Ertugliflozin (as L-Pyroglutamic Acid) Paste

Paste medications are thick and sticky, usually given by mouth using a syringe or tube. They’re often used for dewormers or other oral meds in horses, dogs, and cats. The key is to aim for the back of the mouth so your pet swallows the paste instead of spitting it out.

For Horses:

1. Set the dose on the syringe if it has markings (usually based on weight).
2. Stand beside your horse, not in front, and have someone hold them if possible.
3. Gently insert your thumb into the side of the horse’s mouth (between the teeth) to open it.
4. Insert the syringe into that gap and squirt the paste toward the back of the tongue.
5. Lift the horse’s head slightly and encourage swallowing by stroking the throat or gently blowing on the nostrils.
6. Watch for licking or chewing—that means they swallowed. If paste spills out, check how much was lost and contact your vet if unsure.
7. You can offer a little water afterward and reward them with a treat like a carrot if allowed.

For Dogs & Cats:

1. Gently open your pet’s mouth or slip the syringe into the side of it.
2. Aim toward the back of the tongue and squirt the paste in.
3. Hold the mouth closed briefly, and rub the throat or blow gently on the nose to encourage swallowing.
4. Give praise or a treat afterward to make it a positive experience.

Aftercare:

1. Wipe your pet’s mouth if needed.
2. Clean or recap the syringe as instructed.
3. Store the tube according to label directions.

Tip: Paste can feel weird to pets at first. For horses, try giving applesauce by syringe ahead of time so they get used to the sensation.

The uses and pharmacology described below reflect the FDA-approved labeling for this active ingredient; your veterinarian determines whether and how they apply to your animal's treatment plan.

Veterinarians most commonly consider ertugliflozin in the context of feline patients requiring a management approach for elevated blood glucose levels. It is often a point of discussion for cats where traditional injectable therapies may be challenging to administer or where clinical objectives involve reducing the workload on the pancreas. By utilizing the renal system to influence systemic glucose levels, your veterinarian can manage the metabolic profile of the patient through an oral route.

At a pharmacological level, ertugliflozin acts by inhibiting the SGLT2 protein located in the proximal convoluted tubules of the kidneys. This specific transporter is responsible for the majority of glucose reabsorption from the glomerular filtrate back into the bloodstream. By blocking this pathway, ertugliflozin facilitates the excretion of glucose via the urine—a process known as glucosuria. This mechanism manages blood glucose levels independently of insulin secretion or action. Your veterinarian will determine if ertugliflozin is the appropriate choice based on your cat’s diagnostic history, renal status and current nutritional requirements.

Prescription only. Use only under the direction of a licensed veterinarian. This information is not a substitute for veterinary diagnosis, prescribing or monitoring. Compounded drugs are not approved by the FDA for safety or effectiveness.

Commonly observed effects of ertugliflozin administration include increased thirst (polydipsia) and increased urination (polyuria), which are expected physiological responses to the presence of glucose in the urine. Some owners may also observe weight loss or localized skin irritation near the perineal area. A critical clinical consideration is the potential for euglycemic diabetic ketoacidosis, a state where the patient develops metabolic ketones despite having relatively normal blood glucose readings. Your veterinarian will recommend regular patient monitoring of ketone levels and hydration status during the course of administration.

This medication is typically used with caution or avoided in cats with advanced kidney disease or those experiencing acute illness, as adequate renal function is necessary for its mechanism. It is also carefully evaluated in patients with a history of recurrent urinary tract infections, as the increased glucose in the urine may influence the local environment. Before starting a protocol involving ertugliflozin, ensure your veterinarian has a complete history of all other prescriptions and supplements your cat is receiving. Contact your veterinarian promptly if you observe significant lethargy, vomiting, decreased appetite or any unusual behavior during the transition to this medication.