12/05/2011 Here goes nuthin'

[BJM]

I'll start the ball rolling.

Spitzer has run into problems with appetite and vomiting and when he doesn't eat, reducing the Lantus on the fly doesn't work because of the shed.

Using ProZinc ran into a very steep curve with awful preshots and occasional decent lower values; duration is barely 12 hours, but it may be adjusted more flexibly than Lantus.

Spitzer can have a food spike of 200 points in 1 hour, and I've used 0.25-ish and 0.5 dose of R upon occasion to help bring him down out of the high reds and blacks.

I'm still trying to get him regulated, over a year after his initial diagnosis. He is a rack of bones, but very sweet and still eating, drinking, poohing, and peeing (lots!). He has diagnosed with "diffuse hepatopathy" and enlarged kidneys in August 2011. I've asked the vet about testing him for acromegaly (he's not large, but the kidneys sit under the adrenal glands) and insulin auto-antibodies.

What I'm trying to do is use Lantus as a basal dose - a sort of underlying level, dosed on the 12 hour cycles - and ProZinc as the adjustable on the fly dose on top of it. When necessary (readings 400 and up), I may use tiny dose of R to just knock off a bit of the high; I'm not using it to bring him all the way down.

Edited to add: Yes, I may be playing with fire. I got the message.

Elsewhere

 

[Carolyn and Spot]

Your numbers don't seem to show up on your ss link.

Re: Acromegaly - Location of kidneys is not an indicator of acromegaly. Insulin resistance is an indicator, combined with multiple other things, which are listed on a sticky in the high dose insulin group.

Re: Basal insulin - Recommend you dump the Lantus because of the steep drops and switch to Levemir, which is known for its flatter curves.

Re: Your insulin plan: It is *never* recommended to use two long term insulins concurrently, this is not even done amongst our highest dose acrocats, due to the extreme danger it presents. This is because you will end up with nadir crossing, hypo, impossible to track data, etc. In all, I would not be able to support this dosing plan, even in the Relaxed Lantus Group.

 

[BJM]

Re: Acromegaly - Location of kidneys is not an indicator of acromegaly.

The hormone is released by the adrenal glands; my thought is that maybe it could affect the kidneys faster, because they are nearer and would get the highest concentration going by initially because of the circulation. Maybe not; still worth checking out. He does have a largish frame and his feet seem big to me.

edited to strike out incorrect anatomy & physiology references

 

[MommaOfMuse]

Since I can't see your spreadsheet I keep getting an error message I guess my first question is "how is it working so far?" I, personally don't think I would be comfortable using two long lasting insulin overlaying each other. But I do wonder because Musette is an extreme food spiker as well, and this is something that I have wondered about for awhile. I know my mother is a human diabetic on Levermir, she uses Lev as her basal dose and then at mealtime uses Humalog to take the edge off the food spikes. It makes me wonder if something like that could as be used with cats?

Mel, Maxwell, Musette & The Fur Gang

 

[Robert and Echo]

A brie review that might be helpful in stimulating your vet to look a little further into diagnostics.

Investigating Insulin Resistance in Cats
By Heather Troyer, DVM, Diplomate ABVP (Canine & Feline Practice)
November 17, 2010

Cats with poor glycemic control and clinical signs associated with diabetes mellitus or those with diabetes that require > 6 units of insulin per dose may be characterized as insulin resistant. The most common cause of insulin resistance in cats is antagonism of insulin’s effects at the receptor or postreceptor level by excessive circulating glucocorticoids, progestogens, catecholamines, thyroid hormone, growth hormone, and glucagon. Common concurrent diseases include pancreatitis, hepatic lipidosis, cholangiohepatitis, urinary tract infection, renal failure, hyperthyroidism, inflammatory bowel disease, acromegaly, and heart disease. A previous study evaluated 37 diabetic cats that underwent necropsy; 46% of cats had chronic pancreatitis, while 22% had pancreatic neoplasia. Another report described urinary tract infections in 13% of 141 tested cats; only 40% of cats with urinary tract infections had clinical signs. Obesity is not typically considered a sole cause of severe insulin resistance and can usually be treated by diet and relatively small increases in insulin dose. However, routine blood and urine testing and diagnostic imaging will provide an understanding of the underlying etiology of concurrent disease and therapy for subsequent insulin resistance. Improved diagnostic imaging and blood test modalities currently allow for diagnosis of less common endocrine diseases, such as acromegaly (caused by a growth–hormone-secreting pituitary tumor) and feline pituitary-dependent hyperadrenocorticism. Treatment strategies for a cat with insulin resistance include limiting body weight, feeding a high-protein diet, manipulating insulin type or formulation, and treating underlying disease.

Commentary: Insulin resistance can be a frustrating problem in cats. A thorough diet history, complete physical examination, and general baseline testing are important and assist in client education. It is important to differentiate stress hyperglycemia from global unregulation by additional testing, including glucose curves or serum fructosamine. It is also important to question the owner on compliance issues, including insulin administration (insulin type and site), insulin amounts, and the cat’s eating habits. Home urine and blood glucose monitoring are excellent ways to involve and support the owner in the cat’s regulation. Finally, it is a good standard of practice to perform baseline testing every 6 months to screen for new problems.

Insulin resistance in cats. Scott-Moncrieff JC. Vet Clin N Am Small Anim Pract 40:241-257, 2010.

 

[BJM]

Since I can't see your spreadsheet I keep getting an error message I guess my first question is "how is it working so far?"

The spreadsheet doesn't seem to be automatically publishing, even though I set it to do so; I manually republished it, so see if you can see it now.

I only recently started this and not great. I am keeping the ProZinc and Lantus lined up time wise, as much as possible; My preference is to keep the Lantus the larger maintenance dose and the ProZinc as a smaller, potentially variable dose that I can reduce if he vomits or doesn't eat. Spitzer was consistent in having nadirs on either insulin at around +6.

...But I do wonder because Musette is an extreme food spiker as well, and this is something that I have wondered about for awhile. I know my mother is a human diabetic on Levermir, she uses Lev as her basal dose and then at mealtime uses Humalog to take the edge off the food spikes. It makes me wonder if something like that could as be used with cats? ...

I've been using it, very cautiously, because I couldn't stand seeming him spike so @#$% high and be so miserable - his herpes gets worse and his eyes and nose are all crusty and snotty. The only way to know what will happen is to measure out a teeny, tiny dose and see. Spitzer will drop 100+ points from 0.25-ish insulin; so you might want to wait until she's at least 200 points too high, to give you some room for Each Cat Is Different!
If you have some lactated Ringers or sterile saline, I saw instructions on the children's diabetes board for how to very carefully mix into a syringe to dilute a regular type insulin (R or N) to a lower concentration, and discharge any excess not to be used (because the syringe lubricant would contaminate it over time). Edited to add: Ask your vet for an rx to get it compounded by a pharmacist into a lower concentration so you can be very careful and accurate if you choose to use R.

 

[MommaOfMuse]

Interesting! And definitely food for thought with Musette. She is a weird little bird, she can zoom up from 129 to nearly 400 in an hour in the early part of a cycle and take forever to come back down, but once she starts going down she doesn't always put on the brakes at the end of 12 hours so I end up having to wait her out for her next shot. But if I try reducing her dose she goes high and since she is a DKA survivor I would love to avoid those highs as well as get her on a more predictable shot schedule, so if I could carefully take the edge off that first food spike, then her dose of Lantus should be just about perfect to keep her in good stable numbers.

Mel, Maxwell, Musette & The Fur Gang

 

[Blue]

As you have a link in your signature for a ss, can you please fix it?

https://www.google.com/a/document/Servi ... ue&go=true

That link looks nothing like any ss link.

I am not sure your mixing all sorts of diff insulins and posting this concoction is what I would call 'relaxed' - more like dangerous.

I have two acros and don't get your bit about acromegaly.... makes no sense.

 

[BJM]

I redid the spreadsheet link ... is it visible.

I think Relaxed meant not doing tight regulation.

 

[Carolyn and Spot]

I only recently started this and not great. I am keeping the ProZinc and Lantus lined up time wise, as much as possible; My preference is to keep the Lantus the larger maintenance dose and the ProZinc as a smaller, potentially variable dose that I can reduce if he vomits or doesn't eat. Spitzer was consistent in having nadirs on either insulin at around +6.

Have you given the flatter Levemir some thought? Almost all the acrocats are on Levemir to maintain flat curves. The more shallow the curve, the better regulated the cat, IMO, because the liver is not in hours-long cycles of fighting back and the cat is not constantly in a reaction cycle. If every number you get is a reaction to some other number, then you will soon be inundated with data that is not able to be interpreted. With both Levemir and Lantus, a curve not varying more than 100pts is desired, which is why this new forum is good - people who do not practice TR will be able to learn as well.

Using multiple insulins *is* TR, especially when R is brought into the mix, so this might be a little deep for this particular forum.

Most of the acro owners only use R for resistant cats, once that is no longer necessary, it is no longer used because it distorts data. If the cat can achieve steep drops, insulin resistance is not likely, however, there's no harm in running the tests. I would definitely recommend Levemir, as it is fully capable of powering through high numbers at the proper dose, even though it is known as a gentle insulin. It's gentle because it's flat, which appears to be what you are seeking.

 

[Anne&Muffin (GA)]

Now your link just takes me to a login page... :?

 

[Patti and Merlin]

The hormone is released by the adrenal glands; my thought is that it could affect the kidneys faster, because they are nearer and would get the highest concentration going by initially. Maybe not; still worth checking out. He does have a largish frame and his feet seem big to me.

I'm not sure where you are getting your info BJM - and what hormone you are talking about however - the hormone responsible for causing acro - IGF-1 - is secreted by the pituitary gland - NOT the adrenal's. And regardless of where it is secreted - just because of location - it does not affect any one organ differently because of location. Kidney disease does affect many acrobats eventually but it is like CRF of many older kitties. What is most seen is enlarged hearts! Largish frame and feet - could be a factor for acro but usually late signs - and there are many many many other signs besides that which we see long before those signs.

IMHO - you are playing with fire using 2 long acting insulins and R insulin. I"ve been working with acro's since 2005 - treating Merlin for 3 years. NEVER have I seen any acrocat use anything like that and there have been many different insulins (Lente, Ultra Lente, PZI, BCP PZI, Lantus, Levemir, Prozinc, Vetsulin, Insuvet, Neutral...shall I go on...) during these years AND we work with cats in England and Europe.

Also - I work in a pediatric ICU and take care of diabetic kids as young as 8 months old. We teach families how to care for them at home too and we have never taught them to dilute their insulins so i'm not sure what website you are reading that teaches that info. It's a dangerous practice and one that can cause changes eventually to the insulin itself.

I'm curious why you don't a)go up on a longer lasting insulin and/or b) treat food spikes with R insulin and/or c) spread out your cat's meals more. If you are reading human treatments these are all the approaches taken. And if your cat is super skinny are you feeding him more protein?

 

[Robert and Echo]

As a physician, I concur that using TWO long lasting insulins together is an absolute no-no. Using the R with one of these alone should do the trick plus you will not have as many variables to deal with. Why don't you pick one of the long lasting insulins and then use the R as needed?

What does your vet say about all this?

Adrenal enlargement, of any source, does not typically cause kidney enlargement.

_Rebecca

 

[BJM]

My vet is new, and not very experienced; she wanted me to try the ProZinc when I asked about Levemir.

I'll keep trying.

I understand what everyone is saying about how the insulin is supposed to be used.

Here's the thing: Spitzer has been uncontrolled for a year. Standard stuff isn't working.

If I don't do something different and find something that works, he is going to die from this.

 

[Carolyn and Spot]

My vet is new, and not very experienced; she wanted me to try the ProZinc when I asked about Levemir.

I'll keep trying.

I understand what everyone is saying about how the insulin is supposed to be used.

Here's the thing: Spitzer has been uncontrolled for a year. Standard stuff isn't working.

If I don't do something different and find something that works, he is going to die from this.

I certainly understand your frustration, however, the reason we say this is not a good idea is because it's pretty dangerous. If your vet will search the VIN, she will find at least one knowledgeable vet on there who's posted extensively about Levemir. I'd recommend you start in that direction since you are not happy with how either of these insulins is working. Patience is key when dealing with a worried veterinarian, and with the bean. I'm still noticing your spreadsheet link is broken, I think you've got the CCC link posted instead of the PUB link.. can't remember how to do that though.

 

[BJM]

replaced "ccc" with "pub" in the spreadsheet link.

 

[Carolyn and Spot]

How old is your lantus?

 

[Venita]

I can see your SS now.

I think I would go higher on dosing either Lantus or ProZinc long before I started adding in a 2nd long-lasting insulin as you have done. If ProZinc isn't getting you 12-hour durations, many people dose the PZI insulins up to four times/day.

R can be good at bringing down preshot values to a level that a long-lasting insulin can better handle. In my opinion, because they produce a flatter curve, Lantus and Levemir are better used with R. ProZinc already has a steep element to its curve, although I have used R with a PZI product.

I agree with the suggestion that you ask your vet to research Levemir on VIN. I have never personally done Levemir v. Lantus in the same cat, but I do agree that Lev produces a flat curve (and maybe a flatter curve than Lantus would in the same animal under the same conditions).

Thanks for posting on the "Relaxed" Lantus forum!!

 

[sanrun]

Listen to Patti & Merlin! My kitty Cecil was an acrocat and I never got him regulated. His weight increased and he looked fine once I got him on a higher dose of Lantus. After, he was DX with acro we switched him to Levemir and used some R to combat his food spikes. That was the best we could do for him, his heart was damaged, so he couldn't get the radiostatic treatments by Dr. Lunn at CSU. Please, listen to the people who know about acro and have had kitties with it. There are lots of us around now.

Sandy - Dottie, Jeter & Tilly

 

[BJM]

Current condo in PZI

 

[Venita]

Listen to Patti & Merlin! My kitty Cecil was an acrocat....

The way I read it, Spitzer has not been DX acro or IAA, is that right BJM?

And if I read the spreadsheet correctly, he's not on an overly large dose of insulin.

 

[sanrun]

I looked at Spitzer's SS. Seems crazy to me! Why don't you just use Lantus and work the dose up? You can use some R once you know what his nadir is on Lantus. I used it with Cecil to cover his food spikes. I just think you are messing around, too much with insulins. Pro-Zinc is not supposed to be used with Lantus. No wonder his numbers are crappy! Look at Cecil's SS. You can see how I worked up the dose. It takes time, patience and a lot of testing. I don't see Spitzer being regulated by your approach.

Sandy - Dottie, Jessie and Cecil

 

[sanrun]

Ok... Should have phrased it that way, because I don't know if Spitzer is acro. But, what is being done is not good.

 

[BJM]

The way I read it, Spitzer has not been DX acro or IAA, is that right BJM?
And if I read the spreadsheet correctly, he's not on an overly large dose of insulin.

That's correct; not officially diagnosed with either. Just trying to find possible explanations.

In August (data not transcribed on spreadsheet - sorry!), he wound up at the ER trying to hypo as he'd gotten his insulin before I realized he was vomiting everywhere. He was down to the 80s when I called the vet and the 70s when I took him there. He stayed 24 hours ... and $2,000 worth.

The vet thought he was getting too much insulin because I mentioned he was having major ups and downs; I thought they were due to the GI issues. Either way, trying to hold Lantus at a steady dose with a cat that vomits or won't eat periodically doesn't work well - its too much insulin if he doesn't eat, and not enough if he does, the way he food spikes - thus the switch to the ProZinc and its wild swings. I wanted to try Levemir; the vet that bought the practice is new and she wanted me to try ProZinc.

Please see what I just wrote in his condo in PZI this evening.

 

[LynnLee + Mousie]

Listen to Patti & Merlin! My kitty Cecil was an acrocat....

The way I read it, Spitzer has not been DX acro or IAA, is that right BJM?

And if I read the spreadsheet correctly, he's not on an overly large dose of insulin.

nope and nope is what i see.

fwiw, my two cents, clearly everyone agrees that the use of 3 insulins is crazy and in my own opinion, part of why you're not getting anywhere as evidenced by the worse numbers you are getting on them then when you were using just one. and looking back thru your bits of spreadsheets, while a bit sporadic here and there, i'd suggest going back to one of the l insulins alone for a bit, i don't really care which one you choose because i think either would work and give it a good patient honest try.

earlier this year, with whatever insulin you were using, your numbers were getting better. around february or so. of course there wasn't much midcycle testing, day or night, and i'm not going to harp on that although i think it would have been very useful to have had back then as kitty was headed in the right direction, and suddenly there was no more shooting around the time he got into dry food? is that correct or is the spreadsheet for that time just not complete?

eta: got called away in the midst of my typing so will add in response to other posts that were made while i was tied up.

personally, i think lantus will work just fine with a cat that doesn't eat or vomits, if the dose is right. yes, occasionally there may be a problem. but that can happen on any insulin. andddddd, fwiw, Mousie used to be a big food spiker. easily 100 pts within 1/2 an hour or so. until i got her figured out on lantus. no more food spiking for her on good consistent small doses

 

[sanrun]

Not on a lot of insulin, just alot of mixing and messing with doses. What was the dose of Lantus at in August? Cecil vomited a lot, too. I just had to be careful and test him more when he had an episode. He dropped down low a few times, but I caught it and brought him back up with HC gravy food. Lantus and Levemir are very similar. The nadirs might be a little different. Not much changed when I switched Cecil, you can see that in my SS.

 

[Sherry & Squirt (GA)]

I have used both PZI and Lantus on 2 different cats- my current Lantus kitty is OTJ from using Lantus to its full potential- testing, changing food (as my shop cat is very carb sensitive) and not being able to shoot a 12/12 schedule- I learned to use the insulin in my favor without trying to use a booster of R or another long lasting insulin. The way I did this was to test whenever I could (again shop cat and my hours are 7am-5pm monday thru friday and yes I went once a day on sat & sun to make sure he got one shot a day on weekends). It was very difficult to regulate his dose but I learned my cat and his dosing needs and knew what dose to give to keep him SAFE. Using two long lasting insulins as well as R to try to bring his numbers down is not SAFE by any means... What do you feed? how often? my diet controlled shop cat must have fancy feast less than 5 carbs and he eats every 5 hours in a 24 hr period using a timed feeder. I just checked his bg 8 weeks otj at what would have been at +5 and he was 47. I think you need to stick to ONE insulin and learn how it works in YOUR cat. Also use only a specific food 4 carb or under- if you have been feeding different flavors of wet food they all have different carb levels- I learned this by giving the SAME dose of Lantus and giving different wet food (FF) carb levels and controlling his bgs drops with food NOT EXTRA INSULIN. This takes patience and alot of data and testing but my shop cat can prove that it can be done.

 

[Carolyn and Spot]

re: the vomiting

I just boarded a diabetic in my house for 3 weeks. I talked the owner into switching her diet to raw, which completely eradicated the vomiting and also loose stools she experienced. The cat has Irritable Bowel Syndrome. Have you considered diet? In this cat's case, she can not have ANYTHING from a can. She can not have ANYTHING with anything in it other than meat. I even tried Wellness and Happy Hips jerky treats and they caused her to relapse. She was also a bag of bones and the change in diet not only caused her to gain strength and start to gain muscle mass, but also her coat is improving and her energy level is up. Just a thought.. IBD is quite common in cats, and presents itself in a myriad of ways, some more severe than others. The worst thing about IBD is that it is often intermittent, which confuses the situation.

Hope this helps..

 

[BJM]

Re: Here goes nuthin' - what I'm feeding

I have a house full of 12 cats, plus am feeding 2 outdoors.

I feed 4 sets of this mixture:
a 13.2 oz can of Sophisticat Turkey And Giblets Dinner

1/2 of a 3 oz can of Purina Pro Plan Turkey and Giblets for flavoring.

According to Binky's Pages,

- Sophisticat is 439 calories in a large can (computed based on calories in a 5.5 oz can),with 37% calories from protein, 62% calories from fat, and 0% calories from carbohydrates

- Pro-Plan Adult Turkey & Giblets is 79 calories in a 3 oz can 55% calories from protein, 39% calories from fat, and 6% calories from carbohydrates.

carb calories in a 1.5 oz: 2.37
total calories combined : 478.7
% calories from carbs: 0.5% calories from carbohydrates

Sometimes, I'll drop out the Pro Plan when I first put down food, like this morning, when Spitzer was really hungry and like to binge a lot first. Then I'll add it to the next round being set out, after the edge is taken off the hunger.

 

[Venita]

It might be the binging that is the problem. My FD Ennis, in his younger years, would binge and puke. More times than I cared to clean up.

When I became self-employed from my home (before he became diabetic), I was better able to manage the volume of food I put down at a single setting. And his binging decreased as did his puking.

I am on the same page with Carolyn about the raw food. Raw food is not cheap, but it is effective. I can point you to a great vendor if you want fresh-frozen. Ennis loves it, even though he seldom gets it.

 

[Jan and Buddy]

Venita,
I might be interested in trying raw, for one of my Civvie's, can you give me info on a vendor?? I'm thinking its already to just feed, don't have to do anything to it???
Thanks
Jan

 

[Carolyn and Spot]

Re: Here goes nuthin' - what I'm feeding

I have a house full of 12 cats, plus am feeding 2 outdoors.

I feed 4 sets of this mixture:
a 13.2 oz can of Sophisticat Turkey And Giblets Dinner

1/2 of a 3 oz can of Purina Pro Plan Turkey and Giblets for flavoring.

According to Binky's Pages,

- Sophisticat is 439 calories in a large can (computed based on calories in a 5.5 oz can),with 37% calories from protein, 62% calories from fat, and 0% calories from carbohydrates

- Pro-Plan Adult Turkey & Giblets is 79 calories in a 3 oz can 55% calories from protein, 39% calories from fat, and 6% calories from carbohydrates.

carb calories in a 1.5 oz: 2.37
total calories combined : 478.7
% calories from carbs: 0.5% calories from carbohydrates

Sometimes, I'll drop out the Pro Plan when I first put down food, like this morning, when Spitzer was really hungry and like to binge a lot first. Then I'll add it to the next round being set out, after the edge is taken off the hunger.

If you research IBD in cats, you will find it has nothing to do with calories from carbs or any other nutritional values. It has to do with the ingredients in the can/bag. IBD cats can not tolerate grains, vegetables and many of the listed additives, even simple sounding ones such as "tocopherals", flaxseed oil and other preservatives.

 

[BJM]

I was noting what I was feeding, not responding to the IBD question.

 

[pamela and tigger]

Re: Here goes nuthin' - what I'm feeding

If you research IBD in cats, you will find it has nothing to do with calories from carbs or any other nutritional values. It has to do with the ingredients in the can/bag. IBD cats can not tolerate grains, vegetables and many of the listed additives, even simple sounding ones such as "tocopherals", flaxseed oil and other preservatives.

So true Carolyn.

Not long ago Dr. Lisa mentioned briefly in one of her posts on Health about carrageenan (which is in a lot of canned cat foods) being a likely culprit for bowel inflammation issues:

Dr. Lisa on Carrageenan in canned food:

"And...off on a tangent but as a good analogy.....if one is to do a search on PubMed for carrageenan induced inflammation, they will find a lot of studies showing just how inflammatory carrageenan is. They use it to induce inflammation in experimental models.

Recently a report came out showing that carrageenan causes intestinal inflammation in human cells. Ok...so IBD is pretty common in cats and carrageenan is very common in canned cat food. So...I post on VIN and the response is..."well.. there have been no studies in cats showing that this substance contributes to IBD".

Ok.....fine. You guys take the 'innocent until proven guilty' road....which translates into..."we will wait until someone has the money and interest to study this before we take it seriously..... even though carrageenan is a known inflammatory agent".

But....I will choose the other road....and error on the side of caution and not feed it to cats - especially IBD patients - if I can help it."

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=46910

To Jan - in case Venita doesn't get back to you right away, there is a vendor in my signature (maybe she was thinking of this one - there are so many nowadays that sell raw food).

ETA - sorry BJM - not trying to hijack your thread.

 

[Venita]

Venita,
I might be interested in trying raw, for one of my Civvie's, can you give me info on a vendor?? I'm thinking its already to just feed, don't have to do anything to it???
Thanks
Jan

Jan, the raw food I have bought in the past is Feline's Pride. https://www.felinespride.com/#/company It's pricey, but it is good. My cats always took to the chicken flavor. They didn't care for the turkey or cornish hen. I don't think we ever tried the duck, and the rabbit is new since I last visited the site.

You don't have to add anything to it. Simply thaw and feed. When I get it, I slightly thaw it and put into separate margarine containers and then re-freeze as "daily" portions.

DCIN became aware of an IBD kitten in a shelter that was having terrible diarrhea. The Feline's Pride owner at the time, Shelby, sent 10 pounds of raw gratis to the shelter for the kitten. It cleared up the kitten's diarrhea and the shelter continued feeding the FP raw. (Sadly, Shelby died the day after he sent the gift for the kitten. But the company he started remains strong.)

 

[DEF]

Hi BJ, you certainly have your hands full with 12 cats and 2 outside. I know you love kitties to help so many!!!!!
You have tested alot and I like the charts you have of your curves.

BJ and everybody, what's past is past. For whatever reason, BJ had serious concerns and thought additional action was needed. Now they have come here to get your input.

He/she was very worried that the cat would die and was out of desperation was trying something else but the mix of those insulins now has everyone in the throes of conniption fits. (I had to look up how to spell conniption.)

Please, BJ please tell everyone you have rethought combining Lantus and Prozinc (and R) and will go to plan B.

BJ, for what it is worth my vet wants me to use another insulin (Humulin N) with lantus and just gave me a prescription but I haven't gone that route yet.

Everybody what it the concensus of what should BJ do now?

BJ , do you have more confidence in Lantus or PZI? You mentioned cat throwing up on lantus but someone mentioned trying it again.

What dose would every one suggest with a fresh start with lantus or PZI? I can't suggest anything as I don't know enough to do so.

BJ, hoping you can find a plan you are happy with and you see better regulation and a happier kitty.

Elaine and Pinky

 

[Cheryl & Whiskers (GA)]

Hi BJM,

Wow feeding 14 cats. You are definitly a hero to all of them!

I too feed our pets raw food. One of our civvies was a bag of bones, I was so worried I took her to the vet and said why is she so skinny. Her name is Minnie. Skinny Minnie. Well anyway we started feeding raw food and she has chubbed up and filled out a lot (sometimes I now think she is a little chubby :lol: ) Weight problem solved. We also feed the raw food to Miss Witty and it help immensly. We were able to lower her insulin dose (and as I'm sure you know had to monitor her BG during the change over exactly because high protien reduces the need for as much insulin) I do not have advise about the pukus, but I believed a few beans have posted in you condo that raw food helped with that as well.
We also feed our Dog Bandit raw food and he has two very serious health conditions Kidney disease and Mega Espohagus, but he is doing very well with both conditions for over two years now (knock on wood, he is older so you know)
I realize you have all the other cats, could you confine Spitzer for a week or so and try the raw food. I know you are concerned that Spitzer will die if you do not do something different. What is that old saying "sometimes desperation is the mother of invention" something like that and you are clearly trying desperatly to help dear Spitzer. I definatly think the raw food is worth a try. You could even use ground chicken to start with. Sometimes you have to transition with a little ground raw and his current food if he is fussy, and than increase until on an all raw diet, but many cats just love it right away. Spitzer is just a beautiful cat. I do remember you posting in TR lantus and you clearly love Spitzer.
I personally would be afraid of trying two long acting insulins. I guess just from what the others have mentioned here. I know that some of the high does kitties beans do add R to there long acting insulins. And some of them have also posted. (I personally don't have that experiance cause Witty did not make it that far, I suspect it may have been something we would have tried eventually because she would, for lack of a better word, bounce pretty high BG's)
In any event I know you are trying you best to get Spitzers health concerns under control, so that Spitzer can have a wonderful life and I hope you can give raw food a try. I am a real believer in it. You can see a link in our signature to the raw pet food deli we use. Unfortunatly they are local to Minneapolis/St. Paul, but I have heard good things about the raw food Venita uses as well. You can also click on the link in my signature to go to the pet food deli I use and read many, many testimonials about how raw food changed so many pets live and significatly improved their health.
My very best wishes to you and hugs to (((((you and Spitzer)))))