Bexacat: New pill treats diabetic cats without daily insulin

When Mark Winternheimer’s 12-year-old tabby cat was diagnosed diabetes Last year, treatment was daunting: twice-daily insulin injections, an implanted monitor, and frequent visits to the vet.

Despite their misgivings, Winternheimer and his wife, Courtnee, of New Albany, Indiana, learned to give Oliver his shots.

“For us, they are part of the family,” says Winternheimer about Oliver and her two other cats, Ella and Theo. “You would not refuse care to another family member if it is available.”

Now, a new once-a-day pill promises to make it easier to treat feline diabetes in newly diagnosed pets without needles.

“A pill is a big step up from a needle,” said Dr. Audrey Cook, a feline veterinarian at Texas A&M University.

One caveat: the pill, called Bexacat, can’t be used on cats like Oliver who’ve previously been on insulin.

The biggest benefit might be ease of use, experts said. While many cat owners have successfully treated their cats with twice-daily insulin, often for years, others struggle. Research shows that owners have been lying down 1 in 10 cats with a new diagnosis of diabetes. Another 10% are euthanized within a year, partly because of treatment difficulties.

“Some people are afraid of injecting insulin. Some people don’t have the time to take care of their cats,” said Dr. Catharine Scott-Moncrieff, a Purdue University veterinarian who consulted with the makers of Bexacat about the product testing.

Manufactured by Elanco Animal Health Inc., Bexacat has been approved by the Food and Drug Administration In December and is expected to be available in the US in the next few 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 isn’t making enough insulin, a hormone, or using it properly. Bexacat lowers blood sugar by causing it to be eliminated in the urine. Symptoms of feline diabetes include increased thirst and urination, increased appetite and weight loss.

About a quarter of US households have one or more cats, more overall than 58 million cats. Between 1 in 100 and 1 in 500 cats in the US will be diagnosed with diabetes, and it’s increasing as the obesity rate for the species approaches 50%, 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 cats, 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 these concerns, the drug must not be used in cats that have previously been treated with insulin, and the animals must be carefully evaluated for liver, kidney and pancreas disorders to make sure they are otherwise healthy, Scott-Moncrieff said.

“It will be life-changing for some cats and some owners, but not for every cat,” said Scott-Moncrieff.

The drug’s list price is about $53 per month, according to Elanco. Most vets will double or triple the cost of the drug and charge pet owners about $100 to $150 a month, Cook said.

Depending on the source, that could be more than the cost of insulin and the syringes or pens to administer it, she said. Cats taking insulin will need frequent monitoring, but cats taking bexacat will also need monitoring.

“I think the 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 blood glucose meter that had to be inserted under its skin, Winternheimer said. His owners were doing well too, but were relieved when Oliver’s diabetes went into remission last fall.

There’s no question the idea of ​​giving Oliver a pill instead would have been appealing, Winternheimer said. “I would definitely have preferred that if it had been available.”