? Anyone have experience with oral hypoglycemic medications for their cat?

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JanetMR

JanetMR

Member Since 2017
My beautiful Bella was diagnosed with diabetes 12/23/17. We have been through hell. She doesn’t seem to tolerate insulin. We’ve tried Vetsulin and Lantus ( low dose .25 unit). Both experiences lead to hypoglycemia and with this last experience with Lantus.. loss of appetite, and very lose stools. We’ve taken her off of insulin and are trying diet alone ( low carb/ high protein)
She’s a challenge... the vet wants to try an oral hypoglycemic medication. Anyone have experience with this?
I’m willing to give it a try.. insulin seems to make things worse.
Thanks!
Janet
 
Oral hypoglycemic drugs are not recommended for cats, and usually are only given if the owner refuses to give insulin and is considering euthanasia. It forces the pancreas to produce insulin and can cause damage, leading to you back to insulin permanently.

I looked at your spreadsheet, and it looks like you actually got some good action on .25u. 68 is not a hypo number, it's normal range on a human meter, and it looks like she hit it on her nadir (the lowest point of the cycle). That is actually good! It looks to me like you just need to keep up with a low dose until you can wean her off the lantus. Getting a daily mid-cycle number (at the nadir) can help you adjust the dose. Many cats need micro-doses to help them reach remission.

The folks in the Lantus forum can help you out with the micro-dosing. There's information about fine dosing in this sticky: http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/
 
Julia & Bandit said:
Oral hypoglycemic drugs are not recommended for cats, and usually are only given if the owner refuses to give insulin and is considering euthanasia. It forces the pancreas to produce insulin and can cause damage, leading to you back to insulin permanently.

I looked at your spreadsheet, and it looks like you actually got some good action on .25u. 68 is not a hypo number, it's normal range on a human meter, and it looks like she hit it on her nadir (the lowest point of the cycle). That is actually good! It looks to me like you just need to keep up with a low dose until you can wean her off the lantus. Getting a daily mid-cycle number (at the nadir) can help you adjust the dose. Many cats need micro-doses to help them reach remission.

The folks in the Lantus forum can help you out with the micro-dosing. There's information about fine dosing in this sticky: http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/
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I appreciate your input.
My cat is miserable on insulin. Lethargic, won’t eat.. looks like hell. I stopped giving it to her.
When her blood sugar drops this is what happens. Sounds as though the oral medication is a no go....
I love my cat... seems pointless to just keep chasing numbers at the expense of quality of life.
 
When Rover was first diagnosed, the vet suggested trying six weeks of glyburide first. The experience was a waste of precious muscle, time, money, and he ended up on insulin anyway. We took Rover in to see the vet at the first sign of hugging the water bowl. In the six weeks of glyburide, Rover lost muscle mass in his hind legs that he never got back.

It could be that the problem was a food change.
 
I just went back and saw that you say she lost her appetite and had loose stools when she hit 68? I'm wondering if there might be something else going on with her, since that would be an unusual reaction to that number, which is not really low. Loose stools aren't usually a symptom of hypoglycemia. When did those issues start and did they resolve? How quickly?
 
I just looked at your spreadsheet again...it looks like she went through a diet change around the same time? That could be your issue...I would try a probiotic (like Fortiflora) and see if that helps settle her gastro issues?
 
Julia & Bandit said:
I just went back and saw that you say she lost her appetite and had loose stools when she hit 68? I'm wondering if there might be something else going on with her, since that would be an unusual reaction to that number, which is not really low. Loose stools aren't usually a symptom of hypoglycemia. When did those issues start and did they resolve? How quickly?
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The loose stools were in direct correlation to the Lantus. several days after being off the insulin she was better.. normal stools and appetite.
Her diet change to high protein low carb was on 12/26. She tolerated the diet change without problems. Every time her glucose levels go below 200 or so she looks crappy, and refuses food. Vicious cycle....
 
Note that cats with normal insulin levels eat less than cats that are insulin-deprived because their cells aren't starved for sugar. Unfortunately cats can become accustomed to high blood glucose levels and take a while to adjust to normal blood glucose levels. Did you try keeping her at normal levels (and 65 is normal) for a week to see if she became acclimated to it? That's not recommended if she's not eating *at all*, but if she's merely eating *less* that may get her past the hump. Make sure to monitor her weight and ketones carefully if you try that though.

Yes, normal blood glucose can cause loose stools, because her intestines are no longer glucose-deprived and are basically operating in hyperdrive. The main issue is whether it continues after a week or so.

The suggestion to go to the Lantus board for microdosing advice is good. You may need to bring her down very slowly from high glucose levels with very tiny doses of Lantus if she's become so accustomed to high blood glucose levels that she just doesn't function well at normal blood glucose levels. Lantus is much gentler than the Vetsulin that you were using, and can be built up very, very slowly over time, it doesn't go "bang" like the Vetsulin.
 
Badtux said:
Note that cats with normal insulin levels eat less than cats that are insulin-deprived because their cells aren't starved for sugar. Unfortunately cats can become accustomed to high blood glucose levels and take a while to adjust to normal blood glucose levels. Did you try keeping her at normal levels (and 65 is normal) for a week to see if she became acclimated to it? That's not recommended if she's not eating *at all*, but if she's merely eating *less* that may get her past the hump. Make sure to monitor her weight and ketones carefully if you try that though.

Yes, normal blood glucose can cause loose stools, because her intestines are no longer glucose-deprived and are basically operating in hyperdrive. The main issue is whether it continues after a week or so.

The suggestion to go to the Lantus board for microdosing advice is good. You may need to bring her down very slowly from high glucose levels with very tiny doses of Lantus if she's become so accustomed to high blood glucose levels that she just doesn't function well at normal blood glucose levels. Lantus is much gentler than the Vetsulin that you were using, and can be built up very, very slowly over time, it doesn't go "bang" like the Vetsulin.
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Exactly what I was going to say. You beat me to it, lol! Very good advice. My cat has been on insulin for three years and is now well-regulated, but before he was, we had many ups and downs, with him having to adjust to being in lower numbers each time his BG dropped into "normal" range.
 
There's always Levemir and it works similarly to Lantus, allows microdosing, etc. Teasel wasn't happy on Lantus (grumpier, lethargic, etc.) and has been much more like himself on Levemir. I put him on it at the end of this past September after being on Lantus for 8 months and he has been doing quite well by Teasel standards - very, very difficult to regulate and we're 2 years post diagnosis.
 
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And there's certainly no harm in giving Fortiflora or another probiotic to see if that helps solve the GI upset, no matter what is causing it (I'm not convinced it's being caused by the normal blood sugar levels, but even if it is, you would still need to get her acclimated to normal BG because you can't keep her high forever).
 
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