Short- and long-term effects of dapagliflozin as an adjunct to insulin therapy in diabetic dogs: a pilot study

This study evaluated adjunctive dapagliflozin therapy in insulin-treated diabetic dogs to assess short- and long-term glycemic, clinical, and laboratory outcomes in dogs with naturally occurring diabetes mellitus. Six diabetic dogs received a compounded liquid oral dapagliflozin (CLODapa) formulation (0.088 ± 0.013 mg/kg once daily) in addition to ongoing insulin therapy for 100 days. We monitored continuous glucose monitoring (CGM) before and after treatment initiation, and serially assessed clinical, biochemical, and urinary parameters. Short-term dapagliflozin administration significantly reduced mean interstitial glucose, glucose nadir and peak values, and increased time within the target glucose range (60-250 mg/dL), while decreasing time above range. Glycemic variability increased, although time spent < 60 mg/dL and clinical hypoglycemia did not increase; however, CLODapa's initial dosage was reduced in four dogs due to concerns about hypoglycemia, increased in one, and left unchanged in another. Long-term treatment was associated with reductions in fructosamine, systolic blood pressure, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and cholesterol concentrations. No evidence of diabetic ketoacidosis, urinary tract infection, electrolyte imbalance, or acid-base disturbance was detected. Unintentional weight loss was documented in three patients and required a ~ 25% increase in food intake. Adjunctive dapagliflozin showed promise in improving glycemic control in diabetic dogs despite posing a risk of hypoglycemia, supporting further investigation of SGLT2 inhibition in canine diabetology.