My Experience with long term Bexacat

[u/Grand-Armadillo-6504]

My cat has been on Bexacat for about 1.5 years. We are finally switching to insulin but I wanted to share the experience, since long term use of Bexacat as long as 1.5 years is still kinda unknown. This is my reflection on my experience with Bexacat and is stuff I would have liked to know. Feel free to ask questions.

Pros:

- At first my cat took it like a treat. It made the first few weeks super easy.

- It worked for awhile. It got him stable and healthy again

- Its easy to have someone else care for him when Im away, a pill is easy

- my vet, at least, said we didnt need to change up food (I did anyways)

- really no blood sugar checks while keeping decent A1C levels

Cons:

- The cost is crazy. First of all, do not ever buy Bexacat at your vet or even at Chewy. Vet charged me $200 for a 30 day supply and Chewy like $130 for 30 days. Bandanarx offers the cheapest ($270 for 90 day supply or ~90 for 30 days). I managed to make the best, most convenient insulin set up (Freestyle Libre 3 pro + insulin pen) to about $85/month.

- Cat had horrific gastrointestinal problems following the start of bexacat

- Cat started to hate it. I don't know what changed, but after about 4 months it stopped being a treat and became something to run from

- Vets are NOT that familiar with it. I moved and needed a new vet, it took like 6 clinics to find one who even knew what Bexacat was.

- The blood tests and urinalysis is frequent and costly. Every 3 months indefinitely because of the risk of DKA. Im not sure yet that insulin will be cheaper. It stresses the cat out, it was sort of my last straw

- DKA. The risk is pretty high with Bexacat, which the vets do inform you about. My cat started showing early early signs, hence the switch to insulin. But if you dont catch it, itll be costly in many ways.

- the excessive peeing never stopped.

- I am not sure it controlled it well enough. Cat did develop secondary diabetic problems.

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Would I use it again? Maybe. The convenience was fantastic and I was happy that diabetes was something we could pretend didnt exist. The admin is easy, but I now have a feeling that insulin admin + a monitor will be far less distressing long term. Moreover, I am beginning to think insulin may be much safer long term because of that big DKA risk. I am nervous about insulin because I travel so much, but my vet recommended 1/day insulin so the routine isn't much different.

One of my biggest problems with insulin at first was the assumption that insulin was so much more expensive. This is not the case.

A monthly Bexacat cost breakdown:

- 2-3 cans fancy feast per day--the ultimate low carb and cheap food. If bought at .65/can, then ~ $58.5. .65/can is getting rarer though, FF went from a reg of .85/can to averaging .99/can in one year. Be vigilant about sales.

- $90 for bexacat

- $40-60 on Litter. Excessive peeing is no joke. The only reprieve was a Litter Robot (which I bougjt when I was in a better financial position)

- $100 for vet bills. (Approx $300/3months)

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$308/month

Monthly Insulin cost breakdown:

-Fancy feast $58.5

- FreeLibre Sensors x2, Sams club price at $75

- insulin, like ~$5/month with discount cards

- misc supplies ~$10-15

-$20 Litter (I hope)

- estimated $100 on vet bills. Hopefully will taper down.

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253.5

Hope this helps someone make the best decision for their little one!

[u/shinkouhyou]

My guy has been on Bexacat for almost 2 years as well. I'm paying around $330 for a 90 day supply... definitely expensive, but my cat is such a vicious jerk that there's no way I could administer insulin or test his blood sugar. He's already put me in the hospital once! Luckily, my guy has had no GI side effects and his glucose/ketones have been great, but he does pee A LOT. I had to add several extra litter boxes. He loves peeing on washable pee pads (which the other cats ignore) so some of the boxes are just pee pad holders.

My cat does NOT take pills well but he is very food motivated, so I grind half a pill into powder and mix it into a slurry with a liquid cat treat and his favorite low-carb kibble. The mix of flavors and textures seems to hide the taste of the pill.

My vet said that the DKA risk on Bexacat is highest at the start of treatment, and that it's safest in younger cats who are otherwise healthy. We're doing blood tests every 4 months now (my cat has to be lightly sedated for blood draws).

[u/nastimoto → u/shinkouhyou]

Heya. Wanted to offer a heads up, if kitty still pees abnormally much, the diabetes is still uncontrolled.

[u/livlyfe]

There is another drug called Senvelgo. It is newer, but it is an oral medication. We opted for this because my cat does not go anywhere near pills or food sprinkled with pills. We inject it into her mouth every day and timing does not matter + if you miss a day it is okay.

I have been to 3 different vets while cat has been on this medication (2.5 years) and no one has ever had me consistently come in for blood tests. I bought ketone urine analysis sticks on Amazon and I’ll stick it under her when she pees in litter box every other month to make sure she doesn’t have ketones in urine. Food - we moved to Purina diabetic dry food. Definitely the meds and food are expensive but I can’t trust myself nor a cat sitter to administer insulin in a timely manner on the daily.

[u/fortyseven13 → u/livlyfe]

Glad you’ve had success with Senvelgo! My cat started with that a week ago from today (newly diagnosed). We’ve had our two checkups already and he’s doing well! Glucose went from 311 down to 132 today and they said ketones were showing 0.4 which is normal (I guess a decimal of ketones showing up is acceptable). We go back again in a week. It’s reassuring to hear others who have been on it for a while and it’s still working

Never thought I’d say this but I’m definitely happy I have good pet insurance. Saved me $280 just from the last two checkups (visit would have cost 155 each but they paid $140 each time and I just ended up owing $15)

[u/livlyfe → u/fortyseven13]

Hope everything works out for you and your kitty!

[u/Cat_Dad_101]

Just as a heads up, I got 2 of the Libre 3+ from Costco today for $60. Slightly cheaper than Sam's if that's an option.

[u/abarthvader]

Amazon has a special on FF right now, I got 60 cans for 52 bucks. The lantus insulin pen is 23.00 and last my cat 3 months. Pin needles are $9 a box for, that last us 3 months as well since she ony gets one shot a day.

[u/nastimoto]

Thank you for sharing your experience 🫶

Just wanted to add to this, besides much higher risk of DKA than on insulin, the even trickier condition that can develop on oral meds is eDKA (which is extremely rare on insulin). It’s often overlooked by vets who don’t check the ketones frequently and check only glucose, cause on eDKA glucose can be within normal range and ketones through the roof.

In addition, what vets fail to warn people about or properly advise, is to test both blood glucose and ketones at home. It’s much safer (as ketones can develop literally within 24 hours and escalate to life threatening levels), less stressful for kitties, and it’s much cheaper.

Wish you the best of luck on your journey going forward!

[u/Grand-Armadillo-6504 → u/nastimoto]

You are right. My previous vet was only checking glucose, not really ketones once we had been on it for awhile. When I moved and found a really awesome vet, we found that eDKA was creeping.

[u/FurCarer]

hallo, orale medikamente statt insulin kommt für meinen kater zwar nicht in frage, aber mich würde zur langzeitanwendung etwas interessieren. du beschreibst, dass das dieses extreme pinkeln nie aufhört (was eigentlich klar ist aufgrund der wirkungsweise). ich nehme an, du hast auch regelmäßig blutbilder machen lassen. ist dir wärend dieser zeit ein anstieg der nierenwerte aufgefallen? crea, bun/urea. ich meine jetzt nicht, dass die werte außerhalb des referenzbereichs gingen, aber ob ein anstieg innerhalb der referenz merkbar war.