Key Features and Mechanism
- Drug Class: It is a sodium-glucose cotransporter 2 (SGLT2) inhibitor.
Mechanism: It prevents the kidneys from reabsorbing glucose, allowing excess sugar to be removed through the cat's urine.
- Low Hypoglycemia Risk: Because it does not spike insulin levels, it carries a very minimal risk of causing dangerously low blood sugar.
Strict Candidate Selection
Bexacat is not suitable for all diabetic cats and requires strict case selection by a veterinarian:
- Approved Candidates: Only for otherwise healthy cats newly diagnosed with diabetes mellitus. The cat must weigh at least 6.6 lbs (3.0 kg) and must still be able to produce some natural insulin.
- Absolute Contraindications: Never use in cats previously treated with insulin, currently receiving insulin, or those with insulin-dependent diabetes. Stopping insulin to switch to Bexacat is highly dangerous.
- Other Exclusions: Do not use in dogs, or cats with hepatic disease, severe renal failure, dehydration, or signs of anorexia/lethargy.
Critical Safety Warnings
- Boxed Warning: Bexacat carries an increased risk of diabetic ketoacidosis (DKA) and a unique variant called euglycemic DKA (eDKA).
- The eDKA Danger: In eDKA, the cat develops life-threatening ketoacidosis but maintains normal or near-normal blood glucose levels. This can lead owners or vets to miss the diagnosis because the blood sugar looks fine.
- Emergency Symptoms: Stop the medication immediately and contact a vet if your cat displays signs like decreased appetite, lethargy, vomiting, diarrhea, or weakness..
Required Veterinary Monitoring
Regular clinic follow-ups are mandatory to ensure safety. According to clinical protocol, checks are typically performed at 2 weeks, 4 weeks, and 8 weeks. Testing during these visits includes:
- An 8-hour blood glucose curve
- Serum fructosamine levels
- Evaluation of liver enzymes
- Blood and urine ketone monitoring (specifically beta-hydroxybutyrate)
Note: Bexacat is a prescription-only veterinary medication. It cannot be purchased over-the-counter