OUTCOMES IN DIABETIC CATS DURING THE FIRST 2WK OF VELAGLIFLOZIN

Barrel RS1, Fleeman LM1, Szasz LA2, Flanagan J3, Poher AL3, Aasholm-Bradley O2, Tågaard SB2, Gravgaard AS2, Bjørnvad CR2; 1 Animal Diabetes Australia, Melbourne, Australia; 2Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg C, Denmark; 3 Royal Canin Research Centre, Aimargues, France

Background: Characteriza@on of early responses to velagliflozin treatment will help guide future case management.

Hypothesis and Aims: Describe clinical outcomes during initial 2 wk of velagliflozin

Methods: Prospective observa@onal study. Clinically stable, client-owned, insulin-naïve and previously insulin-treated diabetic cats (n=35). Exclusion criteria: body condition score <5/9, uncontrolled comorbidity, ketonuria, recent glucocorticoids. Owners recorded daily appetite, activity, fecal score and vomiting. Clinical exam on days 0-1 (V1), 2-4 (V2), 6-8 (V3), and 14 (V4) of treatment included blood glucose (BG), blood ketones (BHB), and Diabetic Clinical Score (DCS). Diet was unchanged, apart from V1: psyllium supplementation, V2: pre-/probiotic if fecal score>5/7, V3: diet transition if fecal score still>5/7.

Results: Sixty percent (21/35) completed 2 wk of velagliflozin treatment. At V1, 3/35 (8%) owners elected to con@nue insulin, 5/35 (14%) cats had newly recognized comorbidity, 2/35 (6%) had ketosis (1 started insulin, 1 euthanized). From the 25 cats included, transient hypersalivation occurred in 2/25 (8%). Exclusions between V1 and V4: 1 owner requested change to insulin, 3/24 (13%) were unwell with BHB >6.0 mmol/L (1/3 had eDKA, 2/3 were outpatients). BG <14 mmol/L was achieved in 22/24: 19/21 treated for 2 wk and 3 with BHB >6.0 mmol/L. Transient ketosis (BHB 2.4-5.4 mmol/L) with improved DCS occurred in 4/21 (19%). Faecal score >5/7 developed in 5/24 (21%) and continued at V4 in 3/21 (14%). Median weight loss was 100 g [-200-600] with 5/21 (24%) cats losing >2%/wk.

Conclusions: Sixty percent of eligible cats were successfully initiated on velagliflozin; ketosis may be transient.

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