Can cats on an SGLT2 inhibitor go into remission?

Remission in feline patients with diabetes is often the goal. With the advent of new treatment options like sodium-glucose cotransporter 2 (SGLT2) inhibitors, clients may have questions about whether a patient can go into remission while on this therapy. In this video, Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM), a consultant at Veterinary Information Network, discusses what is currently known about the potential for remission in cats on SGLT2 inhibitors, as well as steps to take to know if a cat is in remission and the possibility of long-term SGLT2 inhibitor use.

Related: Should cats on an SGLT-2 inhibitor go on a special diet?

Below is the interview transcript, which has been lightly edited for improved clarity:

Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM): A really common question is: Can cats on an SGLT2 inhibitor go into remission? We do know that the answer is yes, based on anecdotal information.

We don't know how often that is. In theory, it would be more common with an SGLT2 inhibitor than in cats on insulin because we do know the better you control the blood glucose and the quicker you control the blood glucose, the more likely the cat's going to go into remission. And SGLT2 inhibitors seem to control the blood glucose more quickly and you have much flatter glucose curves. The only way, though, to know whether a cat is in remission is to stop the drug and see what happens—whether the diabetes comes back.

I typically would do that at 3 months, see if the cat is in remission. If not, you can start the drug again. Try it again at 6 months. If the cat's not in remission at that point, the chances are that it's not going to go into remission, and I would not routinely check again.

You can leave a cat on an SGLT2 inhibitor for life. It's not going to hurt the cat. It would potentially help the cat, as far as it's going to have diabetes controlled for the rest of its life. It will never come out of remission.

But of course, the issue is the owner's pocketbook—so it's really up to the owner whether they want to try or not.