AAHA Splits Diabetes Guidelines Into Separate Canine and Feline Editions

The American Animal Hospital Association (AAHA) released updated diabetes management guidelines for companion animals on Sept. 6, and for the first time the documents are separated into canine and feline editions, replacing the single set issued in 2018.

The split reflects how much the evidence base has grown. An expert task force developed both documents through what co-chair Andrew Bugbee, DVM, DACVIM (SAIM), described as a "long and rigorous process" that included extensive literature reviews, several group sessions, and structured debate before consensus.

"The guidelines reflect evidence-based information, varied clinical experience from several experts in the field, and group consensus on how to provide the most practical and clinically relevant recommendations for veterinary team members to use in their practices," Bugbee said.

Why two documents instead of one?

The task force concluded that species-specific physiology and therapy now demand separate recommendations. According to Bugbee, the volume of new clinical information in recent years made the division necessary, and it "enabled each document to more clearly present species-specific recommendations and allows readers to more quickly identify information needed to answer their questions about diabetic management."

Renee Rucinsky, DVM, DABVP (Feline), who co-chaired the work, said the species separation "allowed the expert task force to really direct our conversations, literature searches, and recommendations in an even more focused way than the previous version of the guidelines."

For practitioners, the practical gain is speed: a clinician facing a diabetic dog or a newly diagnosed cat can go straight to species-relevant protocols.

What changes for dogs at the exam table?

The canine guidelines add basal insulin therapy as a management tool, with treatment algorithms covering the newer long-acting agents. Specifically, the document explains how insulin degludec and insulin glargine U-300 work, what starting doses are appropriate, how to monitor and adjust insulin initially to achieve control, and how to troubleshoot common clinical problems.

Nutrition also receives expanded attention. "A patient's nutrition plan should be specifically tailored to provide appropriate nutrient profiles to manage their diabetes while also considering other comorbidities or patient factors," Bugbee said. That wording signals a move away from one-size-fits-all diabetic diets toward plans built around the individual patient.

The canine edition covers:

• Diagnosing diabetes in dogs
• Treating and monitoring with insulin
• Treating diabetic ketoacidosis
• Monitoring glycemic status
• Managing diet
• Communicating with clients

What changes for cats?

The feline guidelines address patient selection for SGLT2 inhibitor therapy, an oral class that has changed first-line options for some diabetic cats since the previous guidelines appeared. The document also covers euglycemic diabetic ketoacidosis alongside classic DKA, an entity practitioners must recognize because it presents without the marked hyperglycemia that usually flags the condition.

The feline edition covers:

• Diabetes pathophysiology in cats
• Diagnosing diabetes mellitus
• Recognizing and managing at-risk cats
• SGLT2 inhibitor treatment
• Insulin treatment and monitoring
• Treating diabetic ketoacidosis and euglycemic diabetic ketoacidosis
• Testing of glycemic status
• Recognizing diabetic remission
• Managing diet
• Communicating with clients

The explicit attention to diabetic remission matters in feline practice, where remission is achievable and monitoring strategy should reflect that possibility. Client communication appears in both documents, an acknowledgment that long-term diabetic management depends heavily on owner adherence.

Quick-reference materials available

AAHA has also published "Guidelines at a Glance" summary sheets for both dogs and cats, available as downloadable quick-reference guides for busy practice teams. The full documents and the summary sheets all carry the Sept. 6 release date.

The takeaway: clinics managing diabetic patients should retire the 2018 combined document and adopt the species-specific protocols, particularly the new canine basal insulin guidance and the feline SGLT2 inhibitor selection criteria. Both editions are available now through AAHA's resources pages.