Senvelgo^® is a once-daily, flavoured oral solution containing the active ingredient velagliflozin licensed for the reduction of hyperglycaemia in cats with non-insulin-dependent diabetes mellitus. Velagliflozin is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor. It reduces blood glucose by preventing the reabsorption of glucose via the SGLT-2 transporter in the proximal tubule of the kidney. This causes urinary excretion of excess glucose and reduces hyperglycaemia, which relieves glucose toxicity and peripheral insulin resistance resulting in increased endogenous insulin production to control diabetes.

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. A check for ketone bodies in the urine or blood is required prior to use. Treatment should not be initiated or resumed if ketone bodies at concentrations indicative of DKA are present.

Senvelgo^® is a flavoured oral solution which is administered via a reusable dosing syringe with 0.5 kg bodyweight markings either directly into the cat’s mouth or onto a small amount of food so that the cat eats it all at once. It needs to be given at approximately the same time each day. In addition, Senvelgo^® has achieved the ISFM Easy to Give accreditation.

Senvelgo^® does not require any special storage conditions. The shelf-life after opening the bottle is 6 months.

Senvelgo^® is rapidly absorbed with maximum plasma concentrations reached in under 3.7 hours in fed cats, so Senvelgo^® increases glucosuria from the first dose onwards. This leads to glycaemic control, usually within 1 week ^1,2. Improvement in diabetic clinical signs follows, although may take up to 1 month.

The most common adverse event is diarrhoea or loose stool caused by minor inhibitory action of Senvelgo^® on SGLT-1 in the small intestine. The majority of incidences of loose stool or diarrhoea last 7 days or less and usually resolve without specific therapy. The most serious potential adverse event is the development of euglycaemic diabetic ketoacidosis in cats which do not have sufficient endogenous insulin production. For a full list of potential adverse events refer to the Senvelgo^® SPC¹².  

Urinary tract infections, including cystitis, may occur as part of the underlying disease, and the glucosuric effect of velagliflozin may also contribute to UTIs. Urinary tract infections are common in feline diabetic patients, but the frequency of UTIs in cats treated with Senvelgo^® is similar to that in cats treated with insulin¹¹. It may be helpful to remember that even a cat well controlled on twice daily insulin injections usually has glucose in their urine at least some of the time. Standard cystitis/UTI therapy should be initiated if there are clinical signs of cystitis.

Yes. In a European clinical field trial, the efficacy of Senvelgo^® was evaluated and compared to insulin. The study confirmed that once-daily Senvelgo^® is non-inferior to (at least as good as) twice-daily insulin injections.^11,12 

Remission of diabetes mellitus in cats is a complex phenomenon, which can be influenced by multiple factors in individual patients, such as glycaemic control, diet, age, weight and/or genetics. Cats that enter remission while treated with exogenous insulin are often identified following a hypoglycaemic episode (usually due to continued administration of exogenous insulin once endogenous insulin production has increased). Due to Senvelgo^®’s mode of action, it may be difficult to identify cats that are in remission, since these cats would not be expected to have symptomatic hypoglycaemic events. Consideration should be given to continuing treatment indefinitely or discontinuing and closely monitoring glycaemic control and for return of clinical signs. If the patient relapses, Senvelgo^® can be restarted when appropriate. However, cats who relapse will have experienced further episodes of hyperglycaemia (and therefore glucose toxicity), which may affect remaining beta cell function and mean these cats may not respond as well to Senvelgo^® in the future, or be an appropriate candidate to restart Senvelgo^®.

While feeding a restricted-carbohydrate diet improves glycaemic control in diabetic cats, the effect of feeding these diets to cats receiving Senvelgo^® has not been specifically investigated. Feeding such a diet, however, was not an exclusion criterion in clinical trials, and no specific concerns were identified in these cats throughout the trial period. We recommend not making any diet changes during the first two weeks of treatment with Senvelgo^®.