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Increased Insulin/Nuzu Stabul One/Metformin


 

We recently tested insulin , glucose, and acth on my IR/Cushings senior pony Joey...all was in normal ranges except insulin was 118. Joey’s feed and turnout has been the same for quite some time-dry lot with tested low sugar Timothy hay, scoop of soaked Ontario Dehy Timothy Balance Cubes, 1 cup Triple Crown Naturals Golden Ground Flax, ~1 lb Nuzu Stabul One, 1 scoop Elevate Vitamin E am/pm. We started adding in the Nuzu several months ago because he was looking a little thin and needed some taste tempting to eat his balance cubes. Joey had been on 12 Metformin am/pm, 1scoop thyro L, Equioxx and Gabapentin , and 1 Prascend for awhile but he was weaned off the Equioxx ,Gabapentin and Thyro L for at least 2-3 months now, and was just on 12 Metformin am/pm. Since the bloodwork my vet had me increase the Metformin to 20 am/pm, add back 1/2 scoop thyro L. Since doing so it seems that his appetite is decreasing ..,does Metformin do that? He had normal appetite or at least better when he was on the 12 Metformin ...Prascend has remained the same at 1 full tablet...I’m also worried that being back on the Thyro is going to make him too thin again...and my other question is would the addition of the Nuzu have possibly caused the increase in his insulin ?or can the cold weather cause that? Joey is sound and doing well otherwise! My daughter continues to ride him occasionally so he’s even getting some exercise!
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Michele Goldberg
Bernville, Pa 
joined 5/19/2016


Eleanor Kellon, VMD
 

Thyroid supplementation does not improve insulin sensitivity. https://trace.tennessee.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=2019&context=utk_graddiss

It's common for metformin to lose sensitivity over time but cold weather may also be influencing the insulin.

Many have reported mouth ulcers with metformin. That could influence his desire to eat.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Ok so I will stop the thyro l then since it’s not effective for insulin sensitivity ...as for the Metformin he has tolerated 12 tabs am/pm for awhile now ...maybe now that dose has been increased to 20 it’s bothering his mouth? I will have to check but so far he’s never had any mouth issues with it.


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Michele Goldberg
Bernville, Pa
joined 5/19/2016


Amadadelsol@...
 

While my girl was on Metformin I had the vet check her mouth very often for ulcers (we did a lot of frequent ACTH/insulin testing) and she never had ulcers but her appetite was terrible. She looked like a zombie, her personality was dull and she wouldn’t eat anything (including her supplements that balanced her hay) except hay. Once we stopped getting decent results with lowering her insulin and I removed it, I had my horse back. Just my experience. 
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Pat and Frigga
Monkton, VT
2020
https://ecir.groups.io/g/CaseHistory/album?id=252741  

https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Frigga


Eleanor Kellon, VMD
 

I  stand corrected that metformin does not directly suppress appetite. In humans, it doesn't always  have that effect but  does often enough that it is being considered a possible weight loss drug.  Digestive  upset is also very common.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Hmm ok ..would you suggest dropping back down to what he was on at 12 tabs? ...or is it even not useful to continue doing that beings that his level was high? I think I remember you saying it loses effectiveness after awhile ?? Is there another alternative to try? My vet suggested Insulin Wise but he’s super picky about eating , it’s expensive ,and I think I remember you also mentioning that it’s not effective either.


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Michele Goldberg
Bernville, Pa
joined 5/19/2016


 

Hi Pat ..I had a mare on it for only about 10 days and she started refusing to eat and got terrible mouth ulcers and it badly blistered the skin all over her muzzle so we stopped. My little Joey pony has been on 12 tabs twice a day for over a year without any issues ...now he isn’t eating anything :/


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Michele Goldberg
Bernville, Pa
joined 5/19/2016