A newly published study has explored whether a drug already being used in horses with insulin dysregulation could help reduce the rise in insulin seen after intra-articular corticosteroid injections, a response that can increase the risk of laminitis.
Intra-articular corticosteroids, such as triamcinolone acetonide, are commonly used to manage joint inflammation, but they are known to trigger hyperinsulinemia in some horses. This is of particular concern for animals at risk of laminitis.
The study investigated whether treatment with the sodium glucose cotransporter 2 inhibitor ertugliflozin could blunt this insulin response. Using a prospective, controlled cross-over design, eight metabolically normal geldings received intra-articular triamcinolone either with or without ertugliflozin treatment given for seven days before and after the injection.
What the researchers found
Horses treated with ertugliflozin showed significantly lower insulin concentrations following corticosteroid administration, including reduced insulin responses during oral sugar testing. Resting glucose and insulin levels were also lower at multiple time points in the ertugliflozin-treated group compared with controls.
Why this matters
Hyperinsulinemia following joint steroid injections is a recognised risk factor for laminitis, particularly in horses with insulin dysregulation. Although this study was carried out in metabolically normal horses, the findings suggest that ertugliflozin may help mitigate these metabolic effects.
The authors conclude that further research is needed in insulin dysregulated horses, where this approach could potentially reduce laminitis risk associated with intra-articular corticosteroid use.
The study was published in the Equine Veterinary Journal, and adds to the growing body of research aimed at improving the safety of commonly used treatments in horses.
