{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:37:07Z","timestamp":1770745027922,"version":"3.49.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":2347,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The thyrotropin-releasing hormone (TRH) stimulation test and the 2-step insulin sensitivity test are commonly used methods to diagnose, respectively, pituitary pars intermedia dysfunction (PPID) and insulin dysregulation (ID).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the diagnostic value of combining the TRH stimulation test and the 2-step insulin sensitivity test to diagnose PPID and ID simultaneously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>Twenty-seven adult horses, 10 control horses without PPID or ID, 5 horses with PPID only, 5 horses with ID only, and 7 horses with PPID and ID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized prospective study. Horses underwent a TRH stimulation test alone, a 2-step insulin sensitivity test alone, and combined testing with simultaneous TRH and insulin injection in the same syringe. Data were compared by 2-way repeated measures analysis of variance and 2 1-sided tests to demonstrate equivalence. Bland-Altman plots were generated to visualize agreement between combined and independent testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The effect of combined testing on plasma adrenocorticotropic hormone, blood glucose concentration, or percentage decrease in blood glucose concentration was not significantly different from the effect obtained with independent testing. One control horse appeared falsely positive for PPID, 2 PPID-only horses appeared falsely positive for ID, and 1 PPID and ID horse appeared falsely negative for ID when tests were performed simultaneously. Bland-Altman plots supported the agreement between combined and independent testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>Combining the TRH stimulation test and the 2-step insulin sensitivity test appears to be a useful diagnostic tool for equine practitioners in the field, allowing testing of a horse for both PPID and ID simultaneously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.15617","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T13:07:40Z","timestamp":1568034460000},"page":"2249-2256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Evaluation of combined testing to simultaneously diagnose pituitary pars intermedia dysfunction and insulin dysregulation in horses"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-4436","authenticated-orcid":false,"given":"Remona","family":"Horn","sequence":"first","affiliation":[{"name":"School of Veterinary Science, University of Queensland , Gatton, Queensland,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2820-8431","authenticated-orcid":false,"given":"Fran\u00e7ois-Ren\u00e9","family":"Bertin","sequence":"additional","affiliation":[{"name":"School of Veterinary Science, University of Queensland , Gatton, Queensland,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,1]]},"reference":[{"key":"2026020922080630000_jvim15617-bib-0001","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1939-1676.2005.tb02674.x","article-title":"Diagnosing equine pars intermedia dysfunction: are we there yet?","volume":"19","author":"Toribio","year":"2005","journal-title":"J Vet Intern Med"},{"key":"2026020922080630000_jvim15617-bib-0002","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/j.1939-1676.2010.0503.x","article-title":"Equine metabolic syndrome","volume":"24","author":"Frank","year":"2010","journal-title":"J Vet Intern Med"},{"key":"2026020922080630000_jvim15617-bib-0003","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1111\/j.1939-1676.2012.00932.x","article-title":"Diagnostic frequency, response to therapy, and long-term prognosis among horses and ponies with pituitary par intermedia dysfunction, 1993-2004","volume":"26","author":"Rohrbach","year":"2012","journal-title":"J Vet Intern Med"},{"key":"2026020922080630000_jvim15617-bib-0004","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0749-0739(02)00018-4","article-title":"Pituitary pars intermedia dysfunction: equine Cushing's disease","volume":"18","author":"Schott","year":"2002","journal-title":"Vet Clin North Am Equine Pract"},{"key":"2026020922080630000_jvim15617-bib-0005","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/j.2042-3306.2012.00578.x","article-title":"Prevalence, risk factors and clinical signs predictive for equine pituitary pars intermedia dysfunction in aged horses","volume":"45","author":"McGowan","year":"2013","journal-title":"Equine Vet J"},{"key":"2026020922080630000_jvim15617-bib-0006","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/evj.13041","article-title":"Factors associated with survival, laminitis and insulin dysregulation in horses diagnosed with equine pituitary pars intermedia dysfunction","volume":"51","author":"Horn","year":"2019","journal-title":"Equine Vet J"},{"key":"2026020922080630000_jvim15617-bib-0007","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1177\/0300985815608674","article-title":"What's new in old horses? 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