Oral options reshape the feline diabetes treatment discussion

Veterinary conversations about feline diabetes are shifting as oral SGLT2 inhibitors move from novel option to real-world clinical consideration. In podcast episodes from VETgirl and dvm360, Dr. Chris Byers and other veterinary voices highlight how newer non-insulin therapies, including Bexacat and Senvelgo, are changing the treatment discussion for some newly diagnosed cats, alongside a continued emphasis on nutrition, case selection, and monitoring. FDA approved Bexacat in December 2022 as the first oral treatment for feline diabetes, and approved Senvelgo in August 2023 as an oral liquid option; both are indicated only for otherwise healthy cats with diabetes mellitus that have not previously been treated with insulin. (fda.gov)

Why it matters: For veterinary professionals, the opportunity is convenience and potentially better adherence for some pet parents, but the tradeoff is tighter screening and monitoring. FDA safety communications for both drugs warn about diabetic ketoacidosis, including euglycemic DKA, and stress that these products are not for cats previously treated with insulin or cats with insulin-dependent diabetes mellitus. Senvelgo’s FDA letter says cats should be checked for ketonuria within days of starting therapy, while Bexacat’s labeling calls for close monitoring of glycemic control, ketones, pancreatic and hepatic markers, lipids, body weight, and clinical signs, especially early in treatment. (fda.gov)

What to watch: Expect continued discussion around which newly diagnosed cats are appropriate candidates for oral therapy, and how practices standardize early monitoring to catch DKA risk before cats decompensate. (fda.gov)