Senvelgo

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Ragdoll mummy

Member Since 2024
Hi I wouldn't normally sign up to a board but I needed to share the amazing results myv12 year old male ragdoll is having with senvelgo
Honestly day 5 and absolutely no clinical signs no weight loss no ketones and he was previously treated on insulin which just did not work too bouncy !!
So I've had to closely monitor and yes a ton of tests begore hand
But I've seen sceptics about senvelgo and Every cat is different
But wanted to start sharing my senvelgo journey.
 
I know it said that but if you dig deeper there is a protocol for previously treated cats so I had lots of bloodwork he's been on insulin since September
There is a risk of dka regardless of previous insulin treatment or not
Just higher with previously treated cats. Because cats still need to still be able to produce some insulin and this is less likely in previously insulin treated cats. In trials 5% of cats previously untreated had dka and 12% of cats previously treated so I guess the 12% risk is too high
These 12% got dka in first 7 days
I'm testing every day for ketones
Its like he got better overnight
I was willing to monitor and be prepared to stop if piko got poorly.
I had no choice the insulin wasn't working
 
Could you please provide the direct link to the protocol you mentioned? The link you provided is essentially advertising as is the pdf. I just completed a review of the newer insulin products and Larry is correct, the manufacturer and research articles warn against using any of the SGLT-2 inhibitors in cats that were previously prescribed insulin.
 
Its on the actual patient leaflet in the box i don't have the patient leaflet now it was binned with the box
Piko is absolutely fine in the trials 62% of previously treated cats were successfully treated
 
  1. I cant upload a picture for some reason but go to the Defra website which vmd.defra.gov.uk
Or just Google transitioning from insulin to senvelgo.

Piko is literally fine I had a 62% chance he would be bssed
 
The FDA lists this:
Which cats CANNOT take Bexacat and Senvelgo?
Some cats can’t take Bexacat or Senvelgo:

  • Cats that have been treated with insulin in the past or are currently on insulin.
  • Cats that are lethargic (less energy than usual, laying around), dehydrated, or aren’t eating.
  • Cats that have other health problems, especially disease of the kidneys, liver, or pancreas.
  • Cats that have diabetic ketoacidosis.
  • Cats that don’t meet the required weight for the drug.
Based on your cat’s medical history, overall health, and the results of blood and urine tests, your veterinarian can decide if Bexacat or Senvelgo is a good choice to treat her diabetes.
 
The fda does not regulate the uk firstly
Secondly I was trying to help
Thirdly its defra for the UK with vetinary products
Its on the UK patient insert in the box
I was trying to help not cause an argument
In the UK if your vet has direct contact with the manufacturer and follow the monitoring process and know the risks than you will be prescribed it
Vets in the UK are not allowed to prescribe it unless in partnership with the manufacturer.

I'm absolutely aware of contraindications and if they are going to happen the risk is no greater in cats previously treated on insulin after 7 days. I've communicated with the manufacturer myself been on it
I do see that the ability to produce thier own insulin becomes less likely the longer they have been on it.
Its not black and white in the UK
It was only approved in uk 7th November 23 and only available for cats previously treated on insulin in close partnership with your vet who is in direct contact with beringer inglegeim
 
I am aware that the FDA does not regulate the UK. I am not arguing with you but rather helping to inform others.
 
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Hi tifmaxee sorry its just all the replies are telling me I shouldn't be doing what I'm doing im an educated lady and have worked with the manufacturer through my vet
I'm able to do all the testing at home but so are alot of others which I dont think the manufacturers maybe appreciate or maybe they do we are day 7 tomorrow so piko will be on the same playing field as not previously treated cats.he is so happy eating putting on weight socialising more its only now I can see how different he felt when his diabetes was uncontrolled. Bg levels are between 5.5 mmo/l and 11mmo/l
I couldn't get him under 18 on insulin
Abd he was proper poorley
 
The US package insert includes: "Thirty-eight enrolled cats had been previously treated with insulin. Of those 38 cats, 12 (32%) developed ketonuria, diabetic ketoacidosis, or euglycemic diabetic ketoacidosis during the first week and were removed from the study. These 12 cats are included in the 26 cases reported above and represent 46% of the cases removed in the first week of treatment due to ketonuria or ketoacidosis. "

https://docs.boehringer-ingelheim.com/SENVELGO_oral_solution_PI.pdf

Can you google for the package insert for the UK and provide a link

Also see page 22 of:
https://senvelgo.co.uk/sites/default/files/2023-10/Senvelgo_Vet_Management_Guide_0.pdf

Can I switch a cat from insulin to Senvelgo®? Yes, cats can be transitioned from insulin to Senvelgo®, however we don’t recommend switching stable diabetic cats unless there are clinical or compliance reasons. For cats previously treated with insulin/ another anti-diabetic medicinal product the dosing regime is the same as for newly diagnosed cats. When transitioning from insulin, omit the insulin evening dose from the day before starting Senvelgo®. Cats that are transitioned from insulin to Senvelgo® are at increased risk of developing diabetic ketoacidosis (DKA) and euglycaemic diabetic ketoacidosis (eDKA) and must be closely monitored in the post-transition period for the presence of ketones.
 
We weren't trying to tell you what to do. Clearly, prescribing practices differ between the UK and the US.

I followed your suggestion and Googled making the transition between insulin and Senvelgo. I was able to see the UK packaging/labeling instructions. The instructions that Larry included above were not included. It appears that what Larry was able to find is geared to consumers.

At least in the US, the warning is much stronger about not using either of the SGLT-2s with cats that have previously been prescribed insulin. In the UK, as long as the vet has provided you with informed consent, it's your decision. You appear to be comfortable with the risks. I would also be curious what insulin you were using with your cat. Insulin choice has been fairly restrictive in the UK until recently. My understanding is that vets were mandated to use Caninsulin. It's only recently that Prozinc was an option. In the US, and much of what we see on this board, Lantus (glargine) is used more often than any other insulin.

At this point, there is still very limited research using either Senvelgo or Bexacat. And, frankly, there's more research on the use of Senvelgo with ponies than there is with cats. We're all learning about this new class of drugs and their use in species other than humans. There are clearly cats that would benefit from having an oral option available. Because these drugs are still so new, we are very careful with making recommendations. There are any number of caregivers who lurk and don't post. That being the case, we do not want to mislead or misinform anyone and we want to make sure that if there are differences between countries, prescribing practices, etc. that those differences are clear.
 
I completely get that piko was on caninsulin then prozinc it just wasn't working too much /too little/ bouncing, his body just didn't like the insulin, he became unsociable as well
I have tried to Google the package insert when I get another bottle I can take a picture I will get another one by the end of this month
I dont seem to be be able to upload a file it says i dont have permission to perform the action?
 
This is from the senvelgo UK website
Can I switch a cat from insulin to Senvelgo®?
Yes, cats can be transitioned from insulin to Senvelgo®, however we don’t recommend switching stable diabetic cats unless there are clinical or compliance reasons. For cats previously treated with insulin/another anti-diabetic medicinal product the dosing regime is the same as for newly diagnosed cats. When transitioning from insulin, omit the insulin evening dose from the day before starting Senvelgo®. Cats that are transitioned from insulin to Senvelgo® are at increased risk of developing diabetic ketoacidosis (DKA) and euglycaemic diabetic ketoacidosis (eDKA) and must be closely monitored in the post-transition period for the presence of ketones.
 
This isn't a marketing tool by a third party company its written by the manufacturer for the UK

If piko was well on insulin we would all have been happy
I'm relieved he has been ok
I literally have tested for keytoned 3x day, I am more relaxed now going into day 7 tomorrow.
When he was on insulin he was so unhappy and poorly and weak he's 12 and its like taken years off him the senvelgo but I do know I took the risk and I was scared I nearly didn't make the change im just glad I did but I literally didn't have a choice he had no.life he had no underlying medical conditions I just think the whole unmanaged diabetes made him sad.
 
The thing is informing others that its dangerous and categorically off limits is not great either, some cats may be suffering unnecessarily there is that as well. I think this makes for interesting discussion moving forward.
 
Larry posted the same information in post #17 in this thread.

Given that this site is based in the US and the manufacturer's recommendations explicitly state that a cat should not be an insulin dependent diabetic, those are the guidelines we endorse. We have encountered a similar issue with meloxicam. In the US, the FDA (Food and Drug Administration) has a black box warning for the use of this non-steroidal anti-inflammatory drug for cats. (A black box warning is as strong a warning as the FDA can give short of pulling a drug off of the market.) Meloxicam has caused renal failure in cats. However, the dosing that is recommended outside of the US differs and it is used more successfully. The bottom line is that informed consent is imperative so you can agree to a treatment based on weighing the facts.
 
Good morning from the UK
Senvelgo update
Piko has been 5 weeks now on senvelgo and he's literally back to his old self he's put on half a kilo and blood sugar is between 5.5 and 7.5 mmo/l
Literally amazing he was previously treated with insulin and ketones are monitored although not so much an issue now he's 5 weeks in.
Just thought I'd update
 
Piko has been 5 weeks now on senvelgo and he's literally back to his old self he's put on half a kilo and blood sugar is between 5.5 and 7.5 mmo/l
Literally amazing he was previously treated with insulin and ketones are monitored although not so much an issue now he's 5 weeks in.
Just thought I'd update
Hi, waving from Surrey. :bighug:
That's a great update. I'm so glad things are going well for Piko on Senvelgo.

I just read through the whole thread. And yes, it is confusing that the prescribing guidelines are different in the US and the UK. Once we all get used to that it'll get easier... :cat:

Are you also testing urine glucose?
The reason I ask is that it is possible for cats on Senvelgo to go into diabetic remission (just as cats on insulin can). From the cases I've actually read about it may be that changing to lower carb diet has been a significant contributory factor. ...But, it is harder to determine whether remission is happening with Senvelgo.
What some people have found is that it's useful to monitor both urine glucose and blood glucose, and to keep an eye on the relationship between those.
The way Senvelgo works is by getting the body to excrete more glucose in the pee. But, if you're measuring urine glucose and see that urine glucose level dropping, it may mean that more of the glucose is being utilised from the blood (therefore there's less to excrete in the pee...) The cat may also drink and pee less if there's less glucose to excrete... And this 'might' mean that the body is healing... That makes it all the more important to test the blood glucose to make sure it isn't dropping too low (it is possible for it to drop too low on Senvelgo...)

Keeping fingers and paws crossed that Piko continues to do well.

Eliz
 
Good morning from the UK
Senvelgo update
Piko has been 5 weeks now on senvelgo and he's literally back to his old self he's put on half a kilo and blood sugar is between 5.5 and 7.5 mmo/l
Literally amazing he was previously treated with insulin and ketones are monitored although not so much an issue now he's 5 weeks in.
Just thought I'd update
Hello dear, I went through all your comments and replies and I see that you digged deep and know basically everything when it comes to Senvelgo. One of my two cats got recently diagnosed with diabetes and we chose Senvelgo but before I jump into the financial responsibility I wanted to ask if Senvelgo is treating the problem or if is just keeping it in normal/ healthy condition. My question being is this something my cat will need for the rest of his life or if is something that will be eventually no longer needed for him? And I wanted to add how extremely happy me and my mum was when we found out how great is Piko doing!
 
My question being is this something my cat will need for the rest of his life or if is something that will be eventually no longer needed for him?
Many cats. especially newly diagnosed ones, go into remission (no longer require insulin) after being treated w/insulin. I a not aware of any data on cats going into remission with on Senvelgo or the similar (but tablet) Bexacat. It may be hard to determine when a cat insto remission when on one of these drugs since BG does not that low like a cat going into remission on the drugs. Tat is one of the advantages of the drugs it is very hard for BG to go too low.
 
Hi tifmaxee sorry its just all the replies are telling me I shouldn't be doing what I'm doing im an educated lady and have worked with the manufacturer through my vet
I'm able to do all the testing at home but so are alot of others which I dont think the manufacturers maybe appreciate or maybe they do we are day 7 tomorrow so piko will be on the same playing field as not previously treated cats.he is so happy eating putting on weight socialising more its only now I can see how different he felt when his diabetes was uncontrolled. Bg levels are between 5.5 mmo/l and 11mmo/l
I couldn't get him under 18 on insulin
Abd he was proper poorley


My vet was actually at a conference recently where this was discussed. In Europe it is now approved for use in cats who have been on insulin. There are many factors to consider and every case is different, but with correct monitoring this can be done. My cat is having no results with insulin so we are switching to Senvelgo. We have to monitor blood ketones, but we are hopeful this will work
 
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