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(for veterinary information only)
AVAILABLE IN 5 mg TABLETS
Diabetes mellitus is an enormous problem in human medicine. There are hundreds of thousands of human diabetics who require treatment and there are research labs all over the world seeking ways to make life easier for the diabetic patient. This research spills over into veterinary medicine and can be helpful to our animal patients.
Human diabetic patients are classified as Type I (completely unable to produce any insulin) and Type II (unable to produce enough insulin). Type I patients do not respond to oral treatments to reduce blood sugar; they require insulin injections whereas Type II patients may be able to respond to oral medications provided their pancreas has some remaining insulin-producing capacity. While it is not difficult to classify human patients, this is not so straightforward for animals. Diabetic dogs, for example are completely insulin dependent (analogous to Type I) and have no response to treatments other than insulin injections. Cats, on the other hand, are generally felt to fit into the Type II category, meaning some diabetic cats (perhaps as many as 30%) can actually make do with oral medications.
These 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. Some cats will respond adequately to this treatment and thus avoid the use of insulin injections at home.
For more information on Diabetes Mellitus in pets, click here.
Typically, this is an oral medication scripted out to a pharmacy. It is given twice a day. Since it will not be known if a cat will respond, monitoring for the first month or so is very important. We recommend weekly blood sugar levels which will help us determine the dose of glipizide. Some cats will be partial responders and this partial response may or may not be adequate to control their diabetes. Some cats will respond at first but ultimately require insulin later on.
During treatment with glipizide, it is important for the cat to eat a low carbohydrate diet. This kind of dietary management is also helpful in treating diabetes mellitus and will help maximize the medication's effect.
- Hypoglycemia (blood sugar dropping too low) will occur in some cats on this medication. This is one of the reasons why monitoring is so important. Hypoglycemia is reported to occur in approximately 15% of cats on glipizide.
- Nausea and appetite loss can occur in some individuals. Giving the medication with food is helpful. It is important to realize that appetite loss is a dangerous situation for a diabetic.
LET YOUR VETERINARIAN KNOW AT ONCE IF YOUR DIABETIC CAT BECOMES UNINTERESTED IN FOOD. THE CAT WILL NOT SIMPLY EAT WHEN IT IS HUNGRY ENOUGH.
- 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. If the cat's liver enzyme elevations are accompanied by actual signs of illness, the medication should be discontinued. If the ALT enzyme becomes greater than 500 IU/L then the medication should be discontinued.
The following drugs may enhance the effect of glipizide and may be enhanced themselves when used in combination with glipizide: chloramphenicol, non-steroidal anti-inflammatories, salicylates, and sulfa class antibiotics. Monoamine oxidase inhibitors such as selegiline may enhance the activity of glipizide as can the antacid cimetidine (Tagamet®).
Pre-existing liver or kidney disease will predispose the patient to hypoglycemic reactions.
If ketones are discovered in the patient’s urine, this is an indication that oral hypoglycemic treatments will not be useful. Only insulin can stop ketonuria.
One of the most important cautions with the use of this medication is that by increasing the release of insulin, glipizide also increases the secretion of other proteins in the pancreas. It is generally abnormal protein deposition in the pancreas that caused the diabetes mellitus in the first place, thus the use glipizide may lead to progression of pancreatic destruction. For this reason, we recommend glipizide as a last resort when insulin administration cannot be given or for a select few cats who are sensitive to insulin secretion.
Page last updated: 6/8/09
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