Bexacat

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Smrbrz01

Member Since 2023
Hello, my cat recently started taking bexacat and on the third day she had diarrhea twice (I know that’s a common side effect). I called my vet yesterday to let her now and to ask what I should do but she’s gone until Monday. I spoke with another doc that was in the office and she advised me to stop giving my cat bexacat for the weekend and call back on Monday and speak with my regular doc. (She didn’t seem very knowledgeable about cat diabetes) I followed her instructions though. My cat seems fine otherwise. I’m interested to see what my regular doc will say:
 
I'll be honest -- I don't know. From what I read, the recommendation is to stop Bexacat if the cat doesn't respond to conventional treatment for diarrhea. It doesn't sound like there was any suggestion from the vet regarding an intervention. You could try S. boulardii which is a probiotic that is great at stopping diarrhea. (You start with about 1/4 - 1/3 of a capsule and you can mix it into food.)

What I find challenging with Bexacat is that there are a lot of issues where it's recommended that you stop the medication. In a situation like you're running into, it's a weekend. You're likely not going to be able to talk to the vet that wrote the Rx until early next week. This means that your cat's diabetes is going untreated for several days. The risk is that if there's something other than the Bexacat that's causing a GI problem, there may be a chance that it's an infection or inflammation and it puts your cat at risk for ketones developing. Ketones are a major contraindication for using an SGLT-2 inhibitor. All of this is because this form of treatment is very new. We've not had many members who have been using Bexacat and there's just not a lot of research yet to guide decision making.
 
I'll be honest -- I don't know. From what I read, the recommendation is to stop Bexacat if the cat doesn't respond to conventional treatment for diarrhea. It doesn't sound like there was any suggestion from the vet regarding an intervention. You could try S. boulardii which is a probiotic that is great at stopping diarrhea. (You start with about 1/4 - 1/3 of a capsule and you can mix it into food.)

What I find challenging with Bexacat is that there are a lot of issues where it's recommended that you stop the medication. In a situation like you're running into, it's a weekend. You're likely not going to be able to talk to the vet that wrote the Rx until early next week. This means that your cat's diabetes is going untreated for several days. The risk is that if there's something other than the Bexacat that's causing a GI problem, there may be a chance that it's an infection or inflammation and it puts your cat at risk for ketones developing. Ketones are a major contraindication for using an SGLT-2 inhibitor. All of this is because this form of treatment is very new. We've not had many members who have been using Bexacat and there's just not a lot of research yet to guide decision making.

the vet prescribed probiotics for 2 weeks and said she can try bexacat again. The diarrhea should clear up once she’s used to the medicine. And I did get ketone strips and tested her and it was negative. I bought a glucose meter but haven’t been able to get blood from her and I’ve tried multiple times
 
I would strongly encourage you to keep testing for ketones. Stopping diabetes treatment, especially if the diarrhea is due to some sort of GI inflammation, is increasing the risk for ketones developing.
 
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