Sodium-glucose cotransporter 2 inhibitors in horses-Magic bullet or latest fad?
Abstract: No abstract available
Publication Date: 2023-05-15 PubMed ID: 37190880DOI: 10.1111/evj.13944Google Scholar: Lookup
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Summary
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This research study focuses on the application and effectiveness of Sodium-glucose cotransporter 2 inhibitors (SGLT2i) in treating hyperinsulinaemia-associated laminitis (HAL) in horses.
Introduction and Background
- SGLT2 inhibitors like Canagliflozin, Dapagliflozin, Empagliflozin, and Ertugliflozin, widely used as human antidiabetic medications, primarily work to lower insulin concentration, promote weight loss, and reduce blood pressure.
- These drugs block the absorption of glucose in the kidneys, thus promoting urinary glucose excretion, lowering plasma glucose levels, and reducing the insulin secretion stimulus from the pancreas.
- This study examines their use in equine practice as the drugs are increasingly being used today as prevention and treatment of hyperinsulinaemia-associated laminitis in horses with equine metabolic syndrome.
Challenges and Concerns
- The research highlights the need for caution when extrapolating findings from one species to another due to unique biological variations.
- The challenge in managing laminitis, majorly caused by high insulin concentration, is further complicated by horse owners’ hesitation to limit access to pasture or forage on their horse-human bond’s grounds, leading to poor compliance with veterinary recommendations.
- There’s a pressing need for safe and effective treatments for HAL as the condition, largely preventable, leads to unacceptable levels of morbidity and mortality.
Results and Potential Outcomes
- Experimental studies have demonstrated that drugs like velagliflozin can help lower insulin concentrations and prevent laminitis development in horses with high non-structural carbohydrate diets.
- In a retrospective case study of 51 horses with HAL, administration of ertugliflozin for 30 days resulted in a significant reduction in insulin concentration and noticeable improvement in laminitis-associated lameness, and it allowed stopping non-steroidal anti-inflammatory (NSAID) treatment in almost all cases within 2 weeks.
- Similarly, canagliflozin showed promising results with reduced insulin concentration and resolution of lameness in horses suffering from refractory hyperinsulinaemia and laminitis.
Use in Managing Equine Obesity
- SGLT2i may also prove valuable in managing equine obesity where diet adjustment alone has proved inadequate.
- Horses treated with ertugliflozin revealed significant weight loss after 30 days, with a median reduction of 6% body weight over the period.
- However, pharmaceuticals should not be considered a substitute for dietary management, and horse owners should always maintain dietary restrictions when using SGLT2i.
The study recognizes the limits of the research, including the absence of control groups, small sample sizes, and reliance on retrospective data. Despite these constraints, the article points to the potentially transformative impact of SGLT2i in treating laminitis and obesity in horses.
Cite This Article
APA
Sundra T, Lester G, Rossi G, Rendle D.
(2023).
Sodium-glucose cotransporter 2 inhibitors in horses-Magic bullet or latest fad?
Equine Vet J, 55(4), 559-562.
https://doi.org/10.1111/evj.13944 Publication
Researcher Affiliations
- Avon Ridge Equine Veterinary Services, Brigadoon, Western Australia, Australia.
- Equiimed, Perth, Western Australia, Australia.
- School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, Western Australia, Australia.
- EMT Consulting, Tiverton, Devon, UK.
MeSH Terms
- Horses
- Animals
- Hyperinsulinism / veterinary
- Insulin Resistance
- Glucose
- Sodium
- Horse Diseases / drug therapy
- Foot Diseases / veterinary
- Insulin
- Inflammation / veterinary
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