When Mark Winternheimer’s 12-year-old tabby cat was diagnosed with diabetes last year, the treatment was daunting: twice-daily insulin injections, an implanted monitor, and frequent visits to the vet.
Despite their doubts, Winternheimer and his wife, Courtnee, of New Albany, Indiana, taught Oliver to give his injections.
“To us, they’re part of the family,” Winternheimer said of Oliver and their two other cats, Ella and Theo. “You wouldn’t refuse care to another family member if it’s available.”
Now, a new once-daily pill promises to make feline diabetes treatment easier in newly diagnosed animals, without the injections.
“A pill is a huge step forward from a needle,” says Dr. Audrey Cook, a feline veterinarian at Texas A&M University.
A word of caution: The pill called Bexacat cannot be used in cats like Oliver, who had previously received insulin.
Perhaps its biggest advantage is ease of use, according to experts. While many cat owners successfully treat their cats with twice daily insulin, often for years, others struggle. Research shows that owners euthanize 1 in 10 cats with a new diabetes diagnosis. Another 10% are euthanized within a year, in part due to the difficulty of treatment.
“Some people are afraid to give insulin injections. Some people don’t have time to devote to caring for their cats,” said Dr. Catharine Scott-Moncrieff, a Purdue University veterinarian, who consulted with the makers of Bexacat about testing the product.
Bexacat, made by Elanco Animal Health Inc., was approved by the Food and Drug Administration in December and is expected to be available in the US in the coming weeks. It is the first drug of its kind approved for animals; similar drugs have been approved for humans for about a decade.
Diabetes, whether in humans or pets, is caused when too much glucose or sugar builds up in the bloodstream because the pancreas doesn’t produce enough insulin or a hormone or doesn’t use it properly. Bexacat lowers blood sugar by being excreted in the urine. Symptoms of feline diabetes include increased thirst and urination, increased appetite and weight loss.
About a quarter of American households have one or more cats, totaling more than 58 million felines. Between 1 in 100 and 1 in 500 cats in the US are diagnosed with diabetes, which increases as obesity rates approach 50% in the species, said Dr. Bruce Kornreich, director of the Cornell Feline Health Center at Cornell University.
In studies of more than 300 diabetic cats, Bexacat improved glucose control and reduced at least one symptom of diabetes in more than 80% of newly diagnosed, healthy animals, company documents show. But several cats in the studies also died or had to be euthanized after taking the drug, prompting a so-called black box warning about possible side effects, including diabetic ketoacidosis, a life-threatening complication.
Because of those concerns, the drug can’t be used in cats previously treated with insulin, and animals should be carefully screened for liver, kidney and pancreatic disease and to make sure they’re otherwise healthy, Scott-Moncrieff said.
“It will be life-changing for some cats and some owners, but not for every cat,” Scott-Moncrieff said.
The list price for the drug is about $53 per month, according to Elanco. Most vets will double or triple the cost of the drug, charging pet owners about $100 to $150 a month, Cook said.
Depending on the source, that could exceed the cost of insulin and the syringes or pens to administer it, she said. Cats on insulin should be monitored regularly, but cats on Bexacat should also be monitored.
“I think costs will be broadly similar, but there are a lot of variables here,” Cook said.
In Oliver’s case, the cat tolerated the injections — and a glucose monitor that had to be inserted under his skin, Winternheimer said. His owners did well too, but they were relieved when Oliver’s diabetes went into remission last fall.
No doubt the idea of giving Oliver a pill instead would have been appealing, Winternheimer said. “I certainly would have wanted that if it were available.”
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