Use of Glipizide and other Oral Hypoglycemics for your Sugarcat
This document will provide some basic information on glipizide (and other oral hypoglycemics) as well as some insight from folks that have used it on their sugarcats. As always, this information is not meant to recommend for or against the use of oral hypoglycemics, it is intended to provide data and a stepping stone to more information.
Much thanks to Kat and Nox and Karen and Bug for their help compiling this data!
What Glipizide is: Glipizide and other oral hypoglycemics are often used in the treatment of your sugarcat before or in place of insulin therapy. Oral hypoglycemics are usually recommended when the cat's diagnosis is similar to that of a human type II diabetic, meaning the body is still producing some insulin. Oral hypoglycemics are not recommended if ketones are present at time of diagnosis.
From Cornell's Feline Health Center: Healthy diabetic cats can sometimes be successfully treated with a hypoglycemic medication, glipizide. Glipizide acts by lowering blood glucose, but unlike insulin, it is given orally. Adverse side effects are not common but include vomiting, loss of appetite, and liver damage. If hyperglycemia persists after one or two months of therapy, or if the cat becomes ill or ketoacidotic, glipizide therapy should be discontinued and insulin therapy instituted.
From MarVista's Veterinary Pharmacy: Oral medications work by causing the pancreas to release insulin more effectively (obviously if there is no insulin to release, this does not help). They also help increase tissue sensitivity so that smaller doses of insulin may have a greater effect.
Glipizide is contraindicated in the presence of certain pre-existing conditions. If you are using glipizide please make sure to discuss with your vet how often blood panels should be done to monitor the health of critical organs, especially the liver.
From MarVista's Veterinary Pharmacy: Liver enzymes will elevate on diagnostic testing with the use of this medication. This does not appear to be a harmful problem but one should be aware of this reaction if one notes such elevated enzymes on a routine screening test.
Hypoglycemia can occur with oral hypoglycemics just as with insulin therapy. It is important to know the signs of hypoglycemia and how to treat it.
Here's some experience (good and bad) from folks that have used glipizide on their sugarcat
Kat and Nox's Story
Nox was prescribed Glipizide and DM dry initially, because his glucose levels were under 350. My original vet called this borderline, and thought that glipizide was indicated. (The common sense thinking is, the higher the glucose, the less pancreatic function there is.)
Food: For a long time, I mixed a couple of teaspoons of baby food with dry. He wouldn't eat wet at all. The baby food adds protein, and tiny amount of carbs (cornstartch), and makes the DM more palateable. Others have given their ideas for food choices, but it does boil down to one thing, your cat has to eat.
Nox was one of the lucky ones. He responded well to Glipizide, and ended up on a h*neym**n away from all meds. Nox had NO side effects, and, other than being difficult to pill, (normal for cats, my dog eats pills like snacks!) has been doing very well.
- Hypoglycemia is possible with glipizide-when Nox's pancreas began working, the glipizide stimulated it to make insulin, even if Nox didn't need it, so twice, Nox's sugar dropped below 50-hypoglycemic range-and without bg hometesting, I wouldn't have caught it until (if) Nox had symptoms, which can be too late. Also, as Nox's pancreas began to have 'normal' function, the glipizide wasn't needed, and the BG testing helped me see when to give the med, and when to wean him off of it. (I had constant communication with my new vet during this time, as well as advice on this board.)
- When glipizide works, it is because a cat has some pancreatic function left. (still producing some insulin) The glip stimulates the pancreas to make more. This can take some time (results will usually be evident between 2 weeks to a month), depending on the condition of the pancreas. If a cat has a completely non-functioning pancreas, Glipizide will not work. Glip causes 30% of cats to have some response. 15% have a negative response. Familiarize yourself with side effects and symptoms of liver disfunction. (Glipizide CAN cause some liver problems as a side effect.)
For more info on Kat and Nox, see their profile on the FDMB.
Karen and Shutterbug's Story
Just throwing in our 2 cents Bug was also considered borderline, but she is one of the rare kitties that had really bad reaction to glips. She ended up in the hospital, with fatty liver disease, yellow as a crayon and upchucking her guts. $1,000 later and she's home safe and on insulin.
My vet said that you have 3 ways to go with glips
- they work
- they don't work and you try something else, no problem
- they work or don't work but make kitty sicker than all get out
Shutterbug didn't even get to stay on them for 2 full weeks. They did a good job pulling her BG down, but on day 11, her appetite was shot, we got an appetite stimulant and anti-vomiting stuff from the vet, neither worked, 24 hours of not eating and barfing and she was as sick as a dog (LOL!, well, not a DOG, but you know). Scared me silly, I was frantic, thank goodness the folks here said "get thee to a hospital without waiting for regular appointment" and so we were there Monday morning, instead of waiting for our regular Tuesday afternoon appointment.
So with glips, just watch for the side effects, which usually will manifest themselves by a decreasing appetite that NOTHING can stimulate, not even junky Tender Vittles, boiled fresh chicken, tuna fish, nothing!! If vomiting comes along, you can't wait more than 24 hours or kitty will be in deep doo-doo. Diabetics need to eat to avoid the ketone fairy. And not eating throws the entire hepatic (liver) system completely out of whack and you end up with a yellow kitty, among other things.
For more info on Karen and Bug, see their profile on the FDMB.
Here are a number of websites that provide information on glipizide (and similar drugs) used in the treatment of feline diabetes:
Cornell's Feline Health Center
MarVista's info on insulin alternatives
Inno-Vet hosts a number of abstracts on the use of glipizide for diabetic cats (not sure if you can get the full article from Inno-Vet or if you'd have to find that elsewhere):
Journal of Veterinary Internal Medicine
Continuing Education for the Practicing Veterinarian 2001 Volume 23
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