Royal Veterinary College Diabetes Clinic

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Pudding

Pudding

Member Since 2016
This is a message for all UK users. I'm writing to encourage you to enrol on the RVC diabetes drug trial. They are testing a drug called Exenatide to see if it helps with long-term remission.

The trial lasts 6 months and requires a visit once a month to the RVC hospital near Potters Bar. Each visit your cat gets an injection of the trial drug or a placebo and on two visits they also do other more extensive tests. In return you get 6 months' supply of free insulin and a year's supply of diabetic cat food. However, far more important than this you effectively get free on-call advice about how to manage your cat's diabetes. When my cat was first diagnosed I was here on the forum a lot asking questions when I got worried. Now, I can just e-mail the researcher who can give me all the advice I need. I can ask her what to do when I get low figures, get advice on when to change dose and when I need to test and when not etc etc.

The trial still needs lots of participants so I would encourage you to get in touch. I've found it extremely helpful and it also helps care for all cats in the long run. The clinic has a Facebook page called Diabetic Remission Clinic and this is a link to the page on their website http://www.rvc.ac.uk/research/resea...ion-centre/projects/diabetic-remission-clinic
 
I have been wondering about this but it's just too far to be practical for me. It was hard enouh taking Sky for an hour's journey to a specialist vet. Taking her from Lancashire down to Potters Bar would be too much to ask of her. It's a shame really as I would love to help contribute to a better understanding and possible control.
 
I took Angel to the clinic they had 2 years ago trialing prozinc and he went into remission about 6 weeks later. Unfortunately he's not eligible for this trial as they need recently diagnosed cats but I'd encourage anyone to go.
 
Migs is in the trial, and I know that @Alexi 's Cappuccino is also enrolled.

I can't encourage you enough if you are in the South East. Even if your cat ends up randomised to the control group, you'll still get free food, insulin and expert advice. As you say, the advice is more valuable than any amount of goodies - having someone to email and ask for advice is a godsend.
 
I have copies of all Cappuccino's results sent to me and there is consent to sign before every injection. I am very happy so far and now heading towards micro dosing territory. I really would encourage people to join the trial, I think it is worth it.
 
Not to hijack the thread, but Cappuccino's latest curve is very interesting @Alexi , I had a very similar curve for migs this week too (granted on 2.25 IU instead of 0.75!, but the late nadir is very similar).
 
Looks like Louie has been accepted on the trial. He was only diagnosed last week but a friend told me about it at the weekend, I emailed them on Saturday night and they contacted me this morning. I'm super excited and they have already given me some great advice on feeding him. It is very thorough. His first appointment is on Wednesday and we will be there for around 5 hours while they do all the tests and make sure he is suitable. After that if everything is ok he will only have to go once a month and the appointment will be much shorter. Fingers crossed!
 
Louie is back from the RVC and after loads of tests we have insulin and food and I will need to start plotting a curve in a week (need to get the insulin working). Only one fly in the ointment, his symptoms suggest he may have Acromegaly, if this is the case they will do a CT scan and then take it from there. they have another research project for Acro and he may join that. I've posted in the thread about that trial. I'm so glad I took him and would recommend the project to everyone who can get there, if Louie hadn't gone today there is no way my own vet would have even been thinking about Acro only a week after his DM diagnosis.
 
How did Louie go, @Rebecca Thomas ?

Unfortunately Migs is proving very difficult and still hasn't got close to stable or regulated. They are considering a change over to Glargine, but it probably won't magically alter things. I wish he'd play by the rules!
 
@Laszlo and everyone. Sorry I've no been around. Louie had his hypophysectomy last Monday - 6/2. It's been very traumatic for us with lots of worry but it doesn't seem to have affected him quite as much! Everything went really well, so well that I brought him home yesterday. He has a bag full of meds but he's, fingers crossed, off the juice and extremely unlikely to ever return to it (it would be because of something else if he does), he's not longer asking for food every hour and no infections. He's a bit quiet but I think we can forgive him for that. If you have access to it and can afford it I would thoroughly recommend the surgery, different cats may have different experiences, but from my experience I cannot thank Stijn Niessen and the whole team at the RVC for the expertise and care they have given him and giving us as well as Louie our lives back.
 
Laszlo said:
Unfortunately Migs is proving very difficult and still hasn't got close to stable or regulated. They are considering a change over to Glargine, but it probably won't magically alter things. I wish he'd play by the rules!
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I actually wonder how Migs would do on a lower dose. Maybe that would even out the numbers a bit....?
I think the current dose may be slamming him down into lower (and sometimes clearly hypo range) numbers and then causing the blood glucose to swing up high again.

As I recall there was another member here who the RVC were trying a similar-looking dosing strategy on. In her case I think the idea was to see if pushing the cat into hypo numbers would induce remission. ....Have the RVC discussed the purpose of this dosing strategy with you, Laszlo?

Eliz
 
Elizabeth and Bertie said:
I actually wonder how Migs would do on a lower dose. Maybe that would even out the numbers a bit....?
I think the current dose may be slamming him down into lower (and sometimes clearly hypo range) numbers and then causing the blood glucose to swing up high again.

As I recall there was another member here who the RVC were trying a similar-looking dosing strategy on. In her case I think the idea was to see if pushing the cat into hypo numbers would induce remission. ....Have the RVC discussed the purpose of this dosing strategy with you, Laszlo?

Eliz
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an uncom

There is certainly no deliberate desire to push him into hypo ranges. Theoretically they are looking for a nadir of 4-6 during a curve.

So we've tried all sorts of things. It certainly looks like a classic bouncing scenario doesn't it? So, we have tried on a few occasions to drop down to 1.5. However invariably, this has resulted in him having very high results and poor clinical signs (ie drinking), so 'seems' too little. The problem is how unpredictable he is. Sometimes 1.75 is far too much when PS is 20, but then sometimes it hardly makes any dent. It's entirely possible you're right, and a lower amount of insulin would help. He may 'simply' need a better sliding scale, but his response to insulin is (as I say) very variable. Anyway we are off on Friday and they are going to come up with a new strategy. Their experience in previous trials is that some cats are a bit like this, and I guess this tallies with our collective experience on these boards too!
 
Laszlo said:
Their experience in previous trials is that some cats are a bit like this, and I guess this tallies with our collective experience on these boards too!
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Indeed.
(And in fact my Bertie's blood glucose was very erratic at first (well, mostly high with occasional sky dives....))

Hmmm... Is it just the wet Purina DM that you're feeding, or is it a mix of wet and dry? (Just wondering if there are any obvious 'variables' that could be tweaked...?)
.
 
Yes, just the wet Purina DM. It's measured carefully, and he has 4 meals (65g morning, 20g lunch, 65g dinner, 20g before bed). Apart from very occasional disasters, he can't steal food from the other cat, and much to my sadness we have the kitchen closed at all times since he's a big fan of eating bread, cakes, biscuits and (believe it or not) corn flakes. He's addicted to carbs!
 
Laszlo said:
an uncom

There is certainly no deliberate desire to push him into hypo ranges. Theoretically they are looking for a nadir of 4-6 during a curve.

So we've tried all sorts of things. It certainly looks like a classic bouncing scenario doesn't it? So, we have tried on a few occasions to drop down to 1.5. However invariably, this has resulted in him having very high results and poor clinical signs (ie drinking), so 'seems' too little. The problem is how unpredictable he is. Sometimes 1.75 is far too much when PS is 20, but then sometimes it hardly makes any dent. It's entirely possible you're right, and a lower amount of insulin would help. He may 'simply' need a better sliding scale, but his response to insulin is (as I say) very variable. Anyway we are off on Friday and they are going to come up with a new strategy. Their experience in previous trials is that some cats are a bit like this, and I guess this tallies with our collective experience on these boards too!
Click to expand...
Very much like Teasel. I don't feel so inept now that I know he'd likely defeat the experts. o_O
 
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