Diabetes in Cats - other medications and supplements

Diabetes in Cats - Other Medications and Supplements

Chromium and vanadium may be helpful in diabetic cats/maybe dogs

Question: Hello Dr. Mike,

You might remember me and Kodi, my diabetic Siberian Husky, from some e-mail we exchanged a few weeks ago. Thanks again. I just wanted to let you know that one of the other vets in the practice took over Kodi's case, consulted a specialist, and has helped a lot. She's still on Humulin N, but I'm raising the dose slowly and carefully and she is doing much, much better. She weighs 70 pounds, and the specialist says that her insulin can be increased a lot (up to around 32 u per injection) before we conclude she's resistant or needs a change of insulin types. Anyway, I have also added chromium picolinate to her diet (200 mcg at her evening meal) and it looks as though it might be helping maintain lower bg levels. What do you think of the efficacy of chromium picolinate for diabetes management? Are there other supplements I should consider? Thanks. Catherine

Answer: Catherine-

It is funny sometimes how subscriber questions arrive on the days I have just learned new stuff. There was an article in this month's Veterinary Medicine journal that states that chromium and vanadium may be helpful in diabetic cats, which I just read last night.

There is a reason that the article is about cats and not dogs. Cats tend to develop diabetes that mimics the adult onset diabetes seen in humans. In this case, insulin secretion decreases and insulin resistance increases, resulting in the need for supplemental insulin. In some cats, the use of insulin can be discontinued once good control of weight and diet are achieved and oral hypoglycemic agents are used. Dogs tend to develop diabetes that more closely resembles juvenile onset, insulin dependent diabetes in humans, even though it does occur more commonly in older dogs. Chromium may not be quite as specific in its actions to this type of diabetes as vanadium is, so there is more chance that chromium will be helpful in dogs but if you are careful, there probably isn't a problem with trying vanadium, either.

Chromium picolinate is dosed in humans at 200 to 1000 ug/day according the Veterinary Medicine article by Dr. Patricia Dowling and in cats at 200 ug/day. So I guess you could figure out an approximate dosage for Kodi based on her weight compared to a cat and a human.

Vanadium is reported to be more toxic in the same article and a suggested maximum dosage in humans is listed at 100 mg/day. It would probably be best not to exceed this dosage in Kodi, either. Due to the fact that vanadium is listed as being helpful for non-insulin dependent diabetes, it may not be as much benefit to Kodi, either but it is supposed to help glucose uptake into cells so that may be of some benefit.

Exercise is reported to have many benefits in the control of diabetes, too. I really think that it helps our diabetic patients when owners provide moderate exercise on a regular basis but have no strong data to back that perception up with.

Diets moderately high in fiber are reported to help with insulin regulation and control of diabetes, in general, too. Feeding several small meals a day rather than just two meals can help a lot, as well.

If your vet subscribes to Veterinary Medicine you might want to ask if you can read the whole article on vanadium and chromium.

Mike Richards, DVM 4/4/2000

Prednisone and diabetes

Q: Have you seen any reports or studies that indicate an association between the use of predisone in dogs or cats and the onset of diabetes?

A: It is pretty widely accepted that prednisone may predispose dogs and cats to diabetes. It is not as clear to me whether this is enhancement of an existing tendency to develop the disease or if it is an independent effect. They also can induce insulin resistance, leading to hyperglycemia. In diabetic patients, corticosteroids can make insulin regulation more difficult since they have this effect on blood sugar levels. I think this is a relatively rare side effect but it is a consideration, especially in a pet likely to already be predisposed to diabetes.

Mike Richards, DVM

Oral diabetes medication

Q: Greetings--saw your interesting & useful Web site and thought we could sure use your advice...Our ten-year-old neutered male cat was diagnosed with diabetes recently; the giveaway symptom was weakness in the hindquarters, but now he's progressed to the drink-and-pee phase. Where and how we live pretty much makes regular insulin injections impossible, and the local vets have told us not to try any if we can't be firmly scheduled with them. So it's pretty much palliative care to make ol' Willy as comfortable as possible for as long as possible. He's on Hills WD, feeding ad lib; that's all he gets when we're away from home, but when we're there he also gets ca. half a can of Senior Friskies, divided into two meals. That treat is spiked with a potassium pill and Pedialyte to help replace his lost electrolytes (the neuropathy is mostly potassium loss, we were informed via the Internet) plus 4oo units of vitamin E to help his puny supply of insulin do its thing (another Internet infobit, based on a Winn Foundation report) What else is possible? A friend into herbs encouraged adding oatmeal to his diet, because it supposedly lowers blood sugar in humans; the cat will eat some cooked oatmeal if we eat cooked oatmeal--he's that kind of cat--but will it help? Encourage or discourage exercise? Frequent tiny meals better than a few larger ones? Anything? Thanks-- Carla

A: Carla- You are doing a lot of the things that help now. I think that oatmeal has been recommended because it is a source of moderate fiber. So is w/d diet, so I'm not sure you'll gain any advantage by adding the oatmeal.

When I know that my clients with cats can not handle the insulin treatments due to the restrictions on scheduling they require, I usually recommend at least trying the oral medications for insulin resistance. Glipizide is the medication we have used. I seem to remember hearing it may be hard to get right now, though. An alternative might be the new medication Rezulin (Rx) but it is too new for there to be published dosages for cats.

Glipizide is supposed to be helpful short-term in about 50% of cats and helpful longterm in about 30% of cats. That isn't nearly as good as insulin but it is a lot easier to use. When insulin isn't possible, it is worth at least trying this.

Mike Richards, DVM