Reassurance required please for UK newbie - from anyone!

[Diana&Tom]

Hi everyone

Some of you who are members of the Facebook FD pages may have seen posts from a UK newbie, Monica, who has recently started treating her kitty, Josie. Several of us members here on the board are giving her support on FB and we have suggested that she comes over here to read and ask questions so all the info will be in one place! So this thread is on Monica's behalf.

Josie is on Caninsulin and her vet has suggested doses of 3u twice a day which of course we feel is too high to start with. Monica has listened to what we've said about the dose but her husband wants to abide by what the vet says... a familiar scenario! So some support for that issue would be helpful please.

Monica is managing ok with home testing but a few tips might be helpful... warming the ear, getting Josie to associate testing with treats, etc.

She is also understandably a little overwhelmed with so much to learn... testing, dosing, curves, foods, etc... so again any reassurance would be very welcome.

We have all been newbies once so wherever you are in the world, please do chime in with some support for Monica... and I am going to tag some fellow UKers here on the board as they will be well placed to help with queries related to food, online suppliers, etc etc.

Thanks everyone and Monica - welcome to FDMB!

@Elizabeth and Bertie @Marlena @Sootyca @SweetAngel @Anthony Morgan

Diana

 

[Tuxedo Mom]

http://www.felinediabetes.com/FDMB/members/monica-lewis.19053/
Monica Lewis and her kitty Josie. She is still overwhelmed with the diagnosis and a bit overwhelmed with maneuvering through FDMB,

Here are some posts from a FB group to bring everyone up to snuff

https://www.facebook.com/groups/503...tif_t=group_comment&notif_id=1492439062083802

"Hi everyone and thank you for the add. Would love some advice please!
This is our lovely Josie, 13 years old, diagnosed with diabetes 2 wks ago. All internal organs fine, the only visible symptom is drinking excessive water, otherwise very happy eater, playful and running to us for treats. His blood sugar was 20 at the vet. Been told to give her 3 units of Caninsulin twice a day. We did that for 4 days. Josie put up such a fight every time, had to hold her down as she was hissing growling scratching and crying. It was so distressing for everyone, we decided to try out any alternative first and do injections if there's really nothing else left.We stopped the insulin injections, switched her diet to high protein pouches,freshly cooked fish/chicken and very tiny amount of 85% meat no grain no starch dry food. Unhelpful vet just keeps saying do the insulin shots, can anyone recommend anything else for us to try?! We don't want to distress her twice a day every day in her old age..

Taking blood sample also been tricky but managed to do it.. Been giving her herbal Blood Sugar Gold drops and her blood sugar is 18.4 at the mo. Anyone tried out insulin in tablet form?? Thanks so much, any related advice would be much appreciated!"

"Monica Lewis Good morning and thank you for your support. We did a BG read this morning and it was even higher than before so we decided it was time to go with the injections again. As suggested by you we gave it to her whilst eating and it went really well. She only objected to it for a second and went back to eating. I cried with relief over how well it went. Thank you again."



Monica Lewis Just an update that we checked Josie's blood again couple of hours after first insulin shot and numbers went down from 19.2 to 10.4! Ideal would be under 7 which we'll be working towards but we're off to a good start and very happy! Many thanks

"




Monica Lewis Thank you everyone for trying to help. My vet doesn't really care about my cat that much that he'd go into the above details with me, I'm thinking of changing vet to a more compassionate one. I'm finding this whole thing bit overwhelming to deal with actually. The injections, the frequent blood tests, establishing curves, choosing needles, picking out the most suitable food, making sure she gets enough nutrients - actually probably because I love her so much I just want to make sure I'm doing the right thing. I'm finding it all so stressful and I'm not even sure if I can deal with it all. I've got tears running down my cheeks right now.. I'm very confused if I should follow my vets advice of 3 units or yours here of 1 unit, my husband insists on that we should follow the vet's advice.. It's bloody hard to deal with it all in my head and in my heart."

"Monica Lewis He refuses to read as can't be bothered, only wants to follow our vets advice.. Right, with 3 unit starting shot at 8 :15 am here are the blood test numbers:
8:00am 19.2 11:am 10.4 and 3.30pm 8.9.
Too low, too high? Planning to give one unit around 7pm. When should check blood next please? Thank you"

Monica was advised that the starting dose of 3 units was too high. She has just started home testing today using a human meter....Accu-chek performa nano... Any input would be welcome'

 

[Elizabeth and Bertie]

Hi Monica @Monica Lewis ,

Waving to you from Surrey!

I see you've had some great advice.
I agree it's a good idea to reduce the dose, especially if you transitioning your kitty to a low carb wet diet (as that can reduce blood glucose quite a bit in some kitties.)

Are the tablets you're thinking of Glipizide? These don't generally work very well for kitties. And the main issue with them is that, as I understand it, they try to make the (already stressed) pancreas work even harder. These tablets do have their uses in certain circumstances, but insulin is almost always the way to go.

It's very early days, Monica, and there is every chance that your kitty will do just fine! My own cat diabetic kitty is now 18 (he's been diabetic for just over 10 years.)

Well done for starting to hometest. That's a fantastic achievement, and will make managing your kitty's diabetes so much easier.

We all understand that it's stressful at first. But you will soon get the hang of this.
Be kind to yourself. And remember to breathe....
We are here to support you.

Hugs to you, (((Monica)))...

Eliz

 

[Tuxedo Mom]

Monica:

First off this is the link to the caninsulin/vetsulin information I gave you on FB. It is worth reading through here so that you get a better understanding on how the insulin works:

http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/



Since the forum can be "scary" at first to find your way around if you read the yellow "stickies" at the top of this page:

http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/

it will give you an idea on how to find your way around the forum. And of course please ask any questions, at any time.

 

[Monica & Josie]

To say that I'm 'slightly overwhelmed' is an understatement! My husband says I'm getting overly obsessed with all but I just want to make sure that we are doing everything right and what's best for Josie. Thank you so much everyone, you've been so brilliant already and I really appreciate your input!

 

[Tuxedo Mom]

Monica if you weren't feeling overwhelmed I would be shocked. It is a whole new experience. There have been members who are nurses and even diabetic themselves that are overwhelmed with having to deal with feline diabetes. to begin with. Knowledge is power and questions and readings give you more knowledge. Once you get acquainted with the forum it would be useful for you to set up a "signature" which is the general information all of us have about our kitty...date of diagnosis, type of insulin, age of kitty, any other health issues, type of meter you are using, type of food you are feeding etc. This gives a quick snapshot of "who" your kitty is so that people don't have to keep asking when they give information or advice. There is a link to making a signature but I can't find it off hand. (and I have been here over 2 years )

Also setting up a spreadsheet to keep track of your readings gives a wonderful visual look at the treatment process. This link gives you information on setting up the spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You would use this template:

https://docs.google.com/spreadsheets/d/1JQ136YHkxNhhku9AML_OKGHkrg3Ixe27BWAdWONlnP0/edit?usp=sharing

since you are using the mmol/l system (same one I use in Canada) and a human meter. Setting up the signature and spreadsheet will probably look like some foreign language to you, but there are people on here that can help you get it all done. It took me actually a few months before I got mine done and I needed help with it.

 

[Tuxedo Mom]

tagging another Caninsulin/Vetsulin user that has managed to get her kitty into remission @JanetNJ and another UK caninsulin user who is newer to FD @Sootyca as well as @Kris & Teasel who has good insights on various insulins. The more input and information you get the better. There are many more members that can help as well as you get posting more but just tagging a few to get you started.

 

[Yong & Maury GA]

Welcome Monica and Josie!
We have all been through the diagnosis overwhelming feeling. You've found a great support group for YOU and Josie here . I am glad to hear you will be lowering the dose, as others have said the 3U is too high of a starting dose. Too much insulin can also keep numbers higher if her ideal dose was less than 3U. Glad you are home testing, especially if doing a diet change; it's the best tool in our FD tool bet!
Please keep posting questions you have!
Sending hugs . Testing and shots will be a routine in no time. My boy still meows once in a while when poking his ear for BG test and giving his shots.

 

[Monica & Josie]

Hi Monica @Monica Lewis ,

Waving to you from Surrey!

I see you've had some great advice.
I agree it's a good idea to reduce the dose, especially if you transitioning your kitty to a low carb wet diet (as that can reduce blood glucose quite a bit in some kitties.)

Are the tablets you're thinking of Glipizide? These don't generally work very well for kitties. And the main issue with them is that, as I understand it, they try to make the (already stressed) pancreas work even harder. These tablets do have their uses in certain circumstances, but insulin is almost always the way to go.

It's very early days, Monica, and there is every chance that your kitty will do just fine! My own cat diabetic kitty is now 18 (he's been diabetic for just over 10 years.)

Well done for starting to hometest. That's a fantastic achievement, and will make managing your kitty's diabetes so much easier.

We all understand that it's stressful at first. But you will soon get the hang of this.
Be kind to yourself. And remember to breathe....
We are here to support you.

Hugs to you, (((Monica)))...

Eliz

Hi Eliz,

waving to you from Saffron Walden!
yes it was Glipizide I was wondering about but it seems that as of this morning we have passed that stage as we started giving insulin injections again..

Wow your kitty been diabetic for 10 years? Then there is hoe for long life once been diagnosed..Phew!

Thanks so much, your comments and virtual hugs are much appreciated!

 

[Monica & Josie]

Welcome Monica and Josie!
We have all been through the diagnosis overwhelming feeling. You've found a great support group for YOU and Josie here . I am glad to hear you will be lowering the dose, as others have said the 3U is too high of a starting dose. Too much insulin can also keep numbers higher if her ideal dose was less than 3U. Glad you are home testing, especially if doing a diet change; it's the best tool in our FD tool bet!
Please keep posting questions you have!
Sending hugs . Testing and shots will be a routine in no time. My boy still meows once in a while when poking his ear for BG test and giving his shots.

Hello Yong and thank you!

yes I've decided to reduce the dosage although I will still need to convince my husband to ignore the vets advice and go with it..!

I do have lots of questions but have to figure out first where to post them?!

Thanks again!

 

[Diana&Tom]

You can post questions right here, Monica... you are definitely in the right place! If you have a very specific question you can start a new "thread" (click on link at top right, and give it a name, and start typing)... multiple and frequent questions are just fine!

Diana

 

[Yong & Maury GA]

You can make a new thread here, or add on so they're all in one place . Tell your hubby Happy kitty = happy wife = Happy Life lol

 

[Monica & Josie]

Monica if you weren't feeling overwhelmed I would be shocked. It is a whole new experience. There have been members who are nurses and even diabetic themselves that are overwhelmed with having to deal with feline diabetes. to begin with. Knowledge is power and questions and readings give you more knowledge. Once you get acquainted with the forum it would be useful for you to set up a "signature" which is the general information all of us have about our kitty...date of diagnosis, type of insulin, age of kitty, any other health issues, type of meter you are using, type of food you are feeding etc. This gives a quick snapshot of "who" your kitty is so that people don't have to keep asking when they give information or advice. There is a link to making a signature but I can't find it off hand. (and I have been here over 2 years )

Also setting up a spreadsheet to keep track of your readings gives a wonderful visual look at the treatment process. This link gives you information on setting up the spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You would use this template:

https://docs.google.com/spreadsheets/d/1JQ136YHkxNhhku9AML_OKGHkrg3Ixe27BWAdWONlnP0/edit?usp=sharing

since you are using the mmol/l system (same one I use in Canada) and a human meter. Setting up the signature and spreadsheet will probably look like some foreign language to you, but there are people on here that can help you get it all done. It took me actually a few months before I got mine done and I needed help with it.

Hi Tuxedo mum,

thanks so much for taking the time to support me and offer your help to guide me through this madness!

Once I cracked this page I will be posting some questions as i do have loads!!

 

[Monica & Josie]

Hi everyone

Some of you who are members of the Facebook FD pages may have seen posts from a UK newbie, Monica, who has recently started treating her kitty, Josie. Several of us members here on the board are giving her support on FB and we have suggested that she comes over here to read and ask questions so all the info will be in one place! So this thread is on Monica's behalf.

Josie is on Caninsulin and her vet has suggested doses of 3u twice a day which of course we feel is too high to start with. Monica has listened to what we've said about the dose but her husband wants to abide by what the vet says... a familiar scenario! So some support for that issue would be helpful please.

Monica is managing ok with home testing but a few tips might be helpful... warming the ear, getting Josie to associate testing with treats, etc.

She is also understandably a little overwhelmed with so much to learn... testing, dosing, curves, foods, etc... so again any reassurance would be very welcome.

We have all been newbies once so wherever you are in the world, please do chime in with some support for Monica... and I am going to tag some fellow UKers here on the board as they will be well placed to help with queries related to food, online suppliers, etc etc.

Thanks everyone and Monica - welcome to FDMB!

@Elizabeth and Bertie @Marlena @Sootyca @SweetAngel @Anthony Morgan

Diana

Thanks sooo much Diana, you are such a star for helping me loads already. Although still none the wiser just yet about anything Im already feeling better about this whole thing as I know I won't be going through it alone..

 

[Tuxedo Mom]

The best place to start a new thread (post) is on the same forum you are on:

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

At the top on the right you will see "http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/create-thread" Post New Thread. When doing the Title there is a drop down box to the left that says "No prefix" If you hold you pointer over it there are three choices.."911" which is used for a medical emergency; "GA" which is used if a kitty has passed on (gone ahead) and a "?". When posting questions select the "?" icon and this will alert people that you are looking for information and or advice.

You can copy the URL from the top of this page and post in in the new "thread" so that people can look back at this posting.

Sounds confusing to begin with, but if I could figure it out so will you be able to. If this is too confusing then continue posting on here for the time being.


Perhaps if you show your husband the information from the official Caninsulin manufacturer's site he may figure out that the vet is not approaching this correctly:

http://www.caninsulin.ca/faq-answers-p.asp

"
How does Caninsulin work in cats?

A lente (intermediate-acting) form of insulin, Caninsulin contains approximately 30 percent amorphous insulin for rapid onset of activity. The remaining approximately 70 percent of the formula is crystalline insulin which is absorbed more slowly. This formulation allows for a more continuous utilization of glucose to support the body's basic functions. In cats, the peak activity following subcutaneous administration of Caninsulin occurs between 1.5 and 8 hours (with an average of about 4 hours), and a duration of activity varies between 8 and 12 hours. Caninsulin should be administered subcutaneously twice a day in diabetic cats."

"
How often does Caninsulin need to be administered to cats?

In cats, the initial recommended dose is 1 to 2 IU per injection, and the injections should be given twice-daily (BID) at 12-hour intervals. Initial dosing is based on a per animal basis. The duration of activity of Caninsulin in the cat is between 8 to 12 hours – this is shorter than in the dog. Peak activity level occurs between 1.5 to 8 (average of about 4) hours in the cat."

 

[Diana&Tom]

Monica, your questions will be nothing that haven't been asked before by many other people starting out... it is confusing at first but you will surprise yourself with how quickly you "get it". Really, you will be fine. Take a few deep breaths and have another cup of coffee (actually it is now wine o'clock in my house) and just ask away!

 

[Monica & Josie]

You can make a new thread here, or add on so they're all in one place . Tell your hubby Happy kitty = happy wife = Happy Life lol

Hahaha!! Happy kitty happy wife happy life - you made me chuckle! Thank you!

 

[Monica & Josie]

here is my new thread for newbie feeding questions.. well I think I did this successfully but maybe not...
http://www.felinediabetes.com/FDMB/threads/uk-newbie-questions-re-feeding.176494/

 

[Kris & Teasel]

Welcome Monica and Josie! You've been given a lot of good advice so far. Here are a some other things to do that will streamline everything:

1. Set up your "Signature". That's the small grey text you see at the end of our posts. Go to the top right of this page and put the cursor over your name. Click on "signature" in the drop down menu. A text box will open where you can enter: Josie's date of diagnosis, what insulin you use, what blood glucose meter you have, what food she eats, any other health issues or meds she has.
2. Set up a spreadsheet like we use here. It's viewable by all members and is the first thing we look at before giving advice. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Many here have said that the 3 unit dose is too high and I agree. You can see in the official Caninsulin info Tuxedo Mom has provided that 1 to 2 u twice a day is the recommended starting dose. I suggest you get the housekeeping details I listed taken care of and once you've entered all the blood glucose data you have on your spreadsheet we can help you decide on a better dose.

 

[Monica & Josie]

Welcome Monica and Josie! You've been given a lot of good advice so far. Here are a some other things to do that will streamline everything:

1. Set up your "Signature". That's the small grey text you see at the end of our posts. Go to the top right of this page and put the cursor over your name. Click on "signature" in the drop down menu. A text box will open where you can enter: Josie date of diagnosis, what insulin you use, what blood glucose meter you have, what food she eats, any other health issues or meds she has.
2. Set up a spreadsheet like we use here. It's viewable by all members and is the first thing we look at before giving advice. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Many here have said that the 3 unit dose is too high and I agree. You can see in the official Caninsulin info Tuxedo Mom has provided that 1 to 2 u twice a day is the recommended starting dose. I suggest you get the housekeeping details I listed taken care of and once you've entered all the blood glucose data you have on your spreadsheet we can help you decide on a better dose.

Thanks very much, will do as soon as I can!

 

[JanetNJ]

Hi Eliz,

waving to you from Saffron Walden!
yes it was Glipizide I was wondering about but it seems that as of this morning we have passed that stage as we started giving insulin injections again..

Wow your kitty been diabetic for 10 years? Then there is hoe for long life once been diagnosed..Phew!

Thanks so much, your comments and virtual hugs are much appreciated!

It's definitely not a death sentence... and very treatable! and cats, unlike people also sometimes have the potential for healing leading to remission.

 

[Anthony Morgan]

Hello Monica,
Sorry my contribution is a bit late but I thought you might be interested in my story.
My cat Shelley was diagnosed six years ago. And for all of that time her diabetes was under excellent control and all I had to do was inject Caninsulin twice daily and have a fructosamine test every few months.
She must have been the easiest diabetic cat to look after ever. Unfortunately, however, in February 2017 all that changed when she had a hypo and I had to rush her to the vets. She was admitted and given glucose IV and thankfully did not suffer any lasting damage. At first the vets thought she had gone into remission but her blood glucose started to rise again after a few days.
So I had to start the Caninsulin again and that was the difficulty for me as I was very worried about the possibility of a further hypo.
I began with a low dose and monitored her blood sugar but for several weeks her diabetes was not well controlled because I was not giving her enough. Eventually I followed my vets instructions and started injecting 1.0u twice a day. Shelley is certainly brighter and more her usual self on the higher dose but I still have the constant worry about her BG falling to low. Although I can now reduce the risk by home testing where as before I had no idea what her BG was when I injected.
I did acquire an Alpha Trak testing kit last year but had only done a couple of daily curves and never envisaged having to test every day until the hypo occurred.
I am by no means an expert on the subject but I have actually learned more through the very helpful and knowledgeable people on the FDMB in the last two months than I had in the previous six years!
There are many more experienced and knowledgeable people on the FDMB than I but I would be very happy to share any information I do have that may be of help to you.

 

[Lillie]

Monica- I was so completely overwhelmed when my cat was diagnosed. I asked a lot of questions when I started home testing. I didn't know what size needle is best for the ear pricks. In fact I didn't even know what size needle I was already using! I did not get to be an expert because my cat's glucose went back to a normal range after about three weeks on insulin and elimination of dry food. He may go back to his diabetic range at some point so I keep myself informed here in the meant time. I hope you decide to learn the home testing. It may have saved my kitties life at one point. Everyone here will help you-best place to be for help and information.

 

[Diana&Tom]

Hi Monica, I gather from your Facebook post that Josie is doing well on 1u (how did you get your DH to agree?!?!) and that you're taking her to see a different vet tomorrow... all sounds good! Have you managed to get any BG readings? Would be very interesting to see how she is doing on the 1u.
Keep us informed!

Diana

 

[Monica & Josie]

Apologies for delayed response, for various reasons it's been a pretty hectic week! Josie's been taking her 1 unit insulin shots fairly well these days, we found her food that's suitable AND she eats it too, NEW vet is great and seem to be very experienced and knowledgeable, we felt very positive and content after our visit. Best part of the visit was when afterwards my DH told me that he owed me an apology because I took the time and researched thoroughly and trusted my gut feeling that Josie's treatment wasn't good enough and our first vet was wrong and how I went against the vet's advice whereas he would've stayed with him and followed his random guess of 3 units starting dose! He could see now that I had Josie's best interest at heart and I wouldn't let it go until i was happy that she was in good care. He was also very sorry for arguing and giving me such a hard time.. Yay! So things are settling into a good routine now and things feel right. Thank you so much for everyone's support, you guys are truly fantastic and made a difference going through a pretty rough and overwhelming start! Have a lovely day

 

[Tuxedo Mom]

GREAT NEWS!!!

It is always so much better when you have a vet you can trust and work with. SO glad that your DH has come over to your side and finally realizes that what you were doing and all the research you did were all for the benefit of Josie. By taking the matter into your own hands you will keep Josie safe and give her the best treatment approach !!

You are definitely on the right path and continued testing will make sure Josie stays safe. It would be very helpful if you could get your spreadsheet set up so that the members here are able to see the progress and offer more information and advice on "tweaking" the treatment plan. With a large base of people to draw from you can get good advice and help. It is always so much more helpful to have a peer reviewed forum such as this to get proper information from people who live and breathe FD 24/7

 

[JanetNJ]

His apology shows he's a man of good character.

I'm glad you found a new vet

 

[Diana&Tom]

Well done Monica, great work! As Mary Ann says, do get your spreadsheet going if you can, and come back here to ask questions at any point in the future... this board really is the "gold standard" for treating FD and you will get advice from very experienced people who really know what they're talking about!

Best of luck!

Diana

 

[Monica & Josie]

Hello Monica,
Sorry my contribution is a bit late but I thought you might be interested in my story.
My cat Shelley was diagnosed six years ago. And for all of that time her diabetes was under excellent control and all I had to do was inject Caninsulin twice daily and have a fructosamine test every few months.
She must have been the easiest diabetic cat to look after ever. Unfortunately, however, in February 2017 all that changed when she had a hypo and I had to rush her to the vets. She was admitted and given glucose IV and thankfully did not suffer any lasting damage. At first the vets thought she had gone into remission but her blood glucose started to rise again after a few days.
So I had to start the Caninsulin again and that was the difficulty for me as I was very worried about the possibility of a further hypo.
I began with a low dose and monitored her blood sugar but for several weeks her diabetes was not well controlled because I was not giving her enough. Eventually I followed my vets instructions and started injecting 1.0u twice a day. Shelley is certainly brighter and more her usual self on the higher dose but I still have the constant worry about her BG falling to low. Although I can now reduce the risk by home testing where as before I had no idea what her BG was when I injected.
I did acquire an Alpha Trak testing kit last year but had only done a couple of daily curves and never envisaged having to test every day until the hypo occurred.
I am by no means an expert on the subject but I have actually learned more through the very helpful and knowledgeable people on the FDMB in the last two months than I had in the previous six years!
There are many more experienced and knowledgeable people on the FDMB than I but I would be very happy to share any information I do have that may be of help to you.

Hi Anthony,
thank you for sharing your story, what a scare it must've been after six years of things going well! Yes home testing does make a big difference. Hope Shelley is doing well now

 

[SweetAngel]

Glad you got a new vet and your man is supportive, both things must be such a relief. Men, grr, I call mine Mr Cat Food Brain because he would not believe that cat food companies aren't forced to give carb content. Hopefully Josie will start getting regulated now. How are you getting on with the food? x

 

[Monica & Josie]

Hello everyone, it's been a while. Hope all of you are doing well!
As for update Josie's been doing well, regulated and on 0.5 Caninsulin twice a day.
She had a fructosamine test done yesterday with results of 333!
Her preshot numbers are usually between 12-17 but sometimes goes down to around 10. Her nadir is 4-6 most of the time. Please don't ask me to do the spreadsheet, I just could not master it! Sorry!
She had a couple of hypo's recently so time to review her case..
It's decision time for us and vet gave us 4 options and I would REALLY appreciate some expert advice please which direction to go...

Josie's been doing well and hopefully heading towards remission but now the dose is pushing her numbers too low giving her hypos so vet suggested to either go down to 0.25 unit or start her on Glipizide instead..? Or stop treatment completely and see how she would get on. Or change to another type of insulin?
Would appreciate some advice please thank you.
She's a very happy and healthy kitty with her BG level at the higher end of the normal range with no complications, excessive water drinking or any other sign of illness. No idea what would be the best decision right now.. Many thanks!

 

[Diana&Tom]

Hi Monica, very glad to hear that Josie is doing well!

It looks to me actually as if the current dose isn't far out. Pre-shot numbers of 12-17 tell us that she does still need insulin so I can't see that stopping insulin is an option. And a nadir of 4-6 is pretty good. Maybe the issue comes when you get pre-shot numbers of 10 which is normally considered on the low side to shoot - do you give her 0.5u then and is this when she has a hypo?

You could try 0.25u yes, or if that's too little, try what we call a "skinny" 0.5 - a tiny amount less than the full half-unit - and see what that does. It's all about the testing as you know.

If Caninsulin is working well there is no real reason to try another insulin and start all over again, but if Josie is getting hypos on a regular basis on even small doses of Caninsulin, then yes you could try a gentler insulin. I don't know anything about Glipizide but maybe other members do @Elizabeth and Bertie @Marlena

See what others say but well done on doing such a great job!

 

[Monica & Josie]

Hi Monica, very glad to hear that Josie is doing well!

It looks to me actually as if the current dose isn't far out. Pre-shot numbers of 12-17 tell us that she does still need insulin so I can't see that stopping insulin is an option. And a nadir of 4-6 is pretty good. Maybe the issue comes when you get pre-shot numbers of 10 which is normally considered on the low side to shoot - do you give her 0.5u then and is this when she has a hypo?

You could try 0.25u yes, or if that's too little, try what we call a "skinny" 0.5 - a tiny amount less than the full half-unit - and see what that does. It's all about the testing as you know.

If Caninsulin is working well there is no real reason to try another insulin and start all over again, but if Josie is getting hypos on a regular basis on even small doses of Caninsulin, then yes you could try a gentler insulin. I don't know anything about Glipizide but maybe other members do @Elizabeth and Bertie @Marlena

See what others say but well done on doing such a great job!

Hello Diana&Tom,

thanks so much, I really appreciate your reply and input!

She only had 2 hypos so far but could be down to eating little food and the other one happened when she vomited her dinner back up an hour after feed..? Otherwise she seems fairly regulated.

Yes decided to keep her on the Caninsulin for the time being and see how far/low we can go with it.. Thank you, it makes sense.

Will read up more about Glipizide and try for feedbacks from people with experience.

Yes and thank you for your encouragement as well, I suppose I have come a long way since freaking out here a couple of months ago! Then again since April I have become pretty obsessed wanting to know EVERYTHING spending long hours on the internet until 3-4am reading up about stuff and talking to people! Plus testing testing testing....

Thanks again!

 

[Diana&Tom]

You are very welcome, Monica, keep up the good work!

 

[MrWorfMen's Mom]

Hi and welcome to FDMB. Glipizide is not insulin. It is a drug that pushes the pancreas to produce insulin. The problem with using it in our furry friends is that they can't tell us when they are feeling their BG going down and once the dose is given there is no way to back it off. With insulin you can feed the cat and give the insulin something to work on so that BG comes back up. With Glipizide and other similar meds, it can be more difficult to control any potential hypo situations because the drug once in the system is telling the pancreas to continue to produce insulin regardless of how much food is on board. There have been a few folks come here who have tried it. I've seen some manage ok and a few pretty scary situations. Glipizide can be hard on the pancreas too so if you are now able to give injections without causing Josie undue stress, then I'd stick with it.

 

[Monica & Josie]

Hi and welcome to FDMB. Glipizide is not insulin. It is a drug that pushes the pancreas to produce insulin. The problem with using it in our furry friends is that they can't tell us when they are feeling their BG going down and once the dose is given there is no way to it off. With insulin you can feed the cat and give the insulin something to work on so that BG comes back up. With Glipizide and other similar meds, it can be more difficult to control any potential hypo situations because the drug once in the system is telling the pancreas to continue to produce insulin regardless of how much food is on board. There have been a few folks come here who have tried it. I've seen some manage ok and a few pretty scary situations. Glipizide can be hard on the pancreas too so if you are now able to give injections without causing Josie undue stress, then I'd stick with it.

Hello and thank you that's a really good point.
I think I shall stay away from Glipizide, we worked bloody hard to get where we are now and I don't wanna mess that up for something that might or might not work!
Thanks for your advice, much appreciated!

 

[Elizabeth and Bertie]

Hi Monica,
It sounds like you're doing brilliantly!

Reducing the dose sounds like a really good idea.
Which syringes do you have? Are you using U40's or U100's? ...U100's with a conversion chart can make it much easier to measure tiny doses.

Eliz

 

[Monica & Josie]

Hi Monica,
It sounds like you're doing brilliantly!

Reducing the dose sounds like a really good idea.
Which syringes do you have? Are you using U40's or U100's? ...U100's with a conversion chart can make it much easier to measure tiny doses.

Eliz

Hi Eliz,
thanks very much

We're actually using U40's at the moment, will look around for the U100's.

Great tip thank you!

 

[Elizabeth and Bertie]

We're actually using U40's at the moment, will look around for the U100's.

Monica, if you wish I can pop some of my U100's in the post to you so you can have a little play with them. Just PM me your address if you'd like me to do that.

The U100's most of us Brits use are the BD half-unit ('Demi') ones. I think Amazon is currently the cheapest.
https://www.amazon.co.uk/MicroFine-...-U100/dp/B00K86ZO20?tag=felinediabetesfdmb-20

You DO have to use them with a conversion chart. One unit of U40 insulin would measure up to the 2.5 unit mark on a U100 syringe. And .2 of a unit would measure as .5 of a unit on a U100 syringe. So, to give .25 of a unit you'd need to measure a smidge more than that. But measuring small doses is much easier with the U100's, as long as you are comfortable with the idea of using them (some people are not comfortable with doing the conversions).
Here's the link to the conversion chart so you can see how it works:
http://www.felinediabetes.com/insulin-conversions.htm

Eliz

 

[Monica & Josie]

Monica, if you wish I can pop some of my U100's in the post to you so you can have a little play with them. Just PM me your address if you'd like me to do that.

The U100's most of us Brits use are the BD half-unit ('Demi') ones. I think Amazon is currently the cheapest.
https://www.amazon.co.uk/MicroFine-...-U100/dp/B00K86ZO20?tag=felinediabetesfdmb-20

You DO have to use them with a conversion chart. One unit of U40 insulin would measure up to the 2.5 unit mark on a U100 syringe. And .2 of a unit would measure as .5 of a unit on a U100 syringe. So, to give .25 of a unit you'd need to measure a smidge more than that. But measuring small doses is much easier with the U100's, as long as you are comfortable with the idea of using them (some people are not comfortable with doing the conversions).
Here's the link to the conversion chart so you can see how it works:
http://www.felinediabetes.com/insulin-conversions.htm

Eliz

Thanks very much Eliz that's very kind of you and would be great!

Although must say there's no rush as we came across a slight snag due to Josie's numbers going up..

Had to hold off her insulin for few days as she wasn't eating much due to heat and general fussiness/boredom of her same old food cos otherwise she was fine.. Her BG levels were more less within normal range so talked to vet and agreed to hold off insulin until she started eating properly again/or her numbers gone up..

We started her back on 0.5 unit two days ago after she started eating well again and her preshot numbers been consistent at 19-20 and +3 readings are between 10-11

Not sure what caused the raise in her numbers but planning to do a curve next time at home properly to get the exact nadir, should be within next few days.

My dilemma at the moment is whether we should we go back to 1 unit until preshot numbers go down a bit or keep her on 0.5 unit and see what happens within next few days?

Any advice as always would be much appreciated thank you!

Ps. Would you also please be able to advise me what does that mean if her fructosamine test a few days ago was 333?

Is that good? Where does that leave us in this situation? I have no idea...

Thank you!!

 

[Elizabeth and Bertie]

Would you also please be able to advise me what does that mean if her fructosamine test a few days ago was 333?

Monica, according to this from the Caninsulin website that 333 equates to 'excellent control' (actually it is a result that is seen in normal non-diabetic cats)
http://www.caninsulin.co.uk/fructosamine.asp?context=management_cats

The problem with fructosamine tests though is that they give an average of blood glucose levels over the preceeding few weeks, so theoretically, they can include high and very low numbers. In your kitty's case though (given your BG data) it does sound like you have really nice control.

My dilemma at the moment is whether we should we go back to 1 unit until preshot numbers go down a bit or keep her on 0.5 unit and see what happens within next few days?

Hmmm... Shame about those higher numbers, but don't worry. This can happen for lots of reasons, and may just be a very temporary blip.
You could stick with the .5 for a couple of days and see if the BG comes down again.
Or you could increase a tad, as long as you can monitor Josie's BG and cut back the dose if necessary. Are you able to measure a dose between .5 and one unit? Maybe a .75...?

Eliz

 

[Monica & Josie]

Monica, according to this from the Caninsulin website that 333 equates to 'excellent control' (actually it is a result that is seen in normal non-diabetic cats)
http://www.caninsulin.co.uk/fructosamine.asp?context=management_cats

The problem with fructosamine tests though is that they give an average of blood glucose levels over the preceeding few weeks, so theoretically, they can include high and very low numbers. In your kitty's case though (given your BG data) it does sound like you have really nice control.


Hmmm... Shame about those higher numbers, but don't worry. This can happen for lots of reasons, and may just be a very temporary blip.
You could stick with the .5 for a couple of days and see if the BG comes down again.
Or you could increase a tad, as long as you can monitor Josie's BG and cut back the dose if necessary. Are you able to measure a dose between .5 and one unit? Maybe a .75...?

Eliz

Thanks Eliz, must say I am a bit confused by the 'excellent' fructosamine test results as her preshot numbers been pretty much anywhere between 11-19 with the odd 20-22 occasionally.

Will continue with the 'full fat' 0.5 units until I manage to do curve then we'll see if needed to adjust going back to the original 1 unit or stay on 0.5 unit.

Thanks so much once again!

 

[Yong & Maury GA]

Just sticking my nose in but there is also the option for 0.75U. It is easier if your syringes have half unit markings . Did you have a spreadsheet of Josie's numbers we could see?

 

[Diana&Tom]

Thanks Eliz, must say I am a bit confused by the 'excellent' fructosamine test results as her preshot numbers been pretty much anywhere between 11-19 with the odd 20-22 occasionally.

Will continue with the 'full fat' 0.5 units until I manage to do curve then we'll see if needed to adjust going back to the original 1 unit or stay on 0.5 unit.

Thanks so much once again!

Hi Monica
As Eliz says, the fructo test is purely an AVERAGE of blood glucose numbers over a period of two or three weeks, so while the pre-shot numbers have been highish, there must have also been some lowish numbers during the cycles over that period and it's somehow evened out. Vets like fructo tests because they can't obviously do regular tests when the kitty is at home. Testing yourself at home is the only way to know what's really going on, especially where dosing is concerned.
You've come a long way and are doing a great job!

 

[Monica & Josie]

Just sticking my nose in but there is also the option for 0.75U. It is easier if your syringes have half unit markings . Did you have a spreadsheet of Josie's numbers we could see?

Oh no please DO stick your nose in, I appreciate all thoughts and feedbacks from your expertise ladies and gents..

Yes probably going to go for 0.75 soon with the 100u syringes.
Unfortunately didn't get on well with the spreadsheet first time around, ran out of patience and gave up so I've been just writing it all down in an ordinary diary..
Might have to try to tackle it again..!

 

[Monica & Josie]

Hi Monica
As Eliz says, the fructo test is purely an AVERAGE of blood glucose numbers over a period of two or three weeks, so while the pre-shot numbers have been highish, there must have also been some lowish numbers during the cycles over that period and it's somehow evened out. Vets like fructo tests because they can't obviously do regular tests when the kitty is at home. Testing yourself at home is the only way to know what's really going on, especially where dosing is concerned.
You've come a long way and are doing a great job!

Aahh.. thanks so much!

Yes it makes sense I suppose getting an average number for fructosamine test.

I've become quite obsessed with the whole hometesting thing, sometimes I'm not sure if it's a good thing or a bad one...

 

[Yong & Maury GA]

Oh no please DO stick your nose in, I appreciate all thoughts and feedbacks from your expertise ladies and gents..

Yes probably going to go for 0.75 soon with the 100u syringes.
Unfortunately didn't get on well with the spreadsheet first time around, ran out of patience and gave up so I've been just writing it all down in an ordinary diary..
Might have to try to tackle it again..!

I can get one set up for you. All you would have to do is fill in your data . If you could get a scan or photo of your diary, I could probably enter the back log for you. Let me know.

 

[Monica & Josie]

I can get one set up for you. All you would have to do is fill in your data . If you could get a scan or photo of your diary, I could probably enter the back log for you. Let me know.

Goodness me that's very kind of you to offer me to set one up!

Well I got very frustrated last time I tried setting one up and been getting on ok without it so far. However if I need advice I suppose it is very helpful to make these readings visible to you guys..so yes please that would be fantastic.

I wouldn't want to take up too much of your time so if you could just help me to set it up I would be happy to give it another go to fill it in..

Thanks so much I really do appreciate it!

Ps. Finally doing a curve today, very eager to get the results!

 

[Diana&Tom]

Monica, I'm the world's worst when it comes to spreadsheets etc but do take Yong up on her offer... once if's set up, all you have to do is fill it in and honestly, it will make it much easier for people here to help you.
Go on - you can do it and will be surprised at how much easier it is than you think!

 

[Monica & Josie]

Monica, I'm the world's worst when it comes to spreadsheets etc but do take Yong up on her offer... once if's set up, all you have to do is fill it in and honestly, it will make it much easier for people here to help you.
Go on - you can do it and will be surprised at how much easier it is than you think!

Well like I said before Im getting pretty obsessed with things now that I know what Im doing ( well more less.. ) whereas at the beginning I had to slow down and take a step back as everything just got too confusing and overwhelming and I was beginning to lose my sanity!

Well now Im ready to tackle anything and maybe in time I will even be able to help other desperate newbies!!

Thank you for your support x