06/12/2025
We test for metabolic syndrome daily, and have managed a large number of horses now with Ertugliflozin treatment. If you have heard Dr. Ethan talk about this drug, you may have heard him call it “the sugar tablet” for simplicity, but you’ve probably also heard him say that this medication is one of the best drugs to ever be created for horses.
In the war against EMS and metabolic laminitis, we now have a weapon in our back pocket that truly turns the tide, and means with the combination of diet, podiatry by Dr Ethan or the network of farriers we consult to, and the use of Ertugliflozin, we now often can stop these processes in their tracks, as we certainly save a lot of lives.
As with all medications there are some risks, but as the data increases we can see the the risk of adverse events is minute, rare and largely non-clinically apparent (we see changes on blood but not in the horse)
This drug has been particularly good as a preventative in times like these where the grass is at peak growth and blood sugars are at their most variable.
This is not a long term drug either! We find that just one month is usually enough in most horses as acute treatment or preventative. The lasting potential to increase insulin sensitivity is still under debate, but we find that some horses show maintained response to sugar even after cessation of treatment.
🔗: https://equimanagement.com/research-medical/research/updates-on-sglt2-inhibitors-for-horses/
Pharmacological intervention might be necessary for some horses with equine metabolic syndrome. SGLT2 inhibitors work by blocking the kidneys’ proximal convoluted tubules to increase blood glucose secretion into urine, which helps reduce circulating insulin concentrations.
In a horse owner survey of SGLT2 inhibitors, 342 respondents used ertugliflozin. Many of the horses received treatment for 3 to 12 months, with 85% improved, 9% unchanged, and 5% deteriorated. All respondents noted that laminitis pain improved within 30 days.