EN05 - Effect of Sodium-Glucose Cotransporter 2 Inhibitor, Canagliflozin, on Interstitial Glucose in Diabetic Insulin Treated Dogs

Abstract: Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are approved for use in some diabetic cats. The utility of SGLT2i has not been reported in insulin treated diabetic dogs.

Hypothesis: Canagliflozin, an oral SGLT2i, decreases interstitial glucose (IG) concentrations in insulin treated diabetic dogs.

Animals: Four insulin treated diabetic dogs from a university teaching hospital population.

Methods: Ongoing uncontrolled open label longitudinal study. Diabetic dogs are enrolled if they have an unchanged insulin dose for at least 2 weeks prior to enrollment, IG ≤ 300 mg/dl for at least 2 hours/day in one of the 3 days preceding canagliflozin treatment initiation, no vomiting, diarrhea, lower urinary tract clinical signs, or clinical signs consistent with diabetic ketoacidosis, a body weight ≥7 kg, and remaining on the same diet for the study duration. A flash glucose monitoring sensor is placed on day 0, and IG is recorded until day 3, when canagliflozin treatment at 2-4 mg/kg, orally, once a day, begins and is continued until day 10. Insulin treatment continues at the same dose it has been given for the preceding 2 weeks.

Results: Median IG concentration in 2,372 measurements obtained while dogs were treated with insulin and canagliflozin was 85 mg/dl (range, 40-455 mg/dl) and was significantly lower than median IG concentration in 1,111 measurements obtained while dogs were treated with insulin and no canagliflozin (208 mg/dl, range, 41-500 mg/dl).

Conclusions and clinical importance: Canagliflozin may have a role in improving glycemic control in insulin treated diabetic dogs.