Diabetic remission in a newly diagnosed diabetic cat treated with SGLT2 inhibitor

Abstract

Case summary: A 13-year-old castrated male domestic shorthair cat was diagnosed with diabetes mellitus based on hyperglycaemia, glucosuria and an elevated plasma fructosamine concentration. The diagnosis followed a 1-month history of lethargy and weight loss, along with a 1-week history of polyuria and polydipsia, which developed after the patient received a long-acting methylprednisolone injection from the referring veterinarian for pruritus. Treatment with velagliflozin was initiated, resulting in excellent glucose control, weight gain and resolution of clinical signs. However, the owner reported diarrhoea that did not improve with dietary modifications, symptomatic treatments or dose reduction of velagliflozin. Consequently, velagliflozin was discontinued after 64 days. Despite discontinuation, the cat remained euglycemic, with plasma fructosamine levels within the reference interval throughout a 175-day follow-up period. According to the Agreeing Language in Veterinary Endocrinology consensus definition, diabetes mellitus remission was confirmed. Relevance and novel information: This case report highlights that diabetic remission is achievable in cats treated with SGLT2 inhibitors, as described in human patients with type 2 diabetes mellitus.