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Peer-reviewed veterinary case report

Effect of Phenylbutazone Administration on Insulin Sensitivity in Horses With Insulin Dysregulation.

Journal:
Journal of veterinary internal medicine
Year:
2025
Authors:
Kemp, Kate L et al.
Affiliation:
School of Veterinary Science · Australia
Species:
horse

Abstract

BACKGROUND: Phenylbutazone is prescribed to manage pain caused by hyperinsulinemia-associated laminitis. Phenylbutazone reduces glucose and insulin concentrations in horses with insulin dysregulation (ID) but the underlying mechanism of action is unknown. HYPOTHESIS/OBJECTIVES: Investigate the effect of phenylbutazone on tissue insulin sensitivity in horses. It is hypothesized that the reduced glucose and insulin concentrations in horses with ID receiving phenylbutazone are mediated by a higher tissue insulin sensitivity. ANIMALS: Fifteen light breed horses, including seven with ID. METHODS: Randomized cross-over study. Horses underwent a modified frequently sampled intravenous glucose tolerance test (mFSIGTT) after 8&#x2009;days of treatment with phenylbutazone (4.4&#x2009;mg/kg IV daily) or placebo (5&#x2009;mL 0.9% saline IV daily). After a 10-day washout period, horses received the alternative treatment for 8&#x2009;days and a second mFSIGTT. Minimal model analysis was performed, and the effects of ID status and phenylbutazone were investigated with p&#x2009;<&#x2009;0.05 considered significant. RESULTS: In horses with ID, phenylbutazone increased tissue insulin sensitivity index (median [interquartile range]: 0.39 [0.14-0.74] vs. 0.56 [0.55-1.18] &#xd7;10L/mIU/min, p&#x2009;=&#x2009;0.03), and decreased glucose (21&#x2009;726 [19&#x2009;040-24&#x2009;948] vs. 22&#x2009;909 [22&#x2009;496-26&#x2009;166] mg/dL&#x2009;&#xd7;&#x2009;min, p&#x2009;=&#x2009;0.02) and insulin (19&#x2009;595 [16&#x2009;147-29&#x2009;698] vs. 22&#x2009;752 [20&#x2009;578-31&#x2009;826] &#x3bc;IU/mL&#x2009;&#xd7;&#x2009;min, p&#x2009;=&#x2009;0.03) areas under the curves. No effect was detected in horses administered placebo. CONCLUSION AND CLINICAL IMPORTANCE: Phenylbutazone reduces insulin concentration in horses with ID by modulating tissue insulin sensitivity, suggesting that its relevance in the management of ID can extend beyond laminitis-associated pain.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/40011055/