Newcomer to diabetic world.

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Drashiel

Drashiel

Member Since 2023
Hi,
I'm Miguel, from Spain. Unfortunately newcomer to diabetes feline. Last 17th my vet shows me fructosamina results and are not good, about 437.
My cat have IDB, pancreattitis, renal issues, murmur in the heart and now he is diabetic. Since have another illness, we go frequently to the vet and my vet always have the idea her glucose levels are not normal and will end in a diabetes condition. I did regular orine test and from a time to now I have been getting positive results on orine strips. Bought a feline blood glucose meter and did regular test. Never go down 150 and get 280 as spike.
I assimilate this new condition and start with a new feeding routine and shots, 1U every 12h. I bought Vetpen because overwhelmed about the idea putting excessive amount of insulin.
This weekend I'm going to do a glucose curve (is not the first I do) and see results, but two days ago I did a test 4 hours after a shot and get 115 :).

Anybody has experience with Vetpen? My vet instruct me to use a syringe and get feedback about when the needle is on the cat, but with Vetpen I not able to get this feedback.

Thanks,

Best regards.
 
The VetPen is used only with Vetsulin/Caninsulin cartridges which is not a good insulin for cats. It was developed for dogs. The VetPen comes in two models, one with higher dosing range but that only doses in 1-unit increments and the other model with smaller range wich doses in ½-unit increments. I just looked at the instructions for using the VetPen and it easier than a human insulin pen. See: https://www.merck-animal-health-usa.com/vetsulin/cats/vetpen-administration
 
Welcome and it sounds like your kitty has a lot going on not unlike my Minnie who also had IBD, diabetes, cardiomyopathy and asthma.

can you tell us what food you’re feeding? With a diabetic cat, you want to feed low carb food but you want to make sure you’re home testing because a change in diet can drop the bg by up to 100 points. Vetsulin is also a harsh insulin and it hits fast so you need to make sure your cat has eaten at least 20-30 minutes before the insulin. So, test, feed, wait 20-30 minutes then give insulin.

diabetic cats also do better with several meals throughout the day. You want to feed the 2 main meals around shot times and then 3-4 smaller meals or snacks in the day. It’s easier on their pancreas and it helps avoid big sugar spikes.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

keep asking questions!
 
Thanks for your responses.

@Larry, I have the 8U model, 0.5 increments. Sorry about insulin, there must be prescripted so I can´t purchase another than the vet said. I read directions prior to use (in fact I have read 3 times...)

@Ale, food with 75% Hills Z/D and 25% K/D. Took about a year to find this combo with minimal corticosteroids because the more corticosteroids the worse for the pancreas. Also, use IRC-vet + Dialix for renal issues, Lypex for pancreas, and now 1U x12hrs of insulin. My vet tells me that Z/D food is good for diabetes but bad for renal because it has high protein content and low carb. This is the reason to mix with K/D. It is a delicate balance, I did a lot of tests and minimal adjustments to get this combo.

Today I´m on a glucose curve day to adjust insulin (I have a feline glucose meter). At first read, I have 208. My directions about insulin usage are 1U 10 minutes after feeding the cat. Also, concentrate most food in these 2 times of the day.

Regards.
 
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Miguel --

I'm confused. Unless the Hill's food is formulated differently in Spain, neither Z/D nor K/D contain any form of steroid, at least not here in the US. In fact, there is nothing that is "prescription" in these foods. With a diabetic cat, if you are feeding the dry food version of K/D or Z/D, they are very high in carbohydrates. Even the canned food variety of these foods are also very high in carbohydrates -- at least 27%. We recommend feeding a diabetic cat low carbohydrate food -- preferably canned food that is less than 10% carbohydrate. Most of the members here use food that is 5 to 7% carbohydrate.

It's also not necessary to feed your cat only twice a day. You can spread the food out preferably up to 6 hours after you give a shot. You do not want to feed your cat in the 2 hours prior to shot time (unless the numbers drop too low).
 
Sienne and Gabby (GA) said:
Miguel --

I'm confused. Unless the Hill's food is formulated differently in Spain, neither Z/D nor K/D contain any form of steroid, at least not here in the US. In fact, there is nothing that is "prescription" in these foods. With a diabetic cat, if you are feeding the dry food version of K/D or Z/D, they are very high in carbohydrates. Even the canned food variety of these foods are also very high in carbohydrates -- at least 27%. We recommend feeding a diabetic cat low carbohydrate food -- preferably canned food that is less than 10% carbohydrate. Most of the members here use food that is 5 to 7% carbohydrate.

It's also not necessary to feed your cat only twice a day. You can spread the food out preferably up to 6 hours after you give a shot. You do not want to feed your cat in the 2 hours prior to shot time (unless the numbers drop too low).
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Hi,

It is difficult feed with diabetic food because IDB will be a problem. If use diabetic food I must to increase corticoids to control IDB and this is not good for pancreatic issues.

My vet said try to feed twice a day and 10 minutes after, shoot insulin. I can feed small amounts of foods between "big meals". At nights I alternate Z/D with K/D wet food. For vet this is OK.

As you can see, I have to found a balance between diabetes, IDB, kidneys and pancreas. Not easy but I'll do my best.

Cats with IDB and diabetes, what food uses and how control both things?

Thanks,

Regards.
 
With Vetsulin, 10 minutes is not enough. Please make sure you wait 20-30 minutes after you feed to give the insulin.

yes, you can feed the larger meals at shot time but continue to feed smaller meals or treats throughout the day.

if you can set up a spreadsheet with the numbers you’re getting, we can help you better with dosing. We have members that can help you set it up if you need help: https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

IBD does well with nível proteins. Have you tried that? Low carb foods are ideal for the diabetes and they’re fine for the IBD too. A lot of people also feed raw food that they either buy or make at home
 
Many thanks for your inputs.

We used high protein food to IDB on past and causes kidney start to fail due high stress of proteins. I'll discuss with my vet about this when she comes back from her holidays (she gives me her personal phone for emergencies). In about 15 minutes will end glucose curve. I'll post my results.

Many thanks for your help.

Regards.
 
Results from today glucose test:

29/07/2023 7:00 208
29/07/2023 9:00 116
29/07/2023 11:00 132
29/07/2023 13:00 160
29/07/2023 15:00 255
29/07/2023 17:00 289
29/07/2023 19:00 239

All values are mg/dl. Not too bad but not understand spike at 5 pm... Shots at 7am and 7pm. I'll do another at 9pm to check after 7pm meal.
 
Drashiel said:
Many thanks for your inputs.

We used high protein food to IDB on past and causes kidney start to fail due high stress of proteins. I'll discuss with my vet about this when she comes back from her holidays (she gives me her personal phone for emergencies). In about 15 minutes will end glucose curve. I'll post my results.

Many thanks for your help.

Regards.
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Novel protein is not high protein. It’s just new protein that they haven’t eaten before like venison or duck or habit or even pork

what do you mean by kidneys start to fail? Was your cat hospitalized? Or diagnosed with CKD?
 
Drashiel said:
Results from today glucose test:

29/07/2023 7:00 208
29/07/2023 9:00 116
29/07/2023 11:00 132
29/07/2023 13:00 160
29/07/2023 15:00 255
29/07/2023 17:00 289
29/07/2023 19:00 239

All values are mg/dl. Not too bad but not understand spike at 5 pm... Shots at 7am and 7pm. I'll do another at 9pm to check after 7pm meal.
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It looks like it may need a dose increase but we can’t know for sure without seeing more data. Would you be willing to set up a spreadsheet?
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
 
I would also ask your vet about Lantus and prozinc since they’re much better insulins for cats. Vetsulin is also called caninsulin because it was made for canines whom have a much lower metabolism than cats. It hits hard and fast and it doesn’t last the full 12 hours so your cat is not protected the entire time.
 
Ale & Bobo & Minnie (GA) said:
It looks like it may need a dose increase but we can’t know for sure without seeing more data. Would you be willing to set up a spreadsheet?
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
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I think that got it. It is enough information? I added previous glucose curves I did prior get the fructosamine test as a diabetic diagnostic.
 
Great! These are good numbers for a recently diagnosed cat. And you’re testing a lot which is really good. Let’s see what the 1 unit dose is going to do. I’m concerned about the 96amps and it may be that 1 unit is too much. @Bron and Sheba (GA) when should the dose be reduced? It looks like he’s using a pet meter so under 90 doesn’t apply, does it?
 
Ale & Bobo & Minnie (GA) said:
Great! These are good numbers for a recently diagnosed cat. And you’re testing a lot which is really good. Let’s see what the 1 unit dose is going to do. I’m concerned about the 96amps and it may be that 1 unit is too much. @Bron and Sheba (GA) when should the dose be reduced? It looks like he’s using a pet meter so under 90 doesn’t apply, does it?
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96 was previous diabetic diagnostic and insulin shots. Today is the first one with insulin.
 
Some cats need to be on a steroid to help with the inflammation from IBD. The steroid is NOT in the food. Steroids are medications that are given separately. I've never seen any corticosteroid in cat food. I'd suggest you look over this website, Raw Feeding for IBD Cats. Even if you do not choose to feed your cat a raw diet, there is excellent information there. The group also has a Facebook page if you have questions. Just be aware that they have some restrictions about what questions you can ask about diet.

Many cats have food sensitivities that contribute to the IBD. Food such as poultry, beef, and fish are among the more common causes for inflammation. As Ale noted, novel proteins (rabbit, venison, pork, kangaroo) can help to control the inflammation.

You might want to look over this Primer on Pancreatitis that one of our members compiled. Steroids are sometimes given to treat pancreatitis. They are not contraindicated. However, if you are giving your cat steroids for either IBD or pancreatitis, the insulin dose may need to be adjusted to compensate. This is not always the case, though. There are some conditions that require a cat to be prescribed a steroid. The insulin dose can be adjusted to manage the diabetes if a cat needs a steroid. One of my (non-diabetic) cats has IBD and gets a small dose of prednisolone. His blood glucose numbers haven't changed.
 
I think I would try going down to 0.5 U twice a day and see if you can shoot both cycles.
And with using the alphatrak meter, I would stall, don't feed and wait until the preshot BG has gone up over 220 before shooting, until you have more data.
And if you are going to try swapping to a lower carb diet, you will need to be careful and watch for the BGs dropping.
If you were able to get off that high carb food, you might find Moar doesn't need insulin.
 
Hola Miguel, te escribo desde Granada!

It is going to be a balancing act with the food given the conditions, but I don't think that necessarily means a high carb diet is the best for him.

I want to share my experience with George.
My George (24) KIDNEY ISSUES, LIVER, HEART MURMUR, liver issuesDIABETIC (in remisión diet controlled) eats a low carb wet diet, (not prescription) he gets a bit of water added to his food and takes vitamin B12 supplement.
My first vet wanted George to go on a diabetic dry food diet from hills, on this forum I found out that it was too high in carbs at approximately 30%, so I made the decision to move to a wet Low carb diet, there are many non prescription foods that are much better quality and better for your cat than hills. (Antes le daria comida humeda de mercadona a un gato diabetico que pienso de hills). I had to agree to disagree with her and made the change to low carb wet food, best decision I made.

Diabetes, and age have of course resulted in George have renal insufficiency, again vets wanted me to change to a kidney diet ( hills prescription again) , which much like the ibd diet from hills is way too high for a diabetic cat in remission. I knew from some accidents when george has raided the stray cats food (high in carb) his blood glucose levels would spike, so I knew that increasing the carb would ultimately result in his levels becoming high and again facing treatment with insulin, but more importantly, those high glucose levels would be really bad, the vet agreed so we came up with plan, low carb good quality protein, and we aim to keep phosphorus below 1%, we also add water.
When you have both renal insufficiency and diabetes , treating/ controlling the diabetes takes priority, if you do not control the diabetes it will adversely affect the kidneys.

In your case the IBD of course must also be taken into account. The website @Sienne and Gabby (GA) shared with you is a good place to start. If you choose to make food for him (raw or cooked), there is a supplement available that you can add to make the food nutritionally complete.

https://www.zooplus.es/shop/tienda_gatos/complementos_alimenticios/vitaminas/550480

Do you know what proteins your cat can eat? Or which he has a problem with? I could suggest some foods for you.
He was first diagnosed with kidney insufficiency, in March 2016.
Interestingly with George's diet now , and after a number of blood tests which demonstrate that his kidneys are stable, my vet no longer advises the prescrpton diet for him.
 
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Also please keep in mind vets know very little about feline diabetes so you will likely get very different advice from them compared to us. This is why most still prescribe a dog insulin to cats and treat diabetic cats like they treat diabetic dogs. Very different species with different metabolisms and biological makeup. They push expensive prescription foods and expensive pet meters when none of that is necessary.

I agree with Bron. That 96 makes me think that once he’s on low carb food, he may not need insulin at all.
 
Gill & George said:
Hola Miguel, te escribo desde Granada!

It is going to be a balancing act with the food given the conditions, but I don't think that necessarily means a high carb diet is the best for him.

I want to share my experience with George.
My George (24) KIDNEY ISSUES, LIVER, HEART MURMUR, liver issuesDIABETIC (in remisión diet controlled) eats a low carb wet diet, (not prescription) he gets a bit of water added to his food and takes vitamin B12 supplement.
My first vet wanted George to go on a diabetic dry food diet from hills, on this forum I found out that it was too high in carbs at approximately 30%, so I made the decision to move to a wet Low carb diet, there are many non prescription foods that are much better quality and better for your cat than hills. (Antes le daria comida humeda de mercadona a un gato diabetico que pienso de hills). I had to agree to disagree with her and made the change to low carb wet food, best decision I made.

Diabetes, and age have of course resulted in George have renal insufficiency, again vets wanted me to change to a kidney diet ( hills prescription again) , which much like the ibd diet from hills is way too high for a diabetic cat in remission. I knew from some accidents when george has raided the stray cats food (high in carb) his blood glucose levels would spike, so I knew that increasing the carb would ultimately result in his levels becoming high and again facing treatment with insulin, but more importantly, those high glucose levels would be really bad, the vet agreed so we came up with plan, low carb good quality protein, and we aim to keep phosphorus below 1%, we also add water.
When you have both renal insufficiency and diabetes , treating/ controlling the diabetes takes priority, if you do not control the diabetes it will adversely affect the kidneys.

In your case the IBD of course must also be taken into account. The website @Sienne and Gabby (GA) shared with you is a good place to start. If you choose to make food for him (raw or cooked), there is a supplement available that you can add to make the food nutritionally complete.

https://www.zooplus.es/shop/tienda_gatos/complementos_alimenticios/vitaminas/550480

Do you know what proteins your cat can eat? Or which he has a problem with? I could suggest some foods for you.
He was first diagnosed with kidney insufficiency, in March 2016.
Interestingly with George's diet now , and after a number of blood tests which demonstrate that his kidneys are stable, my vet no longer advises the prescrpton diet for him.
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Greetings from Madrid!

Your post is very interesting and provides much valuable help. Now I´m a bit overwhelmed about insulin brands, feeding methods, foods... My biggest worry here is about kidneys. At the beginning of IBD kidneys are working fine (phosphor levels are OK but on an ECO my vet warns me that one of the kidneys was much smaller than the other and cause issues in the future) but after a year with Z/D food, phosphor levels are too high and we have to move to a mix with Z/D and K/D. My vet told me about Z/D food contains a high percentage of protein and waste of protein was causing exhaustion of the kidneys. At this point, I use about 1mg/2-3 days of Modering (for IBD). After moving to a 50-50 Z/D-K/D mix and adding renal supplements, the kidneys had a big improvement. At this point, glucose was not a problem (but my vet warm me about she thinks Moar finally end in a diabetic condition). This causes I had to increase Modering by about 2mg per day. After a time, phosphor levels are OK so we moved to the actual mix (75/25) This let me down Modering to 1mg/day. Everything was working fine but about 3 months ago something changed (and I think that is the culprit of the diabetes): one of the renal supplements was retired and had to move to IRC-Vet.
I had to say that about 2/3 weeks I did glucose urine strips to keep controlled this because when Moar has any kind of stress, glucose levels increase exponentially.
About 2 weeks of moving to IRC-Vet (drops formula) got positive glucose in the urine. I called my vet and tells this new issue but she tells me that maybe any kind of stress is causing this. This did not convince me because I have been using Feliway to keep stress under control, so I started to monitor urine per day and went to the vet for analysis. As you can imagine, travel to the vet causes a crazy level of glucose but a new actor appears in the scene: the pancreas starts to have some issues. A SNAP fPL (I guess this is the name) test said about more than 12 and more than 5.8 is pancreatitis...
I still monitor glucose because the fructosamine test said we are not in a diabetic condition but pancreatitis will not help with glucose at all. Some days I had positive results (the highest possible on the strip) and the next day I can have negative results. This was driving me crazy so I start to review what changes were made that can cause this. I checked IRC-Vet drops and found on formula glucose syrup. I checked with my vet about this and decided to move to pills (a pain because are big). Still, monitor urine and bought a glucometer because I have doubts about strips. Glucometer confirms that glucose levels are high. We wait if moving to IRC on pills made an improvement in glucose levels but unfortunately, the last fructosamine was 437 (the first one when IBD was detected was 230, and fructosamine levels were uprising over the years), and was finally diabetic diagnosed.

All text to say that I am very worried about kidneys and cause an overload again due to high protein content. But I am worried about diabetes and the pancreas too... I have no idea what is more important here. When IBD and kidneys were the "only" issues, my vet prioritizes kidneys over IBD but at his point, I have no idea what is the priority.

When she returns from holidays we have to discuss what is more important at this moment, but I had positive results about the pancreas, and SNAP fPL test shows an improvement from 12.6 to 10.3. Because, from a simplistic point of view glucose levels can be regulated by adding insulin but with kidneys there is nothing to add. What are the effects of insulin in the long term?

Thanks,

Regards.
 
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Ale & Bobo & Minnie (GA) said:
Also please keep in mind vets know very little about feline diabetes so you will likely get very different advice from them compared to us. This is why most still prescribe a dog insulin to cats and treat diabetic cats like they treat diabetic dogs. Very different species with different metabolisms and biological makeup. They push expensive prescription foods and expensive pet meters when none of that is necessary.

I agree with Bron. That 96 makes me think that once he’s on low carb food, he may not need insulin at all.
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Hi. I´m not convinced about this 96 was real because was the firsts times I use a glucometer... In fact, I remember another test that had 303 and this worried me a lot and did another and got 232. So when I have any doubt about reads I do another test for safety.
My vet is a feline specialist, I want to believe that we are in the correct hands. I think that she did a very good job with IBD.

I´ll discuss this with her, as I said in another post I´m worried about kidneys because start to fail about a year after starting with Z/D food. I post here all measures I have (sometimes vet asks about taking a measure pre-fed, others sometime after fed), I have another spreadsheet that shares with my vet containing glucose curves, urine strip test results, aleatory glucose tests, water intake, and some information that I think is relevant like if I see the cat is stressed, if drinks more water, etc). It has 3 columns, the first one is the data of measure, the second is the measure itself in mg/dl, and the last one is the last time Moar was fed (underline all tests made pre-feed):

09/04/2023 13:48 120 09/04/2023 13:30
15/04/2023 13:45 160 15/04/2023 12:30
23/04/2023 19:10 149 23/04/2023 18:00
29/04/2023 9:00 225 29/04/2023 7:55
29/04/2023 10:00 206 29/04/2023 7:55
13/05/2023 8:00 193 12/05/2023 23:00
20/05/2023 7:30 139 19/05/2023 23:00
24/06/2023 12:40 195 24/06/2023 12:15
28/06/2023 19:35 280 28/06/2023 19:00
29/06/2023 16:20 237 29/06/2023 13:30
30/06/2023 15:25 170 30/06/2023 13:35
03/07/2023 18:05 211 03/07/2023 15:10
04/07/2023 16:25 211 04/07/2023 15:00
05/07/2023 17:05 242 05/07/2023 15:05
06/07/2023 17:45 247 06/07/2023 15:05
07/07/2023 13:10 273 07/07/2023 10:00
08/07/2023 8:15 219 07/07/2023 23:00
10/07/2023 16:30 193 10/07/2023 13:30
10/07/2023 18:35 277 10/07/2023 16:30:00 + 18:00
13/07/2023 19:30 246 13/07/2023 18:30
16/07/2023 13:35 227 16/07/2023 11:40

Those are with insulin (do by myself to test about how insulin was working prior first glucose curve):
21/07/2023 21:35 154 21/07/2023 19:20
22/07/2023 12:20 115 22/07/2023 7:20
27/07/2023 20:30 216 27/07/2023 18:30

Do you think I have to add to Moar spreadsheet? At the begin, I had some days with positive results on urine strips and others are completely normal.
 
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But the whole thing or only pre-fed values? Looks like everything turns over measures pre-food. For the non-pre-fed values, do I have to consider the feed time as AMPS?
The idea about urine is to know in a cheap way if glucose levels are too high or not. When a cat has glucose in the urine, levels of glucose in the blood are too high, isn´t it?
 
Amps and pmps are the tests you do before giving insulin and before feeding in the morning and in the evening. You want no food for at least 2 hours prior to these tests so the number you get is not food influenced. The blood test is what you go by when it comes to the insulin dose. The urine test will only tell you there’s sugar in the urine but it doesn’t help when it comes to the insulin dosing.

My vet is an IM specialist and truly wonderful when it comes to everything else like IBD, CKD, asthma you name it. But when it comes to feline diabetes they’re all taught to dose by the preshot numbers and we dose by the lowest the dose takes your cat in a 12-hour cycle because that’s where the danger of a hypo is. Vetsulin is not the best insulin for cats and she prescribed you that for your cat so it raises a red flag for me. A cat specialist should know to prescribe either Lantus or prozinc. That said, feel free to share the link to this forum with your vet so she can browse through all the info here.

Both IBD and CKD take years to progress. Bobo also has a much smaller kidney and his CKD is stage 2 but it hadn’t progressed in over 1 year. There are non-prescription foods that are both low in carbs and phosphorus but vets don’t bother to research them. If you were in the US, there’s a list we could give you. I personally tend to think the diabetes is a priority because when it’s unregulated it can lead to other health issues like neuropathy. And if your cat is getting too much insulin it’s at a risk of a hypo.
 
Miguel, asked me a few questions on a pm and I am answering here in case anyone has anything more
. En la curva de la glucosa de ayer sí vi que a las 6 horas el nivel era de 160 pero 8 horas después ya estaba en más de 200, así que no creo que la insulina sea capaz de aguantar las 12 horas. ¿quizá sería conveniente 3 pinchazos? porque parece que si dura unas 8 horas con 1/2U a las 8 horas y luego una comida fuerte y otra dosis de 1U encajaría...
Yo en tu lugar le preguntaria al vete de cambiar la insulina, a una de más large duración como lantus, o prozinc, mi vete también quizo empezar con caninsulina, pero yo le pedi lantus, despues de leer la información en este foro, y algunos estudios que comparaban insulinas y la probabilidad de remisión de diabetes, generalmente canknsuñlina no es la insulina mas efectiv para la diabetes fwlina porque produce bajones rapidos y le falta duracion, esto es porque gatos tienen un metabolismo mas rapido que perros y caninsuñina fue creada inicialmente para tratar diabetes en perros, tu vete probablemente lo ida bastante frecuentemente von perros pero para gatos nuestr experiencia es que no es la mas apta, al dia de hoy en otros paises ya van cambiando el protocolo y no usan caninsulina como insulina de primera elección. Mi preferencia sería por lantus, es la insulina que use y me dio muy buenos resultados, también la he visto funcionar mu bien en numerosos gatos en el foro.
Creo que sería mejor cambiar que dosificar 3 veces, no solo se trata de duración pero de obtener una curva muy plana, si tw fijas en la tabla de glucosa de George, una vez regulado sus curvas variaban com 20 a lo largo del ciclo. Ese tipo de curva es la típica de lantus en un gato regulado, y ayuda apoyar la recuperacion del pancreas, que se regenera y si hay suerte, puede resultar en la remisión. Con caninsulina es más complicado poder llegar a eso por sus efectos bruscos.



¿Que efectos tiene al final la insulina en el organismo? porque parece que riñones solo tiene los que tiene pero insulina se le puede poner según demande...
Gracias!
El problema no es la insulina, si no los niveles de glucosa altos, la glucosa elevada a largo plazo, es nefasto para los riñones. Si sigues con comida alta en carbohidratos va ser complicado, o incluso imposible controlar la diabetes, . Es como tener un niño diabetico, y estar dándole chuches, o bebidas azucaradas. Si los niveles se mantienen elevados, esos niveles altos de glucosa van a deteriorar el riñón. Los niveles actuales de tu gatito, están elevados pero no están muy mal(george por ejemplo estaba en 400), con una dieta baja en carbohidratos, esos niveles probablemente bjarian. Algo que tendrás que tener en cuenta si cambias la dieta y sigues con insulina, el cambio tendrás que hacerlo poco a poco para evitar hipoglucemia.
Ya te digo que George lleva con problemas de riñones 7 años, y come comida alta en proteínas, de buena calidad, y sus valores renales se han mantenido más o menos estables, algo que sorprendió a mi veterinario, tengo otro gato con problema de riñon y el tiene la misma dieta que mi diabetico, también con buenos resultados.
The problem is not the insulin but the raided blood glucose raided glucose levels are very hard on the kidneys. Continuing with a high carb diet will make controlling his diabetes very difficult. Maintaining a high carb diet is ajin to giving a diabetic Child sheets and sugar drink. His current levels although high are not bad, George was in the 400 at diagnosis, a change to a low carb diet May see those levels reduce, something to keep in mind if you make the change while still on insulin it will need to be done slowly to avoid hypoglycaemia.
As I've already said George has been on a low carb good quality protein diet for 7 years,and this has maintained him stable.



Tu complicación añadida es el IBD, tienes que averiguar de qye forma puedes alimentar a tu gato para minimizar sus problemas gastrointestinales. Pero no es el primer gato que tiene los tres problemas. No es incompatible tratar y estabilizar las tres cosas. La dieta baja en proteínas no es necesariamente la única forma, ni quizás la mejor forma de controlar la insuficiencia renal. El enlace que te dio Sienne de Tanya's ckd es muy bueno, hay mucha información sobre la insuficiencia renal, y wsta más aludía que muchos vetes.
You have the added complications of ibd, you need to figure out which food you can give to avoid his gastrointestinal problems. He isnt the first cat on the forum to have all three problems, stabilising all three things is not impossible.
a low protein diet is not the only way to manage ckd, nor is it necessarily the best way. @Sienne and Gabby (GA) link for Tanya's ckd is excellent, lots of up to date info, more up to date than many vets in my experience.

Otro enlace interesante es el de https://catinfo.org/feline-diabetes/
Y en este parte también https://catinfo.org/#Prescription/Therapeutic_Diets donde está Veterinaria, Lisa, especialista en nutrición felina, también habla de Hills y las dietas terapéuticas merece la pena leerlo antes de que hables de nuevo con tu vete.
Esto dice de la dieta renal de hills
'The purpose of this ‘prescription’ diet is to restrict protein which, unfortunately, it certainly does. However, please understand that there are no studies showing that restricting protein to this level will prevent further deterioration of kidney function. '

Dice más cosas, leelo que vas a flipar, y sobre todo, vas a aprender como evaluar una comida para tu peque.
I also recommend looking at Dr Lisa's pages on diabetes and prescription diets, you will be amazed, it's worth a read, and it will help you understand how tu assess comercial food.

Que proteínas le sienten bien a tu gato? A ver si te puedo orientar algo
Que edad tiene?
What proteins suit your cat? Maybe I can point you in the right direction.
How old is your little one?
 
Glucose in the urine simply means that the cat's diabetes is not yet regulated and as a result, glucose is in the urine. There is a point, referred to as "renal threshold," where you will see glucose in the urine. This point varies for each cat. In general numbers, the blood glucose reading would be over 220. From the Merck Veterinary Manual: "In normal cats, the renal tubules will reabsorb the filtered glucose. However, if the blood glucose rises above the renal threshold of approximately 200 to 280 mg/dL in cats, these tubular reabsorption mechanisms are overwhelmed and glucose appears in the urine." For a newly diagnosed diabetic cat, the range stated for renal threshold is not terribly high. However, there is a difference in the way glucose in the urine may be tested. If the vet is testing based on urinalysis, the reading is likely to be relatively reliable. If you are using urine test strips at home, it's not. The test strips to not give an accurate assessment of low or high levels. In addition, it is not an "at the moment" test. In order to get a reading of anything that's based on urine, it takes hours of metabolic processing. Your cat has to eat or drink, the intake has to be metabolized, filtered by the kidneys, and then collected in the bladder and excreted. Blood glucose readings are more accurate and will tell you immediately if numbers are high or low.

When you are testing at pre-shot times, you want the test to not be influenced by the effect of food. If you feed your cat before you test, you don't know if the pre-shot test value is too low to safely give insulin. This is especially the case with Vetsulin which is harsh and can drop numbers quickly. With Vetsulin, you want to test, feed your cat, wait 20 - 30 min, give the insulin dose. You want to test a minimum of 4 times each day -- your two pre-shot tests and at least one test during the AM and PM cycles. This is a link to information on Vetsulin.
 
Thank you @Gill & George !! Nothing like speaking in the native tongue!

I agree with everything you said. And I want to reiterate that you do not want to give insulin x3 times a day. The numbers you’re seeing are because of the type of insulin that hits fast and wears off fast. It’s not safe to give that much insulin. Insulin is a hormone and too much of it can cause a hypo and your cat can end up in the ER.

also, for an unregulated cat, your cat’s numbers are not that bad at all. Take a look at Bobo’s spreadsheet and you’ll see he was in the 400-500’s at first. You’re already seeing 200-100 which means your cat will likely not need a big dose of insulin. I think that with a better insulin and diet change, he’s got a good shot at remission. You want to stay away from prescription foods as they’re not really great quality and all are almost all high carb.
 
Thanks to all for your replies.
I read this morning about food available for IBD and diabetes and usually talks about high protein food to help to maintain muscles and control IBD (recommendation is about turkey and chicken proteins) but reading about food for renal issues consider is better a diet with less protein. I fact, compare nutritional facts from Hills (as example) renal food have less protein that diabetic food, but IBD food does not have too much protein. I have a little mess at this moment. I consider to go to a pet shop and take pictures of nutritional facts of hypoallergenic, diabetic and renal foods and make a mental idea about what is the formula better for case and make a mix. Also found this page https://www.ibdkitties.net/diabetes/ talking about IBD and diabetes, suggest an increase intake of protein with low Carbo and high amount of Fibre. I'm fact, a diabetic food is consider OK to help on cats with both issues. But there is no mention of effects on kidneys of more proteins on diet.
Also read about differents insulin types and caninsulin is not the best option as yours told me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053045/. But on this paper do a mention about effects of corticosteroids on insulin. I have to discuss about this with my vet, I have no idea if caninsulin is better in combination with corticosteroids or simply is a lack of knowledge of insulin types of my vet.
I have a lot to read and research, I want to consider most of variables that Moar have prior do another movement.

The good thing here (I guess) is that all issues (except IBD) where diagnosed prior get any signs of illnes: we didn't have keto acidosis, weight loss, vomits... So there is no great damage in his body.

Anybody is able to recommend to me a food for IBD and renal? I can check carbohydrates on that food and maybe it fits.

Thanks to all.

Regards.

Add information, I have no idea what proteins are good for him. Tomorrow is her birhdate, 13 years old.
 
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Do read Tanya's site below is some of the information that con incidents me not to go down the low protein Therapeutic_Diets from hillsroute for George, because they are basically to high in carbohydrat. http://felinecrf.org/diabetes.htm
This section talks about diabetes and ckd in cats

This section starts:
'Overview

It is not uncommon for a CKD cat to also have or develop diabetes.

The dietary needs of a diabetic cat may seem incompatible with the needs of a CKD cat but the diabetes must take precedence'

Also it notes

Diet for Cats with Diabetes and CKD

If you are dealing with both diabetes and CKD, it is more important that the diabetes should be regulated, and in fact once this is achieved, you may find the CKD improves too.

With diabetes, the focus is on carbohydrate control (see above). This is not a problem for CKD cats but people dealing with both diabetes and CKD are sometimes anxious because it appears that the protein requirements of the two conditions are incompatible. In fact reduced protein is not necessarily essential in the treatment of CKD in the early stages, see Nutritional Requirements for more information.


There are a couple of renal diets that are not as high in carbs as hills I'll check them and run the calculations for you ( I use zooplus, they have a better selection of good food)

The brand that George, my 24 YEAR OLD CKD diabetic cat has been eating FOR 7 YEARS Are FERINGA, WILDFREEDOM, THRIVE, GRANATAPET, THEY HAVE HUMAN GRADE PROTEUN HIGH IN MUSCLE MEAT, AND ARE BELOW 1% IN PHOSPHORUS.
Even though his phosphorus is OK at the moment it's important to regulate phosphorus intake even in the early stages.

The ckd site tells you more about phosphorus and why you should aim to keep phosphorus below 1%

Do you have his blood test results? Could you share them? I am wondering g what stage ckd he is.


 
Gill & George said:
Do read Tanya's site below is some of the information that con incidents me not to go down the low protein Therapeutic_Diets from hillsroute for George, because they are basically to high in carbohydrat. http://felinecrf.org/diabetes.htm
This section talks about diabetes and ckd in cats

This section starts:
'Overview

It is not uncommon for a CKD cat to also have or develop diabetes.

The dietary needs of a diabetic cat may seem incompatible with the needs of a CKD cat but the diabetes must take precedence'

Also it notes

Diet for Cats with Diabetes and CKD

If you are dealing with both diabetes and CKD, it is more important that the diabetes should be regulated, and in fact once this is achieved, you may find the CKD improves too.

With diabetes, the focus is on carbohydrate control (see above). This is not a problem for CKD cats but people dealing with both diabetes and CKD are sometimes anxious because it appears that the protein requirements of the two conditions are incompatible. In fact reduced protein is not necessarily essential in the treatment of CKD in the early stages, see Nutritional Requirements for more information.


There are a couple of renal diets that are not as high in carbs as hills I'll check them and run the calculations for you ( I use zooplus, they have a better selection of good food)

The brand that George, my 24 YEAR OLD CKD diabetic cat has been eating FOR 7 YEARS Are FERINGA, WILDFREEDOM, THRIVE, GRANATAPET, THEY HAVE HUMAN GRADE PROTEUN HIGH IN MUSCLE MEAT, AND ARE BELOW 1% IN PHOSPHORUS.
Even though his phosphorus is OK at the moment it's important to regulate phosphorus intake even in the early stages.

The ckd site tells you more about phosphorus and why you should aim to keep phosphorus below 1%

Do you have his blood test results? Could you share them? I am wondering g what stage ckd he is.

Click to expand...
But I have to consider IBD too. And it is possible that diabetes is caused by corticosteroids used for manage IBD. I also read about another treatments for IBD that doesn't inhibe insulin. Kidneys at this point looks fine, at least on last blood analysis.

Regards.
 
The hills kd is 40% carbohydrate (dm) the zd is 39%

Both these foods are inappropriate for a diabetic cat regardless of whether the diabetes is steroid induced.

Of course you need to consider the ibd.
One question, what is in the zd hulls diet that is helping the ibd?

I've looked at the ingredients. The zd basically has no wheat...which could well be an allergen your guy is sensitive too. But it lists maize starch as a second ingredient, this means in terms of percentages its the second most important ingredients, this food has a lot of added maize to bulk it up, because its cheap. It is a single protein, chicken.

You might want to look at this food.

https://www.zooplus.es/shop/tienda_gatos/comida_humeda/feringa/1357711?origin=hopps&q=feringa sing&i=2&ro=2
Pollo con calabaza y catnip:
75 % pollo (a base de: carne de pollo, corazón de pollo, hígado de pollo, mollejas de pollo, cuellos de pollo), 21,9 % caldo de pollo, 2 % calabaza, 0,7 % sustancias minerales, 0,2 % catnip, 0,1 % inulina, 0,1 % espirulina.
As you can see, no grains I this, no maize no wheat, single meat protein and pumpkin added which can help both with diarrhoea and constipation. The phosphorus level I this is below 1% (0.8 %) and carb percentage is 3.8% if he's OK with chicken those may be a better choice for him. Just an example. Feringa do a single lprotein lamb as well, that's low in carb and phosphorus

Another possible option would be thrive complete chicken, songle ptotein, 0.95% phosphorus and 1.9% carbohydrate (remember the values I give you are on a dry matter basis, you have to convert the values to dry matter so you can compare, and for diabetes you are aiming for below 10% carbs and below 1% phosphorus for the kidneys.
https://www.zooplus.es/shop/tienda_...e8YSADMmMfbfToE9W7unevjTP29cgGTBoCihAQAvD_BwE

Animonda does a kidney food that is 0.67% phosphorus, and 7% carbohydrate.
The chicken flavour has pork. But I I agile that's OK as you have it I the kd, there are also some other flavours that you might try depending on what proteins he is sensitive to.


Here's a link of foods you can use it says UK but they are available to us here in spain. I order online from zooplus.es and zoop,us.de

https://docs.google.com/spreadsheets/u/1/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

(There are other online suppliers)

I hope I haven't overwhelmed you, just want to give you the benefit of all the experience that this forum has accumulated over many, many years, I benefitted from it in 2016 and I'm more than happy to pass it on and to Continue learning about cats and how best to manage their chronic condition, and how best to keep them healthy.

Aniimo Miguel, me acuerdo como me sentí cuando me dijieron que George tenía diabetes, y que su prognostico no era bueno, el mundo se me vino encima, eso fue en el 2016, y con la ayuda de este grupo, superamos, diabetes, ckd, una gingevitis bestial que fue casi mortal para George y no olvidando una a reacción a corticoides que fue ka causa de una subida de glucosa niveles superiores a 400(llevaba en remisión un tiempo, sin superar 100 , sin insulina y controlado con dieta) Con el apoyo de todos lo superamos y creo que mi vete incluso llegado a aprender algunas cosas nuevas.
Hay luz al final del túnel, verás co o consigues equilibrando todo. :)
 
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Another things to discus with your vet is trying a different steroid, prednisolone (moderin), usually, has more systemic side effects when used long term, including diabetes, but also it affect kidney function adversely. Given your guys kidneys and blood sugar values perhaps worth considering a different corticosteroid.
See this page where it discussed the use of budesonide in ibd and diabetic cats, being preferible for diabetic or pre diabetic cats
https://www.ibdkitties.net/diabetes/

An extract from VCA hospitals

'Methylprednisolone (moderin) should be used cautiously in dogs as it can cause gastrointestinal complications and bleeding and should be used with caution in pets, especially cats, predisposed to diabetes mellitus, and in pets with kidney disease, heart disease, general bacterial or fungal infections, high blood pressure, or in'

I would definitely discuss other treatment options for ibd with your vet.
 
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Hola de nuevo te he buscado algo de información en español por si quieres usar documentacion cuando veas de nuevo la vete, mi Veterinaria no miraba nada en ingles, aunque lo habla creo que era un mareo de cabeza para ella

La ficha técnica de moderin en español
https://www.farmaciaveterinaria.com...matorios/371-moderin-4-mg-30-comprimidos.html

Contraindicaciones

• Animales con tuberculosis, úlcera péptica y síndrome de Cushing.

• Ha de controlarse el uso de corticoesteroides en animales con diabetes mellitus, osteoporosis, predisposición a la tromboflebitis, hipertensión, insuficiencia cardiaca congestiva o insuficiencia renal.

Creo que merece la pena considerar otro medicamento/ corticoide para la ibd, o incluso buscar controlar el ibd con dieta, si averiguas que proteínas son ñas que le provocan reacción.

Yo me pregunto, fue la dieta o fue el uso de moderin/methylprednisolone que provocó que los riñones dieran un bajón?

Te preocupas que la proteína, le esté dañando los riñones, desde mi punto de vista, creo que es más probable que sea moderin. Porque en realidad ni kd ni zd tiene 'alto contenido en proteina' lo que sí tienen alto es carbohidratos.

A mi me pasó con Gworge, me lpusieron n a dieta con Hills metabolic, tb con un contenido de carbohidratos bestial (en ese momento yo era inconsciente de que eso era un problema) mi gato de 9 kg (peso idóneo, 7.5 kg) le daba 60 miserables gramos de pienso, (2 cucharas y media soperas) durante 3 años perdió 75g, no perdía más, la respuesta de hills cuando lo consultamos, que le diéramos menos, mi gato estaba ansioso siempre con hambre, si me descuidaba se subia a la mesa y se comia mi tostada! la comida metabolic le dejaba siempre con hambre. No fue hasta que empezó a orinar mucho que me di cuenta que algo le pasaba, yo pensé riñones, pero ese fue el momento en el que le diagnosticaron con diabetes, tenía 18 años.

Su peso se equilibro y volvio a un peso normal una vez lo cambie a una dieta adecuada para un felino, es decir alta en proteínas, bajo en carbohidratos (menos de 10% materia seca) y además el gato estaba satisfecho, sin hambre, contento.

Al dia de hoy sigo convencida que el uso de hills metabolic fue un factor muy importante en la evolución de diabetes en mi gato. Si su sobre peso lo hubiese tratado cambiando de un pienso normal de hills (también u pienso alto en carbohidratos) a una comida humeda nutricionalmente apropiada para un felino hubiera sido mejor. De hecho como ya he dicho, sigue con esa dieta con sus 24 años, la diabetes y insuficiencia 'controlada' es muy mayor y por supuesto sus riñones se deterioran pero a un paso lento, la vejez nos llega a todos. Pero ya te digo sigue siendo el alfa de la casa, aunque corra como un viejo, los otros 3 de la casa lo respetan, y los 8 que tengo en la finca también :):kiss:
 
Gill & George said:
Do read Tanya's site below is some of the information that con incidents me not to go down the low protein Therapeutic_Diets from hillsroute for George, because they are basically to high in carbohydrat. http://felinecrf.org/diabetes.htm
This section talks about diabetes and ckd in cats

This section starts:
'Overview

It is not uncommon for a CKD cat to also have or develop diabetes.

The dietary needs of a diabetic cat may seem incompatible with the needs of a CKD cat but the diabetes must take precedence'

Also it notes

Diet for Cats with Diabetes and CKD

If you are dealing with both diabetes and CKD, it is more important that the diabetes should be regulated, and in fact once this is achieved, you may find the CKD improves too.

With diabetes, the focus is on carbohydrate control (see above). This is not a problem for CKD cats but people dealing with both diabetes and CKD are sometimes anxious because it appears that the protein requirements of the two conditions are incompatible. In fact reduced protein is not necessarily essential in the treatment of CKD in the early stages, see Nutritional Requirements for more information.


There are a couple of renal diets that are not as high in carbs as hills I'll check them and run the calculations for you ( I use zooplus, they have a better selection of good food)

The brand that George, my 24 YEAR OLD CKD diabetic cat has been eating FOR 7 YEARS Are FERINGA, WILDFREEDOM, THRIVE, GRANATAPET, THEY HAVE HUMAN GRADE PROTEUN HIGH IN MUSCLE MEAT, AND ARE BELOW 1% IN PHOSPHORUS.
Even though his phosphorus is OK at the moment it's important to regulate phosphorus intake even in the early stages.

The ckd site tells you more about phosphorus and why you should aim to keep phosphorus below 1%

Do you have his blood test results? Could you share them? I am wondering g what stage ckd he is.

Click to expand...
Hi,

I have no idea about what contains Hills Z/D but I guess is about hydrolyzed proteins. I checked proteins levels on ZD and KD and surprisingly higher levels are on KD, even renal diets must have less amount of proteins. I'm totally lost XD, I take note of your food suggestion to ask to my vet.

This morning get a WhatsApp of my vet (I sent last glucose curve). She thinks is not very bad but there is margen to improvement. I tell her about this forum and said that have questions about insulin brand, food and treatment for IBD, we will talk when she return from holidays. On a while, I'll continue my research in order to help with examples. I found this article about corticosteroids with diabetes and best option here was 4 (yes, four) shoots per day: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073813/.
I think we have a lot of work here. On another research suggest that depending of the zone of inyection, effects are slower or faster (another thing to try).

I'll do some kind of diary about changes and how Moar reacts.

Thanks again for your valuable help.

Regards.
 
Have you been testing blood glucose Saturday sunday and today.
Could you put all the reading you have in the spreadsheet please.

That articles is looking at a cat with no duration with lantus, (glargarine), it is pretty unusual to have to short more than twice a day with a long acting insulin like lantus, here we also use levemir which has a longer duration than lantus. And in certain circumstances we have also had cats dosing with a long lasting insulin and a shorter acting insulin to achieve better regulation.

The steroids don't necessarily mean that you wont get duration with any insulin. The problem with duration you are seeing is normal for caninsulin, it just does not last long in cats, it's absolutely normal to see that sort of pattern in cats, this is why it is not the best choice for most cats.
I would be focusing on changing insulin type, and getting your guy on a Low carbohydrate diet. I suspect your vet will be resistant to changing diet from Hills, I hope I am wrong.

It is probably worth trying a longer acting insulin like Lantus, swapping onto a LC wet diet and following a tight regulation protocol which is the fastest and safest way of achieving glucemia control. It is important not to rush dose changes, to follow a systematic and proven aproach, giving your cats body time to adjust to the levels of insulin
Insulin is a hormone and interacts with other hormones in your cats body the effects can vary from day to day, this is why the protocols we follow with the long acting insulins allow periods of stabilisation before changing dose, while still allowing us to change and adapt doses to our cats needs so we can achieve glycaemic control relatively quickly but also safely.

A lot of people here, over the years have started with caninsulina (vetsulin in US) and the majority found that it was a waste of time. We don't see it as much now, because advice to vets in US has changed. In Europe the drug companies forced legislation that meant vets had to first prescribe caninsulina, this is why it is often the first insulin prescribed here in spain, they force its use over a given period of time, before vet can change insulin (or at least that was the legislation in force back in 2015 when I first came to the site)

Unfortunately because its not a great insulin for cats, this meant cats spent many months with poor glycaemic control before moving to longer acting insulin better suited to a cats metabolism. Unfortunately wasting months in achieving glycaemic control did reduce the chances of remission for many cats. I was lucky that my vet agreed to give me a prescription for lantus instead of caninsulina.

Before shooting multiple times with caninsuli I would change to a longer acting insulin and a low carbohydrate diet. He is not going to achieve remission with a diet that is high in carbohydrate, and it will also make regulation difficult, yes you could eventually shoot multiple times a day if necessary, but if I were in your place I would take all the steps possible to avoid that, treating a cat with diabetes is exhausting when you shoot twice a day, if you were shooting 3 or four-time a day it will be an enormous pressure on you.
Making the food and insulin changes would probably be a better option for your cat and a much easier option for you to live with day to day.

Drashiel said:
I think we have a lot of work here. On another research suggest that depending of the zone of inyection, effects are slower or faster (another thing to try).
Click to expand...
Yes that is also true, friends on the forum here have found that to be true for their cats.

The glucose levels are not bad. TIght glycemic control would be between 50 to 80 (human meter)( or below 100), so yes there is some room for improvement. :)

It is a steep learning curve! Keep reading!
 
Look at this ss a cat started on caninsulin December 2022, swapped to lantus, 21 February 2023 to lantus.
https://docs.google.com/spreadsheet...PL5s0IFUjIeKWKgTjrSXkI60bsg/edit?usp=drivesdk
You can see short duration very sharp drops with blood glucose and 2 1/2 months of wild swings in blood glucose with no signs of cat becoming regulated. Swaps to lantus and approximately 3 weeks later you can see the effect of a long acting deposit insulin, duration improves and cat glucose levels stop swinging wildly.
 
Hi, I didn't do more test. I have to add previous test when there is no treatment with insulin. My vet ask for another glucose curve in a week and half because as you said, there some time to adjust prior make any changes. I'll do 13th. Meanwhile, today I want to test shooting on different places. I'll do a test prior shoot and another about 4 hours, to see if really is a difference. I'll update spreadsheet with those values.
About insulin brand, is the first thing I want to discuss with my vet, even I bought the Vetpen an a box of insulin. But until second week of September I think it could be challenging. I have to travel to Germany on first week of September for a few days and it is possible that my parents have to shoot the insulin. They are afraid about the idea of shoot the insulin and I guess Vetpen is the easiest way to do.
Don't worry about this, I have perfectly clear that have to ask: insulin brand, low Carbo food and move to another treatment different of corticosteroids for IBD. I think this is the way to go. Maybe I can start on August with low Carbo diet and when I return from Germany start with another insulin, or maybe is better wait until I returned to implement all changes because looks like I'm the only who will be able to do a glucose test.

I'll update as soon as have new information.

Thanks,

Regards.
 
Gill & George said:
Hola de nuevo te he buscado algo de información en español por si quieres usar documentacion cuando veas de nuevo la vete, mi Veterinaria no miraba nada en ingles, aunque lo habla creo que era un mareo de cabeza para ella

La ficha técnica de moderin en español
https://www.farmaciaveterinaria.com...matorios/371-moderin-4-mg-30-comprimidos.html

Contraindicaciones

• Animales con tuberculosis, úlcera péptica y síndrome de Cushing.

• Ha de controlarse el uso de corticoesteroides en animales con diabetes mellitus, osteoporosis, predisposición a la tromboflebitis, hipertensión, insuficiencia cardiaca congestiva o insuficiencia renal.

Creo que merece la pena considerar otro medicamento/ corticoide para la ibd, o incluso buscar controlar el ibd con dieta, si averiguas que proteínas son ñas que le provocan reacción.

Yo me pregunto, fue la dieta o fue el uso de moderin/methylprednisolone que provocó que los riñones dieran un bajón?

Te preocupas que la proteína, le esté dañando los riñones, desde mi punto de vista, creo que es más probable que sea moderin. Porque en realidad ni kd ni zd tiene 'alto contenido en proteina' lo que sí tienen alto es carbohidratos.

A mi me pasó con Gworge, me lpusieron n a dieta con Hills metabolic, tb con un contenido de carbohidratos bestial (en ese momento yo era inconsciente de que eso era un problema) mi gato de 9 kg (peso idóneo, 7.5 kg) le daba 60 miserables gramos de pienso, (2 cucharas y media soperas) durante 3 años perdió 75g, no perdía más, la respuesta de hills cuando lo consultamos, que le diéramos menos, mi gato estaba ansioso siempre con hambre, si me descuidaba se subia a la mesa y se comia mi tostada! la comida metabolic le dejaba siempre con hambre. No fue hasta que empezó a orinar mucho que me di cuenta que algo le pasaba, yo pensé riñones, pero ese fue el momento en el que le diagnosticaron con diabetes, tenía 18 años.

Su peso se equilibro y volvio a un peso normal una vez lo cambie a una dieta adecuada para un felino, es decir alta en proteínas, bajo en carbohidratos (menos de 10% materia seca) y además el gato estaba satisfecho, sin hambre, contento.

Al dia de hoy sigo convencida que el uso de hills metabolic fue un factor muy importante en la evolución de diabetes en mi gato. Si su sobre peso lo hubiese tratado cambiando de un pienso normal de hills (también u pienso alto en carbohidratos) a una comida humeda nutricionalmente apropiada para un felino hubiera sido mejor. De hecho como ya he dicho, sigue con esa dieta con sus 24 años, la diabetes y insuficiencia 'controlada' es muy mayor y por supuesto sus riñones se deterioran pero a un paso lento, la vejez nos llega a todos. Pero ya te digo sigue siendo el alfa de la casa, aunque corra como un viejo, los otros 3 de la casa lo respetan, y los 8 que tengo en la finca también :):kiss:
Click to expand...
Perdona, no había visto este post...

Según mi vete, ha sido la comida. En realidad ya tiene una predisposición a ello por tener un riñón más pequeño que el otro, y de hecho en la primera eco ya me lo avisó.
Si no recuerdo mal, cuando empezaron a subir los niveles de potasio, lo achacó a que la comida de IBD tiene un alto contenido de proteínas. Desde entonces toma una mezcla y varios condroprotectores. Los niveles de potasio y una eco que le hicimos hace unos meses, indican que todo está igual que hace 3 años (es decir, la función renal es normal).

El moderin aunque toma poca dosis, creemos que es el causante de la pancreatitis, de hecho ahora le estoy dando 6mg por semana (un día a la semana me lo salto). Ya me lo he apuntado y tengo un paper en inglés con otras opciones a la prednisolona. Lo que me da un poco de miedo es cambiarlo todo y empezar a ver que algo empeora. Con el ibd y el renal los cambios los notaba, pero con la pancreatitis, si deja de comer ya no voy a saber si es cosa del ibd o del páncreas.

About food... I have those notes about requirements new food must have. Please add anything that you consider I have missed:
For IBD, hypoallergenic food. Maybe a high fiber contents help with IBD. It must be easy digestible. Novel protein is a option to consider.
For kidneys: low phosphorus, with omega 3. I see that must not be very high protein but other sites claims that this is not true.
For diabetes : low carbohydrates (less than 10%).
The best I found until now that may fits for all is Hill's Prescription Diet d/d Venison for skin/food sensitivities, but have 21%of carbohydrates (much better than 40% of actual mix, but far from less than 10%). I have to ask if Gill recommendations are compatible with IBD and renal because Carbo levels are great but I am not sure if fits on IBD (read about cats allergic to chicken protein)
About the food, you feed with wet food because is lower on carbs or there is another reason? My vet thinks that is better a mix.
Yesterday I did a test about where to shoot. Tonight I'll try on other places what are insulin slower absorption.

Keep on reading,

Thanks you very much.

Regards.
 
Miguel, I just noticed you're using the Cera-Pet meter. Please be extremely careful, as it is very unreliable.

Since the "upload file" button doesn't work here and I'm currently on my phone, I can't upload the photo proof of the comparison between my old Cera-Pet and other meter, so here's the link to my Amazon review from April, which has all the details to support my claim. If you go on "reviews with images" you'll see the comparison between the Cera-Pet and a purple meter (AlphaTRAK 2).
I'm not saying your meter behaves the same way mine did, I'm saying if you can, try and do comparison readings with another meter, just to validate its reliability.
 
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.:. in.active .:. said:
Miguel, I just noticed you're using the Cera-Pet meter. Please be extremely careful, as it is very unreliable.

Since the "upload file" button doesn't work here and I'm currently on my phone, I can't upload the photo proof of the comparison between my old Cera-Pet and other meter, so here's the link to my Amazon review from April, which has all the details to support my claim. If you go on "reviews with images" you'll see the comparison between the Cera-Pet and a purple meter (AlphaTRAK 2).
I'm not saying your meter behaves the same way mine did, I'm saying if you can, try and do comparison readings with another meter, just to validate its reliability.
Click to expand...
Hi,
Thanks for your input. I had the same issues at the beginning of use because the first use I got LO, 36, and the next 90 (much lower than expected). I´m very interested in this, because I have the same doubts as you, especially at the beginning. I did some research on the internet and a comparison said this is not too bad: https://www.kjvr.org/journal/view.php?number=3813. I felt uncomfortable with this glucose meter, and since this was driving me crazy, asked my vet (she uses the same, the reason for purchasing this one and no other). She told me that I have to ensure that the sensor strip must be fully filled with blood, and when the countdown starts I have to remove the strip from the ear blood drop or sometimes will get higher reads. I remember a case where on the first test got 303 and did another and got about 250, at this point my cat was under investigation because we suspect diabetes but fructosamine was OK and the first value shocks me. INMO is very sensible about how many and when blood is applied to the strip.
In your photo (I am not able to do bigger) looks like there is not enough blood to meter and the glucose meter said Lo because it is not able to read the glucose blood. Did you perform more tests? There is a big difference with a human meter? Sometimes I consider purchasing another for comparison but this maybe it is nonsense and feel like I'm a little paranoia. When I have doubts about a measure, I do another test as double-check method, and if have too much difference go to a third test.
Regards.
 
I have only compared it to another pet meter, never to a human meter. But yes, I did collect enough data to question its credibility.

I'm surprised your vet is promoting its use, regardless of being aware of how fiddly it is. Personally I would be very unwilling to continue using it. The amount of blood, where and when to place/remove the meter etc should not jeopardise or affect readings, especially not on a pet meter, which's aim should be quickness, convenience and reliability. A meter should never give a false LO reading due to insufficient blood sample.

The meter you see on the photo is an AlphaTRAK 2, which is a pet calibrated meter, but is incredibly expensive. I am now using its "human" equivalent, which is the FreeStyle Freedom Lite (they're exactly the same, only the colour differs, and that the AT2 is calibrated to pet blood, thus to read higher than 28 mmol/L). I have tried several other human meters, but this make was the only one that I found reliable and the most consistent reading wise*, that only requires a tiny amount of 0.3ul blood.

*sometimes my cat blesses me with a huge drop of blood, from which I do as many tests as I possibly can - the readings have always been consistent both on my AT2 and on my FSF Lite (separately, not as a comparison between the two - have not tried that), but never on any other meters, regardless of human or pet. But this is just my experience. Sure there are other good meters out there too, I may have just not come across them.
 
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.:. in.active .:. said:
I have only compared it to another pet meter, never to a human meter. But yes, I did collect enough data to question its credibility.

I'm surprised your vet is promoting its use, regardless of being aware of how fiddly it is. Personally I would be very unwilling to continue using it. The amount of blood, where and when to place/remove the meter etc should not jeopardise or affect readings, especially not on a pet meter, which's aim should be quickness, convenience and reliability. A meter should never give a false LO reading due to insufficient blood sample.

The meter you see on the photo is an AlphaTRAK 2, which is a pet calibrated meter, but is incredibly expensive. I am now using its "human" equivalent, which is the FreeStyle Freedom Lite (they're exactly the same, only the colour differs, and that the AT2 is calibrated to pet blood, thus to read higher than 28 mmol/L). I have tried several other human meters, but this make was the only one that I found reliable and the most consistent reading wise*, that only requires a tiny amount of 0.3ul blood.

*sometimes my cat blesses me with a huge drop of blood, from which I do as many tests as I possibly can - the readings have always been consistent both on my AT2 and on my FSF Lite (separately, not as a comparison between the two - have not tried that), but never on any other meters, regardless of human or pet. But this is just my experience. Sure there are other good meters out there too, I may have just not come across them.
Click to expand...
Hi,
I'll do a test on next visit to vet. Since usually do a blood analysis, I'll do a glucose test and compare with results of blood analysis. I have my doubts about this meter too specially because lancet device is a crap. I look for Alpha trak and there is no seller in Spain, so it is really hard to find a way to get strips and glucometer itself. And my vet discouraged me to use human glucose meter due difference on how glucose is stored on blood. Another thing to ask to vet xD.

There are more members using Cerapet or I'm the only one?

Thanks,
Regards.
 
I know, vets can be a bit funny, some -like my previous one- outright discourages you to even blood test at home...

I'm not sure about any other Cera-Pet users, you may want to open a new thread and ask. I doubt it though, because it's let alone a predominantly US based forum, most members also use human meters here.

My vet uses G-Pet+ (for peripheral blood though, not capillary) but it's even more expensive regarding test strips than the AlphaTRAK.

Edit: Blood analysis measures glucose in peripheral blood, so you'll likely get different results testing that blood sample with the handheld meter. I tested venous blood with my AlphaTRAK and I found that there was a big difference between my numbers and the vet's. When I tested his capillaries with the AlphaTRAK, those numbers aligned with the vet's peripheral blood drawn from his arm.
I do believe handheld meters are calibrated to capillary blood taken from ears or paws, because let's face it, who wants to draw blood of a cat's vein... but I have only done a brief research on vaneous vs capillary blood glucose back in the day, so you may want to look into this properly.
 
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.:. in.active .:. said:
I know, vets can be a bit funny, some -like my previous one- outright discourages you to even blood test at home...

I'm not sure about any other Cera-Pet users, you may want to open a new thread and ask. I doubt it though, because it's let alone a predominantly US based forum, most members also use human meters here.

My vet uses G-Pet+ (for peripheral blood though, not capillary) but it's even more expensive regarding test strips than the AlphaTRAK.
Click to expand...
Is not my case. She prefer I do test at home since he stressed a lot on vet and glucose increases exponentially. And she did me a prescription to purchase insulin on pharmacy because is cheaper than purchase on vet.
I'll open a new thread about cerapet on forum.
Regards.
 
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