Oral Bezafibrate for Hypertriglyceridemia in Dogs

In the Literature

Castonguay-Poirier M, Fifle L, Javard R, Huvé R. Long-term safety and efficacy of oral bezafibrate use in dogs with hypertriglyceridemia. J Vet Intern Med. 2026;40(2):aalag041. doi:10.1093/jvimsj/aalag041

The Research …

Hypertriglyceridemia is common in dogs and may be primary or secondary, with causes of secondary hypertriglyceridemia including endocrine disorders (eg, diabetes mellitus, hyperadrenocorticism, hypothyroidism), drugs, pancreatitis, and obesity.^1,2 Fat-restricted diets and control of underlying endocrinopathies are recommended. Oral bezafibrate, an antilipemic agent, may be a safe and effective addition to treatment; however, long-term efficacy and safety have not been established.

In this retrospective study, data from client-owned dogs (n = 55) with either primary or secondary hypertriglyceridemia (ie, triglycerides >221 mg/dL) were identified and classified into 3 groups. Dogs in group 1 (n = 23) had primary hypertriglyceridemia, group 2a (n = 15) had secondary hypertriglyceridemia and no treatment changes for underlying conditions, and group 2b (n = 17) had secondary hypertriglyceridemia and underwent treatment changes for underlying conditions. Underlying conditions in groups 2a and 2b included diabetes mellitus, chronic pancreatitis, hyperadrenocorticism, and hypothyroidism.

All dogs received oral bezafibrate (median final dose, 5.5 mg/kg [range, 2.2-11.6 mg/kg]) every 24 hours; follow-up monitoring occurred at 1, 3, 6, 12, and >18 months. Treatment response was classified as adequate (ie, triglycerides decreased ≥50%; 51 dogs) or inadequate (ie, triglycerides decreased <50%; 4 dogs). The inadequate response in the 4 dogs from groups 2a and 2b potentially indicates less effective control of underlying conditions and higher initial triglycerides in these groups. The median decrease in triglycerides for all groups was 85%.

Two dogs experienced mild GI adverse effects (eg, nausea, vomiting, diarrhea) that resolved within 48 hours of bezafibrate discontinuation; a lower dose was then administered with no adverse effects. One dog experienced hemorrhagic diarrhea 7 weeks after bezafibrate was initiated that resolved when the drug was discontinued; reintroduction at a lower dose was tolerated. ALT increased in another dog after 6 months of bezafibrate therapy; these elevations decreased by 41% 6 weeks after discontinuation of therapy.

… The Takeaways

Key pearls to put into practice:

• Oral bezafibrate may be a beneficial addition to treatment modalities (ie, dietary fat restriction, control of underlying endocrinopathies) for hypertriglyceridemia in dogs.

• Dogs with uncontrolled endocrinopathies may not respond to oral bezafibrate until the underlying disease is controlled.

• Adverse effects of oral bezafibrate include GI signs (eg, nausea, vomiting, diarrhea) and elevated liver enzymes. These effects appear to be reversible with discontinuation of bezafibrate, and reintroduction may be tolerable with a lower dose. Liver enzymes may take months to become elevated; ALT monitoring is encouraged.