Hopes new drug can help laminitis cases – but good management remains key


A drug being used to treat horses suffering with acute laminitis is proving to be successful – but owners have been warned this does not mean they can become complacent in management practices.

Ertugliflozin, an SGL2 inhibitor used to help lower blood glucose levels in humans, has been found to lower insulin levels in horses, and is being used more in the treatment of laminitis and equine metabolic syndrome (EMS). The drug does not have marketing authorisation for use in horses, but it can be prescribed by a vet in the UK.

David Rendle, chair of the British Equine Veterinary Association’s health and medicines committee, who has been involved in some of the research of the use of ertugliflozin, told H&H that although there is limited data available, the drug has been found to bring insulin levels down “remarkably quickly”.

“We have found in cases of laminitis the horse’s level of comfort increases very quickly. Everything is pointing toward SGL2s being an effective way of reducing the suffering associated with laminitis,” he said.

“This is exciting, but management still has to be the central theme. I wouldn’t want owners to think there’s now a magic bullet and they can be complacent about management, because that’s not the case.”

Pearl James’ gelding Murphy developed laminitis and EMS last autumn. Murphy had sustained an injury and could not be exercised, and despite strict management practices, he continued to put on weight. Having changed vet practices to Pinkham Equine, he was prescribed ertugliflozin by vet Rich Bristow.

Pearl told H&H within two weeks of Murphy being on the drug his insulin levels dropped from 150 to 11. Studies have indicated generally a horse’s insulin level should be below 20.

“We had been desperately trying to make him lose weight but no matter what he was getting fatter and fatter. You can reduce their food as much as you can, but you can’t starve them. Because we had the laminitis, coupled with the other lameness issue, I just felt up against it and desperate,” she said, adding that although the drug is expensive, she believes it has been worth it.

“Ertugliflozin has been like a wonder drug and Murphy looks amazing. If it wasn’t for this I don’t think we would have been able to keep laminitis away – and I don’t know if we would have been able to keep him going.”

Vet Rich Bristow told H&H there are other drugs that can be used for EMS and insulin resistance, but he believes ertugliflozin has been “the most effective”.

“If you can institute good management changes, in terms of feeding and weight loss and increasing exercise levels, then sometimes you can get horses’ glucose levels to come down – but the frustrating cases are when a horse is suffering from laminitis and can’t be exercised. There is no shortage of horses and ponies suffering from EMS so I’m sure there will be some who will benefit from this drug,” he said.


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