Should I switch from Glipizide to insulin??

Hello,
My cat Tigger is about 12 years old and was diagnosed with diabetes 5+ years ago. The vet started him on glipizide right away and he's been on it since very successively, never a problem..that I've noticed atleast. Now i've never hometested him, but i'm about to start. The vet and his others since actually discouraged me from doing it, which i really wish I didn't listen to! However, i've always taken him in to get tested often (I think it's called a frutose test?? shows how he's been doing over a long period of time & not just at that time) None of his vets told me anything negative about Glipizide so I was suprised by what I have learned on this site and feel really guilty I didn't do more research when he was first diagnosed.
So now I'm wondering if I should switch him to insulin? Now ofcourse if I find out thru hometesting that the Glipizide isn't working as well as I thought I'll think of switching even more seriously. I mean if it's been working successfully for over 5 years should I really be considering insulin instead & why? Is Glipizide really that bad? Since he was diagnosed and put on glipizide I've never had to take him to the vets due to a diabetic related problem, just to be tested, and he hasn't just been ok on it but actually thriving. I want to do whatever is best for my Tigger so any advice or suggestions would be greatly appreciated. Thanks for taking the time to read this : )

-Laura & Tigger

 

I'm sure you'll get opposing opinions, but if it ain't broke, don't fix it is my rule of thumb! If the glipizide is working for your cat and he is "thriving" as you say which means that he is not excessively peeing or drinking, not losing weight and is grooming well, eating well, playing well, etc, then the glip is probably working fine for him.

Which begs the question, why hometest after all this time? It does not seem necessary in this case if all clinical signs and fructosamine testing show he is fine. We steer newcomers away from glipizide in the beginning because it helps very few diabetic cats from our experience here, but it sounds like it has worked well for Tigger so despite what you're reading, I don't see why you should change anything.

 

It would be useful if you obtained blood glucose reading now when he is on Glipizide to help determine if it is really working well. Do you have the frutosimine values you previously obtained? Those too would be useful.

As you have probably read, Glipizide makes the pancreases work hard and may "wear" it out. Thus, it may be advantageous to switch even if the Glipizide is working OK now. However, if it is really working OK you probably may not want to change now.


Years ago my Grey Ghost started out on Glipizide but after a month my BG testing shwed it was not working and I switched to insulin which did work

 

I completely disagree with the advice to stick with the glip, and I also disagree that hometesting is not required. Why?

1. as stated, glipizide can cause organ damage
2. glipizide can cause hypoglycemia just as insulin can, therefore hometesting should be done regardless of whether glip or insulin are used.

I'm sorry your vet didn't tell you the side effects; mine sure did when Squeak was diagnosed. I WANTED to give glip until I heard the side effects and that it seldom worked.

Start hometesting, and do the switch...that is my humble opinion

 

Have you asked your vet if they think you should switch to insulin? Or if you're unhappy with the fact they did not give you much information, have you considered seeing a new/different vet for their evaluation and conclusion on whether you should switch?

 

I have no experience with Glipzide.. so I'll leave the switching/not switching to people who do..

But I definitely think you should be home testing either way. Your cat may be doing ok/fine/good.. but without frequent checks, it isn't safe to be aggressive enough to be doing great. Your vets definitions of what is "going good" are probably based on what they expect the average cat owners involvement to be. That you have been researching and ended up here asking questions, you aren't the average pet owner.

Hometesting is tough (real tough imo) at the beginning.. but it's laughable how easy it becomes. Even if it doesn't change how you treat your cat's diabetes, the information it provides to you and the vet is invaluable.

 

I have to agree with Jen on both the glip and the home testing. We have seen cats hypo on glip, home testing can save a life if that happens. As for the glip, we know that continued use burns out the pancreas but we don't know what other organs it may affect. I would not want to take the chance, with insulin you know what you'll get.

 

My thoughts are that what is most natural is best - providing exogenous insulin to replace missing endogenous insulin and changing the diet to a species appropriate one is closest to "natural". And many cat (not all) can become diet controlled once the blood glucose is lowered to a normal level and the pancreas can heal and start functioning in a normal manner.

My understanding of glibizide is that it forces the pancreas to produce more insulin overriding any hormone feedback system that normally governs the pancreas, etc. This is not normal or natural and will not allow the pancreas to resume normal function. With the complications and side effects I have heard about with this drug, and other drugs that are designed to over-ride a normal process or cover up a symptom (rather than address the cause), I would not only never use it for my cat, but I would not want to use it myself.

I think the first step is testing to see what his blood glucose levels are throughout the day - to see if it is really working - and next research further and decide the risk/benefits of glipizide versus insulin. To me, glip is a drug that is perceived to be "easier" to deal with than insulin shots, but at what price?

 

Good write-up on Glip from Marvistavet.com

http://www.marvistavet.com/html/body_glipizide.html

Last paragraph is important. So no matter how well he's doing if your current vet won't take information like this in to account, it's probably best to find another vet who will support your interest in beginning insulin therapy and hometesting monitoring.

 

Thanks for sharing your opinions,
I've actually been to quite a few different vets and NONE of them warned me of the negative effects glipizide could cause. I asked if I should switch to insulin a few years ago and was told no but I'm going to ask next time I go in. I would love to go to a different vet but I'm unable to work so this is the only place I can afford. The vets are always suprised when his test results came back cause they've never seen glipizide work this well in cats. I'm curious why it rarely works, could it possibly be because tigger only slightly has diabetes...does that make sense? Are there different levels and degrees one with diabetes can have. Unfortunately I don't have any of his frutosimine test results but b4 I do anything I'm going to test his blood glucose level for a couple of weeks while he's still on glipizide. Afterwards even if I want to switch to insulin I'm changing his dry food to wet only ( and don't worry, I know to test him often while making the food switch) so mabey he won't need either of the 2. My vet now doesn't c any reason to home test cause his numbers have been the same for 5 years. I defiantely c her point but it doesn't hurt to b extra safe. I get the impression it's more important to test daily while on insulin compared to glipizide...or am I completely wrong? Also is it more dangerous to miss a dose while on insulin then on glipizide? Thanks for any responses, it's more valuable and accurate then any of my vets!!
-Laura & Tigger : )

 

Hi Laura

Ok, so the fructosamine tests come back good, and general appearance is good, so that means you are doing something right and so is the glip. That said, the fructosamines do not tell you if blood glucose levels are swinging high and low or not, which they could do on glip as it forces the pancreas to work. More info than that I do not have as we've had so few cats on glip and hometested.

I think your plan of attack is good. Testing without changing anything will give you a baseline. Then doing a diet change will further improve things and you may or may not need to continue with anything, depending on if the food switch helps. Then, I'd suggest that if something is still needed that you switch to either prozinc pzi or lantus/glargine insulins, at a very low dose, and go from there.

I understand that it is hard when you get conflicting advice from us vs your vet; that said, I'm very surprised that none of the vets consulted mentioned the potential issues with glip, as that should be standard anytime a med is suggested!

Hope this all helps. Come on back with more questions and also updates!

Jen

 

I wonder if the Glipizide is really necessary? It could be the Glipizide is not really doing anything and that the kitty is diet controlled. When I adopted my Snowball from the shelter he was on Glipizide. I measured his BG and he was in the 90's. I then stopped the Glipizide and he is doing fine with no treatment. He did however reach the low 200's when he was pred for a skin problem. Once the pred was stopped his BGs returned to those of a normal non-diabetic cat.

 

This is what I've been wondering.. but without knowing about Glipizide I was hesitant to say anything.. but what diabetic cat (with any treatment type, and level of regulation and control) doesn't have changes over a period of 5 years? Seems a little odd to me (but I suppose anything is possible) to have a cat, with any disease, for that period of time without some sort of changes either way (just from aging alone).

The plan sounds good to me too.. start home testing and in a week or two reassess the situation.. work on switching to a low carb diet.. reassess again.

 

Larry and Kitties wrote:
" I wonder if the Glipizide is really necessary? It could be the Glipizide is not really doing anything and that the kitty is diet controlled"

That's a very good point, I just started considering that myself. I believe I read somewhere that if a cat has an infection it can cause temp. diabetes, is this true? Cause it got me thinking, My cat was in a cat fight a week b4 being diagnosed and now I'm wondering if he got an infection from it?
I just recieved a meter (a free one I recieved from this site that I more then appreciate!!) & I'm very anxious to start using it. I'm not the brightest at understanding directions so it might be a few days till my first go at it, at my parents so I'm going to see if they can help. I guess I shouldn't say that over the years his numbers haven't changed, they have but always within the normal range. However, i'm now concerned what my vet considers normal though. I've realized that I've put WAY to much trust into believing his vets know what they're doing.
One thing that has changed that I posted a question about that no one seems to connect to diabetes is that about a year ago he became obsessed with licking me. I just feel something has to be causing it cause I had him for 10 years b4 this problem started. And when I say obsessed it's putting it lightly, I can't get him to stop, even if I try to push him away he'll push back with all his might. Since we have salt on are skin my only guess is that something is making him crave salt like crazy! Anyone have any opinions on this?

-Thank you
Laura & Tigger

 

Laura

was he diagnosed by a fructosamine test or a simple blood glucose test?

As for the licking, if you've had no response it is likely because nobody has any idea! Kinda wild though!

 

Almost positive it was just a simple blood glucose test. I've learned alot more about diabetes since then and don't understand why vets are diagnosing animals only using a blood glucose test.
-Laura & Tigger