Effects of Velagliflozin in 8 Cats With Diabetes Mellitus and Hypersomatotropism

Background: Velagliflozin is a sodium-glucose cotransporter 2 inhibitor licensed for the treatment of diabetes mellitus (DM) in cats, but its use in cats with hypersomatotropism is not described. Hypothesis/Objectives: To describe the use of velagliflozin in cats with DM and hypersomatotropism. Animals: Eight client-owned cats with DM and hypersomatotropism treated with velagliflozin. Methods: Retrospective multicentric case series. Clinical data, including diabetic clinical score, insulin dose, and continuous glucose monitoring-derived metrics were compared between the last follow-up before velagliflozin introduction (T0) and the first (T1) and last (T2) follow-ups after velagliflozin introduction. Results: Diabetic clinical score improved in 6/8 cats after velagliflozin initiation. Median daily insulin dose decreased from 1.9 U/kg (range 0.8–7.1) at T0 to 0.5 U/kg (0–2.3) at T1 (median difference [MD] = −1.2 U/kg; 95% CI: −5.2 to 0.5; p = 0.02). Mean glucose was lower both at T1 (207 mg/dL, 96–326) and T2 (273 mg/dL, 155–350) than at T0 (435 mg/dL, 298–477; MD = −177 mg/dL, 95% CI: −238 to −92, p = 0.008 and MD = −113 mg/dL, 95% CI: −280 to −18, p = 0.03, respectively). Percentage of time in range was higher at T1 (71%, 21–98) and T2 (41%, 14–100) than at T0 (3%, 0–32; MD = 61%, 95% CI: 21 to 80, p = 0.008 and MD = 34%, 95% CI: 2 to 98, p = 0.03, respectively). Velagliflozin allowed for insulin discontinuation in two cats. One cat developed diabetic ketoacidosis on day 143, and one cat had acute kidney injury. Conclusions and Clinical Importance: Velagliflozin improved diabetic control in cats with DM and hypersomatotropism, either in combination with insulin or as monotherapy.