Has anyone used Steglatro or Invokana for their horse?

[PonyRiderMom]

Has anyone used Steglatro or Invokana for their horse with insulin resistance? If so, how did you like it?

The vet is also suggesting Thyro-L but I think that’s maybe more for weight loss and only incidentally affects insulin resistance?

I’m going to have a talk with her, but I’d like to have done my homework first.

I’m kind of wondering too, whether our first priority should be to get his insulin levels down (insulin level at 32 in the morning, test was sent to Cornell) or to get his weight down (he’s chunky but not obese IMO). Since it seems like one drug is for one thing and the other is for the other.

[Snowdenfarm]

I would highly recommend joining this group and using the search function in the Main group to search for the products. There is a ton of information and anecdotal experience.

[JB]

https://beva.onlinelibrary.wiley.com/doi/10.1111/eve.13738
This trial was done on ertugliflozin which is the same drug class as Invokana (canagliflozin)

And yes, I would focus on getting her insulin down. Chunky isn’t good (obviously) but if she’s really not obese then personally I wouldn’t start the levothyroxine

What’s her diet? Hay absolutely has to be low NSC, or at least low enough that soaking will get it low enough. No grass for now.

Adding a supplement with 4mg chromium propionate can make a significant difference in insulin sensitivity

The Equine PPID (Cushing’s) group on FB is a great resource, in addition to the ECIR grouop above

[PonyRiderMom]

He only gets teff hay, and that’s been true since we moved here a year ago. He was on a dry lot all winter, then on restricted pasture, but when the grass got more mature I un-restricted him. I figured it would be lower in sugar.

I have re-restricted his pasture – I’m letting him out a few hours a day with a grazing muzzle. He still only gets teff hay.

I had forgotten about the chromium – I will ask her about that also.

I did find a great article about case studies ECIR did on horses that were treated with these drugs, and that has me a little concerned: xhttps://www.americanhorsepubs.org/newsgroup/invokana-and-steglatro-use-in-ems-and-ppid-what-you-need-to-know/

I will ask her, given that his insulin level is high but not through the roof, if it would be better for his long-term health to go on meds, at least for now, or if we might try just supplements and lifestyle management.

[cayuse]

I have used both Metformin and Steglatro on a mini. The numbers were not that much different between the two and were actually more consistent with the Metformin.
I was having to have his Insulin level, kidney and liver values monitored about every 6 weeks to 2 months, between that cost and the cost of the Steglatro (just under $400 a month for 1/2 tab a day) and the lackluster results,both the vet and I decided to put him back on the Metformin.
My vet said that for horses whose values are not very high they are finding that the Steglatro does not to much to move the numbers. If the horse is in the OMG range, it will lower it by alot.

[Critter]

Following as my mare is a bit ouchy this week and has gotten super obese lately, even in work (all from grazing…she gets a small bit of ration balancer to get her allergy meds in her). We also had double abscesses back in April (and that was with pads and pour ins)…so starting to think maybe something metabolic is going on.

Vet drew blood for insulin and ACTH tonight and we are going to start the metformin. Vet also mentioned the Steglatro as an option.

Any side effects or things to watch for that people have noticed with the metformin?

[cayuse]

I noticed no side effects with the Metformin with my two.

[pompeiii]

I don’t have any positive experiences, but I did use ertugliflozin on my mini last fall. In his case, his insulin numbers were high, but his weight was fine. He lost weight (he didn’t need to lose) on the Steglarto and his numbers improved a little, but not enough. In our case, it wasn’t enough to get him to a point where we could get him comfortable.

[Calhoun]

I used Metformin on my horse and had good luck. It’s just a total pain to grind the pills, mix with water and put in a syringe. When the vet drew blood for the insulin test it was always in the morning before any food. For those with sore feet, I used a combo of bute and Tylenol.

[Bristol_Bay]

My IR low thyroid horse thrived on Thyro-L and it was super cheap to buy the large tub from Valley Vet. A diet of one flake of alfalfa and two Bermuda or timothy grass kept his insulin under control. Within a year his body transformed.

[NaturallyHappy]

We used Steglatro initially w success. We now use Resvantage w equally good success.

[PaddockWood]

The latest Humble Hoof episode discussed these drugs too.

Laminitis Recovery

[Critter]

I got my mare’s insulin results back - 124 uIU/ml…glucose was fine and ACTH was also good (10).

Vet did offer Steglatro as an option to try…got the Metformin today, compounded by Farm Vet in a powder and gave first dose today. Tried it in some soaked hay pellets and she ate most of it. Going to try picking up beet pulp tomorrow…will be easier if I can give in some feed instead of syringing it in her.

Sorry OP - not trying to hijack your thread, but it was perfect timing! I think I am going to try the metformin first and if we don’t see any improvement, then try the Steglatro.