14/11/2025
A common (and concerning) trend I’m seeing more and more on social media involves horse owners whose horses have been prescribed a short “course of ertugliflozin.”
These conversations and comments often start the same way: the medication was given for a short period, things improved briefly, and then the horse “relapsed” and the drug was restarted.
It’s as though insulin dysregulation is a switch that can simply be turned on or off.
It’s not.
Insulin dysregulation in horses is a complex, chronic condition that affects multiple metabolic pathways. Sudden or abrupt withdrawal of SGLT2 inhibitors (like ertugliflozin) can sometimes lead to a rapid increase in insulin concentrations — and in some cases, worsening lamellar damage in horses who still require time to recover. These horses often need weeks to months for their lamellar tissues to fully heal, even after clinical signs improve.
Yo-yoing horses on and off these medications based on how they appear day-to-day — or keeping them on indefinitely without proper oversight — is a misguided approach that often causes more harm than benefit.
Don’t do it!
▪️ Diet and Farriery: The Major Part of the Equation
SGLT2 inhibitors are powerful tools, but they are not standalone treatments.
For meaningful recovery from laminitis, these medications must be used alongside appropriate dietary management and expert foot care.
Every horse is different. Dietary recommendations must be tailored to the individual’s breed, body condition, management system, and medical history. It’s important to put the right dietary measures in place to help reduce the risk of preventable side effects while using these medications.
At the same time, collaboration with skilled farriers remains vital. Corrective trimming, sole support, and regular reassessment ensure that the metabolic progress achieved with medication translates to structural stability and comfort at the hoof level.
▪️Start with the Basics: Baseline Bloodwork
Before starting treatment, baseline blood tests are essential not optional. They provide critical information about liver and kidney markers and allow us to detect potential side effects early. You need to know what you’re starting with before you can treat safely.
▫️ SGLT2 inhibitors have been a genuine game changer in equine medicine.
They can dramatically improve insulin concentrations, promote recovery, and give laminitic horses a chance at a normal life again.
But their safety and success depend entirely on the advice, monitoring, and management that surround their use.
When prescribed thoughtfully (with dietary guidance, regular bloodwork, and coordinated farriery) these medications can transform outcomes and prevent unnecessary suffering.
🩺 If you would like a more tailored plan to help your horse recover from laminitis or practical advice to help prevent recurrent episodes contact us on 0427 072 095 or book an appointment online: https://avonridgeequine.com.au/book-an-appointment/
