AAHA splits diabetes management guidelines into separate canine and feline editions

The American Animal Hospital Association released updated diabetes management guidelines on Sept. 6, splitting them into separate canine and feline documents for the first time.

The split follows the 2018 combined edition

The previous combined guidelines came out in 2018. The new split reflects the volume of new clinical information on veterinary diabetes management that has emerged since then, according to Andrew Bugbee, DVM, DACVIM (SAIM), who co-chaired the canine guidelines task force.

The separation let the expert task force direct conversations, literature searches, and recommendations with more focus than the earlier version allowed, said Renee Rucinsky, DVM, DABVP (Feline), co-chair of the feline guidelines.

Bugbee told Veterinary Practice News that the guidelines draw on "evidence-based information, varied clinical experience from several experts in the field, and group consensus" to deliver "the most practical and clinically relevant recommendations for veterinary team members to use in their practices."

The canine edition adds basal insulin therapy

The updated canine guidelines add basal insulin therapy as a diabetes management tool. According to Bugbee, the document explains "how insulin degludec and insulin glargine U-300 work," along with appropriate starting doses, initial monitoring and adjustment protocols to achieve control, and troubleshooting for common clinical issues.

The canine guidelines also address nutrition planning. Bugbee said that "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."

Both the canine and feline editions include updated treatment algorithms.

The feline edition covers SGLT2 inhibitor patient selection

The updated feline guidelines address patient selection for SGLT2 inhibitor use. The source article lists key points for both the canine and feline guidelines but does not detail the specific recommendations within those sections.

AAHA published quick-reference "Guidelines at a Glance" documents for both dogs and cats alongside the full guidelines.

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Our read

The species split is a workflow change, not just a formatting one. A combined guideline forces you to track which protocol applies to which species as you read, and that friction costs time in the exam room when a client is waiting and you need to confirm a starting dose or a monitoring interval. Separate documents mean you open the one you need and the protocol you're reading is the one that applies.

The addition of basal insulin protocols to the canine guidelines matters because those formulations, insulin degludec and insulin glargine U-300, have been available but lacked AAHA-endorsed dosing and monitoring guidance. Practices that stock them now have a standard-of-care reference for starting doses and adjustment schedules, which is the piece you need when an owner questions a protocol or an associate asks what the literature supports.

The feline SGLT2 inhibitor section addresses patient selection, which is the clinical decision that determines whether the drug gets used at all. The guidelines do not detail what those selection criteria are, but the fact that AAHA devoted guideline space to it suggests the task force saw enough variability in practice to warrant standardized recommendations.

The task force described the process as long and rigorous, involving extensive literature reviews, group sessions, and consensus-building. That timeline and process suggest the updates reflect material protocol shifts from the 2018 combined edition, not just incremental tweaks. We'd read both documents in full rather than relying on the quick-reference sheets, because the nuance in monitoring intervals and troubleshooting steps is where the clinical value sits.

For practices that standardized diabetes protocols around the 2018 guidelines, the species split means updating two sets of protocols instead of one, and training staff on which document applies to which cases. That's overhead, but it's overhead that buys clarity. A technician pulling up a monitoring schedule no longer has to parse footnotes to confirm it applies to the dog in front of them.

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