Diabetes in dogs and cats: treatments compared
Checked against FDA labels and veterinary references: October 2026
Short answer
Most diabetic dogs and cats are treated with insulin injections, usually twice a day with meals. Dogs almost always need insulin for life, while some cats go into remission with early, steady control and a low-carbohydrate diet. Two once-daily oral medicines, Bexacat and Senvelgo, are approved for otherwise healthy cats that are newly diagnosed and have never had insulin, with a boxed warning about ketoacidosis.
Diabetes treatments for dogs and cats at a glance
- FDA-approved veterinary insulinUsed for: Dogs and catsHow it is given: Injections, usually twice a day with mealsKey caution: Low blood sugar; shake the vial well before drawingWhere to fill: Vet or veterinary pharmacy
- FDA-approved veterinary insulinUsed for: Cats and dogsHow it is given: Injections, usually twice a dayKey caution: Low blood sugar; roll gently rather than shakeWhere to fill: Vet or veterinary pharmacy
- Insulin glargineLantus, Basaglar, Semglee (human)Used for: Often the first choice in catsHow it is given: Injections, usually twice a dayKey caution: Low blood sugar; uses U-100 syringesWhere to fill: Regular pharmacy
- NPH insulinHumulin N, Novolin N (human)Used for: DogsHow it is given: Injections, usually twice a dayKey caution: Low blood sugar; uses U-100 syringesWhere to fill: Regular pharmacy
- Bexacat (bexagliflozin)Once-daily tabletUsed for: Cats newly diagnosed and otherwise healthy, never given insulinHow it is given: By mouth, once a dayKey caution: Boxed warning: ketoacidosis, which can be fatalWhere to fill: Vet
- Senvelgo (velagliflozin)Once-daily oral liquidUsed for: Cats newly diagnosed and otherwise healthy, never given insulinHow it is given: By mouth, once a dayKey caution: Boxed warning: ketoacidosis, which can be fatalWhere to fill: Vet
| Treatment | Used for | How it is given | Key caution | Where to fill |
|---|---|---|---|---|
| Vetsulin (porcine lente)FDA-approved veterinary insulin | Dogs and cats | Injections, usually twice a day with meals | Low blood sugar; shake the vial well before drawing | Vet or veterinary pharmacy |
| ProZinc (protamine zinc)FDA-approved veterinary insulin | Cats and dogs | Injections, usually twice a day | Low blood sugar; roll gently rather than shake | Vet or veterinary pharmacy |
| Insulin glargineLantus, Basaglar, Semglee (human) | Often the first choice in cats | Injections, usually twice a day | Low blood sugar; uses U-100 syringes | Regular pharmacy |
| NPH insulinHumulin N, Novolin N (human) | Dogs | Injections, usually twice a day | Low blood sugar; uses U-100 syringes | Regular pharmacy |
| Bexacat (bexagliflozin)Once-daily tablet | Cats newly diagnosed and otherwise healthy, never given insulin | By mouth, once a day | Boxed warning: ketoacidosis, which can be fatal | Vet |
| Senvelgo (velagliflozin)Once-daily oral liquid | Cats newly diagnosed and otherwise healthy, never given insulin | By mouth, once a day | Boxed warning: ketoacidosis, which can be fatal | Vet |
Dogs and cats are different
Diabetic dogs have usually lost the cells that make insulin, so they need injections for life, along with consistent meals. Cats more often have a form similar to type 2 diabetes in people; with prompt treatment, steady control and a high-protein, low-carbohydrate diet, some cats stop needing insulin, called remission, though they need monitoring because diabetes can return.
The oral options for cats
Bexacat and Senvelgo are SGLT2 inhibitors that make the kidneys pass excess sugar into the urine. They are only for otherwise healthy cats that are newly diagnosed and have never had insulin, and are not started in cats that are not eating, dehydrated, lethargic or have pancreatitis. Their boxed warning concerns diabetic ketoacidosis, which can be fatal and can occur even when blood sugar looks normal, so your vet will check ketones closely, especially in the first weeks. Cats that have had insulin must not be switched to them.
Match the syringe to the insulin
Veterinary insulins Vetsulin and ProZinc are U-40 and need U-40 syringes or the matching pen; human insulins are U-100 and need U-100 syringes. Using the wrong syringe gives the wrong dose, which can be dangerous. Check the label on both every time you buy them, and ask the pharmacist if anything looks different.
Low blood sugar: what to do
- Signs include weakness, wobbliness, twitching, confusion or a seizure.
- Rub a little corn syrup or honey on your pet’s gums, and call your vet or an emergency clinic straight away.
- If your pet will not eat, do not give the usual insulin dose; call your vet for advice first.
- Never give an extra dose because you are unsure whether a dose was given; skipping one dose is safer.
Signs of ketoacidosis
Not eating, vomiting, weakness, dehydration or unusual breathing in a diabetic pet needs same-day veterinary care, because ketoacidosis is an emergency. In cats on Bexacat or Senvelgo, it can occur with normal blood sugar readings.
Monitoring
Your vet will track blood sugar with curves at the clinic or at home, sometimes using a continuous glucose sensor, and a fructosamine blood test that reflects the previous few weeks. Note thirst, urination, appetite and weight at home, since changes are early signs that the dose needs adjusting. See our insulin guide for storage and injection tips.
Frequently asked questions
Can a diabetic cat go into remission?
Yes, some can, especially with early treatment, steady blood sugar control and a low-carbohydrate diet. Your vet will lower the insulin dose as needs fall and keep monitoring, because diabetes can return.
Can my pet use human insulin?
Yes, when your vet prescribes it. Insulin glargine is often used in cats and NPH in dogs, and a regular pharmacy can fill them. Use U-100 syringes with human insulins.
Can Bexacat or Senvelgo replace my cat’s insulin?
No. They are only for otherwise healthy cats newly diagnosed and never given insulin; switching a cat from insulin raises the risk of fatal ketoacidosis.
What if my pet will not eat before an injection?
Do not give the usual dose. Call your vet, who may advise a reduced dose or none, because insulin without food can cause dangerously low blood sugar.