Endocrine Metabolic Dzs Tx

Question 1

What is the mechanism of action of the ‘flozin’ drugs?

Answer 1

(They are sodium glucose linked transporter type-2 inhibitors, inhibition of SGLT2 results in increased elimination of glucose through urine)

Question 2

What type of diabetes mellitus are flozins used for?

Answer 2

(Type 2, specifically insulin resistant diabetes)

Question 3

Why is the use of flozins in cats already on insulin not recommended?

Answer 3

(DKA is more likely to occur in cats on insulin (or with comorbidities) when placed on a flozin drug)

Question 4

Why is diagnosis of DKA while a patient on a flozin drug more difficult?

Answer 4

(Because the cat with be euglycemic due to the nature of the drug, typically you look for hyperglycemia in DKA cases)

Question 5

What is the primary difference in the two flozin drugs (Bexacat/bexagliflozin and Senvelgo/velaglifozin)?

Answer 5

(Administration option, Bexacat is a tablet and Senvelgo is an oral suspension, otherwise efficacy and ADEs are similar)

Question 6

What are the benefits to the use of flozin drugs over insulin?

Answer 6

(Flozins are less likely to cause hypoglycemia, does not need to be refrigerated, no needle needed for administration, are formulated specifically with cats in mind, and once daily dosing)

Question 7

What blood work values might change when a horse is on a flozin (this change is not necessarily associated with clinical signs)?

Answer 7

(Hypertriglyceridemia)

Question 8

What are flozins used for in horses?

Answer 8

(Hyperinsulinemia and laminitis induced by hyperinsulinemia)

Question 9

What is the treatment of choice for PPID in horses?

Answer 9

(Pergolide)

Question 10

What is the mechanism of action of pergolide in relation to PPID?

Answer 10

(Pergolide is a dopamine agonist, PPID is a degeneration of dopaminergic neurons in the hypothalamus that negatively feedback on the pars intermedia (without the negative feedback, ACTH is produced in excess), supplementing dopamine (pergolide) provides that negative feedback)

Question 11

How would you respond to a horse you placed on Prascend developing diarrhea?

Answer 11

(Decrease their dose for 1-2 weeks to allow the horse to acclimate to the drug then increase back to their necessary dose)

Question 12

Why should pergolide be used with caution in breeding animals?

Answer 12

(Mares → dysgalactia, agalactia, poor quality colostrum, prolonged parturition, red bag; stallions → decreased sperm counts)

Question 13

What is the purpose of molidustat?

Answer 13

(It stimulates EPO production in cats with CKD)