In this issue, Drs. Eduardo Benjamin and Darcy Adin discuss emerging medical therapies for congestive heart failure in dogs. A focus of the article is the use of the newly FDA-approved bexagliflozin (Bexacat; Elanco, elanco.com) for the treatment of diabetes mellitus in cats. As is frequently the story in the history of pharmacological therapies, serendipity can reveal unintended uses for new drugs of equal or even greater medical benefit. Traditionally known as antihyperglycemic drugs developed to treat type 2 diabetes, sodium–glucose cotransporter-2 (SGLT2) inhibitors have established themselves as a pivotal therapy for heart failure in human medicine. Cardiovascular outcome trials in human patients demonstrated an unexpected reduction in heart failure hospitalization. This spurred interest in the SGLT2 inhibitor class as a potential treatment for heart failure. Several placebo-controlled clinical trials were conducted to evaluate the effects of SGLT2 inhibitors in the chronic heart failure population. SGLT2 inhibitors have demonstrated up to a 25% relative reduction in the composite end point of hospitalization for heart failure or cardiovascular death when compared with placebo, in addition to significant increases in objective measures of quality of life, regardless of the presence or absence of type 2 diabetes. Although there is uncertainty about the precise mechanisms responsible, the favorable effects of this drug class include reduction of blood pressure, natriuresis and diuresis, improved cardiac energy metabolism, prevention of inflammation, and weight loss. It must be stressed that there are no current published clinical evaluations of this drug group in veterinary medicine for cardiac disease, but it seems that serendipity has already opened this door to its potential.
What We’re Reading
In each issue, a member of our Editorial Advisory Board will share a recent open access publication, including their key takeaways and its practical conclusion.
The Value of Routine Radiographic Follow Up in the Postoperative Management of Canine Medial Patellar Luxation
Brincin C, Payne DJL, Grierson J, et al.
doi:10.1111/vsu.13933
What was investigated?
This study evaluated the influence of stifle radiographs on recommendations made during routine clinical re-evaluation of dogs after medial patellar luxation (MPL) surgery. This multi-institutional study consisted of 825 client-owned dogs.
What was found?
Isolated radiographic abnormalities were identified and led to a change in postoperative recommendations in only 3% of patients. Clinical factors that were most associated with a change in the postoperative plan included lameness, administration of analgesia at follow-up, and history of unplanned veterinary visits.
Take-Home Point
Dogs that present for routine MPL surgery follow-up without any owner or clinician concerns are unlikely to benefit from stifle radiographs.
— Clara S. S. Goh, BVSc, MS, DACVS-SA