Non-insulin Alternative for Cats with Diabetes

Diabetes mellitus, referred to in this article as diabetes, is a well-known condition among people. The CDC reports that 11.6% of the U.S. population has diabetes, approximately 1 out of every 8.5 people. Dogs and cats are at risk for diabetes as well. The exact numbers are more difficult to determine, but it is estimated that approximately 1 out of every 300 dogs and 1 out of every 100-200 cats may develop diabetes in their lifetime.

Just as there are different types of diabetes in humans, cats and dogs have different types as well. Type I is an insulin dependent form where the cells in the pancreas no longer produce insulin, resulting in elevated glucose (sugar) levels in the blood. Type II noninsulin dependent form is where the pancreatic cells have impaired function or the cells in the body are resistant to insulin, resulting in the same elevated glucose levels. Type III is much less common and is associated with pregnancy or hormonally induced, resulting in insulin resistance. Type II diabetes occurs in cats, but not in dogs. Type I and III can occur in both species, with Type I as the most common in dogs. In this article, we are focusing on a noninsulin treatment for Type II, which occurs in cats. It is important to note that the main treatment for dogs with diabetes is still insulin.

The most significant risk factor for developing diabetes in cats is obesity. Age, inactivity, and the overuse of steroids can also increase the risk, but obese cats are four times more likely to develop diabetes compared to cats of a healthy weight. Male cats seem to be at a higher risk than female cats. There does not appear to be a breed predilection in the United States.

If your cat has been diagnosed with diabetes, the treatment is aimed at normalizing blood glucose concentrations, maintaining a healthy weight and healthy activity levels. Previously, insulin and diet were the combination used to achieve these goals, but oral medications have been developed for cats to reach the same objectives.

Just over this past year, medications known as SGLT2 (sodium-glucose cotransporter2) inhibitors were developed for cats, a class of medication used in humans for the past decade. These medications lower the concentration of glucose in the body by excreting it through the kidneys. This lowers the insulin resistance in the body and reduces damage to the pancreas, allowing the cells in the pancreas to make more insulin. It is very important to say that if a cat cannot make its own insulin, this medication is not appropriate, and insulin must be implemented to treat it. Currently, there are two approved medications in the United States – a liquid (brand name Senvelgo) and a tablet (brand name Bexacat).

Because of the requirement that a cat must still be able to make its own insulin, it is very important to discuss this treatment with your veterinarian, as it is not for every cat. There is no easy way to tell if a cat has type I vs. type II diabetes, so education and initial close monitoring are very important. These medications are approved for use in newly diabetic cats who have not yet been on insulin. If a cat is given this medication and they cannot make their own insulin, it will not help to control the diabetes, and the cat can become very sick.

Just as humans with Type II diabetes, it is important to make sure cats are on an appropriate diet. Foods low in carbohydrates are the most effective. Canned food is often preferred as there is increased water, which is beneficial to cats for several reasons including maintaining a lean weight, regulating insulin levels, and improving kidney and urinary health.

The option of oral medications to treat feline diabetes is very exciting, but it requires careful consideration and close monitoring. Be sure to discuss with your veterinarian.