Gill & George
Member Since 2015
thanks mogs.
High BG values
- Thread starter Marina & Chico
- Start date
- Status
Elizabeth and Bertie
Member Since 2010
Hi Gill, I don't currently have a link, because I lost my whole page of links when my old computer died
. But it should be relatively easy to find. It's included in the results of the RVC's remission clinic research, where they trialled Lantus and Prozinc. ...There is also an interesting short podcast talk by Stijn Niessen from the RVC about insulin choices for cats. And one vet/researcher (Ruth Gostelow, if memory serves) achieved recognition for proving that Lantus didn't necessarily produce the highest rates.I will see what I can find...
Critter Mom
Member Since 2014
Thanks, Eliz. 
Presumably your new list will be on Google Drive?
Mogs
.
Noooooooo!!!I lost my whole page of links when my old computer died
Presumably your new list will be on Google Drive?
Mogs
.
Gill & George
Member Since 2015
OK thanks Elizabeth, I'll take another look. Let me know if you find anythingHi Gill, I don't currently have a link, because I lost my whole page of links when my old computer died
I will see what I can find...
Critter Mom
Member Since 2014
She helped me to get Lantus for Saoirse. And she was really nice to speak with. (((Ruth)))
Mogs
.
Elizabeth and Bertie
Member Since 2010
Hi again, Gill. Had a quick rummage on the old interwebs. Not very productive at the mo. So much of what used to be easily available to read online no longer seems to be accessible to ordinary folk... 
Will look again tomorrow...
Did find this link (to a talk) that I posted in this forum a couple of years back though. It's a start, hehe! Info copied from original post:
"The research work the Royal Veterinary College have done is very interesting, and has produced some very useful info, and some surprises...
In the trials Lantus and Prozinc produced similar remission rates.
1 in 3 of the 'general population' of diabetic cats may go into remission.
1 in 4 diabetic cats may have acromegaly."
Link to talk on Facebook:
https://www.facebook.com/vettimesuk/videos/10154849470681010/
Will look again tomorrow...
Did find this link (to a talk) that I posted in this forum a couple of years back though. It's a start, hehe! Info copied from original post:
"The research work the Royal Veterinary College have done is very interesting, and has produced some very useful info, and some surprises...
In the trials Lantus and Prozinc produced similar remission rates.
1 in 3 of the 'general population' of diabetic cats may go into remission.
1 in 4 diabetic cats may have acromegaly."
Link to talk on Facebook:
https://www.facebook.com/vettimesuk/videos/10154849470681010/
Oh, gosh, yes, Mogs.... Lesson learned.... Still feel gutted when I think about it... But it's much harder to find things again... I keep trying search terms that 'ought' to find the same info, but they just don't....Noooooooo!!!
Presumably your new list will be on Google Drive?
Critter Mom
Member Since 2014
Tell me about it. I miss the Pet Education website.
At least you had a list. I used to rely on the forum feature where you get a drop-down list of previous links posted when adding links to new posts, not realisisng that they get wiped when one is on a forum sabbatical.
Now I stick everything useful into a Google doc.Mogs
.
Critter Mom
Member Since 2014
Gill & George
Member Since 2015
https://www.researchgate.net/public...Lente_Insulins_in_Cats_with_Diabetes_Mellitus
this is the one I found, it's just the abstract it concludes that they are the same but dosing of Lantus is just once daily....Haven't found anything else
thanks.
Sorry for hijacking your thread Marina.
How is Chico doing?
Since with vetsulin they can drop fast early in the cycle, you might want to make sure you get a +2.
He dropped quite a bit this morning, but I'm wondering if he went lower than that yellow number you caught earlier in the cycle, see how on the 26 he dropped nearly 300pts in just three hours.... I don't think you are 'catching' his nadir. At the moment we don't know when that is happening for him.
I
Marina & Chico
Member Since 2021
Could you please tell me if you were noticing shorter action of caninsulin than 12 hours? Chico gets these huge BGs before his PM shot and we don’t really understand jow to decrease them
Marina & Chico
Member Since 2021
You were right, at about +5 pm we meassured 6.9 mmol/l even though we gave him food at +2pm. This makes us think how do the rest of you mannage these values in the night? It is weird to even consider lower dosage in the night when the oreshot value is 30mmol/l.
this brings me to our other observation. We gave him food at +3 AM and it did increase the nadir to 13mmol/l but it increased as well the pre shot value to 30mmol/l... we will try to convince our vet today of changing the insulin type, i have no other ideas how to manage it
Marina & Chico
Member Since 2021
No problem
on the 30th we made the 2 hours interval glucose curve and we identified the +5 as being his nadir. Can the nadir change day by day?
That is why yesterday we measured him at +5 again to catch his nadir. We believe it is higher than the previous days because usually we would feed him at +4 am and yesterday we fed him at +3 (at @Bron and Sheba (GA) advice) in order to increase his nadir and maybe manage the highs from before the evening shot.
We would love to measure him more often but his ears are already red from the glucose curve we did the other day and we decided to give him a bit of rest and only measure the nadir.
How often do you measure and how do you identify the nadir?
JanetNJ
Member Since 2016
On the beginning I got short action. If you look at my spreadsheet in 2016 you can see my high numbers in the beginning. Keep in mind I didn't test the first two months. I didn't see a preshot under 300 the first 2.5 months. It's a marathon and could take some time for the preshots to come down.
Gill & George
Member Since 2015
Yes it can. Until they are well regulated especially so.
George was on lantus, his nadir usually was around +5 but he did nadir anytime between +1 and +12, it's a longer acting insulin and works differently to Vetsulin/caninsulin, I wouldn't expect you to get a really late nadir with Vetsulin/caninsulin because typically you don't get that sort of duration with it.
But he could nadir earlier than +5.
When I started a member recommended I apply a cold compress and some pressure to minimize bruising, this worked really well for George. I would have a damp cool cotton pad that I would pinch the test site between thumb and index finger gently but firmly and count to ten. I tested a lot (I was a bit of a junkie for data
) and George's ears were absolutely fine vet was amazed at how good they look.Make sure you are getting the sweet spot, if you are hitting the main blood vessel that does tend to bruise more and you see more swelling.
Check out this link for more tips
https://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/#post-1377750
George is in remission now so I don't
but as I said above I tested a lot because I was home and I could and it gave me peace of mind. Lantus is typically gentler and doesn't usually cause dramatic drops (there are some circumstances when this happens, like when they are clearing a bounce and you learn to recognise that), with Canninsulin they can really dive, so I would be tempted to follow up sharp drops until I see them level out.I think that in these initial stages and seeing how fast he is dropping, and with weaning him of the dry, I would recommend testing early in the cycle getting a +2, then based on what you find there, decide whether you can leave it till +5 or whether you need to follow up sooner. I would at least in these initial stages, follow up any sharp drops no later than +4. (I'd be tempted to not wait and follow up at +3)
In the same way they can nadir earlier he may also nadir after +5 so if your +5 is low, you may want to double check he's on his way up by grabbing a +6 not just assuming that he has reached the low point and will be heading up. So last night I might have got a +6 to make sure he is done with dropping. (cats often have lower cycles at night) It was good to see him hit blue at +5 last night, but we don't know if that was the lowest he dropped or if he went lower earlier or later.
Hope that helps.
Marina & Chico
Member Since 2021
Yes it can. Until they are well regulated especially so.
George was on lantus, his nadir usually was around +5 but he did nadir anytime between +1 and +12, it's a longer acting insulin and works differently to Vetsulin/caninsulin, I wouldn't expect you to get a really late nadir with Vetsulin/caninsulin because typically you don't get that sort of duration with it.
But he could nadir earlier than +5.
When I started a member recommended I apply a cold compress and some pressure to minimize bruising, this worked really well for George. I would have a damp cool cotton pad that I would pinch the test site between thumb and index finger gently but firmly and count to ten. I tested a lot (I was a bit of a junkie for data
Make sure you are getting the sweet spot, if you are hitting the main blood vessel that does tend to bruise more and you see more swelling.
Check out this link for more tips
https://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/#post-1377750
George is in remission now so I don't
I think that in these initial stages and seeing how fast he is dropping, and with weaning him of the dry, I would recommend testing early in the cycle getting a +2, then based on what you find there, decide whether you can leave it till +5 or whether you need to follow up sooner. I would at least in these initial stages, follow up any sharp drops no later than +4. (I'd be tempted to not wait and follow up at +3)
In the same way they can nadir earlier he may also nadir after +5 so if your +5 is low, you may want to double check he's on his way up by grabbing a +6 not just assuming that he has reached the low point and will be heading up. So last night I might have got a +6 to make sure he is done with dropping. (cats often have lower cycles at night) It was good to see him hit blue at +5 last night, but we don't know if that was the lowest he dropped or if he went lower earlier or later.
Hope that helps.
thank you very much for your advice, we will meassure +2.
Chico is upset with us when we meassure, even if we really try to pet him and caress him before, i believe it it because he has too many pinches in his ears already and it hurts him a bit. We dont always manage to take a sample from the first attempt
i hope it will get better
Gill & George
Member Since 2015
It takes time for both of you to get used to itChico is upset with us when we meassure, even if we really try to pet him and caress him before, i believe it it because he has too many pinches in his ears already and it hurts him a bit. We dont always manage to take a sample from the first attempt
does he like treats? George loves the freeze dried treats which are low carb and he always got one or two pieces when I tested him. So he would come up to me when I rattled the test strips sit on my lap and present his ear for a test because he knew he was getting a treat. It of course didn't happen straight away but he soon go the idea that poke=tasty treat.
I also desensitized him to having his ears handled by simply rubbing them for a bit then giving him a treat. (no poke)
I used cosma snackies freeze dried treats. Also orijen freeze dried treats, as long as they are 100% FD chicken/fish/meat with nothing added they are fine to use and will not affect his BG.
Marina & Chico
Member Since 2021
We tried first few times with treats that we had at home, but they are very high in carbs and we still didn't receive the freeze dried ones that we ordered from zoohit. Definitely will try to do the same.It takes time for both of you to get used to it
does he like treats? George loves the freeze dried treats which are low carb and he always got one or two pieces when I tested him. So he would come up to me when I rattled the test strips sit on my lap and present his ear for a test because he knew he was getting a treat. It of course didn't happen straight away but he soon go the idea that poke=tasty treat.
I also desensitized him to having his ears handled by simply rubbing them for a bit then giving him a treat. (no poke)
I used cosma snackies freeze dried treats. Also orijen freeze dried treats, as long as they are 100% FD chicken/fish/meat with nothing added they are fine to use and will not affect his BG.
We ordered Cosma freeze dried ones, i feel much better to know it was the correct choice
Gill & George
Member Since 2015
I'm sure chico will looooove them
If your order is delayed you could try tiny pieces of chicken breast (just plain cooked no salt/spices) as a treat, some people use that instead of the freeze dried treats. The just poach/some chicken breast in water cut it up into small pieces, freeze some and keep some for use, defrosting as they need them.
Gill & George
Member Since 2015
Have you managed to get another test today?
Marina & Chico
Member Since 2021
not yet, we struggled at +2 but didnt manag, we let him be and will try in a few min again
Marina & Chico
Member Since 2021
we will try that today, hopefully will helpI'm sure chico will looooove them
If your order is delayed you could try tiny pieces of chicken breast (just plain cooked no salt/spices) as a treat, some people use that instead of the freeze dried treats. The just poach/some chicken breast in water cut it up into small pieces, freeze some and keep some for use, defrosting as they need them.
PS: cooked=boiled?
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Marina & Chico
Member Since 2021
it is at 14mmol/l and we didn't feed him yet (except the portion with insulin). This value is higher than what he had when we made the BG curve and he reached nadir with 8. I am afraid tonight it will be again in the 30s
Gill & George
Member Since 2015
250@+3 in usa numbers, I would recommend you quote those (the ss automatically calculates it for you) we use the USA numbers and the hours after shot time on the forums and everyone is familiar with those, not everyone is 'bilingual'. You will get more help if people understand what they are looking at.
It's a big drop, 200pts almost, I would check him again at +5 see if he is still heading down, or if he is still flat.
A high pre shot may occur for different reasons, for instance: a bounce or not enough duration from the insulin or both, might result in high PS.I am afraid tonight it will be again in the 30s
Don't get ahead of yourself, feed as you normally would and take it one step at a time.
Marina & Chico
Member Since 2021
I checked CC's spreadsheet and i can see that you have been thru a lot, great job at managing it so well
Marina & Chico
Member Since 2021
You are right, we can get ahold of Lantus and Humulin. Our vet recommends waiting a few more days before taking the decision to make the change. Looks like we will have to monitor him thru the night until then.
Gill & George
Member Since 2015
Just saw he got to blue in the morning.
What was he at pmps?
Do you think you could grab a +2 and one just before bed tonight.
This morning doesn't look like a bounce cycle.
What was he at pmps?
Do you think you could grab a +2 and one just before bed tonight.
This morning doesn't look like a bounce cycle.
Gill & George
Member Since 2015
He doesn't seem to be getting duration and the tests you are getting will help illustrate that. You're doing a great job, and in the scheme of things a few days isn't long to wait for the change to a longer acting insulin.
I'm keeping my fingers and paws crossed vet will be ok to swap him onto lantus.
Marina & Chico
Member Since 2021
we still have another 1.5 hours until pmps. we can take a + 2 and then a +5.
Marina & Chico
Member Since 2021
Thank you very much for the support, we really appreciate itHe doesn't seem to be getting duration and the tests you are getting will help illustrate that. You're doing a great job, and in the scheme of things a few days isn't long to wait for the change to a longer acting insulin.
I'm keeping my fingers and paws crossed vet will be ok to swap him onto lantus.
Our vet is young and not very experienced with diabetes but the good thing is he is very open minded and promised to consult with other colleagues about lantus.
Gill & George
Member Since 2015
Excellent, just st to be clear get a pmbg as well, you don't want to shoot blind.
Marina & Chico
Member Since 2021
Sure, that one is sacred but thank you for reminding us.
Gill & George
Member Since 2015
George was our vets first diabetic cat. She started him on gliclaside, which doesn't work for cats, and recommended dry diabetic food, do we didn't get of to a good start.
But she was open to discussing his treatment. I just made my case, part of that was showing her that I could keep him safe by monitoring, so she prescribed lantus, I joined the board and though I shared the info, Ieith the help of experienced members I made the dosage decisions as per the protocol, and George got regulated and into remission about 5 months later, he's 21 and is still off insulin.
I'll see if I can get you some documentation to support your case for s longer acting insulin.
Gill & George
Member Since 2015
Marina & Chico
Member Since 2021
Wow, dosage decisions... i would be soo scared to do that, you are very brave.
I would be very grateful for the documentation
Marina & Chico
Member Since 2021
So we are at 427 pmbg today. That is such a relief to be honest, on the other hand a long night is ahead of us...
Gill & George
Member Since 2015
Did he eat OK for you at dinner?
I saw your notes about diarrhea on the ss. How bad is he?
Hope it resolves.
I saw your notes about diarrhea on the ss. How bad is he?
Hope it resolves.
Marina & Chico
Member Since 2021
He ate dinner and we will give him some more food at +2.
He has diarrhea for a while now but some days its more liquid than others.
Gill & George
Member Since 2015
Poor guy.
Has it coincided with the food change with diabetes? Or has he been on antibiotics? Or is it more of a long-standing problem for him?
I'm just heading to bed, but I'll get some info together for you tomorrow of things you can try. I'll get that and the documentation together for you.
Marina & Chico
Member Since 2021
Gill & George
Member Since 2015
Hi how are you guys doing?
Is Chico eating OK? How are his poops?
https://www.dovepress.com/managing-...spectives-peer-reviewed-fulltext-article-VMRR
A review of the different insulins, includes vetsulin, PZI, Lantus, amongst others, and what the best first choice for achieving regulation quickly and safely, which in turn gives best chance of remission in newly diagnosed cats. one of the authors is J. Rand, she was involved, together with a group in germany, in devising a dosing stragegy (TR Protocol which is one of the dosing strategies we follow on the lantus forum. What is interesting in both these papers is that they stress the importance of getting a newly diabetic cat into a normal range quickly and safely and how, in particular caninsulin/vetsulin is not able to do this for many cats due to its short duration in cats, this results in kitty being hyperglycaemic for too many hours a day which is detrimental to Bcell health in the pancreas. The longer acting insulins are better at doing this, in particular Lantus.
This describes the Romp Rand method for diabetes management wiith long acting insulins file:///C:/Users/Gill/Downloads/management%20of%20diabetic%20cats%20(5).pdf
Both those papers should support your request for a longer acting insulin and the importance of not waiting too long.
I have found reference to another more recent study comparing lantus and prozinc,(2017) in that lantus still has a better rate of remission, 38% versus 25%, which the researchers did not find to be statistically important. I haven't been able to get my hands on the full study yet, just the abstract.
Everything I read suggests that a long acting insulin is the best first choice,(vetsulin/caninsulin is not long acting in a cat) though a number of articles reference the eu legislation of having to use the cascade rule may aversely affect our kitties here in Europe. That said if your vet won't change to Lantus, Prozinc is significantly longer acting and a better choice, he should be able to prescribe that as it is now licensed as an animal product, which may help you to get Chico into healthy BG for longer periods.
Is Chico eating OK? How are his poops?
https://www.dovepress.com/managing-...spectives-peer-reviewed-fulltext-article-VMRR
A review of the different insulins, includes vetsulin, PZI, Lantus, amongst others, and what the best first choice for achieving regulation quickly and safely, which in turn gives best chance of remission in newly diagnosed cats. one of the authors is J. Rand, she was involved, together with a group in germany, in devising a dosing stragegy (TR Protocol which is one of the dosing strategies we follow on the lantus forum. What is interesting in both these papers is that they stress the importance of getting a newly diabetic cat into a normal range quickly and safely and how, in particular caninsulin/vetsulin is not able to do this for many cats due to its short duration in cats, this results in kitty being hyperglycaemic for too many hours a day which is detrimental to Bcell health in the pancreas. The longer acting insulins are better at doing this, in particular Lantus.
This describes the Romp Rand method for diabetes management wiith long acting insulins file:///C:/Users/Gill/Downloads/management%20of%20diabetic%20cats%20(5).pdf
Both those papers should support your request for a longer acting insulin and the importance of not waiting too long.
I have found reference to another more recent study comparing lantus and prozinc,(2017) in that lantus still has a better rate of remission, 38% versus 25%, which the researchers did not find to be statistically important. I haven't been able to get my hands on the full study yet, just the abstract.
Everything I read suggests that a long acting insulin is the best first choice,(vetsulin/caninsulin is not long acting in a cat) though a number of articles reference the eu legislation of having to use the cascade rule may aversely affect our kitties here in Europe. That said if your vet won't change to Lantus, Prozinc is significantly longer acting and a better choice, he should be able to prescribe that as it is now licensed as an animal product, which may help you to get Chico into healthy BG for longer periods.
Marina & Chico
Member Since 2021
Chico has pretty high BG values too early in the cycle and we don't really understand why. yesterday in the night we were afraid of values lower than 124 but instead it was 403. The same thing today. We really don't know what is the cause for this worsening in BG. He had again pretty liquid diarrhea. We started giving him cooked chicken as a treat for after testing, he started being a bit more complacent to letting us measure but maybe that is what stresses him and respectively increasing his BG. He started overgrooming himself, my husband found online that it is usually a sign of stress. On the other hand, it is difficult to say he is more stressed than usual because he is very playful and reactive... Another day of a lot of questions is our house...
Thank you very much for the links, i will read them and try to go back to the vet with it. The second link is on local disc C:, so i wasn't able to open it. Maybe you cans end it to my email:
Gill & George
Member Since 2015
I will but I would take your email address down, so it is not public.
Marina & Chico
Member Since 2021
already did, and i finally managed to edit the message to answer to parts of it separately
Gill & George
Member Since 2015
https://drive.google.com/file/d/1ONqFx88XSm2x4GrV1-1Rva1NCK7w8dQT/view?usp=sharing
I added it to my google drive anyone with this link should be able to access it now, I'm not sure why the other one didn't work
I added it to my google drive anyone with this link should be able to access it now, I'm not sure why the other one didn't work
Gill & George
Member Since 2015
Last night cycle, if we assume that he stayed flat and red all cycle, may have been a bounce triggered by the sharp drop in the morning cycle.
This morning he dropped from 560 to 193 that is a lot 367
either the duration is up or another bounce got triggered, or possibly both. That results in BG spiking two hours later. The fast drops that canninsulin/vetsulin causes in many cats can result in this sort of cycle.
Though some cats will still bounce on the longer acting insulins like lantus, it is not usually as dramatic as we are seeing here for Chico.
Some of that is attributed to the fast acting vetsulin and the fact that Lantus aside from being 'gentler' and longer acting it also has a depot, which levels out the curves. Infact once regulated, the curves in lantus are almost flat
Below is an explanation from the lantus forum sticky which covers the points above, and may help explain why for many (if not most cats) the slower acting insulins can be a better choice.
A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus/Basaglar or Levemir:
- Carryover - insulin effects lasting past the insulin's official duration
- Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
- Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body
- Lantus, Basaglar & Levemir: What is the Insulin Depot?
- Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Critter Mom
Member Since 2014
Hi Marina.
Mogs
.
It's likely due to the characteristics of Caninsulin. This insulin is capable of quickly dragging numbers down. Trouble is that fast, steep drops can sometimes trigger higher BGs in the next cycle. Also, in many cats treated with it, there just isn't long enough duration of effect, as you can see in the cycles where Chico has gone from nadir blues up to yellows - even into red - around the +7-8 mark.
Mogs
.
Gill & George
Member Since 2015
Just thinking about his poop problem, you may want to give probiotics a try.
get some human ones from the pharmacy/healthfood shop, the link below has advice on how to manage the diarrhea and which probiotics to use to help him with it.
I've used Sboullardi with George when he got runny poop from ab and anti inflammatory and it worked for him, he still has a maintenance dose now, he's an old cat and it has reduced the frequency of him getting runny stinky poops.
https://www.foodfurlife.com/my-cat-has-diarrhea---what-do-i-do.html#/
get some human ones from the pharmacy/healthfood shop, the link below has advice on how to manage the diarrhea and which probiotics to use to help him with it.
I've used Sboullardi with George when he got runny poop from ab and anti inflammatory and it worked for him, he still has a maintenance dose now, he's an old cat and it has reduced the frequency of him getting runny stinky poops.
https://www.foodfurlife.com/my-cat-has-diarrhea---what-do-i-do.html#/
Marina & Chico
Member Since 2021
Thank you, we will definitely try it.
In meanwhile we have found that he might be intolerant to the food he is receiving, which would make sense, because the diarrhea started around the time when we switched to Purina ProPLan DM. We want to go back to our old food - Cosma in jelly, it is pure meat, <1% carbs. Nonetheless it is considered to be supplementary wet cat food. Do you have any experience with Cosma as the main food for cats?
Gill & George
Member Since 2015
No I used it as supplementary, some of the varieties were medium carb do I used them when George went too low.
Take a look at thrive, they're stuff has no weird additives. George gets the shredded chicken, and tuna and salmon, they are shredded in broth but both are complete foods. There are some other flavours.
Kattovit sensitive is also well tolerated.
Take a look at thrive, they're stuff has no weird additives. George gets the shredded chicken, and tuna and salmon, they are shredded in broth but both are complete foods. There are some other flavours.
Kattovit sensitive is also well tolerated.
do you have some though what it is in the food that is causing the issue?
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