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Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: A randomized, placebo-controlled, double-blind, study.
Abstract: Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease postprandial hyperinsulinemia in ID horses are needed. Objective: Compare short-term effects of canagliflozin vs placebo on glucose and insulin responses to an oral sugar test (OST) as well as the effects on body weight and triglyceride concentrations in horses with ID. Methods: Sixteen privately-owned ID horses. Methods: A single-center, randomized, double-blind, placebo-controlled, parallel design study. The horses were randomized (ratio 1:1) to either once daily PO treatment with 0.6 mg/kg canagliflozin or placebo. The study consisted of an initial 3-day period for obtaining baseline data, a 3-week double-blind treatment period at home, and a 3-day follow-up period similar to the initial baseline period but with continued double-blind treatment. Horses were subjected to an 8-sample OST in the morning of the third day on both visits. Results: Maximal geometric least square (LS) mean insulin concentration (95% confidence interval [CI]) during the OST decreased after 3 weeks of canagliflozin treatment compared with placebo (83.2; 55.4-125.0 vs 215.2; 143.2-323.2 μIU/mL). The geometric LS mean insulin response (insulin AUC0-180 ) for canagliflozin-treated horses was >66% lower compared with placebo. Least square mean body weight decreased by 11.1 (4-18.1) kg and LS mean triglyceride concentrations increased by 0.99 (0.47-1.5) mmol/L with canagliflozin treatment. Conclusions: Canagliflozin is a promising drug for treatment of ID horses that requires future studies.
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2023-10-21 PubMed ID: 37864426PubMed Central: PMC10658518DOI: 10.1111/jvim.16906Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Randomized Controlled Trial
- Veterinary
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study investigates the short-term effects of canagliflozin, a drug used to treat diabetes in humans, on horses with insulin dysregulation. Results suggest that canagliflozin significantly lowers insulin levels and body weight in these horses, suggesting its potential as a treatment.
Research Objectives
The primary objective of this study was to evaluate the effects of canagliflozin on horses affected by insulin dysregulation (ID). Researchers wanted to see if the drug, commonly used to treat diabetes in humans, could reduce hyperinsulinemia – an excess of insulin in the blood – which is a key concern in the prevention of laminitis in horses.
- The researchers sought to compare the effects of canagliflozin with a placebo on glucose and insulin responses in horses.
- They also aimed to observe any impact the drug might have on the body weight and triglyceride concentrations of the horses.
Research Design and Methods
Sixteen privately-owned horses with ID participated in this double-blind, placebo-controlled study. The design of the study was such that neither the researchers nor participants knew which horses were receiving the drug and which were given a placebo.
- The horses were divided into two groups – one received 0.6 mg/kg of canagliflozin orally per day, while the other group served as a control and received a placebo.
- The study comprised of an initial 3-day baseline data collection period, followed by a 3-week treatment period, and concluding with a 3-day follow-up period during which the treatment continued while further data was collected.
- To monitor changes, an oral sugar test was conducted on the third day of both the initial and final data collection periods.
Results of the Study
The study found that canagliflozin significantly reduced the insulin levels in horses with ID.
- Horses treated with canagliflozin showed a decrease in the insulin concentration as compared to those on the placebo, with average levels being over 66% lower.
- The horses receiving canagliflozin also lost weight, with an average drop of around 11.1 kg noted.
- However, canagliflozin treatment resulted in an increase in the concentration of triglycerides in the blood.
Conclusion
This study suggests that canagliflozin is a promising drug for the treatment of horses with ID. It was able to significantly reduce insulin levels and led to weight loss. However, the implication of increased triglyceride levels upon treatment with the drug needs to be further researched. Potential long-term effects and optimum dosage also require additional studies.
Cite This Article
APA
Lindåse S, Nostell K, Forslund A, Bergsten P, Bröjer J.
(2023).
Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: A randomized, placebo-controlled, double-blind, study.
J Vet Intern Med, 37(6), 2520-2528.
https://doi.org/10.1111/jvim.16906 Publication
Researcher Affiliations
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
MeSH Terms
- Animals
- Horses
- Canagliflozin / pharmacology
- Blood Glucose
- Insulin / blood
- Hyperinsulinism / drug therapy
- Hyperinsulinism / veterinary
- Horse Diseases / drug therapy
- Triglycerides / blood
- Body Weight
- Male
- Female
Grant Funding
- H-19-47-479 / The Swedish-Norwegian Foundation for Equine Research
Conflict of Interest Statement
Authors declare no conflict of interest.
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Citations
This article has been cited 4 times.- Anger-Håål C, Fjordbakk CT, Ekstrand C, Skedsmo FS, Rørtveit R. Sodium-glucose transporters SGLT1 and SGLT2 in equine renal, hepatic and pancreatic tissue. BMC Vet Res 2025 Dec 17;22(1):36.
- Thane K, Voth R, Klee R, Warnken T, Chukwu V, Frank N. Effects of the Sodium-Glucose Cotransporter-2 Inhibitor Velagliflozin on Insulin Concentrations in Horses With Insulin Dysregulation. J Vet Intern Med 2025 Nov-Dec;39(6):e70256.
- Michanek P, Bröjer J, Lilliehöök I, Fjordbakk CT, Löwgren M, Hedeland M, Bergquist J, Ekstrand C. Pharmacokinetics and Alterations in Glucose and Insulin Levels After a Single Dose of Canagliflozin in Healthy Icelandic Horses. J Vet Pharmacol Ther 2025 Jan;48 Suppl 1(Suppl 1):41-49.
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