Feline diabetes care expands beyond insulin, with new cautions

Feline diabetes treatment is shifting beyond insulin alone, with veterinary educators and clinicians highlighting a broader toolkit that now includes two FDA-approved oral SGLT2 inhibitors for newly diagnosed cats: Elanco’s Bexacat (bexagliflozin), approved in December 2022, and Boehringer Ingelheim’s Senvelgo (velagliflozin oral solution), approved on August 10, 2023. In the VetGirl podcast featuring Dr. Chris Byers and in dvm360’s related discussion, the focus is on how case selection, nutrition, and monitoring now sit alongside drug choice, rather than insulin being the only practical path for every newly diagnosed patient. FDA materials say both products are indicated only for otherwise healthy cats with diabetes mellitus that have not previously been treated with insulin, and both carry important warnings around diabetic ketoacidosis, including euglycemic DKA. (fda.gov)

Why it matters: For veterinary teams, the message is convenience with caution. Oral therapy may improve adherence for some pet parents and reduce the barrier of twice-daily injections, but it doesn’t simplify the medical judgment required up front. FDA and published study data show these drugs can improve glycemic control in more than 80% of appropriately selected cats, yet they require careful screening for prior insulin exposure, concurrent illness, pancreatitis risk, ketones, and the possibility of later loss of glycemic control. Nutrition also remains central: dvm360’s coverage emphasizes individualized diet planning based on protein content, digestibility, palatability, and comorbidities, not a one-size-fits-all feeding recommendation. (fda.gov)

What to watch: Expect continued discussion around which newly diagnosed cats are the best oral candidates, how teams monitor for eDKA early, and whether real-world use changes prescribing patterns or safety messaging. (fda.gov)