Giving Metformin

Q:  My horse has been prescribed Metformin but I am having trouble getting her to eat the tablets.  Any suggestions?

A:  One owner found that crushing Metformin tablets in a coffee grinder then mixing them with a small amount of stevia encouraged her horse to eat the tablets when mixed into her normal feed.  Sugar free peppermints could perhaps also be used.  

Metformin will dissolve in water.  Some owners dissolve it then syringe it into the mouth, either just in water or mixed with apple sauce, sugar free cordial or flavoured yogurt.  Try to keep sugar low!

You might discuss with your vet whether your horse needs to have Metformin.  Metformin is called "exercise in a tablet" by some vets, and may be prescribed if a horse cannot exercise due to laminitis, or if insulin levels are very high.  However, research by David Rendle et al. suggested that any benefit of Metformin may be questionable when  horses are on a low sugar/starch diet (as they should be if they have EMS or a history of laminitis) - see Metformin.  

Here are some tips for encouraging fussy horses to eat mineral supplements in their feed - these may be helpful for disguising medicines too:

• Start by giving a very small amount in a large amount of carrier (e.g. unmolassed chaff/sugar beet), and if that is accepted, gradually increase it up to the recommended amount - a small amount of minerals is better than nothing (however this may not be the case for medicines - check with your vet).
• Keep the carrier (e.g. unmolassed chaff/sugar beet) to mineral ratio low - it seems logical that a horse is more likely to notice 40 g of minerals in 100 g of chaff than in 400 g of chaff.
• Make sure the horse likes everything in the rest of the feed - do a taste test of individual ingredients if necessary.
• Mix the minerals into dry feed before wetting it, to make sure they are well distributed and don't form clumps of yucky tasting minerals when you dampen the feed.  
• Try mixing the minerals into something else, preferably nice-tasting and/or with a strong flavour, first, such as linseed, salt, dried herbs (e.g. mint) or stevia, before adding to the feed. Other possibilities include grated carrot or apple, sugar free apple sauce, low sugar/starch nuts made into a mash with warm water. 
• Try top dressing the bucket with something that the horse will eat - mix the minerals well into the feed, then sprinkle a bit of nice tasting/smelling feed on top of the mixed feed. TLS uses HiFi Molasses Free - this smells of mint and fenugreek and most horses seem to find it appetizing.  Or try grating some carrot or apple on top of the feed - a small amount does not add much sugar to the feed - see Who said "stop the carrots"?
• Try mixing the feed using a fruit tea such as raspberry, mint, cinnamon, apple - find out what your horse likes first.
• Give him plenty of time to eat his bucket feed, ideally with nothing else available for a couple of hours.  Or feed when he is hungry, e.g. first thing in the morning.
• You could try sprinkling the minerals onto damp hay, ideally mixed with the daily salt (again, this may not be suitable for medicines when the full dose needs to be given).

A few more tips:

• Make sure you and your horse remain calm - try to make taking the medicine a fun event, not a stressful one.
• Try introducing a bit of competition - feeding other horses nearby may encourage your horse to eat up. 

More information:
Equine Metabolic Syndrome and insulin dysregulation
Management Strategies for EMS/Insulin Resistance
Diet