Background: Hyperinsulinaemia-associated laminitis (HAL) is encountered commonly in equine practice. There are currently no registered medications which specifically target hyperinsulinaemia in horses and ponies. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been demonstrated to limit post-prandial insulin responses and prevent the development of diet-induced laminitis. Objectives:The objective of the study was to evaluate the efficacy of an SGLT2i, ertugliflozin, in the management of hyperinsulinaemia and laminitis. Study design: Retrospective case series.Methods: Medical records of 51 horses and ponies that had presented with laminitis and hyperinsulinaemia and had been treated with oral ertugliflozin at 0.05 mg/kg once daily for a minimum of 30 days were reviewed.Results: After 30 days of treatment with ertugliflozin, there was a reduction in insulin concentrations from a median of >300 μu/ml (IQR: 149, >300) to 43 μu/ml (IQR: 20, 66) (p < 0.001). Modified Obel laminitis scores improved, reducing from a median of 10/12 to 1/12 (p < 0.001). Median serum triglyceride concentrations increased from 0.6 (IQR: 0.4, 0.9) before treatment to 1.4 (IQR: 0.8, 3.7) mmol/L after 30 days of treatment (p < 0.001) before declining, however, none of the horses developed any clinical signs of hyperlipaemia. Ten horses (19%) were reported to have polyuria and polydipsia during treatment, otherwise no adverse clinical effects were identified. Main limitations:The study was limited by the absence of a control group, the retrospective data collection and the short period of follow-up.Conclusions: Ertugliflozin may be effective in reducing insulin concentrations in horses and ponies with equine metabolic syndrome and its use may hasten recovery from laminitis associated with hyperinsulinaemia.

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Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were initially developed as a new class of human antidiabetic medications that lower insulin concentrations, promote weight loss and reduce blood

Background: Equine glandular gastric disease is a highly prevalent disease, for which there is no universally effective treatment. Given the widespread use of esomeprazole in the treatment of peptic ulcer disease in humans, its use in horses warrants further investigation. Objective: To assess rates of healing of equine glandular gastric disease using oral esomeprazole. Study design: Retrospective case series. Methods: Medical records and gastroscopy images of horses diagnosed with equine glandular gastric disease and treated with esomeprazole by Avon Ridge Equine Veterinary Services were reviewed. Results: Out of four horses treated with esomeprazole for 28 days, 75% (three) healed and 25% (one) did not improve. Out of three horses treated with esomeprazole for 14 days, 67% (two) healed and 33% (one) did not improve. Main limitations: The study was limited by its retrospective nature and small sample size. Conclusions: Esomeprazole may be a valid first-line treatment option for equine glandular gastric disease. Larger and more robust studies of esomeprazole are warranted.

BackgroundAn extended‐release injectable omeprazole formulation (ERIO) has become a popular treatment for equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD) where it is available; however, published data are limited and optimal treatment regimens have not been determined.ObjectivesTo compare effects of treatment on ESGD and EGGD when an ERIO formulation is administered at either 5‐ or 7‐day intervals.Study designRetrospective clinical study.MethodsCase records and gastroscopy images of horses with ESGD or EGGD treated with ERIO were reviewed. Images were anonymised and graded by one researcher masked to treatment group. Treatment responses were compared between the two treatment schedules using univariable ordered logistic regression.ResultsForty‐three horses were treated with ERIO at 5‐day intervals and 39 horses at 7‐day intervals. Signalment and presenting signs did not differ between groups. The proportions of horses with EGGD healing (to grade 0 or 1) in association with ERIO used at 5‐day intervals (93%) were higher than associated with treatment at 7‐day intervals (69%; odds ratio [OR]: 2.41, 95% CI: 1.23–4.74, p = 0.01). For ESGD, there was no significant difference in the proportion of horses healing in association with treatment at 5‐day intervals (97%) compared with 7‐day intervals (82%; OR: 2.75, 95% CI: 0.91–8.31, p = 0.07). Four of 328 injections were associated with an injection‐site reaction (1%).Main limitationsRetrospective study design, lack of randomisation and limited case numbers.ConclusionsThe use of ERIO at 5‐day intervals might be more appropriate than the 7‐day interval that is used currently.