High insulin levels in the blood, called hyperinsulinemia, is commonly associated with endocrine-related laminitis. Australian researchers recently published a case series describing the use of a new drug, ertugliflozin, to treat hyperinsulinemia and the laminitis that often accompanies it.

They reviewed the medical records of 51 horses that presented with laminitis, were diagnosed with hyperinsulinemia and failed to respond to conservative treatment including diet and management changes for 6 weeks.

After 30 days of treatment with ertugliflozin, there was a significant 10-fold decrease in insulin concentration from a median value of over 300 international unit per milliliter (µu/ml) to 43µu/ml. There was a similarly significant and substantial improvement in modified Obel laminitis scores from a median of 10/12 to 1/12. Ten horses (20%) drank and urinated more than usual while on the medication and there was also a transient increase in serum triglycerides; however, none developed clinical hyperlipidemia or other adverse clinical effects.

While not a randomized, controlled trial, this study suggests that ertugliflozin may be an effective treatment for endocrine-related laminitis characterized by hyperinsulinemia.

— Sundra T et al. EVE 2022;13738