Now available: 2026 AAHA Diabetes Management Guidelines for Cats

When it comes to managing diabetes, there are significant and distinct differences between species. That’s why the 2026 AAHA Diabetes Management Guidelines are divided into two parts: one for cats, and one for dogs.

Renee Rucinsky, DVM, DABVP (Feline Practice), is co-chair of the task force for the just-launched 2026 AAHA Diabetes Management Guidelines for Cats. (She’s also co-chair of the 2026 AAHA Diabetes Management Guidelines for Dogs task force; those guidelines are coming this fall.) Having been part of all three updates of AAHA’s Diabetes Guidelines, she has an exceptional understanding of what this latest iteration brings to the forefront.

The evolution of diabetes

While veterinary professionals have long understood that cats are not simply small dogs, the insight into just how different a disease diabetes is in cats vs. dogs is something that’s become more and more evident in recent years.

“In a way, feline diabetes is so much more challenging than canine diabetes. And we have even more options for treatment now,” Rucinsky said.

Those treatment options are a big part of why AAHA has created these cat-specific guidelines.

“Separating the cats from the dogs just made sense, and allows us to really get into especially our newest treatment option, SGLT2 inhibitors,” she said. “The evolution in feline diabetes has been amazing, and when used appropriately, management with SGLT2 inhibitors can make diabetes pretty boring. The first treatment I consider now for new diabetics is SGLT2 inhibitor drugs. What a shift in thinking that has been.”

More experience and confident recommendations

That shift in thinking may be welcome to a feline specialist like Rucinsky, but she acknowledges it may not be as easy for clinicians in general practice.

“Despite these drugs being available for a while now, so many GPs are still uncomfortable with them, even being afraid to use them,” she said. “And I get it! When they first came out the treatment requirements were really strict and it was hard to know which patients were appropriate candidates for them.”

That’s changed now that experts, including members of the task force, have had more experience with this class of medication—which, Rucinsky said, allowed the committee to make “confident recommendations on somewhat broader use, and we were able to help with how to evaluate when to switch to insulin or when not to start at all.”

In fact, Rucinsky said, “[M]y hierarchy in choosing a treatment for a diabetic cat no longer starts with insulin. I plan on treating with an SGLT2i first because of its overall safety and efficacy.  I look for reasons I shouldn’t use it, not reasons I should.”

Ketosis/ketoacidosis concerns

Another aspect of the 2026 AAHA Diabetes Management Guidelines for Cats is the addition of information about treating diabetic ketoacidosis—which is an important part of managing this disease.

“Diabetes management doesn’t end (or necessarily start) with prescribing medication,” Rucinsky said. “We need to know how to manage different aspects of the disease.  Ketosis/ketoacidosis patients are frequently cats who have previously been undiagnosed diabetics, and many of them are manageable in the primary care situation.” After all, she said, it’s important to recognize situations where a wider spectrum of care approach is needed. “Not everyone has access or resources for secondary and tertiary care,” she said.

That’s precisely why these guidelines will be so valuable to general practitioners.

“The guidelines committee wanted to provide some guidance for primary care veterinarians to at least be able to start to stabilize these sick cats, knowing that referral for more unstable situations or when the primary vet isn’t comfortable is still a good option,” she said. “We aren’t advocating for not referring, just giving tools to make good decisions.”

Additionally, the guidelines provide step-by-step guidance on feline diabetes risk factors, identifying comorbidities that may interfere with a cat’s response to treatment, why in-hospital blood glucose curves are not longer recommended for cats, why it’s important to monitor the cat (not just the numbers) when they’re receiving insulin treatment, educating clients, and more.

You can find the 2026 AAHA Diabetes Management Guidelines for Cats at aaha.org/diabetes-management-cats and in the May/June 2026 issue of JAAHA.

Photo credit: Bogdan Kurylo via iStock/Getty Images Plus 

Disclaimer: Trends content is meant to inform, educate, and inspire by providing an array of diverse viewpoints. Any content published should not be viewed as an official stance, position, or endorsement by the American Animal Hospital Association (AAHA) or its Board of Directors.