Ten laminitic horses with hyperinsulinemia refractory to diet control, metformin, levothyroxine and pergolide (if diagnosed with PPID) were treated with the sodium-glucose cotransporter-2 inhibitor canagliflozin (Invokana®). Nine horses were hyperglycemic (>5.5 mmol/L) or had a history of hyperglycemia. Prior to instituting therapy, renal function was assessed by determining serum creatinine and blood urea nitrogen concentrations. Canagliflozin was administered orally once a day, with food. Dipstick urinalysis was performed every 2 wk to confirm glucosuria and screen for proteinuria. Owners were also instructed regarding clinical signs consistent with urinary tract infection. All horses responded with a substantial decrease in serum insulin concentrations to normal or near normal values. Laminitis pain resolved in all cases, with regression of fat deposits. Owner satisfaction with outcomes was 100%.
Key words: horses refractory hyperinsulinemia laminitis canagliflozin
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