Question:

I have many friends who have taken GLP-1 drugs, like Ozempic, to control diabetes and/or combat obesity. The results have been life-changing for many of them. Some have lost between 30 and 40 pounds.  Are there any medications like that for horses? Could a drug like Ozempic potentially help insulin-sensitive horses at risk of obesity and associated laminitis? 

Answer:

This is a very good question. Ozempic mimics the effects of glucagon-like peptide-1 (GLP-1), a natural hormone that helps the body regulate blood sugar and appetite. Although GLP-1 drugs are being used successfully in people, none have been developed for use in horses to date. Perhaps they will be one day. But a lot of research would be required to determine the right formulation and correct dose—and to make sure that horses do not develop side effects.

Diet and exercise remain the best strategies for managing obesity in horses. For tough cases, however, a veterinarian may prescribe the synthetic thyroid hormone levothyroxine—which stimulates metabolism— at higher dosage level for three to six months to induce weight loss.

In other cases where horses have high blood insulin concentrations (hyperinsulinemia) and do not respond to diet and exercise strategies—we are also prescribing a new class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. Horses with hyper- insulinemia are the ones you are referring to in your question, and they are more likely to be insulin resistant.

The SGLT2 inhibitors lower insulin concentrations in the bloodstream by causing horses to excrete more glucose in their urine. These drugs are administered with the intention of preventing hyperinsulinemia-associated laminitis (also known as founder), which can damage the internal hoof structures. There is still much to learn about the use of SGLT2 inhibitors in horses, and research in this area is currently underway.

Nicholas Frank, DVM, PhD, DACVIM
Mississippi State University
Starkville, Mississippi