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Metformin duration
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Nancy & Dot
I am slowly working my way through the vast amount of information ECIR provides, particularly past conference documents. In the 2017 Acute Care for Endocrinopathic Laminitis report by Dr K she says to discontinue metformin after 4 to 6 weeks. I know from my own experience that effectiveness wanes, but if it is working is there any harm in continuing?
The first time we used metformin was prior to Dot’s acute laminitis event. My vet added it based on insulin levels. We gave it for 5 months and while the insulin did decrease before rising again, it was never within limits. Looking back, Dot’s insulin has been high since 2018 and 3 different vets were not alarmed so neither was I. I started it again on 3/13/23 to buy some time while I work with my vet to convince him to do additional testing regards his high liver enzymes. We have also been able to add more exercise due to weather improvement and Dot’s comfort. He will be retested on 4/7/23. As of now I have not added Thyro-L back in, despite my vet’s recommendation. The new case history is up to date. Immense gratitude to all of the moderators for your patience as I continued to learn. Nancy O, Elbert County, CO, 2022 |
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There is no harm in continuing if it is working for you. Some have found it helps with hoof pain even when it's not controlling insulin. This has been noted in human chronic pain states https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538784/ .
-- Eleanor in PA www.drkellon.com |
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Kimberly
Is there a school of thought as to how long to leave on Metformin that is more current than 2017? It seems to be helping Mouse as his pulses are gone and he seems much more comfortable. He started Metformin 2/16/23. He is sound at the walk and trot going left and slightly off going right (if you did not know how lame he had been you would'nt see the occasional off step). The vet cleared him for a few minutes of walking under saddle in the arena. He has adjusted well to the Metformin and we are in the process of tapering Prascend so he can be tested for PPID. I am trying not to rock his boat. Thanks for any input.
-- Kimberly joined 7.17.2018 Virginia https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse https://ecir.groups.io/g/CaseHistory/album?id=275222 https://ch.ecirhorse.org/case-history.php?id=105 https://ecirhorse.org/case-history.php?id=106 |
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Sherry Morse
Hi Kimberly, If it's working for Mouse (have you had his insulin checked since he's been on it?) there's no reason to stop using it and at this point I'd definitely leave him on it until you test his ACTH and make a determination if he needs to be on Prascend or not.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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There's no reason to stop if it's helping him and no reason to think he won't go back to laminitic again without it unless he has a significant increase in his exercise. It can also have effects on chronic pain. See message 289761 from yesterday.
-- Eleanor in PA www.drkellon.com |
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Kimberly
Thanks very much. Reading the article reaffirms for me that he may have neuropathic pain. We did test him and insulin was 58 down from 136 in Nov. We will test again when we are off Prascend. Thank you for the input. It is greatly appreciated. We will continue to increase exercise as he can handle more.
-- Kimberly joined 7.17.2018 Virginia https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse https://ecir.groups.io/g/CaseHistory/album?id=275222 https://ch.ecirhorse.org/case-history.php?id=105 https://ecirhorse.org/case-history.php?id=106 |
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