Drop in insulin after starting invokana


TERRI JENNINGS
 

Hello,
We have our first insulin results 1month after starting invokana. Finn’s insulin dropped from 152 to 103. Unfortunately his ACTH went up from 25.4 to 35.8. I’m guessing once we get his ACTH lowered his insulin will be lower as well.   I was disappointed when I got the results but I know I need to focus on how Finn is feeling. It’s remarkable how well he’s doing. He was sound on pavement today at the vet’s office. 

I’m just curious if anyone using invokana has seen insulin drop more over longer periods of time.  

Thanks
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


LJ Friedman
 

the goal with invokana  is to drop insulin to normal levels quickly. If I remember correctly with Jesse it was usually over 200 and after the first test while Invokana he dropped to normal levels.
  When his AC TH increased, his insulin levels increased.  AC TH doesn’t  affect insulin levels but it means that the PP ID is not been well controlled, and there are other areas within the pituitary that cause higher insulin when your horse is not well controlled.  . so,  we all need well controlled ppid horses
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


LJ Friedman
 

gee, I feel like I’m a genius with all my knowledge. The truth is I just copy and paste things Dr. kellon has mentioned. And hope that I get it correct. I am a moderator wanna be LOL
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Jennifer Murphy
 

Would the seasonal rise be behind the increase in ACTH, or is it too short a period between tests to determine that?  If it were driven by the seasonal rise, would ACTH remain high after the time period it's generally observed, or would it begin to fall?  (Maybe that's dependent upon the individual equine?)  If the ACTH comes down, would one expect the insulin numbers to then begin to fall rapidly as expected on Invokana?
Trying to understand the mechanics of it all! 

Terri - my vet hasn't been very forthcoming about the Invokana.  Is this something you are administering for the short term, or is this a medication that Finn will probably be on for the rest of his life?  I'm glad to hear he at least feels better! 
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0


Kirsten Rasmussen
 

I think it's safe to say ACTH was higher in Sept than in May due to the seasonal rise.  I suspect when it comes down over the next few months insulin will decrease a little with it, but I don't know if we can say for sure how much because ACTH is not grossly elevated.  However, there is room for a little better control over ACTH with more pergolide so maybe increasing the pergolide a bit (at least for the seasonal rise) will help, too.

Still, it's very good to see that insulin (and glucose!) come down with the Invokana!  And to hear how good Finn is feeling! 

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


TERRI JENNINGS
 

I’m trying to understand it too. Then I can help my vet understand it. 

i have had Finn on invokana for a month and my vet agreed today that Elliott can also go on it. They will likely be on it for life. 


Thanks
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


TERRI JENNINGS
 

Thanks for your genius/copy and pasting LJ. Sharing Jesse’s history helped my vet understand the relationship between insulin and acth better. I’m so happy she’s ready to put Elliott on invokana. My super naughty/annoying/hilarious/sweet and sometimes infuriating pony has not been doing any of his antics for quite some time now. He’s quite miserable. I hope he responds as quickly as Finn did so that he can get back to his old self. 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


TERRI JENNINGS
 

Thanks Kristen, 
I’m more worried about Elliott at this point because he’s feeling so awful. I think it’s safe to say that even when his ACTH comes down he will still be at risk for laminitis. I’m so glad my vet agreed. He starts tomorrow!  
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019