Dosage:
Administer one tablet by mouth to cats weighing 6.6 lbs (3.0 kg) or greater once daily, at approximately the same time each day, with or without food, and regardless of blood glucose level.
Monitoring:
- Sudden onset of hyporexia/anorexia, lethargy, dehydration, or weight loss in cats receiving Bexacat should prompt immediate discontinuation of Bexacat and assessment for diabetic ketoacidosis, regardless of blood glucose level.
- During treatment with Bexacat, blood glucose, fructosamine, serum β-hydroxybutyrate (BHBA), serum feline pancreas-specific lipase (fPL), liver parameters, serum cholesterol and triglycerides; and body weight and clinical signs should be routinely monitored.
- Increasing or persistently elevated feline pancreas-specific lipase or liver parameters should prompt further evaluation for pancreatitis and/or hepatic disease and consideration for discontinuing Bexacat.
- BHBA is the predominate ketoacid in diabetic ketoacidosis. Bexacat should be discontinued if a notable reduction in BHBA is not observed after initiation of Bexacat, or if BHBA persistently rises after an initial reduction.
- Cats with increasing or persistently elevated cholesterol and triglyceride levels may be at an increased risk for developing diabetic ketoacidosis or euglycemic diabetic ketoacidosis.
- Bexacat should be discontinued if poor glycemic control, as described below, develops.
- During the first 8 weeks after initiation of Bexacat, assessment of glycemic control and clinical improvement should be evaluated.
- A physical examination, an 8-hour blood glucose curve, serum fructosamine and body weight improvement should be evaluated.
- Cats demonstrating poor glycemic control, including weight loss, an average blood glucose concentration from an 8-hour blood glucose curve ≥ 250 mg/dL, and/or a fructosamine indicating poor glycemic control, as described above, at 8 weeks.
- Bexacat should be discontinued, and initiation of insulin considered in cats demonstrating poor glycemic control, as described above, at 8 weeks.
- Cats may present with diabetic ketoacidosis and a normal blood glucose concentration (euglycemic diabetic letoacidosis). Delay in recognition and treatment of diabetic ketoacidosis and euglycemic diabetic ketoacidosis may result in increased morbidity and mortality.
- Development of diabetic ketoacidosis and euglycemic diabetic ketoacidosis requires the following actions:
- Discontinuation of Bexacat
- Prompt Initiation of insulin therapy
- Administration of dextrose or other carbohydrate source, regardless of blood glucose concentration
- Appropriate nutritional support should be promptly initiated to prevent or treat hepatic lipidosis.