Can J Vet Res 2022;86:52–58
Evaluation of bexaglifloxin in cats with poorly regulated diabetes mellitus
U/kg body weight should be changed to U (units)
Long-term follow-up
Insulin was discontinued in 2 cats during the study. One of these cats continued to receive bexagliflozin for over 2 y and was receiving this medication as sole therapy when this article was submitted. The other cat received bexaglifozin for an additional 5 wk until it was stopped and insulin was restarted due to the development of small bowel diarrhea that the owner reported as moderately severe. The diarrhea resolved after bexagliflozin was discontinued. This cat had a history of inflammatory bowel disease and prior episodes of diarrhea.
The cat receiving 10 mg of bexagliflozin once daily continued to require insulin therapy for the duration of the 4-week study period. On completion of the study, the dosage of bexagliflozin was increased to 15 mg/d and insulin was discontinued, with successful management of diabetes for a further 17 mo until an episode of clinically suspected pancreatitis resulted in the need to supplement with 1 U of insulin glargine twice daily to control hyperglycemia.
The fourth cat in this study continued on 1 U of insulin twice daily in addition to bexagliflozin until hyporexia developed at Day 28. Immediately after completion of the study, bexagliflozin was discontinued and insulin was increased to 2 U twice daily, which resolved the hyporexia. One month after completion of this study, bloodwork revealed marked hypertriglyceridemia (1643 mg/dL) and this cat was gradually increased to 4 U of glargine twice daily, which resulted in ongoing control of clinical signs of diabetes mellitus.
The fifth cat was continued on 2 U of glargine twice daily in addition to bexagliflozin after completion of the study due to ongoing clinical improvement of diabetes mellitus. Although bexagliflozin was ultimately discontinued due to concerns about diarrhea, the diarrhea did not improve. The insulin dosage was gradually increased to 4 U twice daily after bexagliflozin was discontinued.