Terbinafine for ringworm and low BGs

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Jack & Mopem'sMom

Jack & Mopem'sMom

Member Since 2020
Does anyone have any experience with terbinafine lowering BG numbers? We are fighting ringworm (UGH- still no idea where they got it from) and although Mopem's numbers were coming down prior to starting treatment I am wondering if the terbinafine is making them 'normal.' The vet says she does not see anything in any of her books, etc. about terbinafine lowering BG, but I figured I'd ask here since there is such a large knowledge base. Today I am doing a full curve, as it is our first day without insulin. Thanks in advance for any input.
 
Hi Christine,

There is brief mention of hypoglycaemia while on terbinafine at drugs.com but it was linked to reduced food intake due to taste disturbance.

In general, infections typically raise blood glucose levels. If the terbinafine is successfully treating the ringworm then the resolution of the infection might be a possible reason for the improvement in BG levels you're observing.


Mogs
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Critter Mom said:
Hi Christine,

There is brief mention of hypoglycaemia while on terbinafine at drugs.com but it was linked to reduced food intake due to taste disturbance.

In general, infections typically raise blood glucose levels. If the terbinafine is successfully treating the ringworm then the resolution of the infection then that might be a possible reason for the improvement in BG levels you're observing.


Mogs
.
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Thanks for your input. I was wondering if the ringworm infection was one of the causes of the severity of his high BG numbers (we were seeing 500+ originally) His food intake on the wet pate has gone down, so I was giving him Friskies with gravy so he would eat (Terbinafine labels say they have to eat with the med) I was assuming I would see his #'s go up due to the higher carb food, but they seem to be going down, probably because, like you say, the infection is being treated and is resolving. I just don't want to get my hopes for remission too high, and I'm also concerned with too much insulin if the terbinafine is lowering his BG. So much stress...but we love our furkids!
Thanks again for your help, and the link to the website w/the info; Mopem and I appreciate it.

Christine
 
Just wanted to post an update on the BG and terbinafine . The meds are definitely effecting Mopem's BG- he was 68 last night at the PMPS. He didn't want to eat his regular Fancy Feast or Friskies in gravy (shocker since he really likes it) and I was so worried he would go hypoglycemic, I started offering him anything I could think of he might eat. He finally ate about 20 temptations treats and about 1/3 can of Hill's Prescription A/D I had on hand from one of my other cats who was recently at the vet. 3 hours later he was 73, so I went to bed and set the alarm for 12:30am but I slept through it I guess because I woke up with the alarm this morning. I have no idea what his BG was overnight, I'm mad at myself, and his AM PS # was 103 so I guess he was OK. I offered pate but of course, no one wanted it, but since he is still on the Terbinafine and he has to eat, I caved and gave him some FF with gravy which he ate some of. I'll test again at the 6 hr mark today and fingers crossed he is still in a good range. I will be so happy when this Saturday comes and we are done with these dreadful meds. I just pray he is over the ringworm as well, since I can't do another 21 day of this.

On a side note, if any of you are unfortunate enough to deal with ringworm, Terbinafine is awful. It really screws with their system, and obviously with the BG (more than just loss of appetite, I'm convinced) My other cats are also on the meds, and 2 of them are having really bad stomach issues from it. I had to stop treatment and give IV fluids and Cerenia (anti-nausea meds) for 2 days due to vomiting and lack of appetite. We are still not back on track. Ithaconazole is supposedly worse, but now 1 has liver issues from the Terbinafine that will have to be monitored. Just figured I'd put some info out there since I am discovering all of this the VERY hard way.

I will update again after we finish the Terbinafine as to how Mopem's numbers are. I am also going to try to edit the title of this post to include ringworm in case any other poor soul has to go looking for this kind of info. I wouldn't wish this on my worst enemy. :-(
 
Thanks for your support and prayers, folks. We are still hanging in there. Mopem's numbers are creeping up a tiny bit but we are still in a good range, and have not had insulin since his AM shot on 10/29/20. Yesterday was his last dose of Terbinafine, I have to wait a few days before running the first ringworm test, then wait 2 weeks for a negative result, before running a second test; you need 2 negatives in a row to say you're cured. In the meantime, he absolutely refuses to eat pate, FF, Friskies or otherwise, and has become very antsy for BG testing. He had previously been very good about letting me test. I guess he is feeling better, which I am happy about, but if we are not in remission, managing the diabetes is going to be more difficult. OY!

In other news, my other kitty with the liver issues is not feeling well, and hasn't had anything significant to eat in 3 days, despite being off the Terbinafine for 3 days now. I am probably going to be doing IV fluids again today. Another one was throwing up most of the day yesterday, and has started cerenia. I don't know why they administer the terbinafine without massive warnings about the awful side effects, or just prescribe cerenia and terbinafine together and tell you the cure may be worse than the disease. UGH! Just venting...sorry.

We really appreciate your support, prayers, positive thoughts & vibes. Thank you all so much. FDM is enough to make you feel scared and alone and second guess your every decision, but throw something else on top, and you could end up in the loony bin! Mopem and I appreciate you keeping us sane! Love and Light to all.
 
I HONESTLY dont know how you are doing this! My hat is off to you! I have NO experience with the issues your other kitties are having so I cant comment on them, except to say, they are ALL in my prayers:bighug: You as well Christine. :bighug:

As for the testing I'd recommend going back to square one. Start with getting Mopem in his test spot give a treat, release, repeat. Just get him use to those treats! Sending many testing positives!
jeanne
 
Just checking in to keep everyone interested updated:

We are nearing the end of the ringworm treatment, (Mopem is actually done with oral medications, I am still using the topical stuff while I continue to treat the rest of the cats) and I have fingers crossed for negative results for everyone. It visually looks to be better. Gypsy goes back to the vet Friday for repeat bloodwork on her liver.

Mopem's numbers have been slowly climbing, still no insulin, but inching up. He hasn't wanted to eat much of any kind of pate, so when he's lower, I give him some gravy food. The vet has me worried about fatty liver syndrome. How long does Mopem have to be off insulin before he is considered in remission? Also, he is acting great- best he has in years. Could 'his' normal be in the 100's? I thought I wanted to see 85-100 BG? Could he be fine at 140?

Thanks again, everyone, for your support, advice and prayers. They are greatly appreciated.
 
Hey Christine, sorry to be chiming in so late... I battled ringworm A LOT when I was overseeing feline medical at the rescue. We never used the medication your vet prescribed because of the side effects, our vets didn't recommend it. The mainstay was lime dip treatments twice a week (and once weekly for cats exposed with no infections). For cats with compromised immune systems, we used Itrafungol. Also the environment had to be disinfected with bleach & steam (anything porous had to be steam-cleaned). If the environment isn't disinfected, cats can be re-infected from spores in the environment.

I'm hoping your vet already told about the need to deep clean your house... but I'm mentioning it here just in case!

Hope your ringworm nightmare is almost over!
 
Thanks for chiming in, everyone.

Regarding the ringworm- I had been using the BioHex shampoo, but that became unmanagelable. The lime dip was also not helpful, mainly because I am by myself, no help, and several of my cats are 'frisky' to put it nicely. 'Beasts' is probably a more accurate term. I was doing the topical and oral meds at the same time. I ended up getting a product called Ring-Out which I was putting on them with a cloth, or a spray bottle. I was worried they would lick and ingest the creams so I never tried that to be honest. I am now in the middle of retesting them all, with the exception of one who is living in a large dog crate and still being treated. As for the deep cleaning of the house- I literally had a junk removal company come and paid $500 to have them remove all of my soft furniture with the exception of one chair that has been sprayed with every chemical I have and set in the sun. It is covered in multiple layers of mattress protectors, etc that are bleached every 2 days. The cat trees, toys, beds ,anything not able to be cleaned has been discarded. Their new beds are bleached in the washing machine every 2 days. Their blankets as well. The floors are vacummed every day and washed with vinegar and hot water 1x a week cause that's all I have time for. Unfortunately, I still have a carpet in my living room, but I can't afford to rip out and replace it right now. It gets vacuumed every day, and sprayed with the Ring Out. I don't have any extra $ to get a steam carpet cleaner and don't know anyone who has one. As soon as I can the carpet is going though.

Mopem's BG numbers are still under 140. I know they are between 120-140 when he has Dr Elsey's kibble. Unfortunately, the YA was better for his #'s but gave his brother horrible diarrhea that has taken just about 2 months to clear up. I don't have a way to separate them for feeding, and Mopem refuses to eat alone. I worry about fatty liver as he is still very overweight, although he did lose a few pounds. I guess the real question for Mopem is how often to test? At what point do I skip a testing time? I am petrified of going backwards...is this just something that hangs over our heads forever now?

Thanks again for everyone's advice, and sharing of experience. It is greatly appreciated.

Have a happy Thanksgiving if you are celebrating!
 
So this is the hardest thing to write, that's why I have delayed posting. Mopem suddenly passed away late Christmas Eve/early Christmas Day at the Emergency Vet. I took him in because he was having trouble breathing, I thought they were going to tell me he had pneumonia or something, due to the baths and being wet, but they said he had an opaque spot on his lung, had sent the xrays to the radiologist for consult, but he passed a few hours later most likely due to a clot in his lung. They tried CPR but could not get him back. My heart is truly broken, he had such the journey and was in diabetic remission, mostly due to everyone's advice here. So I want to thank everyone for that.

I did want to put some final thoughts on the ringworm meds, since it never fully resolved and we had started the terbinafine again. I DO NOT recommend terbinafine, no matter how bad the ringworm is. It really messed with his BG numbers, you can see when we started again how his numbers came down, and it was impossible to tell if it was him or the meds giving the low numbers. The regular vet didn't think this was related, but the evidence on the spreadsheet indicates otherwise. Also, his liver values were awful, I will try to get them from the ER and update his spreadsheet, but the ER vet said they were off the charts. I do recommend the BioHex shampoo if you can give your cat a bath, but if you can't I also found success with RingOut to spray carpets, cat trees, etc. Bleach for washing beds, blankets, etc. Also helpful is MicoChlor Plus Antifungal & Antibacterial spray by Thomas Labs. I got that on Chewy without a prescription. It has the same active ingredients as the Bio Hex shampoo ((Miconazole and Chlorhexadione) and is easier than a bath.

Thank you all for your advice and support. I will be posting in the Free board for his supplies. I wish you and your fur kids peace, love, good health, and remission in the new year.
 
I'm so sorry :bighug::bighug::bighug::bighug:

Re: ringworm, ask about Itrafungol. It's an oral antifungal but has fewer side effects than the terbinafine.

I'm not sure if you're still fighting the ringworm or not, but lime dip even once a week can be helpful. I never did "dips", I did sponge baths (saturated a sponge and then rubbed it on the cat in the opposite direction of their fur so it could get down to their skin). If you can't do the whole cat, just do where you can. The fewer spores in their coats and in the environment, the more likely they'll be able to fight off the infection.
 
jt and trouble (GA) said:
Congrats on getting a handle on that ring worm situation. :joyful:How frustrating that must be.:oops:
I cant give dosing advice but this post will bump this thread up the page. ;)
j
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I am finally getting to posting Mopem's supplies in the free/for sale forum for any of you who may have use of them. I appreciate all of your help and support.
 
I am finally getting to posting Mopem's supplies in the free/for sale forum for any of you who may have use of them. I appreciate all of your help and support.
 
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