Aiming for remission with caninsulin - how have others managed it?

[Alexi]

Before you think I am going mad I had another talk to the specialist this week who feels this may be a strong possibility and wants to keep Cappuccino on her current insulin for now. I am aware others on the board have managed it.

Progress to date, the final conclusion is that although she has some evidence of pancreatitis this is not currently active, her liver has shrunk noticeably since starting purina DM (which she loves), she has had a 2 weeks course of antibiotic for a urinary infection and her body condition is very good, and at target weight. Repeat urine culture is planned for the end of the month by removing urine direct from the bladder.

Feeding regime, as I have a multicat household, she is being fed separately at 12 hour intervals with no additional food as I am now removing all other food before letting her mingle with the others (much to their disgust but they all need to be on a diet anyway). She shoots out searching for more food when I open the door after her meals.

Blood sugars are stable and she is spending more time in the blues and no more episodes where she looks as though she is going hypo, I have had to reduce the dose on a couple of occasions when she has thrown lower numbers than expected.

In terms of behaviour she is acting a lot younger than she has been for a very long time and seems much happier since the diet change.

I have located some u40 syringes with half unit markings.

The specialist wants me to push up her dose to see if I can get her average glucose lower. I am away for a few days so she will have someone to check her sugars and give her insulin, but will be trying this on my return, initially I was planning to increase in 0.25 unit increments with a curve after every increase to see if I can get some green numbers coming in and keep everything crossed.

Does this sound like a plan?

How did others mange it with this insulin?

 

[Larry and Kitties]

You plan seems good. However based on your SS you are seeing typical response using Vetsulin/Caninsulin, a relatively high PS with lowest in the low 100's. As you bet suggested you seem to have margin to increase the dose a little which you are planning to do later after your trip.
My experience is that it is hit and miss for a cat going into remission. Only one of my 15 cats have done so so far.

 

[BJM]

Would you be able to shoot every 8 hours? (take the total of the dose in a day, divide in thirds, shoot that amount every 8 hours)
That would let you slightly overlap some of the effect, keep the overall glucose levels more controlled, and allow the pancreas to rest and maybe regenerate enough to move towards remission.

 

[jayla-n-Drevon]

I used pro zinc every 6-8 hours in the beginning of our journey -- I wish it had worked better than it did.
I hope you have better luck!

 

[Alexi]

Would you be able to shoot every 8 hours? (take the total of the dose in a day, divide in thirds, shoot that amount every 8 hours)
That would let you slightly overlap some of the effect, keep the overall glucose levels more controlled, and allow the pancreas to rest and maybe regenerate enough to move towards remission.

8 hour dosing is a non starter given my work schedule, she is drifting down on her APMS and PMPS which is good, number one priority is to keep her safe and happy, just hoping she doesn't do anything odd while I am away, I reduced her dose this morning as her minder can't always get a blood sugar but I have left clear instructions on what to do and what to look out for. Keeping everything crossed!

 

[Elizabeth and Bertie]

Hi @Alexi,

I've followed a lot of Caninsulin cases over the years simply because I'm a UK'er and tend to keep an eye on other UKer's; and Caninsulin is the insulin everyone has started out on (until now, that is; Prozinc is now available).
Over the years I've seen a fair number of Caninsulin cats go into remission here, but, to be honest, in all the cases that I've actually followed it seemed to be more a matter of 'luck' than of 'technique'... The cats I've observed have generally gone into remission pretty quickly, often in a couple of months or even a few weeks. My feeling is that these cats fall into that group that would probably go into remission no matter what insulin they were on.... (What I don't know, of course, is whether people who left the forum had cats that went into remission at some later date...)

All those cats were, as I recall, getting 2 insulin shots a day. There are very few people here who've given 3 shots a day, though this may be a way that - in suitable candidates - could bring greater success, as it could involve lower doses (so less steep drops) and keep insulin in the system for longer. ....I do realise that 8 hour dosing is not a possibility for you. (It may provide an interesting experiment for you though if you do get an opportunity at any point. There used to be a few people here who did TID shooting on the weekends, for example.)

My best guess is that Cappuccino would probably do better on a different insulin.
She's given Caninsulin a fair 'crack of the whip', but her blood glucose still seems to be on a bit of a rollercoaster ride.
Would your vet now be willing to prescribe an alternative insulin? Based on the data you've gathered I honestly cannot see any substantive reason for them to refuse...

Edited to add: Cappuccino's numbers are very similar to the ones I used to get with Bertie. It drove me absolutely crazy, so I really DO sympathise...

Eliz

 

[JanetNJ]

I'ts so encouraging that cappuccino (love that name by the way) is in the blues. Gives me hope that I can get my girl better numbers as well.

I just talked to a vet at my vets office yesterday. My reglar vet is on vacation for two weeks, but I've worked with this vet with another cat. I asked if we could switch to ProZinc or some other longer lasting insulin, and she thought two months wasn't long enough to give Vetsulin a try. Not sure why the hesitence. She's having me up the dose, do a curve in a week, and then call with the results. THen in two weeks if there's not an improvement we'll talk about switching. I'm a little frustrated because I'm clearly willing to pay more for the better insulin but they don't wanna change. I'll give it the two weeks because by then the regular vet will be back, but I'm a bit frustrated at the moment. I have yet to see a number in the yellows even mid cycle. I'm going to go later and get a fresh vial and see if that helps.

 

[Alexi]

Thanks @Elizabeth and Bertie that is just the sort of information I needed, she has just given me another PMPS in the normal range which, whilst encouraging, means I can't give as big a dose as I would want to. The original plan was to keep upping the dose and do a curve once settled and check a fructosamine level but she obviously had other ideas! In terms of general health she is now very healthy and I can do no more. Repeat urine testing was negative on culture. I think I will do a curve in the next couple of days as I am curious as to why I am getting pre-shot numbers in the blues. The good news is her overall doses are heading downwards and she is less insulin dependent than she was. However, her spreadsheet resembles an explosion in a paint factory.

So the dilemma is - do I go with ProZinc or bite the bullet and try Lantus? My vet would be open to a change of insulin.

 

[Elizabeth and Bertie]

So the dilemma is - do I go with ProZinc or bite the bullet and try Lantus? My vet would be open to a change of insulin.

Most Lantus users here consider that it works best if dosed (as close as possible to) 12 hours apart. That helps to keep the insulin depot stable. It also seems to work best with fixed dosage. There are a lot of Lantus users on the forum, so anyone using Lantus has access to a large support group here.
Prozinc is more 'forgiving' regarding the timing of shots. And, although most people used fixed dosage, it also lends itself well to 'sliding scale' dosage in some cats.

If your schedule is variable, then Prozinc may be a better fit....

Eliz