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

Canagliflozin did not significantly alter blood pressure, electrolytes, or fluid balance markers in insulin dysregulated horses.

This randomized, double-blind, placebo-controlled parallel design study investigated the effects of 3-week canagliflozin treatment (0.6 mg/kg PO SID) on blood pressure, fluid balance, and electrolytes in 16 privately owned insulin dysregulated (ID) horses and ponies. In humans with type 2 diabetes, SGLT-2 inhibitors are known to reduce blood pressure and transiently alter fluid balance markers; this study sought to determine whether similar effects occur in equine patients. Baseline measurements of systolic, diastolic, and mean arterial blood pressure (via non-invasive high-definition oscillometry), PCV, serum proteins, and electrolytes were collected over an initial 3-day period. Horses were then randomized to canagliflozin or placebo for 3 weeks at home, followed by a 3-day follow-up period during which blinded treatment continued. Results demonstrated no statistically significant differences in systolic, diastolic, or mean arterial blood pressure between treatment groups. PCV, serum protein concentrations, and serum electrolytes also did not differ significantly between canagliflozin-treated and placebo horses. These findings contrast with observations in humans, where short-term SGLT-2 inhibitor use produces measurable reductions in blood pressure and transient changes in fluid balance markers. The absence of these effects in horses may reflect species differences in SGLT-2 distribution, renal physiology, or baseline cardiovascular status. Clinicians should be aware that canagliflozin's blood pressure-lowering and fluid-shifting properties documented in human medicine may not translate to equine patients with insulin dysregulation.

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