Blood pressure, electrolyte and fluid balance in horses with insulin dysregulation after short-term treatment with canagliflozin.

Short-term treatment with SGLT-2 inhibitors decreases blood pressure in people with type 2 diabetes. The aim was to investigate the impact of a 3-week treatment with canagliflozin on blood pressure in insulin dysregulated (ID) horses and to study effects on fluid balance. This was a single-centre, randomised, double-blind, placebo-controlled, parallel design study. The primary study evaluated glucose and insulin responses during an oral sugar test, and these results have been published previously. Here we report the effect of canagliflozin treatment on blood pressure, PCV, serum proteins and electrolytes. Baseline data were collected over an initial 3-day period from 16 privately owned ID horses and ponies. On the morning of the third day, blood sampling was performed for analysis of serum electrolytes, serum proteins and PCV, along with measurement of blood pressure using the non-invasive high definition oscillometry technique. Horses were then randomly assigned to either once-daily oral treatment with 0.6 mg/kg canagliflozin or placebo for a 3-week double-blind treatment period at home and a 3-day follow-up period similar to the baseline period, during which the double-blind treatment continued. There was no significant detectable change in systolic-, diastolic- or mean arterial blood pressure in canagliflozin treated horses compared to placebo. PCV, serum protein and electrolytes did not differ between treatments. Compared to humans, a significant reduction in blood pressure was not observed after short-term canagliflozin treatment. Additionally, there were no significant transient changes in PCV, serum protein or electrolyte concentrations as observed in humans with short-term canagliflozin treatment.