New AAHA Guidelines Update Feline Diabetes Care

Two new developments offer guidance for managing chronic conditions in pets. Updated professional guidelines are changing how veterinarians approach monitoring and treating cats with diabetes. Separately, an expert analysis clarifies the limited practical role of antibody titre testing in making vaccination decisions for dogs and cats.

Feline Diabetes Management

The American Animal Hospital Association (AAHA) updated its diabetes management guidelines for cats this year, emphasizing home monitoring and clinical outcomes over strict blood glucose numbers. Veterinarian Kelly Cairns explained that the guidelines now recommend against routine in-hospital glucose curves, favoring continuous glucose monitors used at home to track trends without causing stress-related hyperglycemia.

Treatment options have expanded. While insulin remains a cornerstone, new tools include sodium-glucose cotransporter-2 (SGLT2) inhibitor drugs like Bexacat (bexagliflozin) and Senvelgo (velagliflozin oral solution) for carefully selected, newly diagnosed cats that have never received insulin. The guidelines also note newer basal insulin options, though these are for extralabel use in felines.

Success is now defined more by the cat's well-being than by laboratory values. The primary goals are resolving clinical signs like excessive thirst and urination, maintaining stable weight, and preventing significant hypoglycemia. Cairns stressed that if clinical signs persist despite high glucose readings, veterinarians should first check injection technique, diet, and other health conditions before simply increasing the insulin dose. Patient selection for SGLT2 inhibitors is strict; they are contraindicated for cats that have ever received insulin and for those who are sick, anorectic, dehydrated, or have certain organ dysfunction.

Vaccine Titre Testing

Antibody titre testing, which measures pathogen-specific antibodies in the blood, is rarely a cost-effective substitute for following established vaccination protocols. The core issue is interpretation: a titre only measures one part of the immune response and cannot assess cell-mediated immunity or the 'boostability' provided by memory cells, which can rapidly produce antibodies upon re-exposure even if current levels are low.

There are no established cutoff values that reliably indicate whether an animal is protected from disease. While detectable titres for diseases like canine distemper, parvovirus, and adenovirus are strongly associated with protection, a low or negative titre does not necessarily mean the animal is vulnerable. For rabies, titres are primarily used as proof of vaccination for travel, not to gauge protection. The expert stated, "I’d rather have a discussion about what vaccines are truly needed for the animal in question."

Niche scenarios may warrant titre consideration. One example involves a 12-week-old puppy that suffered a severe anaphylactic reaction to its initial round of vaccines, making the owner hesitant to administer more. In such a case, discussing the necessity of each vaccine and potentially using titres could inform a tailored plan, though vaccination history typically provides sufficient information about likely protection levels.