) onset laminitis."

Diagnosing PPID

Unfortunately, no perfect PPID test (one that is 100% accurate with a single-sample test) yet exists. Schott noted that 11 tests are possible, from simple evaluation of clinical signs ("over-the-fence" diagnosis of hirsutism) to various measures of hormone levels in blood plasma and urine.

"The dexamethasone suppression test (DST) is considered by many to be the gold standard diagnostic test, probably because of experience with it rather than actual data," he commented. "It's the most widely accepted test, the samples are stable (less affected by variations in handling), and cortisol measurement is readily available (at labs)."

The test is based on the fact that one pituitary pars intermedia hormone product stimulates the adrenal glands to produce excess cortisol (often termed stress hormone).

Schott explained that the DST involves measuring cortisol, giving the horse dexamethasone (a steroid analogue that is used in this case to suppress cortisol stimulation from another lobe of the pituitary gland) in the late afternoon, then measuring plasma cortisol the next morning (15 and 19 hours after dexamethasone administration). Cortisol levels greater than 1 ug/dL at those times support a diagnosis of PPID.

Disadvantages: The DST requires three client visits (although the test can be modified to two visits), it is reported to exacerbate laminitis in rare cases (although Schott noted this observation is poorly documented), its results are not always repeatable, and it might miss early PPID.

He briefly discussed several other hormone tests and their accuracy levels, noting that researchers are finding significant seasonal variation in hormone levels and, thus, seasonal variation in test results, even on the same horses.

"Take-home message #2 is that seasonal variation complicates diagnostic testing--endocrine testing is not recommended from mid-August to mid-November because we have difficulty interpreting the results," he cautioned.

In addition to hormone testing, researchers often will evaluate pituitary gland tissue of research horses post-mortem to try to correlate histological (tissue) characteristics with hormone test results and clinical signs. Schott described a study that found lesions were common in both the pars intermedia and pars distalis regions of the pituitary gland. There was one other notable feature of the horses that were examined--they were all clinically normal.

"Based on this ('abnormal' tissue findings in horses that had no clinical signs of disease), I'm not sure histological examination is the way to go," he opined. "Take-home message #3 is that hirsutism is still the most accurate diagnostic feature (identifying 86% of affected horses). So why test horses further? To evaluate their response to treatment!"

Treating PPID

"Many cases do fine with management changes alone," said Schott. "This might include body clipping, regular hoof care, nutrition changes (such as reducing sugars and other rich carbohydrates), and good dental care to ensure proper eating for these older horses.

"Whether a horse needs medication and when that should be started is decided on an individual basis," he added. "When a horse is put on medications, I recommend twice-annual reassessment--clinical examination and glucose/endocrine (hormone) testing. If needed, we adjust medication dosing, then retest the horse in 30-60 days to make sure his (hormone) responses are in the appropriate range."

There's also the issue of the horse that is a possible PPID case, but it's between August and November, so testing is of little value (see take-home message #2). In these cases, "if the owner can afford it, we might treat the horse for a few months just in case, then try to take him off medications and test to see if it's truly warranted," Schott commented.

For confirmed cases, "Is continuous treatment required?" he asked the audience. "We don't really know. Epidemiological studies are hard enough, let alone following horses for 10 years (for the research needed to answer this question)."

Medication options for PPID include pergolide, cyproheptadine, trilostane, and chasteberry extract. One disadvantage is that no treatment is currently FDA-approved for PPID in horses.

Pergolide Schott described several studies that found this once daily medication to be a superior treatment in terms of improved hormone test results and owner assessment of improvement, although the latter might have also been due to improved management.

Disadvantages are that it's expensive (there's a cheaper compounded product available, but you have quality and liability concerns), it causes transient inappetence in some (less than 10% of horses), and it causes lethargy (depression) in rare cases, he said.

Cyproheptadine "This medication used to be less expensive than pergolide; now it's more expensive," Schott commented. Some have suggested that it might act synergistically with pergolide, but he said there were no studies proving this.

Disadvantages include limited efficacy, no pharmacological data, increasing price, and compounded product quality/liability concerns.

Trilostane This targets the adrenal gland to decrease cortisol production, so it could be used with pergolide, Schott commented. "It was shown to be effective in reversing clinical signs in one study in the United Kingdom," he added. "But adrenal cortex hyperplasia (overgrowth and overactivity) is not very common, so trilostane doesn't make sense as a front-line treatment (it doesn't address the pituitary gland dysfunction).

"Also, it's not approved for use in horses, not available in the United States, and pricey," he added.

Chasteberry extract (Vitex agnus castus) Schott reported that in one field study of this product, all owners reported improved demeanor, 22 of 120 horses had improved shedding, and no horses showed changes in hormone levels. In contrast, another study presented at the 2002 AAEP convention found that 13/14 horses deteriorated on the same product.

"Take-home message #4: Spend money on better management rather than questionable products," recommended Schott.

Understanding Pituitary Pars Intermedia Dysfunction (a.k.a. Cushing's Disease)

Pituitary pars intermedia dysfunction--PPID, or Cushing's disease--is the most common disease of horses and ponies 15 years of age or older. Although it's not fully understood yet, researchers are learning more about how to treat and prevent it. Dianne McFarlane, DVM, PhD, Dipl. ACVIM, assistant professor of physiological sciences at Oklahoma State University's Center for Veterinary Health Sciences, discussed normal and abnormal function of the pituitary pars intermedia lobe of the pituitary gland.

"The horse has three distinct lobes of his pituitary gland--the pars distalis, pars intermedia, and pars nervosa," she began. "Each produces different hormones."

The pars intermedia produces a protein called pro-opiomelanocortin POMC) that is converted into adrenocorticotropin (ACTH). This, in turn, is processed into several different hormones:

• Alpha-melanocyte stimulating hormone (alpha-MSH), a potent anti-inflammatory hormone that plays a role in skin coloring, appetite/satiety balance, and fat metabolism.
• Beta-endorphin, an endogenous (originating within the body) opioid that provides analgesia and behavioral modification and suppresses immune responsiveness and vascular tone (the degree of blood vessel constriction).
• Corticotrophin-like intermediate lobe peptide (CLIP), which stimulates insulin release.

Seasonality of Hormones

Season has been recently found to play a big role in secretion of some pars intermedia hormones in horses; this was already known in many other species (humans, hamsters, sheep, and weasels). Alpha-MSH levels are highest in the fall, coinciding with peak body weight, appetite, and body condition in sheep.

This seasonal increase might occur in horses and ponies as well, "to metabolically prepare them for a decrease in accessible food observed in the wild in winter," explained McFarlane. "If so, dysregulation of this pathway might be associated with abnormalities in body weight and fat storage." This might also explain the heavy haircoat of horses with PPID--it's literally a winter coat gone wild.

"Ponies show a much greater response to seasonal hormone changes than horses," she added.

Why is seasonality relevant? Given the increased activity of pars intermedia hormones in the fall, you're more likely to see clinical signs, false positive tests, and PPID-associated laminitis in fall, said McFarlane. This might have implications for treatment as well.

"It's possible that we might be able to treat affected horses (medically) in summer and fall when their hormones are highest, and wean them off medications in winter and spring," she theorized. "This is untested, but it's something to think about for mild cases."

What Causes PPID?

While several mechanisms for PPID have been proposed, McFarlane suggested that it is a neurodegenerative disease. This seems to be supported by the fact that her research has found almost no dopaminergic (dopamine-producing) neurons in the pars intermedia of affected horses, while there are quite a few in young horses or unaffected horses of similar age.

The lack of dopamine is critical, as she noted that the activity of the pars intermedia is normally inhibited (controlled) by dopamine. Without dopamine, the pars intermedia produces much more hormone than it should, causing the clinical signs of PPID.

Similar activity occurs in other species when dopamine is experimentally inhibited, she reported. This explains why the medication pergolide helps so many horses with PPID--it replaces dopamine activity and thus inhibits pars intermedia hormones.

It also explains why another popular treatment--trilostane--doesn't always work as well. McFarlane explained that trilostane acts on the adrenal gland to control secretion of cortisol hormone--"stress hormone." This helps control biochemical stress, but it doesn't act on the originating problem in the pars intermedia.

"I'm hesitant to recommend trilostane partially because it is only available compounded, and because it doesn't act against the inciting factor," she noted. "Pergolide treats in three ways: It protects neurons, adds dopamine, and has antioxidant activity."

Why would a horse's dopaminergic neurons degenerate? McFarlane speculated that oxidative stress, which is more prevalent in PPID horses, and misfolding of a protein called alpha-synuclein, a nerve terminal protein, might play large roles. Misfolding (improperly developing into a form other than its characteristic functional shape) of this protein can be caused by oxidative stress as well. An interesting side note is that this pathway of disease is the same as that proposed for Parkinson's disease in humans, and many biochemical features of Parkinson's closely resemble features of PPID in horses.

"Dopaminergic neurons are particularly vulnerable to oxidative damage, because dopamine metabolism itself produces free radicals (chemically active atoms or molecular fragments that are missing electrons and damage large molecules within cells while attempting to achieve a more stable configuration)," she commented. Other contributing factors might include inflammation and mitochondrial dysfunction (altered activity in the parts of cells that produce energy for carrying out the cell's functions).

PPID Prevention

"I think obesity drives chronic stress, which is a risk factor for neurodegeneration," opined McFarlane. "If we're going to prevent disease, controlling obesity will be very important. Also measure selenium (an antioxidant mineral that horses need in small quantities) and address that if needed, and keep in mind that antioxidant therapy might slow progression of the disease.

"Mitochondrial dysfunction is known to be a contributing factor to Parkinson's disease, and agricultural chemical usage contributes to Parkinson's in humans--these chemicals might well affect horses too," she suggested. "Also, ponies and Morgans seem to be more susceptible to the disease. What that genetic factor is, we'll understand better with more research. Understanding the mechanisms of disease is essential to knowing how to prevent this disease in these animals."

Adipobiology (The Study of Fat in the Body): An Emerging Field

What exactly does stored fat do to a horse's body? It wreaks serious havoc on at least 11 vital body functions. Nat Messer, DVM, Dipl. ABVP, an associate professor of equine medicine and surgery at the University of Missouri (UM), presented a compelling discussion of the relatively new field of adipobiology--the study of fat and its causes and effects. He discussed a paper submitted by Philip Johnson, BVSc(Hons), MS, Dipl. ACVIM, Dipl. ECEIM, MRCVS, professor of veterinary medicine and surgery at UM.

Excess body fat (both subcutaneous fat, such as the squishy stuff around a horse's tailhead, and visceral fat that accumulates near various internal organs) isn't just an unsightly way to store extra calories. Researchers are learning that fat--or adipose tissue as it's scientifically called--is much more active biochemically in many species than was previously thought (particularly visceral fat), noted Johnson in his paper. Fat produces more than 100 substances (collectively called adipokines or adipocytokines) that can affect:

• Lipid and glucose homeostasis (normal fat and glucose balance in the body);
• Inflammation;
• Hemostasis (control of bleeding);
• Osteogenesis (bone production);
• Hematopoiesis (formation and development of blood cells);
• Complement activities (complement is a sequence of proteins in the blood that work to help the animal respond to inflammatory and infectious challenges);
• Reproduction;
• Angiogenesis (development of blood vessels in tissue);
• Blood pressure; and
• Feeding behavior.

In horses, adipokine-mediated alteration of these body functions can cause or contribute to chronic inflammation, metabolic problems such as insulin resistance and possibly pituitary pars intermedia dysfunction (Cushing's disease), circulatory (blood vessel) compromise, and increased risk of laminitis. Also, hyperglycemia (high blood sugar, which is common in horses with severe metabolic syndrome) has been shown to generate oxidative stress--the production of oxygen free radicals that can damage many kinds of tissues.

"In fact, adipokines have recently been claimed to represent the 'missing link' between IR (insulin resistance) and cardiovascular disease in humans," said Johnson. For example, he noted that the branch of the coronary artery passing through an area of fat storage is the one most likely to develop arthrosclerosis (progressive narrowing and hardening of the artery, which can lead to a heart attack or stroke). Local effects of hormones produced by that fat deposit have been implicated as the cause.

Obesity and Insulin Resistance

Even if a horse is fat, if he is insulin- resistant, the cells in his body that depend on insulin for glucose uptake (generally skeletal muscle cells, as well as liver and fat cells) are actually starved for energy--the glucose they should be getting from food metabolism. "Decreased movement of glucose into the cell through glucose transporters (GLUT-4 in this case) in the cell membrane ... is the first step that is defective in human insulin resistance," explained Johnson. This can occur when fatty acids in skeletal muscle directly inhibit insulin activation of glucose-transport activity, he noted.

Not all obese horses develop insulin resistance, and not all insulin-resistant horses are obese, noted Messer. "But IR- associated medical problems are more likely to develop in concert with obesity in individuals born with IR," he said. "Obesity may be an 'add-on' risk factor."

Obesity and Laminitis

"Compelling experimental data have been published to suggest that glucose is essential for the health and strength of the equine hoof-lamellar interface," noted Johnson. "Hemidesmosomes (HD) represent the important attachment link between keratinocytes (hoof wall cells) and the underlying lamellar basement membrane (attaching the coffin bone to the hoof wall). Keratinocyte glucose starvation (from the aforementioned decreased movement of glucose into the cells) may weaken HD, which leads to separation of the keratinocyte from the basement membrane. Situations associated with cell- glucose starvation, such as IR, might increase the risk for laminitis."

He noted that it remains to be seen whether hoof keratinocytes depend (to any extent) on insulin for their glucose supply; this information is currently unknown.

In obese horses insulin resistance might also contribute to widespread inflammation and, thus, vasoconstriction (narrowing of the blood vessels), which is the case in human metabolic syndrome, Johnson added. "By so doing, IR may, in turn, promote the risk of laminitis. The equine hoof-lamellar microvasculature is extremely sensitive to vasoconstrictors (anything that constricts blood vessels)," he explained. Therefore, adipokine-induced vasoconstriction would pose another pathway for causing laminitis in obese horses.

Glucocorticoids and Obesity

Additionally, glucocorticoids have been implicated as a cause of both laminitis and IR. "Our team has been interested in the role that glucocorticoids (corticosteroid drugs or hormones that are involved in carbohydrate metabolism and the body's response to stress) might play in terms of risk of laminitis," Johnson commented. "Newer work in humans suggests that glucocorticoids play a critical role in the development of visceral obesity and metabolic syndrome.

"Glucocorticoids also cause expansion of adipose tissues in the body," he noted. "If present in sufficient quantity (as in the obese state), locally generated cortisol (often called stress hormone) will both stimulate further local adipogenesis (fat deposition) and contribute to IR.

"Circumstances under which individuals might be influenced by the action of excess glucocorticoids include Cushing's syndrome, the administration of synthetic glucocorticoids for therapeutic purposes, and stress," he wrote.

Treating Obesity

Unfortunately, "Obesity in horses is often desirable to owners," said Messer.

"There clearly exists a need for objective criteria by which horses might be 'scored' in terms of whole-body adiposity (such as the body mass index used in human medicine)," Johnson noted.

He added that a major goal of adiposity research focuses on identifying therapeutic strategies that effectively reduce the ratio of pro-inflammatory (inflammation- causing), insulin-desensitizing adipokines to anti-inflammatory, insulin-sensitizing adipokines. Owners need to control obesity now by properly managing horses' diets and increasing exercise levels.

Messer summarized his presentation quite succinctly: "You've seen what fat cells can do today. Until we get rid of excessive fat cells, we'll have all kinds of problems."

Obesity and Insulin Resistance

Nicholas Frank, DVM, PhD, Dipl. ACVIM, associate professor of large animal clinical sciences at the University of Tennessee, discussed the causes, clinical signs, and management of insulin resistance in horses, and its link to laminitis.

"Insulin resistance can be defined as failure of tissues to respond appropriately to insulin," said Frank. "Insulin is secreted by the pancreas to move glucose (sugar from digestion of food) into tissues when it's readily available (after meals)."

There are three types of insulin resistance. "Compensated IR is the most common form; this is when the pancreas secretes more insulin to achieve the same effect (hyperinsulinemia)," he explained. "Uncompensated IR is when pancreatic beta cells (the source of insulin) fail, so blood glucose concentrations rise and insulin levels are variable; this is fairly rare. An extremely rare event is Type 2 diabetes mellitus (caused by insufficient production of insulin or by resistance of target tissues to the effects of insulin), which describes advanced pituitary pars intermedia dysfunction (PPID, or Cushing's). This results in hyperglycemia (high blood sugar) and glucosuria (sugar in the urine)."

Insulin resistance is a part of equine metabolic syndrome (EMS). Said Frank, "There are three criteria for identifying the horse with EMS: Insulin resistance, prior (founder lines) or current laminitis, and general obesity or regional adiposity (areas of abnormal fat deposition such as a cresty neck or fat pads near the tailhead). It has a genetic predisposition--the 'easy keeper,' or the horse that could stay fat on fresh air, is more likely to have EMS."

Insulin Resistance and Laminitis

There are three theories on why insulin resistance might contribute to laminitis:

1. It decreases the amount of glucose getting into hoof tissue cells, which could starve them and hamper their function.

2. Insulin resistance causes decreased peripheral vasodilation (contraction of blood vessels at the extremities, such as in the hoof). Decreased blood flow to the foot means less nutrition for the tissues and likely less healthy tissues.

3. When adipose tissues reach their capacity for fat storage, they can become stressed and release cytokines, causing a pro-inflammatory state. This could lower a horse's threshold for laminitis. Thus, a smaller trigger could cause laminitis--less of a carbohydrate overdose, for example.

Whatever its mechanism of action might be, insulin resistance has been linked to laminitis. Frank described a study of a Virginia pony herd that found insulin sensitivity could even predict laminitis: "Measuring their insulin sensitivity predicted laminitis would occur in 13 ponies, and it actually developed in 11 (85%). This was the first paper saying insulin sensitivity had something to do with laminitis."

The Role of Obesity in IR

"Not all obese individuals are insulin- resistant, and not all IR-affected horses are obese. But IR-associated medical problems are more likely to develop in concert with obesity in individuals born with IR," said Messer. "Thus, obesity may be an 'add-on' risk factor," much as obesity in humans contributes to diabetes.

"The obese 'easy keeper' is poorly defined scientifically," Frank said. "Presumably this characteristic is inherited as a difference in metabolism where the horse is able to maintain weight on fewer calories--he's evolutionarily adapted to live on less food in harsh conditions. When you take this adapted horse and put him on a high-carbohydrate diet (including good pasture), he tends to become obese. Grain can make it even worse.

The theory of how obesity contributes to insulin resistance is as follows, he said: "The accumulation of lipids (fat molecules or diacylg lycerol) in cells alters the normal signaling events within the cell. Skeletal muscle is the most susceptible to this. The theory is that as animal gets more obese, intracellular lipids interfere with insulin activity. Insulin resistance develops as lipids disrupt insulin receptors. Initially this is a reversible process, but chronic IR causes irreversible damage."

Hold the Grain, Please

Management of insulin resistance might lower the risk of laminitis, and one of the cornerstones of management is diet. "Think of these horses as being in a prediabetic state," Frank said. "They need to exercise more and take in less sugar."

He made these recommendations:

• Take obese horses off sweet feed, they don't need it anyway.
• Consider a grazing muzzle.
• Don't overfeed them.
• Feed hay lower in nonstructural carbohydrates (NSC; forage testing labs can tell you a hay's NSC content).
• Induce weight loss by feeding hay initially at 2% of the horse's current body weight, decreasing to 1.5% of current body weight, then finally dropping to 1.5% of ideal body weight.
• Consider pergolide treatment in horses with EMS to stave off PPID.
• Exercise horses to decrease weight.

If an insulin-resistant horse develops laminitis, Frank recommended the following management practices:

• Take the horse off pasture entirely-- remove some horses permanently, but most temporarily.
• Keep the horse in a dry lot.
• Hand-walk him for exercise once his feet are stabilized.
• If he's obese, feed low-sugar hay.
• If he's lean, feed hay plus a low-NSC feed.
• Consider strategic use of levothyroxine (generally used as replacement therapy in reduced or absent thyroid function) for three to six months in obese horses. However, "We are not treating hypothyroidism!" he stated. "That condition is extremely rare in horses. We are using it to accelerate metabolism (to decrease body weight)."

Frank said in an ongoing study, horses in a dry lot and given levothyroxine (Thyro-L; Lloyd Inc., Shenandoah, Iowa) lost an average of 62 kg, compared to 25 kg lost by horses in a dry lot without evothyroxine.

Take-Home Messages

The following facts should be considered if you have a horse that is showing signs of becoming overweight or having insulin resistance.

• Not all obese horses have EMS, and not all horses with EMS are obese.
• Diet and exercise are the main management and prevention strategies. Owners should avoid feeding concentrates and control affected or at-risk horses' exposure to pasture.
• Levothyroxine can be given to reduce body weight and increase insulin sensitivity for three to six months.

Cushing's Disease: Challenges of Diagnosis and Treatment

We know Cushing's disease (or pituitary pars intermedia dysfunction--PPID--as it's more scientifically called), simply put, is an "old-horse disease" that results in metabolism disturbances and an abnormally heavy hair coat. But when it comes to testing and treatment, there are about as many opinions as there are people to ask. Luckily, Harold Schott, DVM, PhD, Dipl. ACVIM, professor of large animal clinical sciences at Michigan State University (MSU), discussed the challenges of PPID diagnosis and treatment.

"Owners have really pushed us to learn more about this disease," he began. "Unfortunately, I might not leave you with a totally clear picture, because a lot of what we know is still based on experience rather than scientific data."

Pituitary pars intermedia dysfunction describes altered activity of the pars intermedia lobe of the pituitary gland. Schott first described the prevalence of PPID clinical signs seen in various studies: hirsutism (excessive haircoat) 47-100% of affected horses; muscle wasting, 35-88%; chronic laminitis, 24-82%; polyuria/polydipsia (excessive urination and chronic, excessive thirst/intake of fluid), 17-76%; hyperhidrosis (excessive sweating), 14-67%; abnormal fat deposition, 9-67%; chronic infections, 27-48%; lethargy, 43-82%; neurological signs, including seizures, 6-50%

"My subjective impression is that age at onset of clinical signs is important; the younger ones (at onset) do worse," said Schott.

"Laminitis is the clinical problem we deal with the most," he commented. "It's our main reason for looking at these horses. Here's take-home message #1: Evaluation for PPID is warranted in horses more than 15 years old that develop insidious (gradual) onset laminitis."

Diagnosing PPID

Unfortunately, no perfect PPID test (one that is 100% accurate with a single-sample test) yet exists. Schott noted that 11 tests are possible, from simple evaluation of clinical signs ("over-the-fence" diagnosis of hirsutism) to various measures of hormone levels in blood plasma and urine.

"The dexamethasone suppression test (DST) is considered by many to be the gold standard diagnostic test, probably because of experience with it rather than actual data," he commented. "It's the most widely accepted test, the samples are stable (less affected by variations in handling), and cortisol measurement is readily available (at labs)."

The test is based on the fact that one pituitary pars intermedia hormone product stimulates the adrenal glands to produce excess cortisol (often termed stress hormone).

Schott explained that the DST involves measuring cortisol, giving the horse dexamethasone (a steroid analogue that is used in this case to suppress cortisol stimulation from another lobe of the pituitary gland) in the late afternoon, then measuring plasma cortisol the next morning (15 and 19 hours after dexamethasone administration). Cortisol levels greater than 1 ug/dL at those times support a diagnosis of PPID.

Disadvantages: The DST requires three client visits (although the test can be modified to two visits), it is reported to exacerbate laminitis in rare cases (although Schott noted this observation is poorly documented), its results are not always repeatable, and it might miss early PPID.

He briefly discussed several other hormone tests and their accuracy levels, noting that researchers are finding significant seasonal variation in hormone levels and, thus, seasonal variation in test results, even on the same horses.

"Take-home message #2 is that seasonal variation complicates diagnostic testing--endocrine testing is not recommended from mid-August to mid-November because we have difficulty interpreting the results," he cautioned.

In addition to hormone testing, researchers often will evaluate pituitary gland tissue of research horses post-mortem to try to correlate histological (tissue) characteristics with hormone test results and clinical signs. Schott described a study that found lesions were common in both the pars intermedia and pars distalis regions of the pituitary gland. There was one other notable feature of the horses that were examined--they were all clinically normal.

"Based on this ('abnormal' tissue findings in horses that had no clinical signs of disease), I'm not sure histological examination is the way to go," he opined. "Take-home message #3 is that hirsutism is still the most accurate diagnostic feature (identifying 86% of affected horses). So why test horses further? To evaluate their response to treatment!"

Treating PPID

"Many cases do fine with management changes alone," said Schott. "This might include body clipping, regular hoof care, nutrition changes (such as reducing sugars and other rich carbohydrates), and good dental care to ensure proper eating for these older horses.

"Whether a horse needs medication and when that should be started is decided on an individual basis," he added. "When a horse is put on medications, I recommend twice-annual reassessment--clinical examination and glucose/endocrine (hormone) testing. If needed, we adjust medication dosing, then retest the horse in 30-60 days to make sure his (hormone) responses are in the appropriate range."

There's also the issue of the horse that is a possible PPID case, but it's between August and November, so testing is of little value (see take-home message #2). In these cases, "if the owner can afford it, we might treat the horse for a few months just in case, then try to take him off medications and test to see if it's truly warranted," Schott commented.

For confirmed cases, "Is continuous treatment required?" he asked the audience. "We don't really know. Epidemiological studies are hard enough, let alone following horses for 10 years (for the research needed to answer this question)."

Medication options for PPID include pergolide, cyproheptadine, trilostane, and chasteberry extract. One disadvantage is that no treatment is currently FDA-approved for PPID in horses.

Pergolide Schott described several studies that found this once daily medication to be a superior treatment in terms of improved hormone test results and owner assessment of improvement, although the latter might have also been due to improved management.

Disadvantages are that it's expensive (there's a cheaper compounded product available, but you have quality and liability concerns), it causes transient inappetence in some (less than 10% of horses), and it causes lethargy (depression) in rare cases, he said.

Cyproheptadine "This medication used to be less expensive than pergolide; now it's more expensive," Schott commented. Some have suggested that it might act synergistically with pergolide, but he said there were no studies proving this.

Disadvantages include limited efficacy, no pharmacological data, increasing price, and compounded product quality/liability concerns.

Trilostane This targets the adrenal gland to decrease cortisol production, so it could be used with pergolide, Schott commented. "It was shown to be effective in reversing clinical signs in one study in the United Kingdom," he added. "But adrenal cortex hyperplasia (overgrowth and overactivity) is not very common, so trilostane doesn't make sense as a front-line treatment (it doesn't address the pituitary gland dysfunction).

"Also, it's not approved for use in horses, not available in the United States, and pricey," he added.

Chasteberry extract (Vitex agnus castus) Schott reported that in one field study of this product, all owners reported improved demeanor, 22 of 120 horses had improved shedding, and no horses showed changes in hormone levels. In contrast, another study presented at the 2002 AAEP convention found that 13/14 horses deteriorated on the same product.

"Take-home message #4: Spend money on better management rather than questionable products," recommended Schott.

Understanding Pituitary Pars Intermedia Dysfunction (a.k.a. Cushing's Disease)

Pituitary pars intermedia dysfunction--PPID, or Cushing's disease--is the most common disease of horses and ponies 15 years of age or older. Although it's not fully understood yet, researchers are learning more about how to treat and prevent it. Dianne McFarlane, DVM, PhD, Dipl. ACVIM, assistant professor of physiological sciences at Oklahoma State University's Center for Veterinary Health Sciences, discussed normal and abnormal function of the pituitary pars intermedia lobe of the pituitary gland.

"The horse has three distinct lobes of his pituitary gland--the pars distalis, pars intermedia, and pars nervosa," she began. "Each produces different hormones."

The pars intermedia produces a protein called pro-opiomelanocortin POMC) that is converted into adrenocorticotropin (ACTH). This, in turn, is processed into several different hormones:

• Alpha-melanocyte stimulating hormone (alpha-MSH), a potent anti-inflammatory hormone that plays a role in skin coloring, appetite/satiety balance, and fat metabolism.
• Beta-endorphin, an endogenous (originating within the body) opioid that provides analgesia and behavioral modification and suppresses immune responsiveness and vascular tone (the degree of blood vessel constriction).
• Corticotrophin-like intermediate lobe peptide (CLIP), which stimulates insulin release.

Seasonality of Hormones

Season has been recently found to play a big role in secretion of some pars intermedia hormones in horses; this was already known in many other species (humans, hamsters, sheep, and weasels). Alpha-MSH levels are highest in the fall, coinciding with peak body weight, appetite, and body condition in sheep.

This seasonal increase might occur in horses and ponies as well, "to metabolically prepare them for a decrease in accessible food observed in the wild in winter," explained McFarlane. "If so, dysregulation of this pathway might be associated with abnormalities in body weight and fat storage." This might also explain the heavy haircoat of horses with PPID--it's literally a winter coat gone wild.

"Ponies show a much greater response to seasonal hormone changes than horses," she added.

Why is seasonality relevant? Given the increased activity of pars intermedia hormones in the fall, you're more likely to see clinical signs, false positive tests, and PPID-associated laminitis in fall, said McFarlane. This might have implications for treatment as well.

"It's possible that we might be able to treat affected horses (medically) in summer and fall when their hormones are highest, and wean them off medications in winter and spring," she theorized. "This is untested, but it's something to think about for mild cases."

What Causes PPID?

While several mechanisms for PPID have been proposed, McFarlane suggested that it is a neurodegenerative disease. This seems to be supported by the fact that her research has found almost no dopaminergic (dopamine-producing) neurons in the pars intermedia of affected horses, while there are quite a few in young horses or unaffected horses of similar age.

The lack of dopamine is critical, as she noted that the activity of the pars intermedia is normally inhibited (controlled) by dopamine. Without dopamine, the pars intermedia produces much more hormone than it should, causing the clinical signs of PPID.

Similar activity occurs in other species when dopamine is experimentally inhibited, she reported. This explains why the medication pergolide helps so many horses with PPID--it replaces dopamine activity and thus inhibits pars intermedia hormones.

It also explains why another popular treatment--trilostane--doesn't always work as well. McFarlane explained that trilostane acts on the adrenal gland to control secretion of cortisol hormone--"stress hormone." This helps control biochemical stress, but it doesn't act on the originating problem in the pars intermedia.

"I'm hesitant to recommend trilostane partially because it is only available compounded, and because it doesn't act against the inciting factor," she noted. "Pergolide treats in three ways: It protects neurons, adds dopamine, and has antioxidant activity."

Why would a horse's dopaminergic neurons degenerate? McFarlane speculated that oxidative stress, which is more prevalent in PPID horses, and misfolding of a protein called alpha-synuclein, a nerve terminal protein, might play large roles. Misfolding (improperly developing into a form other than its characteristic functional shape) of this protein can be caused by oxidative stress as well. An interesting side note is that this pathway of disease is the same as that proposed for Parkinson's disease in humans, and many biochemical features of Parkinson's closely resemble features of PPID in horses.

"Dopaminergic neurons are particularly vulnerable to oxidative damage, because dopamine metabolism itself produces free radicals (chemically active atoms or molecular fragments that are missing electrons and damage large molecules within cells while attempting to achieve a more stable configuration)," she commented. Other contributing factors might include inflammation and mitochondrial dysfunction (altered activity in the parts of cells that produce energy for carrying out the cell's functions).

PPID Prevention

"I think obesity drives chronic stress, which is a risk factor for neurodegeneration," opined McFarlane. "If we're going to prevent disease, controlling obesity will be very important. Also measure selenium (an antioxidant mineral that horses need in small quantities) and address that if needed, and keep in mind that antioxidant therapy might slow progression of the disease.

"Mitochondrial dysfunction is known to be a contributing factor to Parkinson's disease, and agricultural chemical usage contributes to Parkinson's in humans--these chemicals might well affect horses too," she suggested. "Also, ponies and Morgans seem to be more susceptible to the disease. What that genetic factor is, we'll understand better with more research. Understanding the mechanisms of disease is essential to knowing how to prevent this disease in these animals."

Adipobiology (The Study of Fat in the Body): An Emerging Field

What exactly does stored fat do to a horse's body? It wreaks serious havoc on at least 11 vital body functions. Nat Messer, DVM, Dipl. ABVP, an associate professor of equine medicine and surgery at the University of Missouri (UM), presented a compelling discussion of the relatively new field of adipobiology--the study of fat and its causes and effects. He discussed a paper submitted by Philip Johnson, BVSc(Hons), MS, Dipl. ACVIM, Dipl. ECEIM, MRCVS, professor of veterinary medicine and surgery at UM.

Excess body fat (both subcutaneous fat, such as the squishy stuff around a horse's tailhead, and visceral fat that accumulates near various internal organs) isn't just an unsightly way to store extra calories. Researchers are learning that fat--or adipose tissue as it's scientifically called--is much more active biochemically in many species than was previously thought (particularly visceral fat), noted Johnson in his paper. Fat produces more than 100 substances (collectively called adipokines or adipocytokines) that can affect:

• Lipid and glucose homeostasis (normal fat and glucose balance in the body);
• Inflammation;
• Hemostasis (control of bleeding);
• Osteogenesis (bone production);
• Hematopoiesis (formation and development of blood cells);
• Complement activities (complement is a sequence of proteins in the blood that work to help the animal respond to inflammatory and infectious challenges);
• Reproduction;
• Angiogenesis (development of blood vessels in tissue);
• Blood pressure; and
• Feeding behavior.

In horses, adipokine-mediated alteration of these body functions can cause or contribute to chronic inflammation, metabolic problems such as insulin resistance and possibly pituitary pars intermedia dysfunction (Cushing's disease), circulatory (blood vessel) compromise, and increased risk of laminitis. Also, hyperglycemia (high blood sugar, which is common in horses with severe metabolic syndrome) has been shown to generate oxidative stress--the production of oxygen free radicals that can damage many kinds of tissues.

"In fact, adipokines have recently been claimed to represent the 'missing link' between IR (insulin resistance) and cardiovascular disease in humans," said Johnson. For example, he noted that the branch of the coronary artery passing through an area of fat storage is the one most likely to develop arthrosclerosis (progressive narrowing and hardening of the artery, which can lead to a heart attack or stroke). Local effects of hormones produced by that fat deposit have been implicated as the cause.

Obesity and Insulin Resistance

Even if a horse is fat, if he is insulin- resistant, the cells in his body that depend on insulin for glucose uptake (generally skeletal muscle cells, as well as liver and fat cells) are actually starved for energy--the glucose they should be getting from food metabolism. "Decreased movement of glucose into the cell through glucose transporters (GLUT-4 in this case) in the cell membrane ... is the first step that is defective in human insulin resistance," explained Johnson. This can occur when fatty acids in skeletal muscle directly inhibit insulin activation of glucose-transport activity, he noted.

Not all obese horses develop insulin resistance, and not all insulin-resistant horses are obese, noted Messer. "But IR- associated medical problems are more likely to develop in concert with obesity in individuals born with IR," he said. "Obesity may be an 'add-on' risk factor."

Obesity and Laminitis

"Compelling experimental data have been published to suggest that glucose is essential for the health and strength of the equine hoof-lamellar interface," noted Johnson. "Hemidesmosomes (HD) represent the important attachment link between keratinocytes (hoof wall cells) and the underlying lamellar basement membrane (attaching the coffin bone to the hoof wall). Keratinocyte glucose starvation (from the aforementioned decreased movement of glucose into the cells) may weaken HD, which leads to separation of the keratinocyte from the basement membrane. Situations associated with cell- glucose starvation, such as IR, might increase the risk for laminitis."

He noted that it remains to be seen whether hoof keratinocytes depend (to any extent) on insulin for their glucose supply; this information is currently unknown.

In obese horses insulin resistance might also contribute to widespread inflammation and, thus, vasoconstriction (narrowing of the blood vessels), which is the case in human metabolic syndrome, Johnson added. "By so doing, IR may, in turn, promote the risk of laminitis. The equine hoof-lamellar microvasculature is extremely sensitive to vasoconstrictors (anything that constricts blood vessels)," he explained. Therefore, adipokine-induced vasoconstriction would pose another pathway for causing laminitis in obese horses.

Glucocorticoids and Obesity

Additionally, glucocorticoids have been implicated as a cause of both laminitis and IR. "Our team has been interested in the role that glucocorticoids (corticosteroid drugs or hormones that are involved in carbohydrate metabolism and the body's response to stress) might play in terms of risk of laminitis," Johnson commented. "Newer work in humans suggests that glucocorticoids play a critical role in the development of visceral obesity and metabolic syndrome.

"Glucocorticoids also cause expansion of adipose tissues in the body," he noted. "If present in sufficient quantity (as in the obese state), locally generated cortisol (often called stress hormone) will both stimulate further local adipogenesis (fat deposition) and contribute to IR.

"Circumstances under which individuals might be influenced by the action of excess glucocorticoids include Cushing's syndrome, the administration of synthetic glucocorticoids for therapeutic purposes, and stress," he wrote.

Treating Obesity

Unfortunately, "Obesity in horses is often desirable to owners," said Messer.

"There clearly exists a need for objective criteria by which horses might be 'scored' in terms of whole-body adiposity (such as the body mass index used in human medicine)," Johnson noted.

He added that a major goal of adiposity research focuses on identifying therapeutic strategies that effectively reduce the ratio of pro-inflammatory (inflammation- causing), insulin-desensitizing adipokines to anti-inflammatory, insulin-sensitizing adipokines. Owners need to control obesity now by properly managing horses' diets and increasing exercise levels.

Messer summarized his presentation quite succinctly: "You've seen what fat cells can do today. Until we get rid of excessive fat cells, we'll have all kinds of problems."

Obesity and Insulin Resistance

Nicholas Frank, DVM, PhD, Dipl. ACVIM, associate professor of large animal clinical sciences at the University of Tennessee, discussed the causes, clinical signs, and management of insulin resistance in horses, and its link to laminitis.

"Insulin resistance can be defined as failure of tissues to respond appropriately to insulin," said Frank. "Insulin is secreted by the pancreas to move glucose (sugar from digestion of food) into tissues when it's readily available (after meals)."

There are three types of insulin resistance. "Compensated IR is the most common form; this is when the pancreas secretes more insulin to achieve the same effect (hyperinsulinemia)," he explained. "Uncompensated IR is when pancreatic beta cells (the source of insulin) fail, so blood glucose concentrations rise and insulin levels are variable; this is fairly rare. An extremely rare event is Type 2 diabetes mellitus (caused by insufficient production of insulin or by resistance of target tissues to the effects of insulin), which describes advanced pituitary pars intermedia dysfunction (PPID, or Cushing's). This results in hyperglycemia (high blood sugar) and glucosuria (sugar in the urine)."

Insulin resistance is a part of equine metabolic syndrome (EMS). Said Frank, "There are three criteria for identifying the horse with EMS: Insulin resistance, prior (founder lines) or current laminitis, and general obesity or regional adiposity (areas of abnormal fat deposition such as a cresty neck or fat pads near the tailhead). It has a genetic predisposition--the 'easy keeper,' or the horse that could stay fat on fresh air, is more likely to have EMS."

Insulin Resistance and Laminitis

There are three theories on why insulin resistance might contribute to laminitis:

1. It decreases the amount of glucose getting into hoof tissue cells, which could starve them and hamper their function.

2. Insulin resistance causes decreased peripheral vasodilation (contraction of blood vessels at the extremities, such as in the hoof). Decreased blood flow to the foot means less nutrition for the tissues and likely less healthy tissues.

3. When adipose tissues reach their capacity for fat storage, they can become stressed and release cytokines, causing a pro-inflammatory state. This could lower a horse's threshold for laminitis. Thus, a smaller trigger could cause laminitis--less of a carbohydrate overdose, for example.

Whatever its mechanism of action might be, insulin resistance has been linked to laminitis. Frank described a study of a Virginia pony herd that found insulin sensitivity could even predict laminitis: "Measuring their insulin sensitivity predicted laminitis would occur in 13 ponies, and it actually developed in 11 (85%). This was the first paper saying insulin sensitivity had something to do with laminitis."

The Role of Obesity in IR

"Not all obese individuals are insulin- resistant, and not all IR-affected horses are obese. But IR-associated medical problems are more likely to develop in concert with obesity in individuals born with IR," said Messer. "Thus, obesity may be an 'add-on' risk factor," much as obesity in humans contributes to diabetes.

"The obese 'easy keeper' is poorly defined scientifically," Frank said. "Presumably this characteristic is inherited as a difference in metabolism where the horse is able to maintain weight on fewer calories--he's evolutionarily adapted to live on less food in harsh conditions. When you take this adapted horse and put him on a high-carbohydrate diet (including good pasture), he tends to become obese. Grain can make it even worse.

The theory of how obesity contributes to insulin resistance is as follows, he said: "The accumulation of lipids (fat molecules or diacylg lycerol) in cells alters the normal signaling events within the cell. Skeletal muscle is the most susceptible to this. The theory is that as animal gets more obese, intracellular lipids interfere with insulin activity. Insulin resistance develops as lipids disrupt insulin receptors. Initially this is a reversible process, but chronic IR causes irreversible damage."

Hold the Grain, Please

Management of insulin resistance might lower the risk of laminitis, and one of the cornerstones of management is diet. "Think of these horses as being in a prediabetic state," Frank said. "They need to exercise more and take in less sugar."

He made these recommendations:

• Take obese horses off sweet feed, they don't need it anyway.
• Consider a grazing muzzle.
• Don't overfeed them.
• Feed hay lower in nonstructural carbohydrates (NSC; forage testing labs can tell you a hay's NSC content).
• Induce weight loss by feeding hay initially at 2% of the horse's current body weight, decreasing to 1.5% of current body weight, then finally dropping to 1.5% of ideal body weight.
• Consider pergolide treatment in horses with EMS to stave off PPID.
• Exercise horses to decrease weight.

If an insulin-resistant horse develops laminitis, Frank recommended the following management practices:

• Take the horse off pasture entirely-- remove some horses permanently, but most temporarily.
• Keep the horse in a dry lot.
• Hand-walk him for exercise once his feet are stabilized.
• If he's obese, feed low-sugar hay.
• If he's lean, feed hay plus a low-NSC feed.
• Consider strategic use of levothyroxine (generally used as replacement therapy in reduced or absent thyroid function) for three to six months in obese horses. However, "We are not treating hypothyroidism!" he stated. "That condition is extremely rare in horses. We are using it to accelerate metabolism (to decrease body weight)."

Frank said in an ongoing study, horses in a dry lot and given levothyroxine (Thyro-L; Lloyd Inc., Shenandoah, Iowa) lost an average of 62 kg, compared to 25 kg lost by horses in a dry lot without evothyroxine.

Take-Home Messages

The following facts should be considered if you have a horse that is showing signs of becoming overweight or having insulin resistance.

• Not all obese horses have EMS, and not all horses with EMS are obese.
• Diet and exercise are the main management and prevention strategies. Owners should avoid feeding concentrates and control affected or at-risk horses' exposure to pasture.
• Levothyroxine can be given to reduce body weight and increase insulin sensitivity for three to six months.

Cushing's Disease: Challenges of Diagnosis and Treatment

We know Cushing's disease (or pituitary pars intermedia dysfunction--PPID--as it's more scientifically called), simply put, is an "old-horse disease" that results in metabolism disturbances and an abnormally heavy hair coat. But when it comes to testing and treatment, there are about as many opinions as there are people to ask. Luckily, Harold Schott, DVM, PhD, Dipl. ACVIM, professor of large animal clinical sciences at Michigan State University (MSU), discussed the challenges of PPID diagnosis and treatment.

"Owners have really pushed us to learn more about this disease," he began. "Unfortunately, I might not leave you with a totally clear picture, because a lot of what we know is still based on experience rather than scientific data."

Pituitary pars intermedia dysfunction describes altered activity of the pars intermedia lobe of the pituitary gland. Schott first described the prevalence of PPID clinical signs seen in various studies: hirsutism (excessive haircoat) 47-100% of affected horses; muscle wasting, 35-88%; chronic laminitis, 24-82%; polyuria/polydipsia (excessive urination and chronic, excessive thirst/intake of fluid), 17-76%; hyperhidrosis (excessive sweating), 14-67%; abnormal fat deposition, 9-67%; chronic infections, 27-48%; lethargy, 43-82%; neurological signs, including seizures, 6-50%

"My subjective impression is that age at onset of clinical signs is important; the younger ones (at onset) do worse," said Schott.

"Laminitis is the clinical problem we deal with the most," he commented. "It's our main reason for looking at these horses. Here's take-home message #1: Evaluation for PPID is warranted in horses more than 15 years old that develop insidious (gradual) onset laminitis."

Diagnosing PPID

Unfortunately, no perfect PPID test (one that is 100% accurate with a single-sample test) yet exists. Schott noted that 11 tests are possible, from simple evaluation of clinical signs ("over-the-fence" diagnosis of hirsutism) to various measures of hormone levels in blood plasma and urine.

"The dexamethasone suppression test (DST) is considered by many to be the gold standard diagnostic test, probably because of experience with it rather than actual data," he commented. "It's the most widely accepted test, the samples are stable (less affected by variations in handling), and cortisol measurement is readily available (at labs)."

The test is based on the fact that one pituitary pars intermedia hormone product stimulates the adrenal glands to produce excess cortisol (often termed stress hormone).

Schott explained that the DST involves measuring cortisol, giving the horse dexamethasone (a steroid analogue that is used in this case to suppress cortisol stimulation from another lobe of the pituitary gland) in the late afternoon, then measuring plasma cortisol the next morning (15 and 19 hours after dexamethasone administration). Cortisol levels greater than 1 ug/dL at those times support a diagnosis of PPID.

Disadvantages: The DST requires three client visits (although the test can be modified to two visits), it is reported to exacerbate laminitis in rare cases (although Schott noted this observation is poorly documented), its results are not always repeatable, and it might miss early PPID.

He briefly discussed several other hormone tests and their accuracy levels, noting that researchers are finding significant seasonal variation in hormone levels and, thus, seasonal variation in test results, even on the same horses.

"Take-home message #2 is that seasonal variation complicates diagnostic testing--endocrine testing is not recommended from mid-August to mid-November because we have difficulty interpreting the results," he cautioned.

In addition to hormone testing, researchers often will evaluate pituitary gland tissue of research horses post-mortem to try to correlate histological (tissue) characteristics with hormone test results and clinical signs. Schott described a study that found lesions were common in both the pars intermedia and pars distalis regions of the pituitary gland. There was one other notable feature of the horses that were examined--they were all clinically normal.

"Based on this ('abnormal' tissue findings in horses that had no clinical signs of disease), I'm not sure histological examination is the way to go," he opined. "Take-home message #3 is that hirsutism is still the most accurate diagnostic feature (identifying 86% of affected horses). So why test horses further? To evaluate their response to treatment!"

Treating PPID

"Many cases do fine with management changes alone," said Schott. "This might include body clipping, regular hoof care, nutrition changes (such as reducing sugars and other rich carbohydrates), and good dental care to ensure proper eating for these older horses.

"Whether a horse needs medication and when that should be started is decided on an individual basis," he added. "When a horse is put on medications, I recommend twice-annual reassessment--clinical examination and glucose/endocrine (hormone) testing. If needed, we adjust medication dosing, then retest the horse in 30-60 days to make sure his (hormone) responses are in the appropriate range."

There's also the issue of the horse that is a possible PPID case, but it's between August and November, so testing is of little value (see take-home message #2). In these cases, "if the owner can afford it, we might treat the horse for a few months just in case, then try to take him off medications and test to see if it's truly warranted," Schott commented.

For confirmed cases, "Is continuous treatment required?" he asked the audience. "We don't really know. Epidemiological studies are hard enough, let alone following horses for 10 years (for the research needed to answer this question)."

Medication options for PPID include pergolide, cyproheptadine, trilostane, and chasteberry extract. One disadvantage is that no treatment is currently FDA-approved for PPID in horses.

Pergolide Schott described several studies that found this once daily medication to be a superior treatment in terms of improved hormone test results and owner assessment of improvement, although the latter might have also been due to improved management.

Disadvantages are that it's expensive (there's a cheaper compounded product available, but you have quality and liability concerns), it causes transient inappetence in some (less than 10% of horses), and it causes lethargy (depression) in rare cases, he said.

Cyproheptadine "This medication used to be less expensive than pergolide; now it's more expensive," Schott commented. Some have suggested that it might act synergistically with pergolide, but he said there were no studies proving this.

Disadvantages include limited efficacy, no pharmacological data, increasing price, and compounded product quality/liability concerns.

Trilostane This targets the adrenal gland to decrease cortisol production, so it could be used with pergolide, Schott commented. "It was shown to be effective in reversing clinical signs in one study in the United Kingdom," he added. "But adrenal cortex hyperplasia (overgrowth and overactivity) is not very common, so trilostane doesn't make sense as a front-line treatment (it doesn't address the pituitary gland dysfunction).

"Also, it's not approved for use in horses, not available in the United States, and pricey," he added.

Chasteberry extract (Vitex agnus castus) Schott reported that in one field study of this product, all owners reported improved demeanor, 22 of 120 horses had improved shedding, and no horses showed changes in hormone levels. In contrast, another study presented at the 2002 AAEP convention found that 13/14 horses deteriorated on the same product.

"Take-home message #4: Spend money on better management rather than questionable products," recommended Schott.

Understanding Pituitary Pars Intermedia Dysfunction (a.k.a. Cushing's Disease)

Pituitary pars intermedia dysfunction--PPID, or Cushing's disease--is the most common disease of horses and ponies 15 years of age or older. Although it's not fully understood yet, researchers are learning more about how to treat and prevent it. Dianne McFarlane, DVM, PhD, Dipl. ACVIM, assistant professor of physiological sciences at Oklahoma State University's Center for Veterinary Health Sciences, discussed normal and abnormal function of the pituitary pars intermedia lobe of the pituitary gland.

"The horse has three distinct lobes of his pituitary gland--the pars distalis, pars intermedia, and pars nervosa," she began. "Each produces different hormones."

The pars intermedia produces a protein called pro-opiomelanocortin POMC) that is converted into adrenocorticotropin (ACTH). This, in turn, is processed into several different hormones:

• Alpha-melanocyte stimulating hormone (alpha-MSH), a potent anti-inflammatory hormone that plays a role in skin coloring, appetite/satiety balance, and fat metabolism.
• Beta-endorphin, an endogenous (originating within the body) opioid that provides analgesia and behavioral modification and suppresses immune responsiveness and vascular tone (the degree of blood vessel constriction).
• Corticotrophin-like intermediate lobe peptide (CLIP), which stimulates insulin release.

Seasonality of Hormones

Season has been recently found to play a big role in secretion of some pars intermedia hormones in horses; this was already known in many other species (humans, hamsters, sheep, and weasels). Alpha-MSH levels are highest in the fall, coinciding with peak body weight, appetite, and body condition in sheep.

This seasonal increase might occur in horses and ponies as well, "to metabolically prepare them for a decrease in accessible food observed in the wild in winter," explained McFarlane. "If so, dysregulation of this pathway might be associated with abnormalities in body weight and fat storage." This might also explain the heavy haircoat of horses with PPID--it's literally a winter coat gone wild.

"Ponies show a much greater response to seasonal hormone changes than horses," she added.

Why is seasonality relevant? Given the increased activity of pars intermedia hormones in the fall, you're more likely to see clinical signs, false positive tests, and PPID-associated laminitis in fall, said McFarlane. This might have implications for treatment as well.

"It's possible that we might be able to treat affected horses (medically) in summer and fall when their hormones are highest, and wean them off medications in winter and spring," she theorized. "This is untested, but it's something to think about for mild cases."

What Causes PPID?

While several mechanisms for PPID have been proposed, McFarlane suggested that it is a neurodegenerative disease. This seems to be supported by the fact that her research has found almost no dopaminergic (dopamine-producing) neurons in the pars intermedia of affected horses, while there are quite a few in young horses or unaffected horses of similar age.

The lack of dopamine is critical, as she noted that the activity of the pars intermedia is normally inhibited (controlled) by dopamine. Without dopamine, the pars intermedia produces much more hormone than it should, causing the clinical signs of PPID.

Similar activity occurs in other species when dopamine is experimentally inhibited, she reported. This explains why the medication pergolide helps so many horses with PPID--it replaces dopamine activity and thus inhibits pars intermedia hormones.

It also explains why another popular treatment--trilostane--doesn't always work as well. McFarlane explained that trilostane acts on the adrenal gland to control secretion of cortisol hormone--"stress hormone." This helps control biochemical stress, but it doesn't act on the originating problem in the pars intermedia.

"I'm hesitant to recommend trilostane partially because it is only available compounded, and because it doesn't act against the inciting factor," she noted. "Pergolide treats in three ways: It protects neurons, adds dopamine, and has antioxidant activity."

Why would a horse's dopaminergic neurons degenerate? McFarlane speculated that oxidative stress, which is more prevalent in PPID horses, and misfolding of a protein called alpha-synuclein, a nerve terminal protein, might play large roles. Misfolding (improperly developing into a form other than its characteristic functional shape) of this protein can be caused by oxidative stress as well. An interesting side note is that this pathway of disease is the same as that proposed for Parkinson's disease in humans, and many biochemical features of Parkinson's closely resemble features of PPID in horses.

"Dopaminergic neurons are particularly vulnerable to oxidative damage, because dopamine metabolism itself produces free radicals (chemically active atoms or molecular fragments that are missing electrons and damage large molecules within cells while attempting to achieve a more stable configuration)," she commented. Other contributing factors might include inflammation and mitochondrial dysfunction (altered activity in the parts of cells that produce energy for carrying out the cell's functions).

PPID Prevention

"I think obesity drives chronic stress, which is a risk factor for neurodegeneration," opined McFarlane. "If we're going to prevent disease, controlling obesity will be very important. Also measure selenium (an antioxidant mineral that horses need in small quantities) and address that if needed, and keep in mind that antioxidant therapy might slow progression of the disease.

"Mitochondrial dysfunction is known to be a contributing factor to Parkinson's disease, and agricultural chemical usage contributes to Parkinson's in humans--these chemicals might well affect horses too," she suggested. "Also, ponies and Morgans seem to be more susceptible to the disease. What that genetic factor is, we'll understand better with more research. Understanding the mechanisms of disease is essential to knowing how to prevent this disease in these animals."

CRACK OF DAWN
The light from the morning sun is nearly blinding as we glide across the rolling, snow-covered land. The cold makes my skin feel stiff, like a thin layer of ice. I can't control the ear-to-ear grin, even if it means my cheeks will crack. The movement feels like slow dancing, swaying to soft music with a rhythm of hooves sinking in snow, harnesses clanking and horses breathing.

I turn to the driver next to me, eyes watering partly from the cold but also from the feeling of pure joy stirring in my heart. "This is heaven on earth," I say.

Patrick Palmer smiles and pauses for a moment. Then in his quiet, kind manner he responds, "And I get paid to do this..."

HORSE WORK
Throughout history, horses have performed many difficult and important jobs. Beyond their role as a reliable mode of transportation (the true definition of horsepower) they've been "employed" as ranchers, farmers, soldiers, police officers, teachers, athletes, sight guides, tour guides, and the list goes on.

Although working horses are still important contributors throughout the world, in many countries a horse's role is less about work and more about pleasure. At Thornapple Farms in Vermont, USA, horses make work a pleasure for Patrick and Cathy Palmer.

CLEAN-BURNING HORSES
Meet Spud and Chief, two dapple gray Percherons with a rather unique job. These BIG boys work for their good life by pulling sleighs and carts around the Champlain Valley. But they're most known (and loved) for their job as the local garbage collectors.

Yes, garbage collectors.

Together with their human co-workers, each Friday morning Chief and Spud travel an eight mile route through the town of Bristol to collect trash and recycling from the town's residents. Rain, sleet, snow or anything short of dangerous conditions won't deter this horse-powered garbage truck.

Spud (on your left in this picture) is a bit larger than Chief at 18hh, but Chief is the boss. He stands on the driver's side, closest to the road where a steady stream of traffic passes. When a large truck comes up from behind, Chief looks back to assess the origin of the noise then turns to Spud, passing a silent communication to let him know the situation is under control. "As a team, they're nearly unshakable," says Lynda Malzac, a professional horse trainer who works alongside Patrick, Chief and Spud each week. "They're gentle giants."

So the next time you think being a garbage collector is the worst job in the world, think again. With the right attitude, a kind employer and an equine co-worker, any work can be a pleasure.

CRACK OF DAWN
The light from the morning sun is nearly blinding as we glide across the rolling, snow-covered land. The cold makes my skin feel stiff, like a thin layer of ice. I can't control the ear-to-ear grin, even if it means my cheeks will crack. The movement feels like slow dancing, swaying to soft music with a rhythm of hooves sinking in snow, harnesses clanking and horses breathing.

I turn to the driver next to me, eyes watering partly from the cold but also from the feeling of pure joy stirring in my heart. "This is heaven on earth," I say.

Patrick Palmer smiles and pauses for a moment. Then in his quiet, kind manner he responds, "And I get paid to do this..."

HORSE WORK
Throughout history, horses have performed many difficult and important jobs. Beyond their role as a reliable mode of transportation (the true definition of horsepower) they've been "employed" as ranchers, farmers, soldiers, police officers, teachers, athletes, sight guides, tour guides, and the list goes on.

Although working horses are still important contributors throughout the world, in many countries a horse's role is less about work and more about pleasure. At Thornapple Farms in Vermont, USA, horses make work a pleasure for Patrick and Cathy Palmer.

CLEAN-BURNING HORSES
Meet Spud and Chief, two dapple gray Percherons with a rather unique job. These BIG boys work for their good life by pulling sleighs and carts around the Champlain Valley. But they're most known (and loved) for their job as the local garbage collectors.

Yes, garbage collectors.

Together with their human co-workers, each Friday morning Chief and Spud travel an eight mile route through the town of Bristol to collect trash and recycling from the town's residents. Rain, sleet, snow or anything short of dangerous conditions won't deter this horse-powered garbage truck.

Spud (on your left in this picture) is a bit larger than Chief at 18hh, but Chief is the boss. He stands on the driver's side, closest to the road where a steady stream of traffic passes. When a large truck comes up from behind, Chief looks back to assess the origin of the noise then turns to Spud, passing a silent communication to let him know the situation is under control. "As a team, they're nearly unshakable," says Lynda Malzac, a professional horse trainer who works alongside Patrick, Chief and Spud each week. "They're gentle giants."

So the next time you think being a garbage collector is the worst job in the world, think again. With the right attitude, a kind employer and an equine co-worker, any work can be a pleasure.

CRACK OF DAWN
The light from the morning sun is nearly blinding as we glide across the rolling, snow-covered land. The cold makes my skin feel stiff, like a thin layer of ice. I can't control the ear-to-ear grin, even if it means my cheeks will crack. The movement feels like slow dancing, swaying to soft music with a rhythm of hooves sinking in snow, harnesses clanking and horses breathing.

I turn to the driver next to me, eyes watering partly from the cold but also from the feeling of pure joy stirring in my heart. "This is heaven on earth," I say.

Patrick Palmer smiles and pauses for a moment. Then in his quiet, kind manner he responds, "And I get paid to do this..."

HORSE WORK
Throughout history, horses have performed many difficult and important jobs. Beyond their role as a reliable mode of transportation (the true definition of horsepower) they've been "employed" as ranchers, farmers, soldiers, police officers, teachers, athletes, sight guides, tour guides, and the list goes on.

Although working horses are still important contributors throughout the world, in many countries a horse's role is less about work and more about pleasure. At Thornapple Farms in Vermont, USA, horses make work a pleasure for Patrick and Cathy Palmer.

CLEAN-BURNING HORSES
Meet Spud and Chief, two dapple gray Percherons with a rather unique job. These BIG boys work for their good life by pulling sleighs and carts around the Champlain Valley. But they're most known (and loved) for their job as the local garbage collectors.

Yes, garbage collectors.

Together with their human co-workers, each Friday morning Chief and Spud travel an eight mile route through the town of Bristol to collect trash and recycling from the town's residents. Rain, sleet, snow or anything short of dangerous conditions won't deter this horse-powered garbage truck.

Spud (on your left in this picture) is a bit larger than Chief at 18hh, but Chief is the boss. He stands on the driver's side, closest to the road where a steady stream of traffic passes. When a large truck comes up from behind, Chief looks back to assess the origin of the noise then turns to Spud, passing a silent communication to let him know the situation is under control. "As a team, they're nearly unshakable," says Lynda Malzac, a professional horse trainer who works alongside Patrick, Chief and Spud each week. "They're gentle giants."

So the next time you think being a garbage collector is the worst job in the world, think again. With the right attitude, a kind employer and an equine co-worker, any work can be a pleasure.

CRACK OF DAWN
The light from the morning sun is nearly blinding as we glide across the rolling, snow-covered land. The cold makes my skin feel stiff, like a thin layer of ice. I can't control the ear-to-ear grin, even if it means my cheeks will crack. The movement feels like slow dancing, swaying to soft music with a rhythm of hooves sinking in snow, harnesses clanking and horses breathing.

I turn to the driver next to me, eyes watering partly from the cold but also from the feeling of pure joy stirring in my heart. "This is heaven on earth," I say.

Patrick Palmer smiles and pauses for a moment. Then in his quiet, kind manner he responds, "And I get paid to do this..."

HORSE WORK
Throughout history, horses have performed many difficult and important jobs. Beyond their role as a reliable mode of transportation (the true definition of horsepower) they've been "employed" as ranchers, farmers, soldiers, police officers, teachers, athletes, sight guides, tour guides, and the list goes on.

Although working horses are still important contributors throughout the world, in many countries a horse's role is less about work and more about pleasure. At Thornapple Farms in Vermont, USA, horses make work a pleasure for Patrick and Cathy Palmer.

CLEAN-BURNING HORSES
Meet Spud and Chief, two dapple gray Percherons with a rather unique job. These BIG boys work for their good life by pulling sleighs and carts around the Champlain Valley. But they're most known (and loved) for their job as the local garbage collectors.

Yes, garbage collectors.

Together with their human co-workers, each Friday morning Chief and Spud travel an eight mile route through the town of Bristol to collect trash and recycling from the town's residents. Rain, sleet, snow or anything short of dangerous conditions won't deter this horse-powered garbage truck.

Spud (on your left in this picture) is a bit larger than Chief at 18hh, but Chief is the boss. He stands on the driver's side, closest to the road where a steady stream of traffic passes. When a large truck comes up from behind, Chief looks back to assess the origin of the noise then turns to Spud, passing a silent communication to let him know the situation is under control. "As a team, they're nearly unshakable," says Lynda Malzac, a professional horse trainer who works alongside Patrick, Chief and Spud each week. "They're gentle giants."

So the next time you think being a garbage collector is the worst job in the world, think again. With the right attitude, a kind employer and an equine co-worker, any work can be a pleasure.

GREETINGS FROM NEW YORK CITY! Today we paid a visit to the Claremont Riding Academy, located close to Central Park in Manhattan's upper west side.

Claremont is a National Historical Site built in 1892, the only remaining riding stable in Manhattan. The multistory barn is connected by ramps, with horses kept in stalls in the basement and on the second floor. Riders have little or no access to the stables and tours are not permitted. There is a small indoor riding arena with several posts that interrupt the space.

Claremont offers a range of lessons (dressage, hunt seat equitation, jumping), classes (horse care, stable management), and has a show team that competes in the area. They also rent horses for riding in Central Park, but only to experienced riders since getting to the park requires riding a horse through traffic on city streets.

The concept of a riding stable in the heart of The Big Apple (a common nickname for New York City) is a romantic notion from the rider's perspective. Can you imagine the clip-clopping of horse shoes drowning out the noise of car engines and taxi horns as you make your way to the beautiful bridle paths that traverse Central Park?

But from the horse's perspective, Claremont looks a bit like living in a teeny New York apartment. That seems anything but romantic, and certainly not as tasty as a *real* big apple...

GREETINGS FROM NEW YORK CITY! Today we paid a visit to the Claremont Riding Academy, located close to Central Park in Manhattan's upper west side.

Claremont is a National Historical Site built in 1892, the only remaining riding stable in Manhattan. The multistory barn is connected by ramps, with horses kept in stalls in the basement and on the second floor. Riders have little or no access to the stables and tours are not permitted. There is a small indoor riding arena with several posts that interrupt the space.

Claremont offers a range of lessons (dressage, hunt seat equitation, jumping), classes (horse care, stable management), and has a show team that competes in the area. They also rent horses for riding in Central Park, but only to experienced riders since getting to the park requires riding a horse through traffic on city streets.

The concept of a riding stable in the heart of The Big Apple (a common nickname for New York City) is a romantic notion from the rider's perspective. Can you imagine the clip-clopping of horse shoes drowning out the noise of car engines and taxi horns as you make your way to the beautiful bridle paths that traverse Central Park?

But from the horse's perspective, Claremont looks a bit like living in a teeny New York apartment. That seems anything but romantic, and certainly not as tasty as a *real* big apple...

GREETINGS FROM NEW YORK CITY! Today we paid a visit to the Claremont Riding Academy, located close to Central Park in Manhattan's upper west side.

Claremont is a National Historical Site built in 1892, the only remaining riding stable in Manhattan. The multistory barn is connected by ramps, with horses kept in stalls in the basement and on the second floor. Riders have little or no access to the stables and tours are not permitted. There is a small indoor riding arena with several posts that interrupt the space.

Claremont offers a range of lessons (dressage, hunt seat equitation, jumping), classes (horse care, stable management), and has a show team that competes in the area. They also rent horses for riding in Central Park, but only to experienced riders since getting to the park requires riding a horse through traffic on city streets.

The concept of a riding stable in the heart of The Big Apple (a common nickname for New York City) is a romantic notion from the rider's perspective. Can you imagine the clip-clopping of horse shoes drowning out the noise of car engines and taxi horns as you make your way to the beautiful bridle paths that traverse Central Park?

But from the horse's perspective, Claremont looks a bit like living in a teeny New York apartment. That seems anything but romantic, and certainly not as tasty as a *real* big apple...

Disasters can happen anytime and anywhere and can take many different forms, from barn fires to earthquakes, from a propane line explosion to flooding from a violent storm. Any of these might necessitate evacuation. If you have horses or other large animals, it is important to have a plan to move your animals to a safe area. A plan is even more critical if you have a large group of animals.

During an emergency, the time you have to evacuate your horses will be limited. If you are unprepared or wait until the last minute to evacuate, emergency management officials could tell you that you must leave your horses behind. Once you leave your property, you have no way of knowing how long you will be kept out of the area. If left behind, your horses could be untended for days without care, food or water. To help avoid this situation, the following information and suggestions are offered by the Humane Society of the United States for planning for emergencies. With an effective emergency plan, you might have enough time to move your animals to safety.

Disasters can happen anytime and anywhere and can take many different forms, from barn fires to earthquakes, from a propane line explosion to flooding from a violent storm. Any of these might necessitate evacuation. If you have horses or other large animals, it is important to have a plan to move your animals to a safe area. A plan is even more critical if you have a large group of animals.

During an emergency, the time you have to evacuate your horses will be limited. If you are unprepared or wait until the last minute to evacuate, emergency management officials could tell you that you must leave your horses behind. Once you leave your property, you have no way of knowing how long you will be kept out of the area. If left behind, your horses could be untended for days without care, food or water. To help avoid this situation, the following information and suggestions are offered by the Humane Society of the United States for planning for emergencies. With an effective emergency plan, you might have enough time to move your animals to safety.

Disasters can happen anytime and anywhere and can take many different forms, from barn fires to earthquakes, from a propane line explosion to flooding from a violent storm. Any of these might necessitate evacuation. If you have horses or other large animals, it is important to have a plan to move your animals to a safe area. A plan is even more critical if you have a large group of animals.

During an emergency, the time you have to evacuate your horses will be limited. If you are unprepared or wait until the last minute to evacuate, emergency management officials could tell you that you must leave your horses behind. Once you leave your property, you have no way of knowing how long you will be kept out of the area. If left behind, your horses could be untended for days without care, food or water. To help avoid this situation, the following information and suggestions are offered by the Humane Society of the United States for planning for emergencies. With an effective emergency plan, you might have enough time to move your animals to safety.

Disasters can happen anytime and anywhere and can take many different forms, from barn fires to earthquakes, from a propane line explosion to flooding from a violent storm. Any of these might necessitate evacuation. If you have horses or other large animals, it is important to have a plan to move your animals to a safe area. A plan is even more critical if you have a large group of animals.

During an emergency, the time you have to evacuate your horses will be limited. If you are unprepared or wait until the last minute to evacuate, emergency management officials could tell you that you must leave your horses behind. Once you leave your property, you have no way of knowing how long you will be kept out of the area. If left behind, your horses could be untended for days without care, food or water. To help avoid this situation, the following information and suggestions are offered by the Humane Society of the United States for planning for emergencies. With an effective emergency plan, you might have enough time to move your animals to safety.

Disasters can happen anytime and anywhere and can take many different forms, from barn fires to earthquakes, from a propane line explosion to flooding from a violent storm. Any of these might necessitate evacuation. If you have horses or other large animals, it is important to have a plan to move your animals to a safe area. A plan is even more critical if you have a large group of animals.

During an emergency, the time you have to evacuate your horses will be limited. If you are unprepared or wait until the last minute to evacuate, emergency management officials could tell you that you must leave your horses behind. Once you leave your property, you have no way of knowing how long you will be kept out of the area. If left behind, your horses could be untended for days without care, food or water. To help avoid this situation, the following information and suggestions are offered by the Humane Society of the United States for planning for emergencies. With an effective emergency plan, you might have enough time to move your animals to safety.

Legislators introduced horse slaughter prevention bills simultaneously today (Jan. 17) in both the House and Senate in an effort to increase public awareness. Last year the bill was passed in the House with a 263 to 146 vote, but the Senate adjourned before members were able to vote on the bill.

America's Wild Horse Advocates try to halt the BLM's herd management program

A Las Vegas federal judge has refused to stop the U.S. Bureau of Land Management from rounding up wild horses and burros Tuesday in the Spring Mountains west of Las Vegas.

America's Wild Horse Advocates filed an emergency motion earlier this week and argued that the federal government's environmental assessment report, which led to the gathering, was "flawed, inaccurate, and lacks a solid grounding in legitimate rangeland science."

America's Wild Horse Advocates try to halt the BLM's herd management program

A Las Vegas federal judge has refused to stop the U.S. Bureau of Land Management from rounding up wild horses and burros Tuesday in the Spring Mountains west of Las Vegas.

America's Wild Horse Advocates filed an emergency motion earlier this week and argued that the federal government's environmental assessment report, which led to the gathering, was "flawed, inaccurate, and lacks a solid grounding in legitimate rangeland science."

America's Wild Horse Advocates try to halt the BLM's herd management program

A Las Vegas federal judge has refused to stop the U.S. Bureau of Land Management from rounding up wild horses and burros Tuesday in the Spring Mountains west of Las Vegas.

America's Wild Horse Advocates filed an emergency motion earlier this week and argued that the federal government's environmental assessment report, which led to the gathering, was "flawed, inaccurate, and lacks a solid grounding in legitimate rangeland science."

America's Wild Horse Advocates try to halt the BLM's herd management program

A Las Vegas federal judge has refused to stop the U.S. Bureau of Land Management from rounding up wild horses and burros Tuesday in the Spring Mountains west of Las Vegas.

America's Wild Horse Advocates filed an emergency motion earlier this week and argued that the federal government's environmental assessment report, which led to the gathering, was "flawed, inaccurate, and lacks a solid grounding in legitimate rangeland science."

Legislators introduced horse slaughter prevention bills simultaneously today (Jan. 17) in both the House and Senate in an effort to increase public awareness. Last year the bill was passed in the House with a 263 to 146 vote, but the Senate adjourned before members were able to vote on the bill.

Artist: Templeton Thompson
Title: girls & horses
Category: Music
Genre: Country

Our Rating:

HORSE GIRL APPROVED
Have you ever heard a song that touches your soul? It's as though the songwriter got inside your head and put words and a tune to your thoughts. A song like that can ignite strong feelings. It can make you laugh or cry. It can inspire you. It can give you goose bumps, or make you sing at the top of your lungs for the world (or at least your neighbors) to hear.

If you're a girl who loves horses, nearly every song on Templeton Thompson's latest collection is likely to have an affect, from the title track "girls & horses" (which finally answers the question our friends and family have been asking -- what is it with girls and horses?) through the hidden song at the end.

Templeton is gifted with singing talent, but her voice is much more than technical ability. As the writer or co-writer of all but one of the tunes in this collection, she sings the *feeling* behind each song. Every track tells her story, about the ups and downs of life (she remembers ridin', ride before it rains), the pursuit of dreams (just stay crazy), finding happiness (shouldn't we all, beautiful day, wake up grateful) and the courage, values, and strength we gain from our connection to horses (guardian angel, cowgirl creed, tall in the saddle).

From the perspective of this horse girl, Templeton Thompson is spectacularly talented. Her music is soulful, inspiring, touching, and just great to hear.

HUSBAND APPROVED
There are all sorts of jokes passed around among the loved-ones of horse girls. A favorite has to do with the delight we find in our horse's little "buck 'n toot" sessions vs. the disgust we express when the same comes from our human partner... Fortunately I'm blessed with a wonderful hubby who supports my horsiness. Although his musical taste is stuck in the '70's and his idea of "horse power" is a Harley Davidson, he gave girls & horses an unsolicited thumbs-up.

ANIMAL APPROVED
We had a noisy storm around the holidays and our dog was very anxious, always wanting to be on my lap (which makes it hard to get anything done) so I cranked-up girls & horses. He relaxed, curled up at my feet, and went to sleep. IMHO, kids and animals are the best judge of character, and apparently music too.

TEMPLETON'S BIO

Singer/songwriter Templeton Thompson draws from a deep well of influences that combine with her Texas roots to give her style of country music a distinctive, soulful edge. She names Emmylou Harris, Bonnie Raitt, Sheryl Crow, and Don Williams as her most influential heroes.

You can find her songs on million-selling CD's from country superstars like Reba McEntire, Jo Dee Messina and Little Texas. Her song, “Settle Down Cinderella” is featured in the 2006 20th Century Fox Motion Picture, “Dr. Doolittle 3.”

Templeton is one of Nashville's sought after session vocalists, having sung countless demos as well as background vocals for major label artists like Reba McEntire. She has performed on stage for audiences across the US, in Europe, and in Japan.

Combining her love for horses with her passion for music, Templeton includes major horse expos and other National horse events in her touring schedule, often performing from horseback. In 2006 she performed to sold-out crowds at the All American Quarterhorse Congress and the National Reining Horse Association Futurity.

Additionally, Templeton serves on the board of directors for the Nashville chapter of the American Federation of Television and Radio Artists. She's also been named worldwide ambassador for EAGALA (the Equine Assisted Growth And Learning Association).

Artist: Templeton Thompson
Title: girls & horses
Category: Music
Genre: Country

Our Rating:

HORSE GIRL APPROVED
Have you ever heard a song that touches your soul? It's as though the songwriter got inside your head and put words and a tune to your thoughts. A song like that can ignite strong feelings. It can make you laugh or cry. It can inspire you. It can give you goose bumps, or make you sing at the top of your lungs for the world (or at least your neighbors) to hear.

If you're a girl who loves horses, nearly every song on Templeton Thompson's latest collection is likely to have an affect, from the title track "girls & horses" (which finally answers the question our friends and family have been asking -- what is it with girls and horses?) through the hidden song at the end.

Templeton is gifted with singing talent, but her voice is much more than technical ability. As the writer or co-writer of all but one of the tunes in this collection, she sings the *feeling* behind each song. Every track tells her story, about the ups and downs of life (she remembers ridin', ride before it rains), the pursuit of dreams (just stay crazy), finding happiness (shouldn't we all, beautiful day, wake up grateful) and the courage, values, and strength we gain from our connection to horses (guardian angel, cowgirl creed, tall in the saddle).

From the perspective of this horse girl, Templeton Thompson is spectacularly talented. Her music is soulful, inspiring, touching, and just great to hear.

HUSBAND APPROVED
There are all sorts of jokes passed around among the loved-ones of horse girls. A favorite has to do with the delight we find in our horse's little "buck 'n toot" sessions vs. the disgust we express when the same comes from our human partner... Fortunately I'm blessed with a wonderful hubby who supports my horsiness. Although his musical taste is stuck in the '70's and his idea of "horse power" is a Harley Davidson, he gave girls & horses an unsolicited thumbs-up.

ANIMAL APPROVED
We had a noisy storm around the holidays and our dog was very anxious, always wanting to be on my lap (which makes it hard to get anything done) so I cranked-up girls & horses. He relaxed, curled up at my feet, and went to sleep. IMHO, kids and animals are the best judge of character, and apparently music too.

TEMPLETON'S BIO

Singer/songwriter Templeton Thompson draws from a deep well of influences that combine with her Texas roots to give her style of country music a distinctive, soulful edge. She names Emmylou Harris, Bonnie Raitt, Sheryl Crow, and Don Williams as her most influential heroes.

You can find her songs on million-selling CD's from country superstars like Reba McEntire, Jo Dee Messina and Little Texas. Her song, “Settle Down Cinderella” is featured in the 2006 20th Century Fox Motion Picture, “Dr. Doolittle 3.”

Templeton is one of Nashville's sought after session vocalists, having sung countless demos as well as background vocals for major label artists like Reba McEntire. She has performed on stage for audiences across the US, in Europe, and in Japan.

Combining her love for horses with her passion for music, Templeton includes major horse expos and other National horse events in her touring schedule, often performing from horseback. In 2006 she performed to sold-out crowds at the All American Quarterhorse Congress and the National Reining Horse Association Futurity.

Additionally, Templeton serves on the board of directors for the Nashville chapter of the American Federation of Television and Radio Artists. She's also been named worldwide ambassador for EAGALA (the Equine Assisted Growth And Learning Association).

Artist: Templeton Thompson
Title: girls & horses
Category: Music
Genre: Country

Our Rating:

HORSE GIRL APPROVED
Have you ever heard a song that touches your soul? It's as though the songwriter got inside your head and put words and a tune to your thoughts. A song like that can ignite strong feelings. It can make you laugh or cry. It can inspire you. It can give you goose bumps, or make you sing at the top of your lungs for the world (or at least your neighbors) to hear.

If you're a girl who loves horses, nearly every song on Templeton Thompson's latest collection is likely to have an affect, from the title track "girls & horses" (which finally answers the question our friends and family have been asking -- what is it with girls and horses?) through the hidden song at the end.

Templeton is gifted with singing talent, but her voice is much more than technical ability. As the writer or co-writer of all but one of the tunes in this collection, she sings the *feeling* behind each song. Every track tells her story, about the ups and downs of life (she remembers ridin', ride before it rains), the pursuit of dreams (just stay crazy), finding happiness (shouldn't we all, beautiful day, wake up grateful) and the courage, values, and strength we gain from our connection to horses (guardian angel, cowgirl creed, tall in the saddle).

From the perspective of this horse girl, Templeton Thompson is spectacularly talented. Her music is soulful, inspiring, touching, and just great to hear.

HUSBAND APPROVED
There are all sorts of jokes passed around among the loved-ones of horse girls. A favorite has to do with the delight we find in our horse's little "buck 'n toot" sessions vs. the disgust we express when the same comes from our human partner... Fortunately I'm blessed with a wonderful hubby who supports my horsiness. Although his musical taste is stuck in the '70's and his idea of "horse power" is a Harley Davidson, he gave girls & horses an unsolicited thumbs-up.

ANIMAL APPROVED
We had a noisy storm around the holidays and our dog was very anxious, always wanting to be on my lap (which makes it hard to get anything done) so I cranked-up girls & horses. He relaxed, curled up at my feet, and went to sleep. IMHO, kids and animals are the best judge of character, and apparently music too.

TEMPLETON'S BIO

Singer/songwriter Templeton Thompson draws from a deep well of influences that combine with her Texas roots to give her style of country music a distinctive, soulful edge. She names Emmylou Harris, Bonnie Raitt, Sheryl Crow, and Don Williams as her most influential heroes.

You can find her songs on million-selling CD's from country superstars like Reba McEntire, Jo Dee Messina and Little Texas. Her song, “Settle Down Cinderella” is featured in the 2006 20th Century Fox Motion Picture, “Dr. Doolittle 3.”

Templeton is one of Nashville's sought after session vocalists, having sung countless demos as well as background vocals for major label artists like Reba McEntire. She has performed on stage for audiences across the US, in Europe, and in Japan.

Combining her love for horses with her passion for music, Templeton includes major horse expos and other National horse events in her touring schedule, often performing from horseback. In 2006 she performed to sold-out crowds at the All American Quarterhorse Congress and the National Reining Horse Association Futurity.

Additionally, Templeton serves on the board of directors for the Nashville chapter of the American Federation of Television and Radio Artists. She's also been named worldwide ambassador for EAGALA (the Equine Assisted Growth And Learning Association).

Artist: Templeton Thompson
Title: girls & horses
Category: Music
Genre: Country

Our Rating:

HORSE GIRL APPROVED
Have you ever heard a song that touches your soul? It's as though the songwriter got inside your head and put words and a tune to your thoughts. A song like that can ignite strong feelings. It can make you laugh or cry. It can inspire you. It can give you goose bumps, or make you sing at the top of your lungs for the world (or at least your neighbors) to hear.

If you're a girl who loves horses, nearly every song on Templeton Thompson's latest collection is likely to have an affect, from the title track "girls & horses" (which finally answers the question our friends and family have been asking -- what is it with girls and horses?) through the hidden song at the end.

Templeton is gifted with singing talent, but her voice is much more than technical ability. As the writer or co-writer of all but one of the tunes in this collection, she sings the *feeling* behind each song. Every track tells her story, about the ups and downs of life (she remembers ridin', ride before it rains), the pursuit of dreams (just stay crazy), finding happiness (shouldn't we all, beautiful day, wake up grateful) and the courage, values, and strength we gain from our connection to horses (guardian angel, cowgirl creed, tall in the saddle).

From the perspective of this horse girl, Templeton Thompson is spectacularly talented. Her music is soulful, inspiring, touching, and just great to hear.

HUSBAND APPROVED
There are all sorts of jokes passed around among the loved-ones of horse girls. A favorite has to do with the delight we find in our horse's little "buck 'n toot" sessions vs. the disgust we express when the same comes from our human partner... Fortunately I'm blessed with a wonderful hubby who supports my horsiness. Although his musical taste is stuck in the '70's and his idea of "horse power" is a Harley Davidson, he gave girls & horses an unsolicited thumbs-up.

ANIMAL APPROVED
We had a noisy storm around the holidays and our dog was very anxious, always wanting to be on my lap (which makes it hard to get anything done) so I cranked-up girls & horses. He relaxed, curled up at my feet, and went to sleep. IMHO, kids and animals are the best judge of character, and apparently music too.

TEMPLETON'S BIO

Singer/songwriter Templeton Thompson draws from a deep well of influences that combine with her Texas roots to give her style of country music a distinctive, soulful edge. She names Emmylou Harris, Bonnie Raitt, Sheryl Crow, and Don Williams as her most influential heroes.

You can find her songs on million-selling CD's from country superstars like Reba McEntire, Jo Dee Messina and Little Texas. Her song, “Settle Down Cinderella” is featured in the 2006 20th Century Fox Motion Picture, “Dr. Doolittle 3.”

Templeton is one of Nashville's sought after session vocalists, having sung countless demos as well as background vocals for major label artists like Reba McEntire. She has performed on stage for audiences across the US, in Europe, and in Japan.

Combining her love for horses with her passion for music, Templeton includes major horse expos and other National horse events in her touring schedule, often performing from horseback. In 2006 she performed to sold-out crowds at the All American Quarterhorse Congress and the National Reining Horse Association Futurity.

Additionally, Templeton serves on the board of directors for the Nashville chapter of the American Federation of Television and Radio Artists. She's also been named worldwide ambassador for EAGALA (the Equine Assisted Growth And Learning Association).

hOW DO YOU COPE WITH THE PASSING OF A BELOVED FRIEND,tESSY THE LAST ARABION PASSED AWAY TODAY AT REIDSVILLE HORSE CLINIC AFTER BEING STRICKEN WITH PNEWMONIA.SHE HAD BEEN RUNNING AND PLAYING UP AND DOWN THE HILLS JUST THE DAY BEFORE,JUST BEINING A BEAUTIFUL PICTURE...OF HEALTH HAPPENESS WHEN HER LIFE STARTED TO END.

im in total shock,every morn bob and i turned them out and we would get her last cause she would put on a beautiful show for us run like the wind fly like a bird circle back as if to say mom dad did you see me??we would lauph and tell her she was the most beautful girl in the world and she would shake her head rear up spin and run to the top of the hill whinny at the top of her lungs , with her big eyes watching us wave at her, then run to the other field to annoy dolly and chase..every morning we would shake out heads at how beautiful our girl was...today we turned out and it was empty,they all walked with there heads down,got to the gate turned and stood looking everywere..there was no thundering hoofs no whinnying.no beauty in this day at all.they went to the top of the hill and turned and looked all over for her again.such saddness in our hearts that i cannot explain what i feel.

WHEW OK LETS SEE.THE OTHER DAY FRIDAY SHE CAME BARRELING UP THE HILL AND STOPED TO TAKE SOME WATER.I WAS CLEANING THE STALLS AND YELLED AT HER FOR RUNNING AND DRINKING.A FEW MINETS WENT BY AND I HEARD 4 TERRABLE COUPHS,THERE WERE 5 HORSES UP THERE AND I COULDNT FIGURE WHO IT WAS AS I WAS CARTING THE STALLS MANUA DOWN THE HILL. WHEN I GOT DONE AND CAME UP I HEARD IT AGAIN BUT COULDNT SEE WHO IT WAS SO I WALKED OVER AND OF COURSE THEY ALL WERE NORMAL AND RAN OFF INTO THE BACK FIELD,SO I FORGOT ALL ABOUT IT I FED AT 4 PM ALL WAS WELL.

JUST MAKING NOTE HAVEING JUST LOST MY SHEPARD REX FOUND HIM DEAD AT THE SIDE OF MY BED IN THE MORNING I WASENT THINKING OF LOOSING ANYONE ELSE,HE WAS A BIG 9 YR OLD AND HAD HAD A HEART ATTACK IN HIS SLEEP.SO COPING WITH HIS LOSE IV BEEN IN LALA LAND.

hOW DO YOU COPE WITH THE PASSING OF A BELOVED FRIEND,tESSY THE LAST ARABION PASSED AWAY TODAY AT REIDSVILLE HORSE CLINIC AFTER BEING STRICKEN WITH PNEWMONIA.SHE HAD BEEN RUNNING AND PLAYING UP AND DOWN THE HILLS JUST THE DAY BEFORE,JUST BEINING A BEAUTIFUL PICTURE...OF HEALTH HAPPENESS WHEN HER LIFE STARTED TO END.

im in total shock,every morn bob and i turned them out and we would get her last cause she would put on a beautiful show for us run like the wind fly like a bird circle back as if to say mom dad did you see me??we would lauph and tell her she was the most beautful girl in the world and she would shake her head rear up spin and run to the top of the hill whinny at the top of her lungs , with her big eyes watching us wave at her, then run to the other field to annoy dolly and chase..every morning we would shake out heads at how beautiful our girl was...today we turned out and it was empty,they all walked with there heads down,got to the gate turned and stood looking everywere..there was no thundering hoofs no whinnying.no beauty in this day at all.they went to the top of the hill and turned and looked all over for her again.such saddness in our hearts that i cannot explain what i feel.

WHEW OK LETS SEE.THE OTHER DAY FRIDAY SHE CAME BARRELING UP THE HILL AND STOPED TO TAKE SOME WATER.I WAS CLEANING THE STALLS AND YELLED AT HER FOR RUNNING AND DRINKING.A FEW MINETS WENT BY AND I HEARD 4 TERRABLE COUPHS,THERE WERE 5 HORSES UP THERE AND I COULDNT FIGURE WHO IT WAS AS I WAS CARTING THE STALLS MANUA DOWN THE HILL. WHEN I GOT DONE AND CAME UP I HEARD IT AGAIN BUT COULDNT SEE WHO IT WAS SO I WALKED OVER AND OF COURSE THEY ALL WERE NORMAL AND RAN OFF INTO THE BACK FIELD,SO I FORGOT ALL ABOUT IT I FED AT 4 PM ALL WAS WELL.

JUST MAKING NOTE HAVEING JUST LOST MY SHEPARD REX FOUND HIM DEAD AT THE SIDE OF MY BED IN THE MORNING I WASENT THINKING OF LOOSING ANYONE ELSE,HE WAS A BIG 9 YR OLD AND HAD HAD A HEART ATTACK IN HIS SLEEP.SO COPING WITH HIS LOSE IV BEEN IN LALA LAND.

hOW DO YOU COPE WITH THE PASSING OF A BELOVED FRIEND,tESSY THE LAST ARABION PASSED AWAY TODAY AT REIDSVILLE HORSE CLINIC AFTER BEING STRICKEN WITH PNEWMONIA.SHE HAD BEEN RUNNING AND PLAYING UP AND DOWN THE HILLS JUST THE DAY BEFORE,JUST BEINING A BEAUTIFUL PICTURE...OF HEALTH HAPPENESS WHEN HER LIFE STARTED TO END.

im in total shock,every morn bob and i turned them out and we would get her last cause she would put on a beautiful show for us run like the wind fly like a bird circle back as if to say mom dad did you see me??we would lauph and tell her she was the most beautful girl in the world and she would shake her head rear up spin and run to the top of the hill whinny at the top of her lungs , with her big eyes watching us wave at her, then run to the other field to annoy dolly and chase..every morning we would shake out heads at how beautiful our girl was...today we turned out and it was empty,they all walked with there heads down,got to the gate turned and stood looking everywere..there was no thundering hoofs no whinnying.no beauty in this day at all.they went to the top of the hill and turned and looked all over for her again.such saddness in our hearts that i cannot explain what i feel.

WHEW OK LETS SEE.THE OTHER DAY FRIDAY SHE CAME BARRELING UP THE HILL AND STOPED TO TAKE SOME WATER.I WAS CLEANING THE STALLS AND YELLED AT HER FOR RUNNING AND DRINKING.A FEW MINETS WENT BY AND I HEARD 4 TERRABLE COUPHS,THERE WERE 5 HORSES UP THERE AND I COULDNT FIGURE WHO IT WAS AS I WAS CARTING THE STALLS MANUA DOWN THE HILL. WHEN I GOT DONE AND CAME UP I HEARD IT AGAIN BUT COULDNT SEE WHO IT WAS SO I WALKED OVER AND OF COURSE THEY ALL WERE NORMAL AND RAN OFF INTO THE BACK FIELD,SO I FORGOT ALL ABOUT IT I FED AT 4 PM ALL WAS WELL.

JUST MAKING NOTE HAVEING JUST LOST MY SHEPARD REX FOUND HIM DEAD AT THE SIDE OF MY BED IN THE MORNING I WASENT THINKING OF LOOSING ANYONE ELSE,HE WAS A BIG 9 YR OLD AND HAD HAD A HEART ATTACK IN HIS SLEEP.SO COPING WITH HIS LOSE IV BEEN IN LALA LAND.

hOW DO YOU COPE WITH THE PASSING OF A BELOVED FRIEND,tESSY THE LAST ARABION PASSED AWAY TODAY AT REIDSVILLE HORSE CLINIC AFTER BEING STRICKEN WITH PNEWMONIA.SHE HAD BEEN RUNNING AND PLAYING UP AND DOWN THE HILLS JUST THE DAY BEFORE,JUST BEINING A BEAUTIFUL PICTURE...OF HEALTH HAPPENESS WHEN HER LIFE STARTED TO END.

im in total shock,every morn bob and i turned them out and we would get her last cause she would put on a beautiful show for us run like the wind fly like a bird circle back as if to say mom dad did you see me??we would lauph and tell her she was the most beautful girl in the world and she would shake her head rear up spin and run to the top of the hill whinny at the top of her lungs , with her big eyes watching us wave at her, then run to the other field to annoy dolly and chase..every morning we would shake out heads at how beautiful our girl was...today we turned out and it was empty,they all walked with there heads down,got to the gate turned and stood looking everywere..there was no thundering hoofs no whinnying.no beauty in this day at all.they went to the top of the hill and turned and looked all over for her again.such saddness in our hearts that i cannot explain what i feel.

WHEW OK LETS SEE.THE OTHER DAY FRIDAY SHE CAME BARRELING UP THE HILL AND STOPED TO TAKE SOME WATER.I WAS CLEANING THE STALLS AND YELLED AT HER FOR RUNNING AND DRINKING.A FEW MINETS WENT BY AND I HEARD 4 TERRABLE COUPHS,THERE WERE 5 HORSES UP THERE AND I COULDNT FIGURE WHO IT WAS AS I WAS CARTING THE STALLS MANUA DOWN THE HILL. WHEN I GOT DONE AND CAME UP I HEARD IT AGAIN BUT COULDNT SEE WHO IT WAS SO I WALKED OVER AND OF COURSE THEY ALL WERE NORMAL AND RAN OFF INTO THE BACK FIELD,SO I FORGOT ALL ABOUT IT I FED AT 4 PM ALL WAS WELL.

JUST MAKING NOTE HAVEING JUST LOST MY SHEPARD REX FOUND HIM DEAD AT THE SIDE OF MY BED IN THE MORNING I WASENT THINKING OF LOOSING ANYONE ELSE,HE WAS A BIG 9 YR OLD AND HAD HAD A HEART ATTACK IN HIS SLEEP.SO COPING WITH HIS LOSE IV BEEN IN LALA LAND.

Would you like to know what your horses sign is? Then check it out here, maybe read a little about that signs personality and traits. This is all for fun, so please don't take what you read seriously, though there are some good points within.

CAPRICORN: (Dec. 22-Jan. 21) Only a few horses are born during the cold winter months, which may help to explain why Capricorn youngsters act so silly. But they grow to be such serious-minded adults that you may not believe thier acquired dependability. Often grey or chestnut in color, this horse may have enlarged knees or perhaps some knee trouble. He's a hard worker with excellent performance potential for plowing or driving where style is not too important.

Would you like to know what your horses sign is? Then check it out here, maybe read a little about that signs personality and traits. This is all for fun, so please don't take what you read seriously, though there are some good points within.

CAPRICORN: (Dec. 22-Jan. 21) Only a few horses are born during the cold winter months, which may help to explain why Capricorn youngsters act so silly. But they grow to be such serious-minded adults that you may not believe thier acquired dependability. Often grey or chestnut in color, this horse may have enlarged knees or perhaps some knee trouble. He's a hard worker with excellent performance potential for plowing or driving where style is not too important.

Would you like to know what your horses sign is? Then check it out here, maybe read a little about that signs personality and traits. This is all for fun, so please don't take what you read seriously, though there are some good points within.

CAPRICORN: (Dec. 22-Jan. 21) Only a few horses are born during the cold winter months, which may help to explain why Capricorn youngsters act so silly. But they grow to be such serious-minded adults that you may not believe thier acquired dependability. Often grey or chestnut in color, this horse may have enlarged knees or perhaps some knee trouble. He's a hard worker with excellent performance potential for plowing or driving where style is not too important.

Would you like to know what your horses sign is? Then check it out here, maybe read a little about that signs personality and traits. This is all for fun, so please don't take what you read seriously, though there are some good points within.

CAPRICORN: (Dec. 22-Jan. 21) Only a few horses are born during the cold winter months, which may help to explain why Capricorn youngsters act so silly. But they grow to be such serious-minded adults that you may not believe thier acquired dependability. Often grey or chestnut in color, this horse may have enlarged knees or perhaps some knee trouble. He's a hard worker with excellent performance potential for plowing or driving where style is not too important.

A Seville, Calif., woman convicted of starving more than 80 horses on her ranch north of Visalia was sentenced to 10 months in county jail.

A Tulare County Superior Court judge also prohibited Sandra Werner, 61, from keeping any horses during the three years she is on probation.

A Seville, Calif., woman convicted of starving more than 80 horses on her ranch north of Visalia was sentenced to 10 months in county jail.

A Tulare County Superior Court judge also prohibited Sandra Werner, 61, from keeping any horses during the three years she is on probation.

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