09/02 Singha off Caninsulin, BG went up

Good morning. Some of you know me from my posts about Milo. He and his litter mate, Singha, have been diagnosed with diabetes (at different times). Singha was first, last August. He was on 1 unit of Caninsulin 2x daily for a year. I didn’t know about this group and just kept up this routine as I was told by the vet (no BG testing at all).
In July his brother Milo was diagnosed. I started doing testing on both cats and Singa was always under 5.5 and his vet told me to stop the insulin. I didn’t know at that time to reduce him slowly. He remained for the past month always in the 5 range when I would do spot checks.
Now that I found this group, I’m doing things very differently with Milo and I realize that Singha should never have been taken off his 1u dose completely but should have been reduced gradually.
Singha has been throwing up the last little while and yesterday refused food (not like him at all). I checked his BG and he was 189 before bed and 178 this morning. So... what to do? I still have his Caninsulin and I think it worked for him. I feel like 1u is a lot with him just being in the blues. I don’t even know what protocol to follow since he’s more than I year post diagnosis. Plus I have to return to work very soon. I’m not sure I have time to monitor him enough to know what he’s like to try TR at this point. But I’m also not sure about trying to follow two different protocols and two different insulins etc. Maybe I should go straight to Lantus with him like Milo? But I still have lots of Caninsulin left too but fewer syringes.
I need help!! I think I’d like to shoot tomorrow morning when I can monitor him no matter what I protocol I choose.
Singha ate this morning and seems more like himself. No vomiting. He seemed to vomit the raw of if I fed him too much in the am. can vomiting cause BG to go high or vice versa? I can never get a keytone urine test done with him or I would have already tried.
Thanks in advance for your help.
@Briere Fur Mom @Sue and Luci @tiffmaxee @thebigfuzz @Wendy&Neko @carfurby

 

I'd love to help, but have no knowledge of Caninsulin...other than I think it's a faster acting insulin.

I hope some of the other experienced folks can come over to read and reply to your post.

 

Unfortunately I’m in the same boat as Sue. I hope something who knows will answer. I hope you get him back into remission.

 

There’s a forum for it!
https://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/

 

Thank you!

 

I would be inclined to take him to the vet first, before starting insulin to see if there is something else going on that could cause his BGs to raise. With vomiting and loss of appetite, he could have an infection of some kind making him feel out of sorts? Pancreatitis, for example, can cause all 3, I think.

Hope all goes well

 

Or dental problems.

 

Thanks. I’ll try to get him in. I’m discouraged to think the diabetes is back. How do they diagnose pancreatitis?

 

Blood work, I believe. Like @Red & Rover (GA) mentioned, dental issues and other things can also cause BG to raise. A vet visit with physical exam, maybe some blood/urine may be in order to figure out what's going on?

Hope it all goes well!

 

I agree with Tanya, a vet visit first. Try doing the odd spot test in between now and then. When cats are unwell, an vomiting, their numbers can go up. If he settles down again, test again to see if he comes down. I have some experience, but limited with Caninsulin, and never went down dose on it. There is a dosing method on the Caninsulin forum.

Pancreatitis is tested with a blood test. If it's been over 6 months, maybe a geri or senior panel with a Spec fPL as well. A Primer On Pancreatitis

 

Thank you for this. He has not vomited today since this am when he regurgitated a little bit of his food. He wanted to eat again after a couple of hours and he held this down just fine. He's up wandering around, snuggling, interested in eating more, BG is coming down. His SS is now up-to-date. Yesterday he wasn't acting like himself and his BG was higher than it has been since coming off the Caninsulin.
It sounds like there's just supportive care for pancreatitis as opposed to a drug to make it go away, if I'm reading that all right. I'll see what the doctor has to say tomorrow. Right now I seem to only hold down a job to pay animal bills! It has to get easier but with two of them, the challenges are immense. It feels overwhelming sometimes...

 

They sure are a beautiful pair!

 

Thank you! They are beautiful with their personalities too!

 

So cuteeee

 

Oooohhhh I want to SMOOOOOOCH them together! They are stunning. Thank you for sharing them with us!

 

You're not alone in that desire, Jeanne. They're gorgeous!


Mogs
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Alas, you are correct for the chronic condition. Should it transpire that Singha does have pancreatitis it might be just a one-off acute flare. The right combination of supportive treatments and a diet that's agreeable to the cat can make a significant difference. Here's a helpful resource:

IDEXX Pancreatitis Treatment Guidelines

Fingers 'n' paws crossed that Singha doesn't have it.


Mogs
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On insulins, I've used both Caninsulin and Lantus.

Should Singha need to go back on insulin for a little while, I'd suggest talking to your vet about giving him Lantus. The reason I suggest this is that Singha's running in a relatively low BG range and I think you may find it very difficult to keep him in safe numbers on Caninsulin - even at a tiny, tiny dose - because of the way that that particular insulin can really drop BG levels from preshot to nadir. Lantus has a much gentler mode of action and, if my experience is anything to go by, it's much more straightforward to give cats with low-ish BG levels the small doses they need while still keeping the cat in safe numbers at nadir. Longer duration too.


Mogs
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I really appreciate your input. I will discuss this with my vet. Honestly, he said that I have done better than he could have. He doesn't have any experience with Lantus but he does seem to value the expertise here. I think my spreadsheet with Milo proves this is the way to go!

In your experience, can the switch to raw diet bring on pancreatitis? He seemed better on his old diet (Hills W/D , recommended by the vet but I know it's not good for him).

 

I have not fed Singha because I thought I read they should fast first for bloodwork for pancreatitis. He's not interested in eating today so this is unusual for him and different from yesterday.

 

Yep. You do need to fast the kitty prior to drawing a blood sample for a pancreatitis test.

I've no experience of feeding a raw diet but any food change can in general trigger GI upsets. A food change from w/d dry to low carb wet foods is what triggered Saoirse's first pancreatitis flare (and it was quite severe).

FYI, when Saoirse was first diagnosed she was put on Caninsulin and Hill's w/d dry food by the vet she was under at the time. Hill's actually do two ranges for diabetics: m/d and w/d (wet and dry in both). The m/d has fewer carbs so I thought it was completely nuts for the vet to prescribe the w/d. A little further along the learning curve I worked out that the Caninsulin / w/d combo may be a popular protocol used by vets because it keeps the cat really carbed up and, to a degree, it enables getting away with less precise dosing by reducing the risk of hypos. Unfortunately it also reduces the chance of a newly diagnosed cat going into remission.


Mogs
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