Unresponsive insulin resistance


Nicole
 

Strawberry’s insulin came back >200 again from her 9/3 bloodwork. Her ACTH was 34 I think, but I don’t have the report yet. She is worse today and has started laying down more. Nothing seems to help. She is on 9.5 tabs Metformin twice a day, planning to retest insulin in a couple weeks to see if there is any affect. Is there an info sheet on Invokana? Is that the only other option and are there many people using it with success, or is it too high of risk.  Are some ponies (or horses) just never able to bring their insulin back down? If she doesn’t get some relief soon I can’t keep her going like this. 

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Nicole P
2021, Minnesota 

Case History: Strawberry Case History

Photo album: Strawberry Photo Album


Eleanor Kellon, VMD
 

Nicole,

I have quite a bit of background information on Invokana that I will send directly to your vet if you want to try it. Yes, there are many people using it with success and hopefully they will read your message. I'm not sure what you mean by risk. Some horses have had elevations in triglyceride levels but that has been manageable with diet.
Before trying it you need a blood chemistry run and triglyceride levels as a baseline.  You will need to get some urinalysis dipsticks to follow her urine glucose in response to the Invokana.

--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nicole
 

Hi Dr Kellon,

I sent you a private message with my vet’s email so you could send that info, thanks. 
I didn’t know if it was really “approved” yet for standard use or widely used, so I just figured there were some risks or something, that’s all. Is it really expensive, and does it become a regular maintenance drug they stay on or is it just taken until they get to a good insulin number? 
--
Nicole P
2021, Minnesota 

Case History: Strawberry Case History

Photo album: Strawberry Photo Album


Eleanor Kellon, VMD
 

Hi Nicole,

It is a new drug with no equine FDA approval and that's why the suggested testing before and after starting is extensive. It's very expensive if you buy it from a US pharmacy, even with the discount codes, but much more manageable if you use a Canadian pharmacy. It doesn't cure anything so yes, they stay on it unless there is a change in management like a significant increase in exercise but you may be able to lower the dose.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


LJ Friedman
 

Your horse is the ideal candidate for invokana. It’s the same principle as humans taking insulin. They must take it and they must always take it. Keep in mind that the major manufacturer of horse  medication  prascend etc,  BI, will probably soon come out with a medicine in the US similar to Invokana . So you will be ahead of the curve by getting this from Canada.  best to get it done. Any owner with an  >200 insulin horse( next test  .  ask vet to request the exact nunber if >200) should try this.  success is soon approaching!!  good luck 
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Nicole
 

LJ, 
What do you mean when you say "ask vet to request exact number if >200"... You can do that?!? Why wouldn't they just tell you that in the first place! So if the vet asks Cornell, they can get an exact number?
--
Nicole P
2021, Minnesota 

Case History: Strawberry Case History

Photo album: Strawberry Photo Album


Eleanor Kellon, VMD
 
Edited

They can get you an exact number by diluting the sample before running it.  For example, if it's diluted in half and the result is 150, the result is 300. This can be helpful when tracking response to treatment but all assays lose some accuracy at the upper end of the spectrum so don't get too hung up on the number.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001