Senvelgo

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Hope Y.

Member Since 2023
Our cat Smokey hadn't been responding well to insulin (diagnosed in June 2023) and was later diagnosed with agromegaly. Our vet then suggested a new liquid treatment for diabetic cats called Senvelgo (SENVELGO® (velagliflozin oral solution) | Boehringer Ingelheim Animal Health (bi-animalhealth.com) etc.. As of now, it's for cats not previously on insulin, which Smokey was. Our vet did say that trials in Europe with cats previously on insulin are showing good results, and he is pretty sure that this will soon be approved for use here. As of now, we're using Senvelgo off label. At his check last week, Smokey's glucose numbers were 138 and his ketones were .6, in the normal range. For diabetic cats, this is another avenue to explore.
---Hope
 
https://www.fda.gov/animal-veterina...ditions-associated-use-senvelgo-velagliflozin
https://dailymed.nlm.nih.gov/dailym...ca1f-bded-459e-a813-24d931d50b9a&type=display

"Cats treated with SENVELGO may be at an increased risk of diabetic ketoacidosis or euglycemic ketoacidosis (see Adverse Reactions). As diabetic ketoacidosis and euglycemic ketoacidosis in cats treated with SENVELGO may result in death, development of these conditions should be treated promptly, including insulin administration and discontinuation of SENVELGO (see Monitoring).
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Due to the risk of developing diabetic ketoacidosis or euglycemic ketoacidosis, do not use SENVELGO in cats with diabetes mellitus who have previously been treated with insulin, who are receiving insulin, or in cats with insulin-dependent diabetes mellitus (see Contraindications).
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SENVELGO should not be initiated in cats with anorexia, dehydration, or lethargy at the time of diagnosis of diabetes mellitus or without appropriate screening tests (see Animal Safety Warnings)."

Your cat probably shouldn't be taking this medication if he is a diabetic and has previously used insulin. I know you are aware of this, but I would question my vet as to why they are going against the drug regulations set forth by the maker. Did you see the trials out of England?

What are the case/field studies on this medicine in cats?

I would be leary using anything that doesn't have years worth of unbiased testing on cats.

There are many underlying issues that can cause unregulated blood glucose in our cats and unless I exhausted each of those avenues, I would not try this medication.

Was Smokey given Cabergoline for his acro?

With both diabetic and euglycemic DKA as a potential side effect listed, I'm not sure if ketostrips/or ketone meter pick up the . I would definitely look into that too. The euglycemic DKA may oy be detected via lab work.

I'm hopeful you further research this decision and please home test your cat's bg and ketone levels.

I am not telling you any of this to worry you and others here may have different opinions, but that is my personal opinion.
 
I haven't seen anything in the studies on Senvelgo or Baxacat (both SGLT-2 inhibitors) about testing this medication with cats with acromegaly. There are other ways to treat acromegaly that have proven to be safe and will help with the acromegaly symptoms, not just the high blood sugar. I'd be worried about longer term effects of this drug on acrocats since there haven't been any studies on them.

As Sybil mentioned above, DKA is a real side effect and we've seen a kitty here pass from using Bexacat that caused DKA. Test every day for ketones. Don't wait for tests at the vet, get some ketostix and test an home. DKA can come on quickly.

I do hope it works out for you. Keep us updated.
 
The manufacturers are adamant in their warnings that none of the SGLT2 inhibitors (Bexacat and Senvelgo) should be used with cats that have been prescribed insulin previously. They also state that cats should be evaluated for concurrent disease including pancreatitis, infectious disease, urinary tract infection, neoplasia, and hypersomatotropism (acromegaly) before initiating and while receiving either Bexacat or Senvelgo. In other words, whether it is because of the lack of data to support the use of an SGLT2 with in cats with any of these conditions or these conditions contraindicate the use of this form of treatment, there is nothing to support Senvelgo's use in cats with acromegaly. It is clearly off-label in a drug that so far has limited research to support it's use.

I would ask your vet to produce the research that supports his recommendation. If he can't do so, he's putting your cat's life at risk. I've been doing a fair amount of reading on this topic. There is not a great deal of research and much of the research is on small samples. Frankly, there's more research on Senvelgo with ponies than there is with cats.
 
Hope Y. said:
Our cat Smokey hadn't been responding well to insulin (diagnosed in June 2023)
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Can you provide some information like insulin tried, dose and BGs? I have had two and maybe three cats w/acromegaly. Typically the the insulin dose required to maintain reasonable BG goes up rapidil. Mh MurrFe got up to 50 units twice daily. Thus, I doubt that any SGLT2 inhibitor would give reasonable BG control for long even it it works in the shorterm.
 
Hope Y. said:
Our cat Smokey hadn't been responding well to insulin (diagnosed in June 2023) and was later diagnosed with agromegaly
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Hope…I meant to add this last night and I’m glad Larry referred to it.

While not wanting to undercut any vet as they are doing their best, we have found here that most vets do not know how to successfully manage FD. They often start the insulin at the wrong dose and increase it too much, too fast. If a cat has acromegaly, it can be even more of a challenge especially with a cat diagnosed as recently as June, 2023.

Lastly, one test does not a well-regulated cat make. In order to determine if the medication has brought Smokey down into normal BGs, you’d have to do a few curves. We are big on hometesting here to actually see what progress a cat is making. I have seen unregulated cats occasionally dip down into lower BGs but then go right back up.

We would love to see more data but, at this time, we are still on the fence on the efficacy of the newer drugs especially for acro cats or cats who have previously been on insulin.
 
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