New Member - Questions about Senvelgo

[AutumnMom]

My 10 year old girl, Autumn, was diagnosed last week. Her BG was high (500) but her ketones were low (.2) so my vet said we can start her on Senvelgo. Her first blood test is tomorrow, so I'm crossing my fingers that it will be okay. My vet has said nothing about feeding, and there is limited information on the Senvelgo literature/site. I know I need to switch her over to a low carb diet. Both her and my second cat, Onyx, are used to free-feeding. Both are overweight (Autumn just weight in a 14 pounds and Onyx is about 13 pounds.

I know with insulin a cat needs to eat below/after they get their shot, but I can't find any information related to this for Senvelgo. Autumn typically licks the juices off wet food, but eats very little of it. She is still eating on Senvelgo, but still not very interested in wet food. I'm reluctant to take away their kibble completely because I don't want her to go hypoglycemic from lack of food. As it is, I use an autofeeder to portion their kibble and limit their access. Does anyone have advice about changing over to a low carb diet while using Senvelgo?

PS Onyx loves wet food and changing him over will be pretty easy. He needs to lose weight but has no other health issues.

 

[Sienne and Gabby (GA)]

I'm concerned about using Senvelgo with a cat that has even trace ketones. Please look at our post on the newer diabetes treatments. The presence of ketones is a major contraindication for the use of either Senvelgo or Bexacat. Both drugs increase the likelihood of diabetic ketoacidosis (DKA) so if Autumn already has even a small indication of ketones being present, I would not take the risk. DKA can be life threatening.

 

[Wendy&Neko]

Are you testing Autumn regularly for ketones at home? We strongly recommend when they are first diagnosed and put on Senvelgo. You can either test with urine testing sticks such as Ketostix (available at human pharmacy) or use a blood ketone meter. Tips to catch and test a urine sample

Switching Onyx to low carb wet food will help him lose weight. I had a recent adoption (17 lb) when Neko was diagnosed and I switched him to the same diet as her. It did wonders for his figure. We've seen cats on Bexacat do better when switched to a low carb food. If kitty is a grazer, that's OK. Just add water to the wet food to keep it fresher longer. Most of the diabetic kitties here get multiple small meals of food, easier on their pancreas.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
I also would be cautious using Senvelgo and I would be testing daily for ketones.
Diabetic cats need to be eating well.

 

[AutumnMom]

Thanks everyone! Autumn had blood ketones of 0.2 on Thursday, which is in the normal range for a cat (the Vet said if she was 1.0 or above we could not use Senvelgo). But I know DK is a concern, so I'm keeping a close eye on her food and water intake. BTW, I found information that you can't use urine testing for ketones with Senvelgo or Bexacat because they cause the cat to excrete glucose, which causes inaccurate readings. Her three day follow-up is tomorrow morning and I will ask about home testing, as well as feeding as I transition them to wet food. I have some Dr. Elsey's on order to help with the transition.

She's not thrilled about getting her daily dose, but she is eating a little more and she's active. I got her to play a while today.

 

[Sienne and Gabby (GA)]

There are blood ketone meters that you can purchase. The strips are pricey but you don't need to test all that frequently.

 

[AutumnMom]

Aaand now I've found a bunch of sources that say to test urine ketones when using Senvelgo. Once of my frustrations is the amount of conflicting information that is out there, even from medical sites. Small wonder this feels overwhelming! Some places say stay to a strict two meal a day to monitor how much she is eating, others say that free-feeding of low carb food is okay. I would much rather let them free-feed, but Onyx will eat any wet food he can get to, so I can't get an accurate sense of what Autumn is eating unless I watch her.

 

[Bron and Sheba (GA)]

You could invest in an automatic timed feeder with a chip attached that will only let Autumn eat from the feeder

 

[AutumnMom]

An update on Autumn's progress and some information I've been able to find:

Autumn had a little vomiting after her first dose of Senvelgo, but it cleared up by the next day. Her water intake and peeing have decreased. She ate pretty well the first three days, but has pretty picky the last two days. She had her 3-day blood work done on Monday. Her BG had dropped from 500 to 137. Her blood ketones looked good as well. The vet clarified that blood ketones at 1.0 or above would mean she's not a candidate for Senvelgo, due to increased risk of DKA. The first 14 days on Senvelgo are the highest risk for DKA; after that, there is always a risk, but it drops significantly.

The vet also recommended allowing her to free-feed as she is adjusting to the medication. She's not a fan of wet food, but I got some Dr. Elsey's Pure Protein kibble to help with the transition and she loves it! So now the cats are only allowed to free-feed on low-carb wet food and Dr Elsey's.

While I was researching, I found the European Commission Summary on Senvelgo. I found it a lot clearer and informative than the information in the US packaging or on the website. I also found a really clear explanation of ketones and levels at Diabetic Cat International, including a helpful table.

European Commission Summary on Senvelgo https://ec.europa.eu/health/documents/community-register/2023/20231120160841/anx_160841_en.pdf

Diabetic Cat International Info on Ketones in Felines https://www.diabeticcatinternational.com/knowledge/ketones/

 

[Bron and Sheba (GA)]

@Sienne and Gabby (GA) and @Wendy&Neko might be interested to read the 2 links.
Thanks

 

[Wendy&Neko]

Thanks for the European link on Senvelgo. It contains more detail that I've seen elsewhere.

I've seen the DCI post before, there's been lots of debate about the ketones scale they use. One of our posts links to a couple published articles with different scales for when you become concerned.
Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

 

[Larry and Kitties]

BTW, I found information that you can't use urine testing for ketones with Senvelgo or Bexacat because they cause the cat to excrete glucose, which causes inaccurate readings.

I never heard that. However, the type of ketones that a DKA cat produces is not really detectable by urine test strips but are by ketone blood meters. See:
https://vetemcrit.com/ketone-detection/