ABSTRACT OF THE WEEK

Journal of veterinary internal medicine/ American College of Veterinary Internal Medicine
Volume 38 | Issue 4 (2024 Jul-Aug)

Efficacy and safety of once daily oral administration of sodium-glucose cotransporter-2 inhibitor velagliflozin compared with twice daily insulin injection in diabetic cats.

J Vet Intern Med. 2024 Jul-Aug;38(4):2099 - 2119.

Stijn J M Niessen¹, Hans S Kooistra², Yaiza Forcada³, Charlotte R Bjørnvad⁴, Balazs Albrecht⁵, Franziska Roessner⁶, Esther Herberich⁷, Carla Kroh⁸

¹ Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands.; ² Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.; ³ Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands.; ⁴ Bjørnvad Consultancy, Vedbæk, Denmark.; ⁵ Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.; ⁶ Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.; ⁷ Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.; ⁸ Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.

Abstract

BACKGROUND:Options for treatment of diabetes mellitus in cats are limited to insulin injections and monitoring for hypoglycemia.

HYPOTHESIS:Once daily sodium-glucose cotransporter-2 inhibitor velagliflozin PO is noninferior to insulin injections.

ANIMALS:Client-owned diabetic cats (127 safety; 116 efficacy assessment).

METHODS:Prospective, randomized (1 mg/kg velagliflozin), positive controlled (titrated Caninsulin), open label, noninferiority field trial, comparing number of cats with treatment success in ≥1 clinical variable and ≥1 glycemic variable (margin Δ: 15%) on Day 45; secondary endpoints included glycemic and clinical assessments during 91 days.

RESULTS:On Day 45, 29/54 (54%) velagliflozin-treated cats and 26/62 (42%) Caninsulin-treated cats showed treatment success, demonstrating noninferiority (difference -11.8%; upper 1-sided 97.5% confidence interval, -∞ to 6.3%). By Day 91, quality of life (QoL), polyuria, and polydipsia had improved in 81%, 54% and 61% (velagliflozin); on blood glucose (BG) curves, mean BG was <252 mg/dL in 42/54 (78%; velagliflozin) and 37/62 (60%; Caninsulin); minimum BG was <162 mg/dL in 41/54 (76%; velagliflozin) and 41/62 (66%; Caninsulin); serum fructosamine was <450 μmol/L in 41/54 (76%; velagliflozin) and 38/62 (61%; Caninsulin). Velagliflozin's most frequent adverse events were loose feces/diarrhea (n = 23/61, 38%), positive urine culture (n = 19/61, 31%), and nonclinical hypoglycemia (BG <63 mg/dL; n = 8/61, 13%); Caninsulin's: clinical and nonclinical hypoglycemia (n = 35/66, 53%), positive urine culture (n = 18/66, 27%), and loose feces/diarrhea (n = 10/66, 15%). Diabetic ketoacidosis occurred in 4/61 (7%; velagliflozin) and 0/66 (Caninsulin).

CONCLUSIONS AND CLINICAL IMPORTANCE:Once daily oral administration of velagliflozin was noninferior to insulin injections, showed good QoL and glycemia without clinical hypoglycemia.

Keywords

antidiabetic; beta‐cell; compliance; feline diabetes mellitus; glucosuria; glucotoxicity; glycemic control; prospective clinical trial; sodium‐glucose cotransporter‐2 (SGLT2) inhibitor;

Article Tools:

Medline

Email to me

Grants:

Boehringer Ingelheim Animal Health

Archives Highlights:

The 4 prokinetic drugs metoclopramide, cisapride, pyridostigmine, and capromorelin do not increase fecal output or food intake in healthy New Zealand rabbits (Oryctolagus cuniculus).
Every day, rabbits produced a median of 75 g (range, 9 to 145 g) of feces, 226 fecal pellets (range, 12 to 412 pellets), and 151 mL (range, 5 to 420 mL) of urine. Metoclopramide, cisapride, pyridostigmine, and capromorelin had no effect on fecal production (both weight and number of pellets), food intake, urine production, or water intake compared to placebo at 24, 48, or 72 hours after administration.

The Most Common Environmental Risk Factors for Equine Asthma-A Narrative Review.
The symptoms of equine asthma are typical of respiratory inflammations, and they include coughing, nasal discharge, and breathing difficulty even at rest in horses with severe asthma. BALF and tracheal wash analyses are the most popular methods of diagnosing equine asthma. Inadequate housing conditions undoubtedly increase the risk of asthma.

Guide for nonswine practitioners to enhance swine disease diagnoses.
This review aims to help clinicians across the country that may not have an in-depth experience in swine medicine become more familiar with both common and novel pathogens, formulate a differential diagnosis based on the age of the animals and affected system (eg, respiratory, systemic, nervous, and enteric), select proper samples and laboratory testing, and interpret laboratory data to achieve a disease diagnosis in porcine patients.

Development of a dog owner caregiving style scale (Lincoln Owner Caregiving Questionnaire, LOCQ) and its relationship with behaviour problems in dogs
Compared to owners of dogs without behaviour problems, owners with high scores for the Disorganised caregiving style predicted dogs with separation related problems or with more than one behaviour problem, owners with high Avoidant caregiving style scores predicted dogs with Fear, and owners with high scores for both Disorganised and Avoidant caregiving styles predicted dogs with Aggressivity problems.

Litter box size and litter type preference and their associated behavioral changes in cats.
Our findings indicated that cats preferred litter boxes measuring ≥50 cm as well as clumping clay litter. Moreover, a comfortable litter environment combining these two elements promoted normal urination behavior while improving house-soiling (both urination and defecation).