Horses affected by equine metabolic syndrome (EMS) and pituitary pars intermedia dysfunction can be difficult to manage, requiring the use of grazing muzzles, specific feed, and daily medication. Even with every precaution in place, some horses will still experience unregulated hormone levels, which can endanger their welfare.
Interest in the use of canagliflozin (brand name Invokana) and ertugliflozin (brand name Steglatro) has skyrocketed, as both drugs can reduce glucose and insulin in horses with EMS and PPID when other management changes have not. While the drugs may seem like magic bullets, they are not without side effects – some of which can be dangerous.
It's important to remember:
- These drugs are not substitutes for a safe, low-carbohydrate diet. A low-carb diet is one in which starch and simple sugar content is less than 10 percent).
- Blood chemistry and serum triglycerides should be checked before starting and periodically while on the drug(s).
- These drugs may increase glucose in the urine; horses may have significant urinary tract complications and kidney injury if they receive non-steroidal anti-inflammatories while on these drugs.
- These drugs might increase triglyceride levels, which may lead to fatty liver.
- These drugs can increase urine output, which may cause the horse to become dehydrated and may possibly lead to colic.
Though these drugs are effective in reducing insulin and glucose levels, it's imperative that owners and veterinarians understand their potential side effects.
Read more at the Equine Cushing's and Insulin Resistance Group.
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