Trial for diabetic dogs with cataracts
Comparison of effects of ophthalmic prednisolone and diclofenac on diabetes mellitus regulation in dogs
Purpose and Brief Study Description:
An issue of debate is whether topical ophthalmic steroids exacerbate insulin antagonism and interfere with glycemic control in diabetic dogs. Currently, no studies have evaluated possible systemic effects of topical ophthalmic steroids in diabetic dogs. Topical steroid preparations and nonsteroidal anti-inflammatory medications are used to treat lens-induced uveitis, as well as to prevent and control inflammation following cataract surgery. Cataract formation is a very common complication of canine diabetes mellitus; therefore, diabetic dogs constitute approximately 50% of all dogs presented to veterinary ophthalmologists for cataract surgery. Human diabetics undergoing cataract surgery that were treated with topical application of an ophthalmic steroid (dexamethasone) experienced significantly increased blood glucose levels. Treatment with ocular steroids may produce similar effects in diabetic dogs undergoing cataract treatment. The results of this study are expected to alter medication selection in diabetic patients, especially in poorly controlled diabetic dogs.
To evaluate and compare the effects of a topically applied ophthalmic steroid (prednisolone acetate) to a nonsteroidal anti-inflammatory drug (diclofenac) on blood glucose concentrations, serum fructosamine concentrations, and clinical scores in diabetic dogs with cataracts.
Dogs with cataracts and insulin-treated diabetes mellitus determined to be controlled per history and physical examination findings will be enrolled in the study following client consent.
What does enrollment into this trial involve?
Once enrolled, your dog will be assigned to one of two groups using a blocked randomization design stratified by sex, age, and weight. Each dog will receive prednisolone acetate 1% (Pred Forte®), or diclofenac solution 0.1% (Voltaren®) based on group assignment.
Owners will apply 1 drop of the dispensed ophthalmic anti-inflammatory medication 4 times daily to both eyes of their dog for 4 weeks.
Patient history and complete physical and ophthalmic examination will be performed and a clinical score assigned at the beginning of the study (day 0) and again after 4 weeks of topical anti-inflammatory therapy (day 32). At these time points, blood work (CBC and serum chemistry panel), urinalysis, and serum fructosamine levels will be evaluated.
On day 0 and 32, dogs will be hospitalized for 72 hours and a continuous glucose monitoring system (Guardian®) will be used to acquire continuous glucose measurements for additional analysis of glucose control.
This trial covers all study required procedures, including exam, blood work, urinalysis, and hospitalization fees, as well as the topical, ophthalmic medication. The cost of insulin will be the owner’s responsibility.
Please contact Misty Bear, Clinical Trials Coordinator, for more information. Phone: (785)532-3046; email: ClinicalTrials@vet.k-state.edu