Pilot study on the effects of dapagliflozin on echocardiographic parameters in dogs with symptomatic myxomatous mitral valve disease

Myxomatous mitral valve disease (MMVD) is the most common valvular heart disease in geriatric small-to medium-sized dogs. Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor (SGLT-2i), has shown promise in managing heart failure in human patients. This pilot study aimed to explore the short-term effects of dapagliflozin, when added to conventional therapy in symptomatic MMVD dogs. In a prospective, randomized, single-blind study, five dogs with stage C MMVD received dapagliflozin (0.31 mg/kg, PO, q24h) alongside pimobendan, furosemide, and ramipril. A control group (n = 7) received conventional therapy without dapagliflozin. Echocardiographic, electrocardiographic, blood pressure, blood glucose, NT-proBNP, and urinary glucose data were collected at baseline (D0) and follow-up (D28, D84, and D140). Compared to the control group, dogs receiving dapagliflozin showed significant reductions in the percent change from baseline for left atrial to aortic root ratio, left ventricular internal diameter in diastole normalized to body weight, end-diastolic volume, end-diastolic volume index, end-systolic volume, and end-systolic volume index (P < 0.05). Additionally, ejection fraction significantly increased in the dapagliflozin group (P < 0.05). Glucosuria was consistently present only in the dapagliflozin group. These findings suggest that dapagliflozin, when added to conventional therapy, may promote reverse remodeling and improve cardiac function in dogs with stage C MMVD. Further studies with larger sample sizes and longer follow-up are warranted to validate the cardioprotective effects of dapagliflozin in veterinary patients.