Ertugliflozin - experiences?

[amyjnes109]

Hi. My 7 y/o cob has laminitis and the vet came out and put him on box rest and took his bloods. his insulin came back at 84 so he was put on Ertuguflozin alongside inflacam to get it to drop and help him shift the weight. 2.5 weeks on and he is already looking great and has shifted a lot of weight alongside box rest and soaked hay. Just interested how it went for people who finished a months course and if the insulin dropped and if it lasted? My friend has just had theirs drop from 74 to 2.4 but its early days for them yet.

 

[Widgeon]

Personally I've found it to be incredibly useful, but it would appear that different horses have different long term outcomes.

This is the biggest published study that seems to be around at present. All 51 horses were treated for at least 30 days. At a median follow up of 60 days (range 30–240 days):

- 33 horses remained on treatment either because insulin concentration remained increased, or it had increased when treatment was withdrawn
- 10 had had treatment discontinued as laminitis and insulin concentrations had improved and were being controlled with diet and management alone
- 3 owners couldn't afford to continue treatment
- 5 horse shad been sold and lost to follow up

Critically, for the subset of horses with follow-up data beyond 30 days, insulin concentrations remained below baseline values (i.e. lower than when the horses started treatment), for the samples taken between Days 60 and 240. So it does appear to have a lasting effect.

Personally, my own vet said that they'd found in about one third of horses, a treatment course acted as a "system reset" and their insulin remains normal long term. For another third, it works; insulin goes up again when they come off it, but but not as badly. For the final third, it doesn't work particularly well, or insulin goes right back up again once they come off the drug. So that's at least a 2/3 chance that your horse will end up better off long term!

Mine has responded brilliantly and I'm very hopeful that we'll see pretty well normal insulin long term, with appropriate management. He was on it for longer though - we had him on 3ml/day for 6 weeks, which took his insulin from 75 to 37. We've put him on a second six week course so hopefully blood testing in a couple of weeks will show a drop yet again. After that he'll come off it, whatever the blood results say. He's also shifted a lot of very, very stubborn weight.

 

[Katelouise]

hiya. I've just posted asking the same, not having seen your post.

How have you found it? My horse was diagnosed with EMS this week and his insulin levels were at 86. Palomino cob and very cresty, shoulder fat pouches and so overweight despite all efforts to drop kgs through work and soaking hay etc.

How effective have you found it so far?

Thank you

 

[maya2008]

My vet suggested it is best as a short term treatment and her advice was to use it to get pony sound, then control with a ton of work. I could not have kept pony on it even if I have wanted to. Even eating enough haylage and feed for a pony twice her size could not stop her losing weight once she was the correct weight, and I had an underweight pony. Friend of mine had the same issue. We are weaning off it slowly and upping the work alongside the reducing dose.

 

[amyjnes109]

hiya. I've just posted asking the same, not having seen your post.

How have you found it? My horse was diagnosed with EMS this week and his insulin levels were at 86. Palomino cob and very cresty, shoulder fat pouches and so overweight despite all efforts to drop kgs through work and soaking hay etc.

How effective have you found it so far?

Thank you

Hi - sorry for the delayed reply - His bloods dropped from 84 to 3 which is impressive! he's had a month still on soaked hay as the vet felt he could lose a few more lbs and hes coming out next thursday to see if his bloods have stayed low now hes lost that extra little weight and he can start having some limited turnout if it has stayed low. Luckily y/o has let us build a dry lot for him so hes still got daily turnout whilst limiting grass. Heres a pic of his before and after!