New drug to reset insulin resistance

[Alwaysmoretoknow]

So had a blood panel drawn on my 3 retired loafers. Was absolutely horrified to see one of them (NF) returned 556.0 ulU/ml on his basal insulin - a high risk for lami is > 21ulU/ml. He's not had it yet...but damn.
Started on Invokana 300mg 1 tablet a day and retested 14 days later. Insulin now down to 9.6 ulU/ml. Also started soaking hay which would have helped but still. Now on a 1/4 tablet a day as Triglycerides were a bit high (0.57 mmol/l) on original blood draw.
The weight loss has been remarkable and the fat pad and crestiness which I've really struggled to reduce are significantly down and his energy levels have increased.
Now thinking he has probably had subclinical lami for a while and I hadn't noticed (pulses ok, no heat in feet and not lame or posturing) but still feel like a crap owner.
However this drug does seem to have remarkable qualities and I wondered if anyone else had any experience of it? It is a bit expensive but its not a continuous treatment and having apparently reset the horse's insulin sensitivity they can then come off it as long as they're managed appropriately.
Thoughts?

 

[Chianti]

That's very interesting. Did the vet say that the Invokana would help with weight loss?

 

[HappyHollyDays]

That's very interesting. Did the vet say that the Invokana would help with weight loss?

If you look at the Forage Plus website Dr Eleanor Kellon has written an article called Using New Medication for EMS which explains about the new drugs available.

 

[scats]

No experience of it but I’m interested. I have an EMS pony that you wouldn’t normally think would be the type. At the moment she shows ribs when she moves, but she always has a crest that just will not shift.
I have to monitor her like a hawk from March to October- soaked hay, muzzled when moving fields, strip grazed strictly (about half a foot at a time).

She had a blip about a month ago but recovered within 48 hours. A big telltale with her is the swollen pads above her eyes. That’s when I know she’s in a metabolic struggle, even if there are no other outward signs.

 

[Alwaysmoretoknow]

Maybe talk to your vet about it. I'd be interested to hear their feedback.

 

[Alwaysmoretoknow]

That's very interesting. Did the vet say that the Invokana would help with weight loss?

Yes definitely so but more importantly it reduces the danger of laminitis.

 

[Chianti]

Yes definitely so but more importantly it reduces the danger of laminitis.

Thanks. I think I'll get the vet out to discuss.

 

[SEL]

I've had mine on steglatro - similar drug.

She has type 1 pssm but the vet was happy to prescribe it (I asked) because her insulin was around 150 on blood draw.

I've used it alongside 24:7 muzzling to allow her to stay out with her friends. I run a grass track anyway but this year's grass growth was bonkers and she couldn't cope.

Fat pads definitely down and crest is wobbling - but even after one month it has made an enormous difference to those pssm muscles. I feel quite sad to be taking her off it but it isn't great for kidneys long term.

 

[winnie]

My Dartmoor was on a similar drug for just one month over a year ago. She lost a significant amount of weight and has kept it off. But it made no difference to her insulin levels - they remain around 100.

 

[JenJ]

My not-remotely-overweight Section A came down with lami last summer, and was subsequently diagnosed with EMS. She had one month of Invokana, which brought her insulin level right down, and I've used it twice more since then, for a month each time, when I've been concerned about her crest increasing.

It does seem to be a 'miracle' drug, based on what I've read on various lami FB groups, but as you said, short-term use only, as the effects of long-term use are not yet known, and it does carry a risk of damage to the liver.

 

[Orangehorse]

Gosh, that sounds very interesting.

 

[ihatework]

Interesting to see it’s coming into horses. I actually did some of the clinical development on the drug to get it licensed in humans!

Out of interest what dosage are they giving it at?

 

[BronsonNutter]

Interesting to see it’s coming into horses. I actually did some of the clinical development on the drug to get it licensed in humans!

Out of interest what dosage are they giving it at?

0.5-0.6mg/kg usually, once daily.

It's been a game changer for us in many cases.

 

[Alwaysmoretoknow]

With mine it was 1 x 300mg tablet for a 450 kg (approx) pony daily for 2 weeks then reduced to 1 1/4 daily after 2 week blood test as triglycerides were high with 3rd blood test scheduled for 2 weeks after that.

 

[holeymoley]

There have been quite a few posts about it on social media pages which are aimed at EMS types. Thankfully mine coping well at the moment with lifestyle but certainly worth knowing about in case of the worst.

 

[HorsesRule2009]

There is also Ertugliflozin which has very good results this is a paste.
You can also use Steglatro tablets.