Reply To: Bexacat

Hello everyone.

I hope you are well. It is an interesting drug. I have no direct experience of using it.

This is probably the most useful paper discussing the drug:

Safety and effectiveness of the sodium-glucose cotransporter inhibitor bexagliflozin in cats newly diagnosed with diabetes mellitus

Michael J. Hadd, Stephen E. Bienhoff, Susan E. Little, Samuel Geller, Jennifer Ogne-Stevenson, Thomas J. Dupree, J. Catharine Scott-Moncrieff

Abstract

Background
Bexagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. A pilot study has shown that bexagliflozin can decrease dependence on exogenous insulin in cats with diabetes mellitus (DM).

Objective
To evaluate the safety and effectiveness of bexagliflozin as a monotherapy for DM in previously untreated cats.

Animals
Eighty-four client-owned cats.

Methods
Historically controlled prospective open-label clinical trial. Cats were dosed PO with 15 mg bexagliflozin once daily for 56 days, with a 124-day extension to evaluate safety and treatment effect durability. The primary endpoint was the proportion of cats experiencing a decrease in hyperglycemia and improvement in clinical signs of hyperglycemia from baseline on day 56.

Results
Of 84 enrolled cats, 81 were evaluable on day 56, and 68 (84.0%) were treatment successes. Decreases in mean serum glucose, fructosamine, and β-hydroxybutyrate (β-OHB) concentrations were observed, and investigator assessments of cat neurological status, musculature, and hair coat quality improved. Owner evaluations of both cat and owner quality of life were favorable. The fructosamine half-life in diabetic cats was found to be 6.8 days. Commonly observed adverse events included emesis, diarrhea, anorexia, lethargy, and dehydration. Eight cats experienced serious adverse events, 3 of which led to death or euthanasia. The most important adverse event was euglycemic diabetic ketoacidosis, diagnosed in 3 cats and presumed present in a fourth.

Conclusion and Clinical Importance
Bexagliflozin decreased hyperglycemia and observed clinical signs in cats newly diagnosed with DM. As a once-daily PO medication, bexagliflozin may simplify the management of DM in cats.

I certainly do not think this can be considered a substitute for insulin, but may be helpful in some cases. As far as I am aware, not currently avaiable in the UK.

Scott 🙂