Diabetic cat survey to help owners treat their pets and improve treatment options

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Janina Rzeznitzeck

Member Since 2015
Hello all,

I am a third year vet student in Edinburgh, Scotland, and currently doing research for my thesis on feline diabetes. I have designed an owner survey to investigate how they cope with their cat's treatments at home in order to investigate treatment methods that are easier for owners to deliver to their diabetic cats.

If you currently own a diabetic cat or have owned one in the past, I would be so grateful if you could please fill in my questionnaire. The link is: http://www.vetprofessionals.com/diabetic.html
I would appreciate it very much if you could also share this link with friends/ family who have diabetic cats as well.

If you like, there is a prize draw in the end of the survey into which you can enter to win a shopping voucher.

I'm really hoping to make a difference in terms of treatment administration for diabetic cats with this survey and it would be great if you could help me out. Hopefully I will be able to find methods that not only make the control of your cat's diabetes better and but also make it easier on you to treat your cat.

Thank you so much.

All my best,
Janina
 
Um ... Did you run this by the message board administrator @Robert and Echo ? Please do that ASAP.



Also, by "worked" do you want to include volunteering?
 
Hi, I sent a message just now. I was not sure who to contact about this. Thank you for letting me know.
Yes, I consider volunteering working too, so yes.
Thank you!
 
I didn't, so now the survey isn't accurate. It'll be the one mentioning Spitzer & Gracie. For a while, I volunteered with the local humane society, helping with giving meds.
 
Hello Janina,

Folks have posted surveys on FDMB before, and sometimes it has been about testing the market for a new product (such as continuous glucose monitoring).
Are you able to tell us exactly what your interest is? (Just so that folks know before they complete the survey). :)

Thanks,

Eliz
 
BJM said:
I didn't, so now the survey isn't accurate. It'll be the one mentioning Spitzer & Gracie. For a while, I volunteered with the local humane society, helping with giving meds.
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Thats completely fine. thank you for letting me know and for completing the survey. I appreciate it :)
 
Elizabeth and Bertie said:
Hello Janina,

Folks have posted surveys on FDMB before, and sometimes it has been about testing the market for a new product (such as continuous glucose monitoring).
Are you able to tell us exactly what your interest is? (Just so that folks know before they complete the survey). :)

Thanks,

Eliz
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Hey Eliz,
Thank you for asking.
The survey specifically asks questions about how owners cope with various treatments for their diabetic cats at home. For example, if you have a diabetic cat who is receiving insulin injections and you indicate this on the questionnaire, specific questions will pop up that will ask you further about administering injections, drawing up the insulin, etc.
I'd like to know which methods of treatment owners are finding easier and which are more difficult and why they chose certain treatments (difficulty administering them, work schedule, costs, etc.). I think the study will help evaluate not only which treatments are best for the cats but which treatments are also easiest for owners to give to their cats.
I hope this clarifies things a bit more. Please let me know if you'd like to know anything else.
Thank you!
Janina
 
@Elizabeth and Bertie -

The survey does ladle it on a bit thick about Caninsulin VetPens (Merck are supporting the survey).


@Janina Rzeznitzeck -

I was in the process of completing the survey, but the form software glitched and I lost everything. I have health problems so I might not be able to do it again.

I think the survey asks some very good questions. I'm really pleased to see that you've asked a lot about home testing of blood glucose.
 
Have done the survey. :cat:

Janina @Janina Rzeznitzeck , I'm pleased that you have an interest in feline diabetes. We really need more vets in the UK who are interested in and really understand feline diabetes.

One of the main problems we caregivers face in the UK is that many vets tend to treat our diabetic cats like small dogs.
The vast majority of UK cats are prescribed Caninsulin (a canine insulin) initially. On this forum Caninsulin is considered one of the harder insulins to work with. This is because it has the potential to drop the blood glucose really fast in the first few hours. And it often has quite a short duration (8 - 10 hours is not uncommon), meaning that cats may have a number of hours in the day when they have no insulin in their systems.

UK vets seem to vary enormously in their willingness to prescribe alternatives to Caninsulin. And some vets don't seem to know that they are able to prescribe alternatives (ie Lantus, Levemir or Hypurin PZI). I'm lucky in that my vet was willing to prescribe an alternative insulin, but some caregivers here have had vets that refused to prescribe an alternative, even when the hometesting data showed that the cat wasn't doing well on Caninsulin.

The RVC is currently conducting research into remission in diabetic cats. And they are trialling longer-lasting insulins and different dosing protocols. Some of us are hoping that the knock-on effect of this is that more caregivers will soon have access to better insulins.
I don't know if you've heard about the RVC remission clinic, but if you haven't (and you are interested) their Facebook page is here:
https://www.facebook.com/RVC.Diabetic.Remission.Clinic

Wishing you the very best of luck in your future career. And may many diabetic cats in your care sail smoothly into remission...;)

Eliz
 
Thank you all for your help. I really appreciate all of your input.

@ Critter Mom: Thank you very much for attempting the survey anyway. No worries about not being able to complete it again. I am sorry for the technical difficulties you encountered. Just to clarify, the survey is not supported by Merck in any way. I was simply asking the questions about the insulin pen because im genuinely interested whether having the pen as opposed to the traditional insulin and syringe makes any difference to owners in treating their cats. Those questions only appear if someone selects the option that they are using the vetpen as a treatment.

@ Eliz: Thank you so much for your input. I 100% agree with you. Unfortunately, there is a sort of hierarchy in the UK in which drugs need to be prescribed. The only licensed insulin that can currently be used in cats is Caninsulin, the others are all off-license, even if evidence has shown that some may be better options for cats. What is missing is a pharmaceutical company that is willing to invest in a study to get the other drugs licensed. I believe these are the reasons why vets in the UK still chose to prescribe Caninsulin. Hopefully with more studies like mine, what vets prescribe for cats in the future will change. I'm really excited to analyse the results from the questionnaires.
Thank you for the advice on contacting the RVC. I will definitely look into that.
I hope that your cat is doing well on the new insulin. :)
 
I just did the survey - Maggie (deceased). I wanted to add that Maggie originally used Humulin U. When she went out of remission, my vet was totally unaware of Lantus or Levemir because they were very new and human insulins. I provided her with info from here about them and how they work differently than the old insulins. More needs to by published for vets about all this.
 
Janina Rzeznitzeck said:
Thank you all for your help. I really appreciate all of your input.

Just to clarify, the survey is not supported by Merck in any way.
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Really? I'm confused. It says at the bottom of the questionnaire introductory page that the survey is supported by MSD Animal Health.

I was simply asking the questions about the insulin pen because im genuinely interested whether having the pen as opposed to the traditional insulin and syringe makes any difference to owners in treating their cats. Those questions only appear if someone selects the option that they are using the vetpen as a treatment.
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This is part of the reason that I'm disappointed that I lost my response to your survey (I was up to question 22! :( ). I really want to do anything I can to help other diabetic cat caregivers and I provided very comprehensive feedback wherever possible, including my experience of using both traditional insulin syringes (with Caninsulin and Lantus) and a VetPen (with Caninsulin).

How long do we have to complete the survey? I'd like to try again if there's time.

Unfortunately, there is a sort of hierarchy in the UK in which drugs need to be prescribed. The only licensed insulin that can currently be used in cats is Caninsulin, the others are all off-license, even if evidence has shown that some may be better options for cats. What is missing is a pharmaceutical company that is willing to invest in a study to get the other drugs licensed. I believe these are the reasons why vets in the UK still chose to prescribe Caninsulin.
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For the benefit of all readers, UK vets don't legally have any choice when first prescribing insulin for a cat: it has to be Caninsulin. Under drug cascade rules, the cat must be treated with Caninsulin first and evidence gathered to prove that it's not working for the cat before a vet is legally permitted to prescribe a different insulin. I really wish that diagnosing vets would explain the cascade system to caregivers straight away. Were it not for my own internet research, I might never have heard about Lantus, Prozinc, etc., or that there might be more cat-friendly - and possibly more effective - treatment protocols available down the line if the 'Caninsulin + w/d Dry' protocol didn't work for my cat.

Hopefully with more studies like mine, what vets prescribe for cats in the future will change.
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I really hope so too, Janina. You're asking so many of the right questions. I hope it is very well received. :)

I'm really excited to analyse the results from the questionnaires.
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I hope that you'll be sure to share the results with us here when they're ready. I think FDMB members in the UK will be particularly interested in your findings. I know I certainly am! :)
 
Janina Rzeznitzeck said:
The only licensed insulin that can currently be used in cats is Caninsulin, the others are all off-license, even if evidence has shown that some may be better options for cats. What is missing is a pharmaceutical company that is willing to invest in a study to get the other drugs licensed.
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The RVC are trialling Prozinc, a very good US insulin made for cats. Apparently, this is licensed for use in Europe, but for some reason doesn't yet seem to be 'on general release' here...

Critter Mom said:
For the benefit of all readers, UK vets don't legally have any choice when first prescribing insulin for a cat: it has to be Caninsulin. Under drug cascade rules, the cat must be treated with Caninsulin first and evidence gathered to prove that it's not working for the cat before a vet is legally permitted to prescribe a different insulin. I really wish that diagnosing vets would explain the cascade system to caregivers straight away. Were it not for my own internet research, I might never have heard about Lantus, Prozinc, etc., or that there might be more cat-friendly - and possibly more effective - treatment protocols available down the line if the 'Caninsulin + w/d Dry' protocol didn't work for my cat.
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Ditto to all of the above. With knobs on. :smuggrin:
.
 
Dear all,

Thank you once again to all of you for putting in so much effort and time to fill in the questionnaires for me. I don't know how to thank you enough for that. This is really great and I didn't expect to get so many responses at all.

@ Critter Mom: Sorry, I may have not been clear about the MSD Animal Health part. I meant to say that they had no influence on the questions asked in the survey. They all came from me and the research team. They only decided to sponsor the survey after they saw the questions just before we launched this a few days ago. I really appreciate it that you are willing to try the survey again. It will be up for quite some time still (at least another month), so please don't feel rushed. Thank you for also clarifying the drug cascade rules. It is really unfortunate that this is the case. Of course I will also post all my results here that I find for everyone to read. :cat:
 
Critter Mom said:
For the benefit of all readers, UK vets don't legally have any choice when first prescribing insulin for a cat: it has to be Caninsulin. Under drug cascade rules, the cat must be treated with Caninsulin first and evidence gathered to prove that it's not working for the cat before a vet is legally permitted to prescribe a different insulin. I really wish that diagnosing vets would explain the cascade system to caregivers straight away. Were it not for my own internet research, I might never have heard about Lantus, Prozinc, etc., or that there might be more cat-friendly - and possibly more effective - treatment protocols available down the line if the 'Caninsulin + w/d Dry' protocol didn't work for my cat.
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No disrespect to the UK (my Mom's folks are from the UK) but that is :confused:CRACKERS:confused:. Is there any vehicle to change the legislation? One would think that vets should have the discretion to create treatment protocols as their expertise dictates. I'm assuming the original legislation was not created by vets, for who would hamstring themselves professionally like that? I haven't seen all the literature, but certainly there is enough accredited documentation to support different treatment options for cats?

Is there a similar drug cascade system for humans? Just wondering.
 
@Brashworks Our Canadian systems for human drugs work along similar lines. Certain drugs are covered and only if failure of that drug is proven will a different more costly drug be covered. Even the insurance companies work along the same lines by paying a higher % of cost for generic vs. lower % of brand name drugs and there are some drugs they don't cover because they aren't on the provincial approved drug listing.
 
I completed the survey for you even though Rosa's been OTJ for a few months now - hopefully something will come out of it that can help other cats in the future. :)

Brashworks said:
Is there a similar drug cascade system for humans? Just wondering.
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There sort of is, yes. Because the major part of the cost of medication in the UK is covered by the National Health Service, doctors are limited to trying the cheaper drugs first, although they do then have the option to go to something more expensive if necessary. And some of the more expensive drugs aren't available at all.
 
Critter Mom said:
For now. I dread to think what things will be like when Cameron's jackals have had their way with it. :( :mad::mad::mad:
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Fair point - while I don't live there any more, my family still do. It does worry me that they may finish up having to pay private rates for everything, or have to buy insurance which, for my parents certainly, wouldn't be at any sort of reasonable rate. :(
 
Janina Rzeznitzeck said:
I really appreciate it that you are willing to try the survey again. It will be up for quite some time still (at least another month), so please don't feel rushed ... Of course I will also post all my results here that I find for everyone to read.
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Oh that's great news, Janina. I have chronic PTSD and it causes cognitive problems that make written communication difficult, especially when trying to draft novel material. I had spent a-g-e-s filling out the questionnaire and optional feedback for you the other evening. I was gutted when it hiccuped and I lost all my answers; all 22 questions worth!!! :banghead: :banghead: :banghead: I need a bit of time to recover health-wise before attempting it again (I get majorly fatigued.)

Thank you for clarifying MSD's support for the survey, and I am delighted to read that you'll be letting us know about the results of the survey. Studies like yours are very, very welcome and could save many kitties' lives. :)
 
@manxcat419 -

A huge part of the reason my health is so bad now is that I was living in another country when I had my accident and I could not afford to get the health care I needed. It infuriates me that the Tories are leading the population in this country by the nose toward an American style system. Profit before people. :mad::mad::mad::mad: :(:(:(:(

(Apologies for the slight frankenthread, Janina. :oops:)
 
Critter Mom said:
For now. I dread to think what things will be like when Cameron's jackals have had their way with it. :( :mad::mad::mad:
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Don't get me started on that one.... Grrrrrr......
Somebody (can't remember who) said 'they'll start by going for the foxes and then come for the rest of us'. Be afraid. Be very afraid...:nailbiting:

Sorry for going off topic, Janina. Feelings are running high in our little corner of the world. I'll shut up and get back in my box now. :oops:
.
 
Critter Mom said:
A huge part of the reason my health is so bad now is that I was living in another country when I had my accident and I could not afford to get the health care I needed. It infuriates me that the Tories are leading the population in this country by the nose toward an American style system. Profit before people. :mad::mad::mad::mad: :(:(:(:(
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I was incredibly lucky when I moved here that Michael has a good insurance plan through his employer that he was allowed to add me to. It's still not cheap, but we do get decent cover and it's a lot cheaper than paying for everything individually. And even with insurance, the kids can run up horrendous medical bills really quickly. I'm all for having a choice, and most of my employers in the UK did offer private medical insurance as part of their benefits, but being forced into buying insurance that is ever-increasing in price because you don't have a choice but to buy it really doesn't work for most people. Having experienced both types of healthcare first-hand, I'd hate to see the UK go the route of compulsory insurance and the health service being privatized. :(
 
Janina Rzeznitzeck said:
Hello all,

I am a third year vet student in Edinburgh, Scotland, and currently doing research for my thesis on feline diabetes. I have designed an owner survey to investigate how they cope with their cat's treatments at home in order to investigate treatment methods that are easier for owners to deliver to their diabetic cats.

If you currently own a diabetic cat or have owned one in the past, I would be so grateful if you could please fill in my questionnaire. The link is: http://www.vetprofessionals.com/diabetic.html
I would appreciate it very much if you could also share this link with friends/ family who have diabetic cats as well.
I did the survey and hope that it helps in feline diabetic research. I think one of the best thing that could come out of this survey is that vets become more knowledgeable with feline nutrition and stop promoting the RX diets that are too many carbs for cats to be consuming. If I would have known more about cat nutrition, my cat would not be in this situation right now. Please stop letting Hill's pet food seduce you with their million dollar research which equates to pet owner speeding too much money and pets staying sick. That you for reaching out to this forum and good luck with your research and the rest of you academic career.

If you like, there is a prize draw in the end of the survey into which you can enter to win a shopping voucher.

I'm really hoping to make a difference in terms of treatment administration for diabetic cats with this survey and it would be great if you could help me out. Hopefully I will be able to find methods that not only make the control of your cat's diabetes better and but also make it easier on you to treat your cat.

Thank you so much.

All my best,
Janina
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Bobbie And Bubba said:
. I think one of the best thing that could come out of this survey is that vets become more knowledgeable with feline nutrition and stop promoting the RX diets that are too many carbs for cats to be consuming. If I would have known more about cat nutrition, my cat would not be in this situation right now. [*] Please stop letting Hill's pet food seduce you with their million dollar research which equates to pet owner speeding too much money and pets staying sick. [Thank] you for reaching out to this forum...
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^^^^ This. ^^^^

A thousand times this.



* Emphasis mine.
 
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Thank you all for taking my survey. Again, I can't tell you enough how grateful I am for that.
I am also really please to see all the discussion points you are raising about various topics. This is really interesting to see. I think it is important for a vet to take the clients' perspectives as well to see what they are actually going through with their pets, which is why I am doing this research. I really hope this will encourage some vets to look at things a bit differently.
Please, if you have anything else that comes to your mind that you would like your vet to do more/ less, let me know. It will only help me be a better vet later on.
Thank you all again.
All my best,
Janina
 
Janina Rzeznitzeck said:
Please, if you have anything else that comes to your mind that you would like your vet to do more/ less, let me know.
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Be careful what you ask for, Janina. Remember that you might get it. ;) (OK peeps. Open the floodgates...)

Being serious, I think it's wonderful that you're asking all the right questions. I think you're well on the way to being a very good vet. You're asking and listening. :)
 
For many chronic conditions children get (ex diabetes, asthma), there are self management programs which teach the parents and the child how to manage the condition. That concept should be extended to the veterinary field where the caregiver can be taught to manage the condition following a standard protocol (rx diabetes, asthma, CRF). While there are some caregivers who won't go the extra mile, if you have a handout or video with the information broken up into sections or steps, you may be able to slide them into more complex tasks without freaking them out.

Of course it will depend on where in the disease course you start - acute DKA is not the time to be discussing diet, its the time to get to the ER.
 
BJM said:
For many chronic conditions children get (ex diabetes, asthma), there are self management programs which teach the parents and the child how to manage the condition. That concept should be extended to the veterinary field where the caregiver can be taught to manage the condition following a standard protocol (rx diabetes, asthma, CRF). While there are some caregivers who won't go the extra mile, if you have a handout or video with the information broken up into sections or steps, you may be able to slide them into more complex tasks without freaking them out.

Of course it will depend on where in the disease course you start - acute DKA is not the time to be discussing diet, its the time to get to the ER.
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That's a very good idea. I was thinking about having training sessions etc. for pet owners before. Thank you for bringing this up. :)
 
Several folks here have run into exceptionally autocratic vets - my way or the highway. This is not the way to win friends and influence people, nor is it the way to retain clients.

While "Dr Google" can be misunderstood, incorrect, or totally irrelevant to the pet's condition, when you have a motivated client who will do research, point the person to the reputable web sites and have them read. There are only so many hours in the day and it is impossible for any one person to stay on top of the entire field of veterinary medicine all the time, including the vet. Let your clients do some legwork and bring in ideas that could help, from reputable sites such as FDMB, Feline CRF, Feline Constipation, Cat Info, Cornell free veterinary resources, Koret Shelter Medicine (good for folks running rescues or with many cats), Pub Med for the real researcher types (hi there!) and so on.
 
@Janina Rzeznitzeck -

If you're not already familiar with it, I can't recommend highly enough that you familiarize yourself with Dr Lisa Pierson's site - catinfo.org. I wish I had known about it sooner. Every health issue I have had with all of my cats can be traced back to my having fed them a dry diet (vet-recommended on grounds that it was better for their teeth).

I have lost some of my little ones very young because of what I now realise were problems caused by feeding them the wrong thing in good faith. It adds insult to injury because I specifically asked my vets when I adopted my first two rescue cats, Tara and Psycho Fatboy the Third, exactly which diet would be best for them. I trusted my then vet and I fed them the recommended dry food. I lost Tara to a severe UTI - at six years of age. I nearly lost her brother a few short months later when his urethra became blocked. Now I look at my beloved Saoirse struggling to eat without pain and I am both hurt and angry. I am actually more angry at myself than the food companies and the vets I asked for advice, because my little ones were my responsibility: I should have educated myself, not taken things as gospel because their vet said it was OK. I'm also sad because I think that the trust of both vets and caregivers is being abused by the big pet food companies.

Dry food companies, in my considered opinion, use bad 'science' to back up false assertions that their products are good for cats. They aren't. Period. And cats have needlessly suffered, countless lives have been lost - in many, many cases prematurely - and so many hearts torn out as a result of accepting such false assertions, hence the impassioned comments about foods on this thread (and elsewhere on this forum).

If you are not already familiar with her work, I also recommend Debra Zoran's paper: The Carnivore Connection to Nutrition in Cats.

(You might also find it interesting to check out Insulin Resistance: The Carnivore Connection Hypothesis of Miller and Colagiuri, which compares and contrasts evolutionary adaptations affecting insulin sensitivity in humans in response to high carb and high protein diets - particularly thought-provoking when it's considered alongside the evidence of how our food manufacturers' (commercial) decisions to promote high carbohydrate diets for creatures who are not evolutionarily equipped to handle same are having their health and well-being so adversely impacted.)


Mogs
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Thank you so much for all of your input. I really value everything you tell me because most of the time I didn't know this was going on. i'll check out all the links and sources you named, too, once I am done with my clinical externships and have a bit more time.
 
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