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:

Factors Associated with Medication Noncompliance in Dogs in New Zealand.
Medication noncompliance was recorded for 47% (71/151) of owners. Increasing dog age was associated with better owner compliance. Forty-seven percent (71/151) of owners reported that "nobody" showed them how to administer the medication. One-third of dog owners (47/151) reported challenges in medicating their pets. The most common reason cited by clients reporting challenges was a resistant pet.

How to plan and provide general anesthesia for a troop of 98 hamadryas baboons (Papio hamadryas) for contraceptive and preventative health interventions.
A group of 12 veterinarians, 2 zookeepers, and 6 volunteers anesthetized all animals within 2 days. The baboons were orally premedicated with midazolam (0.1 to 0.5 mg/kg) and anesthetized with medetomidine (40 to 60 µg/kg, IM) and ketamine (2 to 4 mg/kg, IM); isoflurane at rates of 1.5% to 2% was used for maintaining anesthesia if necessary. For population management, the animals received a contraceptive implant (adult females), orchiectomy (young males), or vasectomy (breeding males).

Nursing care of the small animal oncology patient. Part 2: pet carer support
This article outlines how RVNs can alleviate caregiver burden, facilitate shared decision-making, and provide practical and emotional support throughout the oncology journey.

Oral Flea Preventive to Control Rickettsia typhi-Infected Fleas on Reservoir Opossums, Galveston, Texas, USA, 2023-2024.
Spinosad killed 98% of fleas infesting opossums.

Investigating the relationship between canine training classes and post-adoption return rates in North American shelters
Of all the returned dogs, those who attended training were more likely to be returned for owner-related reasons (58.8?%), whereas dogs who did not attend training were more likely to be returned for animal-related reasons (78.9?%). While attending training classes at animal shelters may help to reduce behavioral returns, as shown by the shift in return reasons, they do not appear to reduce return rates significantly for the general shelter population.