Rachael Conwell BVetMed CertEM(IntMed) DipECEIM MRCVS Rachael qualified from the Royal Veterinary College in 1997. Initially working in mixed practice in Wales, she then completed a 3 year residency in equine internal medicine at the University of Liverpool and gained the RCVS Certificate in Equine Internal Medicine. After her specialist training, Rachael worked in first opinion and referral equine practices in Buckinghamshire, Gloucestershire and Yorkshire. After passing the European College specialist examinations, she became a European Specialist in Equine Internal Medicine in 2010. Rachael established EquiMed Referrals Ltd and sees referral cases across the North of the UK.
Metformin may be indicated as a treatment for IR in equids. Further studies are required to define appropriate selection of subjects warranting therapy, dosing schedule and pharmacokinetics.
SummaryReasons for performing study: Metformin is a potential therapeutic agent for the treatment of insulin resistance (IR). In laboratory animals, orally administered metformin reduces intestinal glucose absorption and may therefore affect insulinaemic responses to oral carbohydrate ingestion. Objectives: To determine whether pretreatment with metformin reduces plasma glucose concentration and insulin responses following consumption of dextrose in horses. Study design: Therapeutic cross-over study. Methods: Seven healthy Standardbred and Thoroughbred geldings were subjected to an oral dextrose challenge test on 4 occasions: with and without metformin, before and after induction of IR with dexamethasone. Metformin was administered by nasogastric tube at 30 mg/kg bwt 1 h before administration of dextrose. Glucose and insulin concentrations in plasma/serum were measured at regular intervals during each test. Linear mixed models were specified for each predetermined outcome variable, and for each model the 'treatment' was included as a fixed effect with 4 categorical levels (none, metformin, dexamethasone and dexamethasone with metformin) and horse accounted for as a random effect. Results: In healthy horses, the administration of metformin resulted in a statistically significant reduction in peak glucose concentration (P = 0.002), area under the glucose curve (P<0.001) and insulin concentration 120 min after dextrose administration (P = 0.011). Following the induction of IR, administration of metformin was associated with significant differences in peak glucose concentration (P<0.001), the percentage increase in glucose concentration (P = 0.010), the area under the glucose curve (P<0.001) and insulin concentration at 120 min (P = 0.034) and 150 min after dextrose administration (P = 0.014). Conclusions: Metformin resulted in reduced glycaemic and insulinaemic responses both in healthy horses and in horses with experimentally induced IR. Potential relevance: Metformin may benefit horses with naturally acquired IR by reducing glycaemic and insulinaemic responses to dietary nonstructural carbohydrates. Further investigations into the mechanisms of action of metformin in horses and controlled clinical trials are warranted.
T2DM should be considered as an important differential diagnosis in mature to elderly horses and ponies suffering from weight loss, polydipsia and polyuria. Clinicians should be encouraged to offer treatment and management advice when such cases are encountered.
Foreword This document was commissioned to provide UK veterinary surgeons with up-to-date information on Streptococcus equi infection and to provide practical recommendations for veterinary surgeons in the field. The participants were selected to provide representation from a range of expertise and viewpoints and included practitioners, academics and social scientists. The document and practical recommendations were developed using a modified non-anonymised two-round Delphi process, considering published and unpublished research relating to ‘strangles’ using online discussion. The expert group was convened by UK-Vet Equine and Redwings and an online meeting held on 20th January 2021 with sponsorship from MSD and support from World Horse Welfare. The sponsors did not participate in the meeting and had no influence over editorial content. Each of the panellists was provided with a sub-topic and presented a review of the evidence pertaining to that area prior to taking two rounds of questions relating to the evidence presented. Where research evidence was conflicting or absent, collective expert opinion, based on the experience of the group, was applied. The opinions expressed are the consensus of views expressed by the authors who all approved the final manuscript. Where it was not possible to reach consensus, different viewpoints are presented.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.