Bexagliflozin (Bexacat) for Diabetic Cats in 2025: A Vet’s Guide to Oral Diabetes Management 🐱💊🩺

By Dr Duncan Houston, BVSc
Updated July 2025

💡 Bexagliflozin—marketed under the brand name Bexacat—is the first oral medication approved specifically for managing diabetes mellitus in cats. For owners daunted by insulin injections or strict dietary regimens, Bexacat offers a promising alternative—but only under very specific conditions.

🔬 What Bexagliflozin Is & How It Works

• Drug class: SGLT2 inhibitor—blocks glucose reabsorption in kidneys so more sugar is lost in urine.
• Helps reduce blood sugar without insulin—but carries risk of glucosuria, dehydration, infections, and ketoacidosis.
• Once-daily oral tablet (15 mg), given with or without food.

📈 Why This Matters in 2025

For newly diagnosed diabetic cats with owner preferences against insulin, Bexacat offers a less invasive option. Still, it's not insulin—it suits only carefully selected, non‑insulin-dependent cats. Wise selection and close monitoring are essential.

📋 Inclusion & Exclusion Criteria

• Suitable for: ≥6.6 lbs, newly diagnosed diabetic cats without pancreatitis, ketoacidosis, liver or kidney disease, or elevated ketones.
• Not suitable for: those with prior insulin use, weight loss, lethargy, chronic disease, or ketone elevations.

⚙️ How It's Used

• One 15 mg tablet daily, at the same time each day.
• Monitoring plan: tests at 2, 4, 8 weeks (glucose curve, fructosamine, BHB ketones, liver enzymes), then quarterly.
• Any instability → switch to insulin therapy.

⚠️ Common Side Effects

• Glucosuria → polyuria/polydipsia (sometimes dehydrating).
• Vomiting (44%), diarrhea (33%), decreased appetite (31%), mild pancreatic enzyme elevations.
• UTIs and potential hepatic lipidosis—monitor and stop medication if appetite drops or weight loss occurs.
• Risk of diabetic ketoacidosis (both euglycemic and classic)—requires immediate insulin therapy and hospitalization.

📉 Risks & Interactions

• Glucose loss and diuresis → can worsen dehydration, especially alongside antihypertensives.
• High BHB or rising weight loss → contraindication; stop and initiate insulin.

📲 Role of Ask A Vet App

The Ask A Vet app integrates with Bexacat therapy to support owners:

• Medication reminders and tracking of water intake, appetite, weight.
• Symptom alerts for GI upset, dehydration, or ketone concerns.
• Guidance on when veterinary reevaluation is urgent.

➡️ Use the app to stay aligned with vet monitoring schedules and ensure early detection of complications.

✔️ Tips from Dr Duncan Houston (2025)

• Bexacat is a valuable oral option—but only for carefully-screened cats and owners committed to schedules and testing.
• It requires ongoing lab monitoring and education to avoid serious risks.
• Always have insulin and a treatment plan ready should the cat become insulin-dependent.
• Work closely with your vet via Ask A Vet and in-person visits to maintain optimal safety and effectiveness.

🐾💉 In 2025, Bexagliflozin offers a new frontier in cat diabetes care—but its safety and success hinge on diligence, monitoring, and owner-vet teamwork. If used responsibly, it allows an easier, less invasive way to manage diabetes in the right cat—while ensuring insulin remains a trustworthy backup.