Changes

==Description==

 

 

==Introduction==

'''Hyperlipaemia''' is a severe metabolic disorder which occurs in response to a negative energy balance, the end result is multi-organ failure as lipid is deposited in the liver and kidneys. Fatty acids are mobilised from adipose tissue, some are used peripherally but most are taken up by the liver. Here they are oxidized to provide energy or re-esterified to triglycerides and phospholipids, and deposited in hepatocytes or released into the blood as very low density lipoproteins. These very low density lipoproteins are the cause of lipaemic plasma in hyperlipaemic ponies. Hypoglycaemia reduces insulin response, compounding the problem by increasing peripheral lipid mobilisation and decreasing removal of triglyercides from the circulating blood. Insulin resistance has been reported to be a factor in many cases of hyperlipaemia but affected animals may aslo have a normal insulin response.     

'''Hyperlipaemia''' is a severe metabolic disorder which occurs in response to a negative energy balance, the end result is multi-organ failure as lipid is deposited in the liver and kidneys. Fatty acids are mobilised from adipose tissue, some are used peripherally but most are taken up by the liver. Here they are oxidized to provide energy or re-esterified to triglycerides and phospholipids, and deposited in hepatocytes or released into the blood as very low density lipoproteins. These very low density lipoproteins are the cause of lipaemic plasma in hyperlipaemic ponies. Hypoglycaemia reduces insulin response, compounding the problem by increasing peripheral lipid mobilisation and decreasing removal of triglyercides from the circulating blood. Insulin resistance has been reported to be a factor in many cases of hyperlipaemia but affected animals may aslo have a normal insulin response.     

==Treatment==

==Treatment==

Treatment must be prompt and aggressive.

Treatment must be prompt and aggressive.

Nutritional support is the most important part of treatment. Constant slow infusion of glucose IV (dexrose 5%) should be given initially. Followed by protamine zinc insulin and glucose or high energy gruel based on barley or oats given by stomach tube and supportive amino acids. Heparin may be given in an attempt to reduce plasma triglyerides but will not correct the underlying cause and may alter haemostasis.

Nutritional support is the most important part of treatment. Constant slow infusion of glucose IV (dextrose 5%) should be given initially. Followed by protamine zinc insulin and glucose or high energy gruel based on barley or oats given by stomach tube and supportive amino acids. Heparin may be given in an attempt to reduce plasma triglycerides but will not correct the underlying cause and may alter haemostasis.

==Prognosis==

==Prognosis==

Prognosis is poor.   

Prognosis is poor.   

==References==

==References==

* Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''

* Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''

*Rose, R. J. and Hodgson, D. R. (2000) '''Manual of Equine Practice''' (Second Edition) Sauders.

*Rose, R. J. and Hodgson, D. R. (2000) '''Manual of Equine Practice''' (Second Edition) Saunders.

[[Category:Liver_-_Degenerative_Pathology]][[Category:Horse]]

 

[[Category:To_Do_-_Review]]

 

[[Category:To_Do_-_lizzyk]]

 

 

[[Category:Liver_-_Degenerative_Pathology]][[Category:Alimentary Diseases - Horse]]

[[Category:Expert_Review]]