Updates in vet med: drugs (part 2)

It’s already springtime, so it’s time for another update on new and exciting drugs, either already available or coming soon to vet med.

*Please be aware this list only covers the past few months of updates, is not exhaustive, and was selected for small animal medicine relevancy.

** Disclaimer, I do not receive any compensation for mentioning any product listed below. All names and brands are owned by their respective companies.

*** This is a brief summary of each drug. If you want more detailed information than listed here, please go directly to the manufacturer or your local representative.

1) Bexacat™-(bexagliflozin tablets)

This is a new oral drug for managing diabetes mellitus in cats. This is meant to be an alternative to using insulin. Per their website, “.. [it’s a] once-daily tablet alternative to insulin for treating feline diabetes. It lowers blood sugar by increasing urine excretion of glucose through inhibition of sodium glucose cotransporter 2 (SGLT) and results in effective glycemic control.” While I am excited to use this drug in practice, as many cat owners cannot give insulin injections twice a day, there are some usage indications that you need to be aware of. First of all, this is meant for newly diagnosed first-time diabetics with no previous history of insulin injections. The oral tablets are administered to cats weighing 3.0 kg (6.6lbs) or greater once daily, with or without food and regardless of blood glucose level. Because the pill does not affect insulin levels, there shouldn’t be hypoglycemic episodes and no need for dosage changes, as does happen with insulin resistance.

However, some points need to be addressed when giving this drug. It is imperative that you choose the correct patient/client for this drug. Cats taking the tablets are at an increased risk of developing DKA, so they must be monitored closely by both the vet and owners at home for any changes in the cat. Routine bloodwork is recommended and should not be used in cats with a history of liver or renal disease. If the cat has had insulin before, they cannot be prescribed Bexacat. That being said, hopefully, having a daily pill as an option will help make treatment easier at home to manage diabetic cats. Please see the full product label for more detailed information.

2) Vaccine for bees

While small animal veterinarians are not usually treating bees, they are important to our daily life. They are responsible for pollinating most of the fruits and vegetables we eat, not just the flowers we see in the fields. So we must have a healthy population around the world. In the past few years, we have seen sudden die-offs of millions of bees from a condition called “foulbrood,” which is very concerning.

The USDA has conditionally approved Dalan Animal Health’s bee supplement’s labeling to include a new indication for controlling American foulbrood (Paenibacillus larvae) in honey bees. It is available to commercial beekeepers only. It is fed as a jelly to the queen bee and transferred to the larvae when she lays the eggs. So you can vaccinate an entire colony from just one bee! Vet med is cool, right?!

3) Nexgard Plus

Coming down the pipeline soon for the U.S. is Nexgard Plus. It will be a once-a-month pill covering flea, tick, and heartworm prevention all in one. It will have the same active ingredients as Nexgard and Heartgard but in slightly different concentrations. Australia has had a similar product, NexGard Spectra, for a few years, and soon we will have our own version. My local rep has told me that it should be available by summer, and pricing will roughly be the same as if a client purchases Heartgard and Nexgard boxes together. Once that hits the market, we will have two options for single tablets of flea, tick, and heartworm prevention along with Simparica Trio. Ask your Boehringer Ingelheim rep for more information.

4) Panoquell-CA1 (Fuzapladib sodium)

Conditionally approved at the end of 2022, this new drug hails from Japan to treat acute pancreatitis cases in dogs. They have been using it in Japan since 2018. Gold standard treatment up to this point has been primarily supportive care with IV fluids, GI support, pain control, antiemetics, and prescription low-fat diets. This product is a leukocyte function-associated antigen 1 (LFA-1) inhibitor. Broadly speaking, the drug inactivates the neutrophil response to reduce inflammation of the vascular system and pancreas.

Panoquell comes in two vials, one in powder form and the other in a sterile diluent for reconstitution. Per the FOI Summary, the reconstituted product will give you a 4mg/ml solution. The dosage instructions are 0.4mg/kg or (0.1ml/kg) once daily for three days, given over slow IV injection for 15 -60 seconds. This drug is meant to be given concurrently with current supportive care methods. Indications are for acute pancreatitis in dogs only. In the safety trials, Panoquell was administered to dogs with at least two clinical signs of pancreatitis, i.e., vomiting and painful abdomen, and a positive CPL or cPLI test. This drug is one to watch and see how it works in a clinical setting vs. testing. It should be available now to purchase if you want to try it.

5) Bravecto updates

In my last drug update blog, I mentioned that Bravecto and Bravecto Plus for cats were approved for Asia longhorned tick prevention. I surmised that more product approvals would be announced as trials are conducted. So, I’m happy to announce that Bravecto for dogs has since been approved for Asian longhorned tick prevention, too!

That’s all for now. It’s always exciting to see what new, wonderful products are being developed to help treat our patients. Again, for full details and further questions about any product, please see their product summaries or talk to your local rep for more information.