Received: 18 September 2023 | Accepted: 8 November 2023 DOI: 10.1111/eve.13924
OR IG INA L A R T I C L E
Oral sugar test responses to ertugliflozin in ten horses with insulin dysregulation
Tania Sundra 1,2 | Gabriele Rossi 2 | Erin Kelty 3 | Guy Lester 4 | David Rendle 5
1 Avon Ridge Equine Veterinary Services , Brigadoon , Western Australia , Australia 2 School of Veterinary Medicine , Murdoch University , Murdoch , Western Australia , Australia 3 School of Population and Global Health , The University of Western Australia , Crawley , Western Australia , Australia 4 Equiimed , Perth , Western Australia , Australia 5 EMT Consulting , Tiverton, Devon , UK
Correspondence: Tania Sundra Email:
info@avonridgeequine.com.au
Summary Background : Preliminary evidence indicates that ertugliflozin benefits horses and ponies (hereafter collectively referred to as horses) with hyperinsulinaemia and hyperinsulinae- mia-associated laminitis. The effects of ertugliflozin on the results of the oral sugar test used widely in the assessment of insulin dysregulation (ID), have not been reported. Objectives : To report the effects of ertugliflozin on responses to the oral sugar test (OST) in horses with ID. Study design : Retrospective case series. Methods : Clinical records were reviewed to identify horses with ID that had an OST (0.45 mL/kg Karo-Light PO) performed before and after 4 days of treatment with 0.05 mg/ kg ertugliflozin PO s.i.d. Pre- and post-treatment insulin concentrations were compared using Wilcoxon sign-ranked tests. Results : Ten horses with ID met the inclusion criteria. Significant reductions in plasma insulin concentration were identified at all time points after 4 days of treatment with ertugliflozin relative to pre-treatment values. At T0 (prior to oral sugar), median insulin concentration reduced from 22.4 μu/mL (IQR: 6.5, 39) pre-treatment to 4.8 μu/mL (IQR: 3.7, 9.2) at day 4 ( p = 0.004). At T60 (60 min after oral sugar), median insulin concentration was 165 μu/mL (IQR: 61.2, 222) pre-treatment and 78.1 μu/mL (IQR: 30.5, 137) at day 4 ( p = 0.004). At T90 (90 min after oral sugar), median insulin concentration was 170 μu/ mL (IQR: 88.6, 269) pre-treatment and 84.7 μu/mL (IQR: 28.7, 122) at day 4 ( p = 0.002). Serum triglyceride concentration increased from a median of 0.4 mmol/L (IQR: 0.2, 0.8) pre-treatment to 0.9 mmol/L (IQR: 0.6, 2) at day 4 of ertugliflozin treatment ( p = 0.006). Main limitations : A small heterogenous group of horses and ponies, some with PPID, were used in the absence of a control group. Conclusions : Four daily doses of ertugliflozin at 0.05 mg/kg was associated with lower- ing of insulin concentrations at baseline and in response to an OST in horses with ID; however, insulin levels did not return to normal in all horses. Increases in triglyceride concentrations were also observed.
K E YWORDS horse , endocrine , equine metabolic syndrome , laminitis , obesity , sodium-glucose cotransporter 2 inhibitor
The study was performed at Avon Ridge Equine Veterinary Services.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. Equine Veterinary Education published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Equine Vet Educ. 2024;36:317–324.
aaep.org/wiley-redirect | 317
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