Dapagliflozin in poorly controlled canine diabetes mellitus - case report

Sodium-glucose cotransporters 2 inhibitors (SGLT2i) are a class of drugs used in human medicine and, more recently, in feline medicine as adjunctive therapy for diabetes mellitus (DM). Their mechanism of action promotes urinary excretion of 90 to 97% of the glucose filtered by the kidneys, aiming to improve glycemic control, and reduce insulin applications and the risk of hypoglycemia. In diabetic dogs, which are mostly insulin-deficient, the literature lacks studies evaluating the effects of these drugs, with no data regarding dapagliflozin. This report describes the case of an 11-year-old spayed female English Mastiff, with DM, initially treated with degludec insulin. Due to poor glycemic control, dapagliflozin, an SGLT2i, was introduced at doses of 5 to 10 mg/dog, administered orally every 24 hours. The therapy resulted in no adverse effects, with reductions in blood glucose levels and required insulin doses. Although SGLT2i are not approved for use in dogs by any regulatory agency worldwide and may be associated with potential adverse effects, such as hypoglycemia and euglycemic diabetic ketoacidosis, dapagliflozin was well tolerated in the case reported here, contributing to improved disease management.