Invokana and Steglatro for EMS and PPID in Horses: Essential Information for Owners

As a horse owner, ensuring the health and well-being of your equine companion is a top priority. Two common endocrine disorders that can affect horses are Equine Metabolic Syndrome (EMS) and Pituitary Pars Intermedia Dysfunction (PPID), also known as Cushing’s disease. Understanding the treatment options available, including medications like Invokana and Steglatro, can help you manage these conditions effectively. Here’s what you need to know about these medications and their use in treating EMS and PPID.

Understanding EMS and PPID

Equine Metabolic Syndrome (EMS): EMS is characterized by obesity, insulin resistance, and an increased risk of laminitis (a painful inflammation of the tissues in the hoof). Horses with EMS tend to accumulate fat deposits in specific areas such as the neck, shoulders, and tailhead. Management of EMS typically includes dietary modifications, weight management, and exercise.

Pituitary Pars Intermedia Dysfunction (PPID): PPID, or Cushing’s disease, is a progressive disorder caused by an overactive pituitary gland, leading to excessive production of hormones, particularly cortisol. Symptoms include a long, curly coat that doesn’t shed, increased thirst and urination, lethargy, and susceptibility to infections and laminitis. Treatment usually involves managing symptoms and hormone levels through medication.

Medications: Invokana and Steglatro

Invokana (Canagliflozin): Invokana is an SGLT2 inhibitor that helps manage blood sugar levels by preventing the kidneys from reabsorbing glucose. While primarily used in humans for diabetes management, there is emerging interest in its potential application for horses with insulin dysregulation, particularly those with EMS.

Steglatro (Ertugliflozin): Similar to Invokana, Steglatro is also an SGLT2 inhibitor used to lower blood glucose levels in humans. Its role in equine medicine is being explored for managing insulin resistance, a key component of EMS and sometimes seen in PPID.

Benefits of Invokana and Steglatro in Horses

1. Improved Insulin Sensitivity:
   • Both Invokana and Steglatro can help improve insulin sensitivity in horses, which is crucial for managing EMS. By reducing the glucose load in the bloodstream, these medications can help lower insulin levels and reduce the risk of laminitis.
2. Potential Weight Management:
   • By managing blood sugar levels more effectively, these medications can aid in weight management, which is a critical component of EMS treatment.
3. Enhanced Quality of Life:
   • Managing the symptoms of EMS and PPID effectively can significantly enhance the quality of life for affected horses, reducing pain and discomfort associated with these conditions.

Considerations for Horse Owners

1. Consult Your Veterinarian:
   • Before considering the use of Invokana or Steglatro for your horse, it is essential to consult with your veterinarian. They can provide guidance based on your horse’s specific condition, medical history, and overall health.
2. Monitor for Side Effects:
   • As with any medication, there may be side effects. Monitoring your horse closely and maintaining regular veterinary check-ups will help manage any adverse reactions and ensure the treatment is effective.
3. Comprehensive Management Plan:
   • Medications should be part of a comprehensive management plan that includes diet, exercise, and regular monitoring. This holistic approach will provide the best outcomes for your horse’s health.
4. Current Research and Trials:
   • The use of Invokana and Steglatro in equine medicine is still relatively new and under research. Staying informed about the latest studies and veterinary recommendations is crucial.

Conclusion

Invokana and Steglatro present promising options for managing insulin resistance in horses with EMS and potentially aiding in the treatment of PPID. While more research is needed to fully understand their benefits and risks, these medications could become valuable tools in the equine healthcare arsenal. Always consult with your veterinarian to determine the best course of action for your horse’s specific needs.

Stay informed, stay proactive, and give your horse the best chance at a healthy, comfortable life.

References

Equine Veterinary Education

Use of the SGLT2 inhibitor canagliflozin for control of refractory equine hyperinsulinemia and laminitis. Open Vet J., 12:511-518. PMID: 36118716