metformin dosage


vicky monen
 

Hi,

Can I ask what is the dosage for metformin for a 1000lb horse?

My vet gave me the following prescription and it sounds like alot to me.

my vet  "He’ll get 30 (500mg) tablets twice daily for 30 days. I put in 6 refills"

Under the metformin info under the files here, it suggests 
"The Metformin dose in horses is 30 mg/kg, twice daily, for a total of 60 mg/kg/day. After one week, retest insulin and glucose."

I just got his newest labs back and his Insulin is steadily increasing.  It is now at

ACTH Baseline Equine 8.53 pg/mL 2 - 35
Insulin Baseline Equine 91.26 uIU/ml 10 - 40

I obviously  have to add the metformin as his diet is very tight.  No grass, weighed low starch and sugar hay in ultra slow feed nets, rationed out 4 feedings through the day.  He has lost weight and definitely looks thinner than ever.  Hay is at 4.7% for the past few months now new hay is 5.2%. 

Prascend is at 2 mg per day at 1 xday.

I will add the metformin in hopes that it will help with the insulin.  Is this something he will need indefinitely, or until the insulin comes back down? He is super sensitive with any changes in diet, hay, medications, supplements, is there anything else to add with the metformin other than milk of magnesia? How much of milk of magnesia does he need?  He is also currently on omeprozole due to GI upset and diarrhea lately. 

Currently he shows no outward signs or symptoms that his pracend is not sufficient. 

Thank you for any suggestions. 
--
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

https://ecir.groups.io/g/CaseHistory/album?id=1226

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson


Maxine McArthur
 

Hi Vicky
If we calculate 1000lbs to be 500kg, your vet is suggesting exactly the dose that ECIR recommends. 

30mg per kg of 500kg bodyweight = 15,000mg.
30 x 500ng tablets = 15,000mg. 

Twice daily.

 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


vicky monen
 

Is this something he will need indefinitely, or until the insulin comes back down? He is super sensitive with any changes in diet, hay, medications, supplements, is there anything else to add with the metformin other than milk of magnesia? How much of milk of magnesia does he need?  He is also currently on omeprozole due to GI upset and diarrhea lately.
--
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

https://ecir.groups.io/g/CaseHistory/album?id=1226

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson


 

Hi, Vicky. when I used milk of magnesia, it took about 20-30 ml to dissolve that same dose of ground metformin. An important detail is to check insulin labs again quickly, within a week if you can manage. Not all equines respond to metformin. No reason to continue syringing it twice a day if it doesn’t reduce insulin. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Mary Kane
 

I started my mare Dawn on metformin three weeks ago. 15 of 1000m pills twice a day. I feed 3 x a day. When my vet came to take blood and xrays after two weeks, he said she should take the metformin 30 minutes before each of the 3 meals she gets, so half again more per day. Is this correct? 
Mary and Dawn

--
Mary Kane
Maple Valley WA
2019


Eleanor Kellon, VMD
 

There are some vets using it 3 times a day but there is no good research to show this does any good. Taking metformin on an empty stomach  may improve bioavailabilility but it increases risk of GI side effects in people. Horses rarely have an empty stomach.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001