Assessment of Exenatide Extended‐Release for Maintenance of Diabetic Remission in Cats

ABSTRACT Background Insulin‐treated diabetic cats frequently achieve transient remission. The glucagon‐like peptide‐1 receptor agonist, exenatide extended‐release (exenatide‐ER), preserves β cell function in people with type 2 diabetes mellitus (DM). Objectives Investigate the effect of exenatide‐ER on the duration of diabetic remission in cats. Animals Twenty‐two client‐owned cats with recent diabetic remissions. Methods Placebo‐controlled, single‐blinded study. Cats were assigned randomly to receive exenatide‐ER (0.13 mg/kg) or saline injection SC, once monthly for 2 years or until DM relapsed. Cats were fed low‐carbohydrate diets; weight control was actively supervised. Paired t‐tests and Mann–Whitney were used to compare pre‐ versus post‐study characteristics within groups and between group outcomes, respectively. Results Treatment groups (placebo, N = 10; exenatide‐ER, N = 12) were similar in age, sex, and body weight upon inclusion. Thirteen cats completed the 2‐year study without diabetic relapse. Nine cats (placebo, n = 4; exenatide‐ER, n = 5) exited prematurely. Three of these exited because of DM relapse (placebo: N = 1, day 212; exenatide‐ER: N = 2, days 553 and 558). There was no difference in remission duration between treatments (placebo: 669 [121–721]; exenatide‐ER: 662 [28–735] days, p = 0.9). Median body weight decreased in both groups at study exit (placebo: −0.6 kg [−1.3 to +0.3], p = 0.03; exenatide‐ER: −0.2 kg [−1.2 to +0.5], p = 0.02). Hemoglobin A1c remained unchanged on exenatide‐ER (−0.05% [−6.9 to +2.1]) but increased on placebo (+2.3% [−1.7 to +4.4]; p = 0.03). Conclusions and Clinical Importance Exenatide‐ER contributed to the maintenance of glycemic control as reflected by hemoglobin A1c but did not affect remission duration. Management might have contributed to the extended remission duration.