Efficacy of transitioning cats on low dose insulin to once daily oral administration of sodium glucose cotransporter 2 inhibitor

The University of Florida College of Veterinary Medicine is currently recruiting cats on low dose insulin.

Enrollment Status: Currently Enrolling

Inclusion Criteria: Cats with well controlled diabetes mellitus with low and consistent insulin requirement (< 0.5 U/kg/d) for at least 3 months and consistent diet for at least 2 weeks will be eligible for enrollment.

Exclusion Criteria: Cats with diabetic ketoacidosis, significant ketosis or chronic renal disease IRIS stage 3 or 4 will not be eligible.

Treatment: Cats with well controlled diabetes mellitus on low daily insulin dose will be transitioned to a once daily oral therapy (SGLT2i).

• Visit 0 (screening)
  • At UF Small Animal Hospital: Owners will fill out an assessment of cat’s clinical signs and quality of life- this will be done at each veterinary visit.
    Your cat will receive a full physical examination and small blood draw.
    This will determine if your cat is eligible for the study.
    If eligible, your cat will be started on an SGLT2i. Clients will be required to keep weekly logs including ketone measurements, weight and diabetic clinical score and email weekly logs to investigators.
• Visit 1 (2-3 days later) at the UF Small Animal Hospital:
  • Physical exam, blood collection (5-6 drops) for beta-hydroxybutyrate, quality of life and assessment of your cat’s clinical signs. We will teach owners how to monitor ketones either by blood or urine collection.
• Visit 2 (7 days later): at the UF Small Animal Hospital:
  • Physical exam, blood collection (5-6 drops) for beta-hydroxybutyrate, quality of life and assessment of your cat’s clinical signs..
• Visit 3 (14 days later): at the UF Small Animal Hospital:
  • Physical exam, blood collection (5-6 drops) for beta-hydroxybutyrate, quality of life and assessment of your cat’s clinical signs..
• Visit 4 (45 days later): at the UF Small Animal Hospital:
  • Physical exam, blood collection (5-6 drops) for beta-hydroxybutyrate, quality of life and assessment of your cat’s clinical signs.
• Visit 5 (3 months later): at the UF Small Animal Hospital:
  • Physical exam, blood collection (5-6 drops) for beta-hydroxybutyrate, quality of life and assessment of your cat’s clinical signs.

Cost: The costs of all other procedures and drugs are NOT covered by the research study. Clients will be responsible for all clinic costs. An estimate of costs for which you will be responsible will be prepared for you at the time of admission. Any adverse events that your cat may experience during the study are also NOT covered by the research study.

Contact: jmott@ufl.edu

Background: Sodium glucose cotransporter 2 inhibitors (SGLT2i) are a once daily oral therapy for cats with diabetes mellitus. SGLT2i lower blood glucose levels by increasing glucose loss in the urine. These drugs are very effective and may be a safe alternative for cats with good diabetic control on low dose of insulin. Pet owners will likely experience an improvement in quality of life and flexibility in schedule. Cats will be started on SGLT2i and transitioned from insulin.