Advice needed - struggling to stabilise

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Harrycat

Member Since 2012
Hi all,

I have found this site really useful for our initial diagnosis and we're a month into attempting to manage Harry's condition. Please bear with me as we're in the UK so my units and measurements are UK based.

He was on 2iu twice a day, until this weekend when in discussion with my vet, we have upped it to 2.5iu. I am measuring on the alphatrak and doing random samples and curves. He is measuring REALLY high still :( Last night he was at 31, this morning 21, and at 11 (so 5 hours after his dose) 16.1. He is obviously responding to insulin, but just not dropping low enough. (there were no keytones in his urine last night though, thank god)

I am feeding him x2 Felix pouches per morning and evening. He has lost a lot of weight (2kg) at diagnosis and has still lost slightly since we have been trying to regulate him. Having read this site I have avoided giving him dry food - however he is now having sloppy poos (he usually goes in the garden so I don't always know, but he was in overnight last night and poo was runny :( ) and I am beginning to think that going back to his original (pre-diagnosis) balance of part wet part dry food would suit him better. I am tempted to try a specialist diabetic dry food. He is STARVING between meals and I think this might help regulate his hunger if he feels fuller for longer with it? He is not a great fan of the dry and tends to snack on it after eating the wet, but I just don't think 100% wet is suiting him.

I am also unsure if he is responding properly to the insulin. He is on Caninsulin atm and I am wandering if a change of brand should be considered (after I have messed around with the food - one thing at a time!!!!). I just can't seem to get his levels to drop into the normal range and he's been above 10 every time I hav tested recently :(

I know we should only change one thing at a time and luckily my vet is very supportive. As you may know it's not commonplace to home glucose test over here and they seem to go for the Flucosamine sampling (seriously expensive!!!) and I am in the minority wanting to home test him.

Any thoughts or general advise welcome. I know it's relatively early days but it bothers me he doesn't seem to come down enough. Vet has tested for Thyroid and unrine infections - both thankfully negative!

Thanks in advance

Mrs B
 
Runny poo during the conversion from dry to wet is normal. You can try doing the change gradually so it is easier on the tummy, or just tough out the diarrhea and give it a few days to get better. You can feed him more than twice a day too - heck you can feed him whenever you want really. Just no food around 2 hours before each shot - this is to make sure you get a "clean" BG reading, one not influenced by recent food intake :) I wouldn't go back to dry, especially if you have to use Caninsulin. We recommend starting at 0.5 or even 1u of insulin - 2u is much too high of a starting dose. 2.5u is a relatively high amount of insulin for a cat without an underlying condition, so please be careful and test lots if you're giving him that much.
 
Hello Mrs B and Harry! Welcome to FDMB!

There are a few UK folks here. I'm in Surrey.

Well done, you, for cracking on with the home testing. It sounds like you're doing a great job!

I know those numbers are high but it's very early days. My own cat's numbers were very similar. Try not to worry.

Can I ask you about food?
What Felix pouches are you feeding? Some of them (such as 'As Good As It Looks') contain vegetable protein extract which seems to elevate blood glucose in some cats. My cat is one of those, which is how I found out about it...

Newly diagnosed diabetic cats are often ravenous. That's because they can't utilise the food they are eating. So don't stint on the food. And there is no reason to stick to just 2 meals a day. I free-feed my lot including my diabetic boy. I've found that smaller meals throughout the day keep his blood glucose more stable.

Re the runny poo; Did that just start after you removed the dry food? It may just take Harry's tummy a wee while to get used to it.

Edited to add: If you want to post in US numbers (as well as 'rest of the world' numbers :lol: ) you multiply by 18 (or conversely divide US numbers by 18).

Eliz
 
Hi again, Mrs B,

Here's a link to some info about Caninsulin that you may like to read through. As you may know (if you've read a bit on this forum) Caninsulin is not considered the easiest insulin to work with (typically drops BG fast and has short duration), but a few UK cats have gone into remission (become diet-controlled) on Caninsulin recently.

If it doesn't work for your cat then there are other insulins available. But the typical UK vet will want to see evidence that the Caninsulin isn't working. My cat is on Hypurin bovine PZI. It has a longer duration than Caninsulin (and more than some other 'PZI' insulins too). There are also cats in the UK on Lantus/Glargine.

http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=302
 
Well, you're using an insulin designed for a dog, which has a slower metabolism than a cat.

Have you run a curve? From pre-shot test to pre-shot test, test every 2 hours. This will show you how the insulin works for him ... or not. And may convince your vet to try Lantus or Levemir. Also, it will show when to pick up the food - about 1-2 hours before it stops working - so you aren't feeding a rising glucose level.

Another possibility for high numbers is that too much insulin is being given. The liver releases glycogen to adjust for a lower that usual glucose level, and then the tests go high ... but you should NOT increase in that case, you actually should decrease. Again, a curve will show if this is happening.
 
Hi there,
THanks for replies :)

I didn't realise there was a difference in Felix pouches - I used a website that gave a conversion of ingredients (I buy the big selection boxes) to give an approx carb content and it came out pretty low which is how I convinced my vet not to insist on the prescriptions meds.

I didn't realise there were any insulins specifically made for cats..? As far as I was aware from web research there are NO insulins specifically licenced for cats (but this could be a UK thing? - I dunno!!)

Nah, the squits is a recent thing (I think). It may be linked to the cold weather as he does sometimes change toilet habits when it gets cold outside but I am clutching at straws perhaps.

I don't think it is a symogi thingy (however you spell it!!) as I have done 3 full curves on him since he was diagnosed. He does drop after the dose, but never below 10 (on the last 2 curves) and always goes back up high again. He is not yo-yoing, he is just not responding :(

Will read the stuff on caninsulin - any more advice you have would be fab. I am finding it quite tough going :sad:
 
Actually, the human insulins Lantus and Levemir have been used quite successfully in cats.

ProZinc and BCCP PZI may only be available in the USA and these are used sith pets.
 
Yes, that's right. In the UK there are no cat-specific insulins.

Caninsulin didn't work for us and I managed to persuade our vet to prescribe Hypurin Bovine PZI. It's a 'depot' insulin and typically has a long duration with some overlap so my vet was only willing to prescribe it because I was hometesting. (Hometesting can really come in handy sometimes!) There are other insulins too, ie Lantus (called Glargine in the UK) and Levemir. A few vets will prescribe them but it's not commonplace. And more of them will be familiar with the 'PZI' insulins.

The curves I did on my cat while on Caninsulin showed that it was only working in his system for about 7-8 hours. That meant, on 2 shots a day, that he only had insulin in his system for 2/3 of the time... It was on that basis (and the consistently high BG numbers) that my vet agreed to order a different insulin for us.

I have to say, your BG numbers are way better than ours were! But the swing up to really high pre-shot numbers must be immensely frustrating for you.

But, whatever insulin you are on, it can sometimes take a little while before you see some good results.

Oh, re the cat food; those that caused us problems were the ones containing 'vegetable protein extract'. A sachet of that can send Bert's blood glucose into the stratosphere. It may be worth checking the ingredients on the food that you have. IF it contains 'vegetable protein extract' then it will certainly be worth trying something else. (Not all cats are affected by it, but for those that are the effect is quite profound....)
 
That's great, thanks so much Elizabeth :) Gives me something to discuss with my vet.
I will check the pouches for veg protein (the ingredients are on the big box and we're away at the outlaws at the moment - complete with sugarcat - lol).

He's such a star, I've had to bring him with me as there's no-one else I can leave him with for them to inject him, it's a lot to ask! The vets have been fab and will board him for £10 a day but most cats hate being shut in those hospital cages :( . He's such a star, he's been no bother going visiting. (When he was a baby we took him to Scotland and Wales on holidays so I know he will travel - be let out, and find his way back to us - even though I keep sticking needles in him he comes back to me :-D )
 
If a curve demonstrates about 8 hours of usefulness AND you are available to do it, an option is to test and shoot 1/3 of the total daily every 8 hours. You'd still need to test before every shot, so you'd have increased costs for testing supplies doing that.
It would be better to be on PZI or Lantus, though.
 
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