FDA Approves the First Oral Treatment For Cats With a Type of Diabetes

The US Food and Drug Administration approved Elanco Animal Health Inc.'s Bexacat™, the first orally administered prescription medication for cats with a type of diabetes, on December 8, 2022.

Bexacat (bexagliflozin tablets) is not insulin and is not intended for cats with diabetes that requires insulin treatment. Rather, it is an inhibitor of sodium-glucose cotransporter 2 (SGLT2).

This pill's active ingredient prevents the cat's kidneys from reabsorbing glucose into the blood. This excess glucose is excreted in the urine, lowering blood sugar levels.

FDA required that Bexacat labels include a boxed warning about the importance of patient selection as part of the approval. As determined by careful screening, only certain cats should be given the drug.

Potential patients must be evaluated for kidney, liver, and pancreatic disease, as well as ketoacidosis, which is a high-level type of acid known as ketones in the blood.

Bexacat should also not be used in cats who are receiving insulin or who have previously received insulin. The medication should not be administered to cats who are not eating well, are dehydrated, or are lethargic at the time of diagnosis.

Cats taking this medication should be examined, and their blood tested regularly and monitored for lack of appetite, lethargy, dehydration, and weight loss.

Bexacat treatment in cats may increase the risk of severe adverse reactions, including diabetic ketoacidosis, according to the FDA. This is potentially fatal and should be treated as an emergency.

The FDA explained in a news release about the approval that, like humans, the cells of a cat's body require sugar in the form of glucose for energy. Diabetes causes cats to be unable to produce or respond to the hormone insulin. Insulin aids cells in their normal use of glucose.

Diabetic cats will have high glucose levels in their blood and urine if they are not treated. They may exhibit symptoms such as increased thirst and urine production, weight loss, and increased appetite.

Diabetes in cats is typically treated with a combination of diet and insulin therapy, which includes twice-daily injections 12 hours apart. Bexacat is a once-daily flavored pill for cats weighing at least 6.6 pounds with or without food.

In its approval, the FDA cited two six-month field studies and a comprehensive field study. According to the studies, the medication was more than 80% effective in improving blood sugar control in diabetic cats.

Any adverse events should be reported to the FDA by veterinarians and clients.