Re: Advise on giving Metformin
Eleanor Kellon, VMD
I have to retract the statement about no Invokana failures. Working with a horse now that had a dramatic improvement in hoof comfort but first retest of insulin and glucose not good. Staying the course for another month to see what happens.
It's typically very difficult to get EMS horses all the way back to normal (12 uIU or less on a low S+S diet) without exercise. The goal is to get them out of the danger zone for active laminitis pain which usually means in the 20s, maybe low 30s.
Metformin also has activity against neuropathic pain, which is an issue in some chronic cases. There are horses that have lost the drop in insulin but still were getting pain relief from metformin.
Eleanor in PA