? Oreo Joe is heading to 9½ U tried with labs

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Bonnie & Oreo Joe

Bonnie & Oreo Joe

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Hello,
Well today I am drawing up the insulin without a problem and without panic. tomorrow, Tuesday, I up his insulin to 8½ He is practically flat and today so far has been the worst it barely wiggled. I have it posted up to his +7. I picture him getting an entire vial every day! I just keep going up every 4 cycles until something happens? I thought it would happen way sooner. My husband is a big man and he gets 8 units. Oreo has lost weight from close to 16 pounds to 9 pounds 4 ounces and is holding that but eats 600 grams of food a day plus several pieces of raw chicken breast. Normal amount for a cat is 300 grams and he used to eat that 600 gram can in 2 days and part of his first serving the next. He is not handling the heat well and has even been panting and I know cats don't get cool from panting. He spends the night on the enclosed porch with his body against the screen and it drops down to cold at night. No vet money and no blood test money. It has gone for his meds and supplies. Just like to know cats do this. Thank you for being here. Oh if I order from Amazon it is Germany or the UK. How do I get money to this group?
 
I honestly don't know what to make of this. There are so many possible issues:
  • something wrong with the insulin (I'd start here - maybe get a new vial)
  • he might have another health condition that will make him a high dose cat - eg. acromegaly or antibodies to the insulin
  • some other undiagnosed health problem.
This is beyond the scope of people here to diagnose. If he was my cat I'd ask the vet to do a thorough exam including a full blood panel, etc. If you can't afford to get this done you can try increasing as you have been.

Bonnie & Oreo Joe said:
Oh if I order from Amazon it is Germany or the UK. How do I get money to this group?
Click to expand...
You could try contacting each to see if they'll ship to you. Those of us who order online often use a credit card or PayPal for the transactions.
 
I'm glad to hear you're feeling better about drawing up the insulin now, though sad to hear that Oreo isn't responding better. It's so difficult to see our kitties unwell! Unfortunately, Kris is right - we really can't diagnose since we lack lab equipment and aren't vets. Getting no response from the insulin could be a number of things. As Kris has mentioned, the easiest problem to solve would be if the insulin has gone bad. Prozinc is rather fragile, especially compared to Lantus or Levemir, so it's possible your vial just isn't working. Beyond that, it would take a vet visit. I do understand finances being tight. Since Oreo saw the vet recently, perhaps they would let you bring him in just for a blood draw and not also pay for an office visit?

As for Amazon, I'm afraid I don't know which one to use. A decade ago when I was in Sweden, it was Amazon UK, but that's because there wasn't one in Germany yet. Perhaps ask around with your neighbors and see if someone knows?
 
Replying to all. The last full blood scan cost $800. The vet has to charge a full visit unless it is within a couple of weeks of the last visit. Then she doesn't charge full price.
blood work April 10 work done
I don't know what to do. I have no place to borrow from, Roger just took the savings and paid $8000 for the replacement of the roof over 1 room.
I guess I will look up a couple of the words you wrote about. Try the insulin a bit longer. I just bought the insulin and it hasn't been open very long. July 14th I opened the vial. Thank you! Here is his last blood work.

content.gif
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OREO JOE


Hane

HUSKATT

10867

SÖDERQUIST ROGER

20180410


Distriktsveterinärerna Högsäter

458 70 Högsäter

Öxnäsvägen 5


FA


150

Djurslag KATT


* Provet innehåller aggregerade trombocyter The sample contains aggregated platelets


Status/Analys Result and then last is reference

-FT4, Fritt Tyroxin 17,4 pmol/L 9,0-35,0 kt


S-TSH, Canine <0,03 ug/L <0,28 kt

Utredningsstatus, Katt

S-T3, Trijodtyronin 0,9 nmol/L 0,4-2,0 kt

S-T4, Tyroxin 37,5 nmol/L 10,0-60,0 kt

S-Kolesterol 4,1 mmol/L <3,4 kt H


S-Natrium 149 mmol/L 147-156 kt

S-Kalium 4,8 mmol/L 3,5-4,7 kt H

S-ALAT 1,90 ukat/L <1,20 kt H


S-ALP 2,1 ukat/L <4,2 kt

S-Gallsyror 5,0 umol/L <20,0 kt

S-Urea 6,5 mmol/L <10,0 kt

S-Kreatinin 74 umol/L <160 kt

S-Fosfat 1,77 mmol/L 1,40-2,60 kt

S-Calcium 2,77 mmol/L 1,50-3,00 kt

S-CK 1,7 ukat/L <6,0 kt

S-Protein 84 g/L 54-78 kt H


S-Albumin 31 g/L 25-40 kt

B-LPK, Leukocyter 2,2 10^9/L 5,5-19,5 kt L

B-EPK, Erytrocyter 15,7 10^12/L 5,0-10,0 kt H

B-HB, Hemoglobin 219 g/L 80-150 kt H

B-EVF, Hematokrit 74,1 % 24,0-45,0 kt H


ERY-MCV 47,2 FL 39,0-55,0 kt

ERY-MCHC 295 g/L 260-360 kt

B-Trombocyter 193* 10^9/L 180-600 kt

Neutrofila 38,9 % 35,0-78,0 kt

Lymfocyter 52,3 % 20,0-55,0 kt

Monocyter 2,5 % < 7,0 kt

Eosinofila 5,6 % 1,0-12,0 kt

Basofila 0,7 % <=1,0 kt

Serum Amyloid A <2 mg/L <10 kt


Analysrapport 2018-Apr-13

Resultat Enhet Referensvärde L=Sänkt H=Förhöjt


CaniLab-EquiLab
 
@Marje and Gracie What do you make of these? They're in Swedish but comprehensible and the normal range is listed right beside Oreo Joe's value. Some are out of normal range but I don't know the significance of that.
 
Kris & Teasel said:
I honestly don't know what to make of this. There are so many possible issues:
  • something wrong with the insulin (I'd start here - maybe get a new vial)
  • he might have another health condition that will make him a high dose cat - eg. acromegaly or antibodies to the insulin
  • some other undiagnosed health problem.
This is beyond the scope of people here to diagnose. If he was my cat I'd ask the vet to do a thorough exam including a full blood panel, etc. If you can't afford to get this done you can try increasing as you have been.


You could try contacting each to see if they'll ship to you. Those of us who order online often use a credit card or PayPal for the transactions.
Click to expand...
Kris & Teasel said:
I honestly don't know what to make of this. There are so many possible issues:
  • something wrong with the insulin (I'd start here - maybe get a new vial)
  • he might have another health condition that will make him a high dose cat - eg. acromegaly or antibodies to the insulin
  • some other undiagnosed health problem.
This is beyond the scope of people here to diagnose. If he was my cat I'd ask the vet to do a thorough exam including a full blood panel, etc. If you can't afford to get this done you can try increasing as you have been.


You could try contacting each to see if they'll ship to you. Those of us who order online often use a credit card or PayPal for the transactions.
Click to expand...
I do order from both the UK and Germany but I see that if I order from Amazon I can choose this site to receive some donation but I never could find it. I will write and ask Amazon about it.
 
Kris & Teasel said:
@Marje and Gracie What do you make of these? They're in Swedish but comprehensible and the normal range is listed right beside Oreo Joe's value. Some are out of normal range but I don't know the significance of that.
Click to expand...
I’m very sorry but, right now, I am short on the time it takes to convert all the values so I can see the big picture. My mom just recently passed away and I’m really swamped as her trustee and executor getting all of it sorted out. It’s fairly quick for me to look at labs that are already converted.

@Bonnie & Oreo Joe If you have the time to convert the values using this chart and then enter them on the lab tab on his SS (be sure to adjust the normal ranges as needed), then tag me and I’ll be happy to look at them for you. I’m sorry I don’t have the time to convert them.
 
Marje and Gracie said:
I’m very sorry but, right now, I am short on the time it takes to convert all the values so I can see the big picture. My mom just recently passed away and I’m really swamped as her trustee and executor getting all of it sorted out. It’s fairly quick for me to look at labs that are already converted.

@Bonnie & Oreo Joe If you have the time to convert the values using this chart and then enter them on the lab tab on his SS (be sure to adjust the normal ranges as needed), then tag me and I’ll be happy to look at them for you. I’m sorry I don’t have the time to convert them.
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Thanks Marje - totally understandable. Take care!
 
Kris & Teasel said:
Thanks Marje - totally understandable. Take care!
Click to expand...
I am lost, I have no idea how to change them and I can't find a conversion table because if I have to multiply this by that and divide by something I can't do it. Ro checked the blood work at the hypo/hyperthyroid group. She changed the amount of his thyroid meds slightly. I understood that the High Leukocytes were nothing to worry about. Also the good vet told me it wasn't anything to worry about.
 
This is the link to the conversion table that Marje referred to. https://www.vin.com/calculators/ChemConvCalc.htm

Your Swedish units are SI and you want US units. The conversion tool on this link is already set to go from SI to US units. All you have to do is find the thing you're converting in the long horizontal bar's menu then input the numbers for that from your blood panel in the short blank horizontal bar and press "calculate". The answer will appear in the yellow bar.
 
Bonnie & Oreo Joe said:
I am lost, I have no idea how to change them and I can't find a conversion table because if I have to multiply this by that and divide by something I can't do it. Ro checked the blood work at the hypo/hyperthyroid group. She changed the amount of his thyroid meds slightly. I understood that the High Leukocytes were nothing to worry about. Also the good vet told me it wasn't anything to worry about.
Click to expand...
Kris is correct. It is super simple ....you don’t have to do the conversion yourself. Just look at the calculator, look for what you have and what you want, and select the parameter. It will convert it.
 
Marje and Gracie said:
Kris is correct. It is super simple ....you don’t have to do the conversion yourself. Just look at the calculator, look for what you have and what you want, and select the parameter. It will convert it.
Click to expand...
I am looking up the english words for the test and can't find many of them in the list on the chart. When I put in the results on the ones I found many come out NaN it is a mess. I don't know that the couple I found even came out correct. I am sorry I can't find a lab tab and .... I don't know. I was giving his 8½ U and had the needle in and just as I shot he shook his head to get a bite more of food and it ended up a fur shot.
I looked up the big words and all require massive tests which are out of the question. I will keep raising his dosage and if nothing is happening by the end of the bottle I will have to make the decision to put to sleep. It breaks my heart as I need a companion but if there is nothing to do for him it isn't right to keep him alive.
 
Bonnie & Oreo Joe said:
I am looking up the english words for the test and can't find many of them in the list on the chart. When I put in the results on the ones I found many come out NaN it is a mess. I don't know that the couple I found even came out correct. I am sorry I can't find a lab tab and .... I don't know. I was giving his 8½ U and had the needle in and just as I shot he shook his head to get a bite more of food and it ended up a fur shot.
I looked up the big words and all require massive tests which are out of the question. I will keep raising his dosage and if nothing is happening by the end of the bottle I will have to make the decision to put to sleep. It breaks my heart as I need a companion but if there is nothing to do for him it isn't right to keep him alive.
Click to expand...
If you can use google, it’s easy to look up the words. The lab tab is on the SS right next to the World tab...you can’t miss it.

Why would you put him to sleep just because he needs more insulin? His numbers aren’t that bad. There’s a lot you can do....giving him insulin he needs, as you are doing...really helps him. We have other members whose cats need a whole lot more insulin and the cat is likely a high dose cat with acromegaly. But they can’t afford to test for it. And they don’t have to....they can just assume kitty is high dose and give the insulin needed.

Plus...you are missing half your data by not getting any tests at night. You don’t have to stay up but if you got a test a couple hours after his shot and before you went to bed, it would help.
 
I think the simplest thing is to keep increasing his insulin as you have been. You said this is a new bottle so it should be good. Are you rolling it carefully so it has a uniformly cloudy appearance before drawing up the dose? It's important not to shake the vial because that can damage the insulin molecules. Are you keeping it refrigerated on a middle shelf and not near the back (too cold) or in a door shelf (too much movement)?
 
Marje and Gracie said:
If you can use google, it’s easy to look up the words. The lab tab is on the SS right next to the World tab...you can’t miss it.

Why would you put him to sleep just because he needs more insulin? His numbers aren’t that bad. There’s a lot you can do....giving him insulin he needs, as you are doing...really helps him. We have other members whose cats need a whole lot more insulin and the cat is likely a high dose cat with acromegaly. But they can’t afford to test for it. And they don’t have to....they can just assume kitty is high dose and give the insulin needed.

Plus...you are missing half your data by not getting any tests at night. You don’t have to stay up but if you got a test a couple hours after his shot and before you went to bed, it would help.
Click to expand...
I didn't mean I was going to go and PTS. I meant if he gets worse, the one said there was a tumor on his brain, slow growing and he could live a lot longer. There were CT scans and MRI's etc. and that is out. I absolutely will continue giving higher insulin.
I will give him a test 3 or 4 hours after he gets the evening insulin.

I was looking up in the Swedish to English dictionary and when I got a word I put that in or rather went to that name but several of them were not on the converter. I have tried putting in all the numbers of his and get that there is no information. I admit that I do get confused but don't know if that is what is stopping me from what I am supposed to. No My boy will be here as long as he is doing well and seems happy.
 
Kris & Teasel said:
I think the simplest thing is to keep increasing his insulin as you have been. You said this is a new bottle so it should be good. Are you rolling it carefully so it has a uniformly cloudy appearance before drawing up the dose? It's important not to shake the vial because that can damage the insulin molecules. Are you keeping it refrigerated on a middle shelf and not near the back (too cold) or in a door shelf (too much movement)?
Click to expand...
I checked before I began to use the insulin and softly roll it in my hands. I can move it from the door but I do have other things around it so it isn't rolling around. I can put it on the shelf but was afraid it would get knocked around there.
 
It’s been my experience that it is rarely an issue of problems with the insulin when the insulin has been handled properly and has not expired. It’s almost always the dose not being right yet and that might be because he is a high dose kitty with something like acromegaly or he has IAA which means he has antibodies which bind to the insulin so it’s not available for his use. IAA is usually self limiting after a year but one way to fight it is to increase the insulin per whatever protocol you are following.

And since I haven’t used PZ, I’ll leave it to those that have to give you dosing advice.
 
Hi, I really tried with the labs. I filled out what I could of the labs that were H or L. Problem is there are several that were not on the conversion chart, were not in Google and not in my Swedish to English dictionary.
Oreo is up to 9 U started this morning and flat. I have his spread sheet filled with the 3 I took so far. Saturday I will go up to 9½. My vet is out indefinitely. I managed to get a vet we saw before and I find her more knowledgeable and she said that it was right to keep raising the dose until his body decides to start accepting it and his glucose lowers. I didn't have to argue with her at all. Nice.
I am sorry about the labs and I am not sure about what I put in.
Thanks just wanted to check in with what I am doing. Praying that the 9½ will be the magic number. Insulin goes to fast. yikes. Hugs, Bonnie
 
I'm glad you have a vet who agrees with the increases. Did she have a look at his labs? She would be able to give you a good explanation of what they mean without you having to translate everything and wait for a response here.

Do continue the increases every few days. You WILL get to a dose that drops his BGs eventually.
 
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Kris & Teasel said:
I'mm glad you have a vet who agrees with the increases. Did she have a look at his labs? She would be able to give you a good explanation of what they mean without you having to translate everything and wait for a response here.

Do continue the increases every few days. You WILL get to a dose that drops his BGs eventually.
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She was in between patients so didn't have time. I will call on Monday morning during telephone time and try. I just hope that my furry little boy doesn't use a vial a day. ha ha Thanks.
 
Has anyone discussed high dose conditions with you? Usually once the dose gets above 6u bid, we suggest you have your kitty tested for acro and IAA. I don’t know where in Sweden you can have that done or the costs.

If he has IAA, it’s usually self limiting after a year but there are things you can do to help break through it. If it’s acro, there are treatment options but it can’t be cured. You might want to do some reading on the High Dose Forum.
 
I have a new vet who has proven knowledgeable although none have treated diabetic cats before. She said the tests and the scans are very expensive and the treatment is way to expensive, like the surgery. She felt, like someone on this forum said, many people have high dose cats and can't afford the scans and possible surgery and they just keep pushing through as I have been. ½U every 5th cycle. I am getting no where fast. 17.9 this morning! His 3rd shot at 10½ - Maybe I should listen to hubby but then I have a full new bottle of insulin so should at least use that right? Thank you so much for your help, care and friendship.
 
Kris & Teasel said:
Yes to Marje's suggestion to read about high dose conditions. Here's a link from that forum:
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

Beyond that, I don't think we can give good advice, Bonnie. If continuing with ProZinc is too expensive you could try Lantus. He might still be a high dose kitty but it's a more concentrated insulin so you get more bang for your buck.
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Thanks, I will read that. I have read about it in other sites of course I never put the right thing in the search engine here! I have just gotten a new bottle of ProZinc so will wait until that is almost done and switch to Lantus.
Off to read. Thanks.
 
Kris & Teasel said:
Yes to Marje's suggestion to read about high dose conditions. Here's a link from that forum:
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

Beyond that, I don't think we can give good advice, Bonnie. If continuing with ProZinc is too expensive you could try Lantus. He might still be a high dose kitty but it's a more concentrated insulin so you get more bang for your buck.
Click to expand...
I would not switch to Lantus. If you want to switch insulins, I’d switch to Levemir in the case of high dose cats. Lantus can really start to sting at higher doses and most of our “big gulpers” have done better with Levemir. First, check out the prices because neither lantus nor Levemir are inexpensive in the US but they are relatively so in Canada and other countries with socialized medicine.

I’d urge you to read up on the high dose conditions and consider the tests if you can find a place to do them and it’s affordable. Some members have had a lot of success with giving the drug, cabergoline. Some of the acro cats have even gone off insulin. This drug, if you can get it, may possibly be more affordable than the current, alternative treatments. Again, it is not a cure but it can help get the dose down or, in the best cases, get the kitty into remission. The med will not address IAA but we have other means to help with that and that is curable. Here is a post that discusses treatment options inc cabergoline.

It would be nice for you to know what you are dealing with. Obviously, you can’t start a drug without knowing if he has acro. We have had some cats that only had IAA.
 
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Marje and Gracie said:
I would not switch to Lantus. If you want to switch insulins, I’d switch to Levemir in the case of high dose cats. Lantus can really start to sting at higher doses and most of our “big gulpers” have done better with Levemir. First, check out the prices because neither lantus nor Levemir are inexpensive in the US but they are relatively so in Canada and other countries with socialized medicine.

I’d urge you to read up on the high dose conditions and consider the tests if you can find a place to do them and it’s affordable. Some members have had a lot of success with giving the drug, cabergoline. Some of the acro cats have even gone off insulin. This drug, if you can get it, may possibly be more affordable than the current, alternative treatments. Again, it is not a cure but it can help get the dose down or, in the best cases, get the kitty into remission. The med will not address IAA but we have other means to help with that and that is curable. Here is a post that discusses treatment options inc cabergoline.


It would be nice for you to know what you are dealing with. Obviously, you can’t start a drug without knowing if he has acro. We have had some cats that only had IAA.
Click to expand...

I have read most of the acro info you sent. Since cabergoline is a trial med I doubt it would be available here and the cost is not doable. The other drug that is a shot costs $1000 to $2000 a month. The Treatment they talk about is 10 to 12 thousand.
Since none of these are even something I could say yes to then I really don't need to see if I can get the IGF1 blood test do I in the US it is $58? I can't do more than just up the dose until I hit the correct dose. If I am wrong correct me please.
I have written down the Lev insulin and when the new bottle of ProZinc is finished I will ask for that to replace. I am going to get a Free T3 and Free T4 and TSH hopefully on Monday. Our phone is out until tomorrow.
I am thankful to get the information and feedback and even if I can't get many diagnostic tests done I have the info.
I thought today was Friday but found out it was only Thursday. So I begin 11 U tomorrow morning. he was back up to 17.8 at PMPS.
Say a prayer!! Hugs, Bonnie
 
Bonnie & Oreo Joe said:
I have read most of the acro info you sent. Since cabergoline is a trial med I doubt it would be available here and the cost is not doable. The other drug that is a shot costs $1000 to $2000 a month. The Treatment they talk about is 10 to 12 thousand.
Since none of these are even something I could say yes to then I really don't need to see if I can get the IGF1 blood test do I in the US it is $58? I can't do more than just up the dose until I hit the correct dose. If I am wrong correct me please.
I have written down the Lev insulin and when the new bottle of ProZinc is finished I will ask for that to replace. I am going to get a Free T3 and Free T4 and TSH hopefully on Monday. Our phone is out until tomorrow.
I am thankful to get the information and feedback and even if I can't get many diagnostic tests done I have the info.
I thought today was Friday but found out it was only Thursday. So I begin 11 U tomorrow morning. he was back up to 17.8 at PMPS.
Say a prayer!! Hugs, Bonnie
Click to expand...
If you can’t afford or get the treatments, then, no, you don’t need the IGF-1 test. If you got just the IAA test, you’d know whether he had that but you wouldn’t know if it was just that so I’m not sure that would even be a benefit.

If you decide to switch to Levemir, you’ll want to post on the Lantus/Levemir ISG before you switch so we can suggest a good dose for him to start at. We have some alternative ways to try and get the numbers down for acro/IAA kitties and, hopefully, also get the dose to something you can handle that doesn’t rob the bank.
 
Marje and Gracie said:
If you can’t afford or get the treatments, then, no, you don’t need the IGF-1 test. If you got just the IAA test, you’d know whether he had that but you wouldn’t know if it was just that so I’m not sure that would even be a benefit.

If you decide to switch to Levemir, you’ll want to post on the Lantus/Levemir ISG before you switch so we can suggest a good dose for him to start at. We have some alternative ways to try and get the numbers down for acro/IAA kitties and, hopefully, also get the dose to something you can handle that doesn’t rob the bank.
Click to expand...
Thank you. He will be on ProZink until the new bottle runs out. I have a bit left of his old to use up first. He looks flat again today. Hugs, Bonnie
 
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