- SGLT2 inhibitors introduced as a new treatment paradigm with patient selection criteria and initiation algorithms
- Updated insulin protocols remain for cats not suited to SGLT2 therapy
- Expanded use of continuous glucose monitors (CGMs) for less invasive monitoring
- Shift from tight glycemic control to resolution of clinical signs as a key success metric
- Guidance on hypoglycemia recognition and response for veterinary teams and clients
- New pathways and criteria for identifying diabetic remission in cats
The American Animal Hospital Association (AAHA) has released its 2026 Diabetes Management Guidelines for Cats, delivering a comprehensive update that reflects major shifts in the clinical approach to feline diabetes.
The guidelines mark a notable evolution in treatment strategies, particularly with the introduction of sodium-glucose cotransporter-2 (SGLT2) inhibitors as a therapeutic option. Detailed recommendations outline appropriate patient selection and provide step-by-step algorithms to support safe and effective initiation of these therapies in clinical practice.
While SGLT2 inhibitors represent a significant advancement, insulin therapy remains an important option. The updated guidelines include revised protocols and dosing strategies, with an emphasis on individualized patient monitoring rather than reliance on numerical glucose targets alone.
Advances in monitoring also feature prominently. Expanded access to continuous glucose monitoring (CGM) systems offers veterinarians and pet owners a less invasive and more comprehensive way to track glucose trends. In contrast, traditional in-hospital blood glucose curves are no longer recommended for feline patients.
Refocusing Treatment Goals
A key philosophical shift in the guidelines is the prioritization of clinical sign resolution over tight glycemic control. The guidance underscores that improving a cat’s quality of life and alleviating symptoms are meaningful and achievable treatment endpoints.
The document also provides practical direction on identifying and managing hypoglycemia, a potentially serious complication, and introduces clearer pathways for recognizing and supporting diabetic remission in cats.
Supporting Veterinary Teams and Clients
Beyond clinical protocols, the guidelines emphasize the importance of client communication. Veterinary teams are encouraged to use transparent and empathetic strategies to help pet owners understand the long-term commitment required while reinforcing that successful disease management is attainable.
The 2026 update is the first to separate feline and canine diabetes guidance into distinct documents, reflecting species-specific differences in disease progression and management.
The guidelines include practical tools such as treatment algorithms, insulin selection charts, dosing guidance, and troubleshooting resources for unregulated patients.
Information sourced from the American Animal Hospital Association (AAHA) press release.
