Veterinary Guidelines for Managing Diabetes in Cats

SGLT2 inhibitors are not recommended for sick cats that are clinically anorectic, dehydrated, lethargic, or ketotic (1). Veterinarians must carefully evaluate the cat's overall health before prescribing these drugs, as they are contraindicated in cats that have ever received insulin, who are receiving insulin now, or have insulin-dependent diabetes (1). [1]

Additionally, if a cat is vomiting or has comorbidities, an assessment is necessary, including checking for ketones and beta-hydroxybutyrate (1). Veterinarians must also ensure that the kidney function and the liver function are normal, as both drugs have warnings or overt contraindications in the setting of those diseases, as well as other comorbidities (1). [1]

When a newly diabetic cat is first seen by a veterinarian, the decision between using insulin and an SGLT2 inhibitor is primarily based on safety and patient selection, according to Kelly Cairns, DVM, MS, DACVIM (SAIM) (1). This approach ensures that the treatment is appropriate for the individual cat's condition and health status. [1]

SGLT2 inhibitors are not recommended for sick cats that are clinically anorectic, dehydrated, lethargic, or ketotic (1). These drugs are contraindicated in cats that have ever received insulin, are currently receiving insulin, or have insulin-dependent diabetes. It is important not to discontinue insulin in favor of an SGLT2 inhibitor without careful evaluation. [1]

If a cat is vomiting or has comorbidities, an assessment is necessary, including checking for ketones and beta-hydroxybutyrate (1). Additionally, it is important to ensure that kidney and liver functions are normal, as both drugs have warnings or overt contraindications in the setting of those diseases and other comorbidities. [1]

The decision to use SGLT2 inhibitors in newly diabetic cats is primarily guided by safety and patient selection, as noted by Kelly Cairns, DVM, MS, DACVIM (SAIM), in an article from dvm360 (1). Two SGLT2 inhibitors, Bexacat (bexagliflozin) and Senvelgo (velagliflozin oral solution), are available in both liquid and tablet forms. However, these drugs are contraindicated for cats that have ever received insulin, are currently on insulin, or have insulin-dependent diabetes. Veterinarians should not discontinue insulin to switch a cat to an SGLT2 inhibitor (1). [1]

SGLT2 inhibitors are not recommended for sick cats that are clinically anorectic, dehydrated, lethargic, or ketotic, according to the same source (1). In cases where a cat is vomiting or has comorbidities, a thorough assessment is necessary, including checking for ketones and beta-hydroxybutyrate. This evaluation helps determine the appropriateness of SGLT2 inhibitors for the individual cat (1). [1]

Before prescribing SGLT2 inhibitors, it is essential to ensure that the cat's kidney and liver functions are within normal ranges, as both drugs have warnings or contraindications related to these conditions. The use of these medications should be strictly on label to ensure safety and effectiveness (1). [1]

Sources

dvm360

Prepared with AI assistance from the cited sources.