New Feline Diabetes Drug Velagliflozin Now Available

Jim Budde, PharmD, RPh, DICVP, Plumb's Veterinary Drugs

ArticleLast Updated September 20232 min read
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Drug Details and Pet Owner Handout Available in Plumb’s

Veterinarians have another therapeutic option to manage feline diabetes mellitus. Velagliflozin is the first oral liquid agent approved to treat diabetes mellitus in otherwise healthy cats.

Pharmacology of Velagliflozin

Velagliflozin works by inhibiting sodium-glucose linked transporter 2 (SGLT2), decreasing renal glucose reabsorption and increasing urinary glucose excretion.

Contraindications of Velagliflozin

Velagliflozin is contraindicated in and therefore is not to be used in cats that were previously or are currently treated with insulin, in cats that have insulin-dependent diabetes mellitus, and in cats with or that have evidence of hepatic disease or reduced renal function.

Velagliflozin increases the risk for potentially fatal diabetic ketoacidosis (DKA) and euglycemic DKA, which can occur at any time during treatment, including in cats with improved glycemic control. Velagliflozin should be immediately discontinued if DKA is diagnosed or suspected.

The drug should also not be initiated in cats:

  • That are currently anorexic, dehydrated, or lethargic

  • With ketonuria or ketonemia

  • With current or past history of diabetic ketoacidosis

  • With clinical signs or other objective evidence (fPL level greater than 12, diagnostic imaging) within the previous month consistent with pancreatitis, or with a history of pancreatitis.

  • With chronic or unresponsive diarrhea

  • With cachexia

  • With BUN greater than 2 mg/dL or bilirubin greater than 0.5 mg/dL

Side Effects of Velagliflozin in Cats

Common adverse effects include GI signs (eg, vomiting, diarrhea, anorexia), weight loss, lethargy, dehydration, UTIs, and elevations in laboratory parameters (ie, blood urea nitrogen [BUN], fPL, bilirubin). Rarely, pancreatitis/pancreatic necrosis, hepatopathy, hepatic lipidosis, and death also have occurred. Velagliflozin-induced glucosuria results in an osmotic diuresis that increases the risk of dehydration.

Additional Information & Dosing Instructions

The risk for potentially fatal diabetic ketoacidosis (DKA) and euglycemic DKA is increased during velagliflozin treatment; careful screening is required before initiating therapy, and diligent monitoring must be continued during treatment. A comprehensive look at how to manage diabetes in cats using velagliflozin is offered by the experts at Plumb’s; full details, as well as a pet owner handout, can be found here.