Metformin mouth sores


Anna.warzecha4@...
 

At first Joker was eating the Metformin in his feed for about 2 weeks. He did not have sores when metformin was mixed in his with his supplements. Then he stopped eating eat and I had to syringe it to him. I have been syringing it for a week mixed with milk of magnesia. He now has sores on his inner lip and bad cracked and peeling lips on the side that I syringe it to him. 

How can I avoid the mouth sores and cracked lips? 

I also just  got test results back and his insulin is down from 133 to 40 now that he is on the Metformin. In addition his crest has shown a significant change from it being too thick before and now back to a normal softer and thinner crest after being on the Metformin. I was so surprised at how quickly his crest changed. 

My vet has also suggested that I could use steglatro instead of metformin since it is one pill once a day that I could put in a gel capsule and just add it in his feed. I would love feed back on this alternative. 
--
Anna Warzecha, MI, 2022

Joker (IR), Coco (PPID, IR)
https://ecir.groups.io/g/CaseHistory/files/Anna%20Warzecha:%20Joker%20%28IR%29,%20Coco%20%28PPID%29


Anna.warzecha4@...
 

Joker gets 5 oz of stabul 1 mixed in with about 7-9 oz of other pellet supplements. He also has Jiaogulan and a powdered immune herb. He its this great with 1 oz of cocosoya oil. I have really tried to limit the amount of stabul he gets to keep his insulin down as much as possible. I am wondering if it would be worth  increasing his stabul 1 to something more signicant that would make him eat the Metformin in his feed. How much stabul 1 can I give him wothout it being problematic?
--
Anna Warzecha, MI, 2022

Joker (IR), Coco (PPID, IR)
https://ecir.groups.io/g/CaseHistory/files/Anna%20Warzecha:%20Joker%20%28IR%29,%20Coco%20%28PPID%29


Anna.warzecha4@...
 

If his diet was already as controlled and low as I can get it, and the Metformin has made a significant improvement won't he need to stay on it "forever"? What do I do with the fact that the Metformin becomes less effective and is supposed to be for short term use. Will he eventually need to be switched over to steglatro? 
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Anna Warzecha, MI, 2022

Joker (IR), Coco (PPID, IR)
https://ecir.groups.io/g/CaseHistory/files/Anna%20Warzecha:%20Joker%20%28IR%29,%20Coco%20%28PPID%29


Eleanor Kellon, VMD
 

He will need to stay on it unless you institute a vigorous exercise program. If that's not possible and the metformin stops working (it doesn't always), you may need to switch to another drug if all other factors are well controlled.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Eleanor Kellon, VMD
 

The lips can be protected with Vaseline before you dose. For mouth sores, rinse his mouth thoroughly with water after you dose him and make sure he has something to eat right away.

Steglatro costs considerably more and comes with triglyceride problems.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Anna.warzecha4@...
 

Thanks Dr. Kellon! I will plan on him staying on the Metformin. Do you have any suggestions about the possibility of adding more stabul to get him to eat the Metformin in his feed or suggestions on what to do with the syringed metformin causing sores and chapped lips? 
--
Anna Warzecha, MI, 2022

Joker (IR), Coco (PPID, IR)
https://ecir.groups.io/g/CaseHistory/files/Anna%20Warzecha:%20Joker%20%28IR%29,%20Coco%20%28PPID%29


Eleanor Kellon, VMD
 

You can certainly try a larger meal to see if he will eat it then. That has worked for other horses. Also see if you can get some timothy balance cubes from Triple Crown or directly from an Ontario Dehy distributor.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Lesley Bludworth
 

I use the soaked tc balance cubes as the carrier for metformin and all her supplements.
1 lb. To the 13 ground pills.
If she doesn't eat it all, due to other stuff I've added, I soak a few more cubes and add it to whats left and she licks it clean.
She won't eat grain and I'm not sure her insulin levels would be as good.
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749