Good news for all you cat owners! The Food and Drug Administration Agency in December 2022 approved Bexacat, an oral drug for treatment of diabetes in cats. While this drug is a game-changer, the FDA also released a letter to veterinarians outlining the safety considerations for proper use of the drug and possible side-effects. Read on, because in this article I will share some insights on the proper use of Bexacat (bexagliflozin tablets), the new oral medication for cats.
A brief overview of diabetes in cats
Diabetes mellitus is caused by the pancreas failing to regulate blood sugar. In cats, it may be difficult for you as a cat owner to notice the symptoms of diabetes, which are:
Thirst
Increased urination
Weight loss
Increased appetite
It is worth noting that diabetes is the most common endocrine disease in cats after hyperthyroidism and it is more common in males than females. Obesity is also a risk factor for diabetes, so as a cat owner you need to keep your furry companion in optimum shape.
How does it work?
Bexacat blocks the reabsorption of glucose by the kidney. This in turn increases glucose excretion and lowers blood glucose levels in cats with diabetes.
What are the benefits of Bexacat
An estimated 600 000 cats in the U.S are diagnosed with diabetes during their lifetime. 125 000 of these cases go untreated mainly because traditional insulin medication requires frequent dosages. The sky-rocketing cost of insulin is an additional deterrent. On the other hand Bexacat is a non-insulin, needle-free and oral medication that is taken once a day.
Some diabetic cats may also be insulin resistant and traditional insulin medication is not effective. This is when this new medication comes in handy because it improves glycemic control without providing additional insulin. Field studies showed that Bexacat was over 80% effective in improving glycemic control in cats with diabetes.
Why is there need for proper screening for before starting your cat on the medication?
Bexacat should not be used in:
Cats with diabetes who have been previously been treated with insulin.
Cats who are receiving insulin
Cats with insulin dependent diabetes
Cats with hepatic disease or reduced renal function
Another warning by the FDA is that the medication should not be initiated on cats with anorexia, dehydration, or lethargy at the time of diagnosis of diabetes without proper screening.
If these contraindications are ignored, complications include:
An increased risk of diabetic ketoacidosis (DKA) which is a serious complication of diabetes that can be life threatening.
An increased risk of Euglycemic diabetic ketoacidosis characterized by ketoacidosis and relatively lower blood glucose
Death
Cats should also be monitored for urinary tract infections and treated when initiating Bexacat. Additionally, it is worth noting that the long term use of the medication may increase the risk of urothelial carcinoma.
Monitoring your cat while on Bexacat is important!
While your cat is under treatment, the onus is on you as a cat owner to monitor your cat’s health during this critical period. You should discontinue the use of the medication and asses your cat for diabetic ketoacidosis if you notice the following side effects:
Hyporexia/anorexia
Lethargy
Dehydration
Weight loss
Additionally, during treatment with Bexacat, you should routinely monitor:
Blood glucose
Fructosamine
Serum β-hydroxybutyrate (BHBA)
Serum feline pancreas-specific lipase (fPL)
liver parameters
serum cholesterol and triglycerides
body weight
What information do you need to have as a cat owner?
Before starting your cat on Bexacat, it’s important that you read the Client Information sheet. You should also read the product labelling so that you arm yourself with information on possible side effects and what to look out for and monitor when you begin treatment. The medication package insert describes specific monitoring during the first 8 weeks of treatment.
You must also know that Bexacat may cause an increased risk of DKA and euglycemic DKA. Additionally it is advised to discontinue the drug and contact a veterinarian immediately if your cat develops anorexia, lethargy, vomiting, diarrhea, or weakness.
Conclusion
This new oral diabetes medication for cats is definitely a game changer but as a cat owner, you should be vigilant and do your homework. Make sure that proper screening is done before starting treatment and keep a keen eye on your furry companion’s state of health while they are on Bexacat.
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