Can anyone help me

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Harry and Katies Mum

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I am really hoping someone here can help me. My Harry has been diabetic for 2 1/2 years now and we had everything under control using Insuvet Lente insulin 2 i/u's twice a day. However everything went wrong at the beginning of August. We had to change Harry onto Caninsulin on Friday 5th August as we couldn't get the other one anymore. Friday 12th August Harry wasn't right so phoned the vet thinking it was his insulin all she advised was if he wasn't better in the morning to take him in. He wasn't eating and was generally very lethargic I'm aware that you shouldn't give insulin if not eating so was doing his blood glucose before giving him his dose. Saturday morning he still wasn't well so called vet and got emergency appointment. Harry was kept in as he was dehrydrated and had a temperature also appears Harry may have been being sick but with 2 cats I wasn't sure which one it was. Anyway Harry was in all weekend on a drip, antibiotics they though he had cystitis and possibly pancreatitis. They took bloods on Monday and sent away. On Tuesday morning I got a call to say he was really floppy and could we drive him 2 hours to a different vet that would be able to do hourly blood lab results as they thought he had a potassium deficiency. Of course we did and his potassium when they tested it was 2.1 very low apparently. Anyway the new vet kept him in and was doing much the same but also syringe feeding him. Anyway he made progress and was allowed home on Monday 22nd August. He's having antibiotics, pepcid and something else to help his digested system as well as his caninsulin and we also now feed him a gastro intestinal food. As he'd been home a week we thought we ought to do his blood glucose curve at the weekend and I've got some horrible results. ranging from 15 to 24. He started at 18 dropped to 15 after 3 hours and then shot up to 24 where he didn't really come down from. I have faxed his curve to the vet but I'm desperate to sort this out as quickly as I possibly can I don't think if he has another crisis like at the beginning of the month he'll survive this time it was touch and go last time. Generally he seems fine in himself.

I'm sorry if the above is all a bit of a ramble and if I need to clarify anything please let me know but I'm really worried now. We went to the vets this morning and they admit his curve is too high but they want to wait for the blood test results. However all they could say is Caninsulin is the only insulin licensed in the UK for use on pets there is nothing else.

Any help, words of advice or even if its to tell me I'm being stupid are much appreciated.
 
I'm so sorry you're going through this, no words of wisdom as I don't have much expertise with this, but bumping to keep at the top so hopefully others will see and respond. Take care.
 
I'm sorry if the above is all a bit of a ramble and if I need to clarify anything please let me know but I'm really worried now. We went to the vets this morning and they admit his curve is too high but they want to wait for the blood test results. However all they could say is Caninsulin is the only insulin licensed in the UK for use on pets there is nothing else.
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You should try to get Lantus; I know of one cat, George, and his owner, Lyn is in Kent, UK. George was on Lantus.
 
Hi and welcome!
First off, you aren't "just being stupid"! Thing is, just about all of us arrive here in the same state of confusion and anxiety as you have. It seems so overwhelming at first. But try to keep breathing, and with small steps, you'll find that it isn't as bad as you first thought.
We do have other members who are familiar with caninsulin, and have several that are also in the UK. As soon as I can figure out exactly who they are, I'll ask them to come here and post!

Obviously, Harry has been through a lot. The number that popped out at me was his potassium level, only because my Bob had similar issues. Assuming the scale is the same, 2.1 is very low ("normal range" is 3.6 to 5.something). Do you know if they treated that symptom and what his level was at when they released him for you to take him home? Potassium is important to muscle and heart function. Bob got lots and lots of sub-q fluids, and they sent me home with a bag of lactated ringers w/ potassium and I had to administer fluids regularly. Did your vet give you fluids or some sort of potassium supplement? They may have "normalized" his level before releasing him.
Just a couple of questions so that people here can better help -
You say you are home testing BG, which is fantastic. Most people arrive without that skill.
What dose of caninsulin are you giving Harry?
What is his normal diet?
Those two things will help people figure out his numbers and where you may be able to go from here.
Again, welcome! Breath! and people will be along shortly to help!
Carl in SC
 
Thank you both for your replies. The vets have refused point blank to do anything until they have the blood results back and unless one of the other vets at the practise will give us a different insulin the one we spoke to today says its the only one on offer. I also have issues with the food they have put him on. First of all its a dry food royal canin gastro instestinal moderate calorie which has something like 26% carbs. Thankfully Harry isn't keen on dry food so in a desperate bid to try and get him to eat earlier in the week the said he could switch to wet food but thats still 26%. I used to feed him normal whiskas tins and I still have loads as we bought a load just before he got sick so I'm really tempted to put him back on this despite what the vet says.

I just sort of despair at the moment as I seem to be going round and round in circles surely if his blood glucose is up its not doing him any good. They thought he had pancreatitis and cyctitis could that be caused because his blood glucose was too high. He finished up with low potassium so hes got a potassium supplement we have to put on his food which has fructous in it I think which I believe is sugar but they won't let us stop this til they get the blood results back. It just seems to me that everything is affecting everything else and I just don't know how to stop this stupid cycle.
 
carlinsc said:
Hi and welcome!
First off, you aren't "just being stupid"! Thing is, just about all of us arrive here in the same state of confusion and anxiety as you have. It seems so overwhelming at first. But try to keep breathing, and with small steps, you'll find that it isn't as bad as you first thought.
We do have other members who are familiar with caninsulin, and have several that are also in the UK. As soon as I can figure out exactly who they are, I'll ask them to come here and post!

Obviously, Harry has been through a lot. The number that popped out at me was his potassium level, only because my Bob had similar issues. Assuming the scale is the same, 2.1 is very low ("normal range" is 3.6 to 5.something). Do you know if they treated that symptom and what his level was at when they released him for you to take him home? Potassium is important to muscle and heart function. Bob got lots and lots of sub-q fluids, and they sent me home with a bag of lactated ringers w/ potassium and I had to administer fluids regularly. Did your vet give you fluids or some sort of potassium supplement? They may have "normalized" his level before releasing him.
Just a couple of questions so that people here can better help -
You say you are home testing BG, which is fantastic. Most people arrive without that skill.
What dose of caninsulin are you giving Harry?
What is his normal diet?
Those two things will help people figure out his numbers and where you may be able to go from here.
Again, welcome! Breath! and people will be along shortly to help!
Carl in SC
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Hi Carl

Thank you - I know I need to take a deep breath I don't know how Harry feels but I've feel like for the last month I've been beaten up time and time again.

They did stabilise his potassium but he does have a potassium supplement that we put on his food morning and evening and he gets a little bit of food lunchtime but only a mouthful to put the syrup on (well thats what I call it its very sticky and smells sweet). He went to the vets today so they could take bloods to test his potassium level, his pancreas function (sorry forgotten what they call it) and they were also going to do a fructosamine test but we'd already done the blood glucose curve.

We've been home testing for a while and his curves on Insuvet Lente were lovely but not this last one.

Harry currently has 2 i/u's morning and evening at the same time as his food.

His food is an area I think I need to change. Harry always used to have tinned whiskas but when he was ill the vet switched him to royal canin gastro intestinal moderate calorie dry food. Harry doesn't like dry food and so wasn't eating well when we bought him home so I checked with the vet and they said we could switch to the wet version, however having done some homework I'm really not sure its good for him the data sheet says its 26% carbs wet or dry. Can I go back to the tinned whiskas or does it need to be something else?

Anyway thank you all for talking to me and I'm actually about to leave work now (yep naughty me I'm so distracted I've been doing this at work) I'll be back online as soon as I can. Any help you guys can give me is really appreciated as I really don't know which way to turn at the moment.

Thank you.

Janet
 
Hello there, I'm in the UK and am sorry to hear of your worries with Harry - I know how stressful and upsetting it is.

As others have said, you are certainly not being stupid - you are just being a responsible and caring owner, and that is great. I can't offer any specific advice, but will just offer a few thoughts...

You say Harry seems fine in himself apart from the high BG readings you've been getting, so try to take heart from that - if he was seriously poorly he wouldn't be fine. But of course the readings are higher than you'd like. My first thought is to say that this is probably due to him getting used to the change of insulin - Caninsulin works in a very different way to the insulin you had been using - it has "fast onset" which means it starts working quite quickly, but then is used up quite quickly also and peters out by the time the next shot is due. So, Harry may have been experiencing periods of time with very little insulin in his system and feeling poorly because of that - high BGs can make a cat appear generally unwell, lethargic, not want to eat etc. It may be that the dose needed adjusting - but it may be that he picked up an infection, or possibly there is something else going on too - we don't know, but the fact that the symptoms appeared soon after the change of insulin has to be a clue, I think.

You may get some other, better advice here but meanwhile I would call the vet and ask if there is one there who specialises in feline diabetes (you never know) and if so ask to discuss with him/her if Harry's symptoms could be a result of the new insulin. I'm not so sure about Caninsulin being the only insulin available in the UK - I believe there are others, but not all vets will prescribe all others (for their own reasons). If you have no luck with this with your own vet, I would ring around others in your area and ask the same questions including "What is your insulin of choice for a diabetic cat?". When I was treating my Tom, I actually switched vets to one who seemed more clued-up.

I'm sorry I can't say any more, but that would be my first line of attack in this - look at the insulin. Oh and wet food is much much better (please ignore what the vet says about this). Whiskas in jelly - tinned or pouches - is fine. Can't see where the 26% carbs comes from as most wet food has a very high moisture content.

I do wish you all the very best and hope you will keep us posted - everyone here is great and will give you all the moral support they can!

Diana
 
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I second getting a different insulin. Lantus works very well in cats and has a very high remission rate. I've attached an article for you to give to your vet. Hopefully, you'll be able to get a prescription from one of the vets at the practice if you take it in. The use of Lantus (glargine) is off-label for cats, but it's perfectly legal and I know there are people in the UK whose vets have prescribed it for them.

I would not feed him high carb food right now, because high blood sugar could play a part in his illness. Hopefully you can find a low carb wet food that also meets the needs of his secondary ailment. Was did he end up being diagnosed with? Was he tested for ketones?
 

Attachments

Eating is the most important thing for your kitty now - and the lo carb wet that he was eating b4 is great. I have used Caninsulin in the past, and know that its action isn't the greatest, but leaving your kitties bg high all the time isn't good either. Since you are testing, can you tell us some of your test numbers? Do you have a morning pre-shot (noted as AMPS on this board), and maybe some mid cycles (shown as +3 for 3 hours after the shot) that you could share?

Because Caninsulin has a sharp drop, it might help to give him some food about 1.5 to 2 hours after his shot to slow the drop a bit. You might have to experiment a bit with food timing to manage the curve.

There are a couple of members in the UK, and some are using Lantus. If you can tell us where in the UK, we might be able to find a vet who is more open to trying another insulin when Caninsulin doesn't work so well. If it is anywhere accessible to you, I know that the RVC in London has a more up to date approach to diabetes.
 
I also want to add that keeping him eating is very important--if he wants to eat the whiskas and not the other foods, feed him the whiskas. It's better than the prescription food anyway.
 
Re: Can anyone help me Hullo from Hastings

All three of mine were on Insuvet (it might be good to contact Shering-Plough and ask what they would recommend as the Insuvet is not available)

Bushey arrived on Caninsulin and b/g of 35! I might just as well injected water! I stabilised him with an old vial of Insuvet that had been Katy's

As for feeding.... good quality meat in jelly, usually comes in at 5-10% carbs, Check Binky's lists..... there are some UK pages. Do you know how to check?
Carbs are rarely noted so do some adding up. mIt goes something like this

Moisture 80%
Protein 10%
Ash 2%
Other 3%
-----------
add 95%
-------
Take that from 100 and what is left is 5% carbs

Any dry food is about 50% carbs!

Hope this helps.

If you want to talk pm me and I will send you my phone number

Mary
from 1066 country
 
Evening everyone thank you all so much for taking the time to reply I was really quite desperate earlier. I've spoken to the vet this evening and she had said that Harry had or still has pancreatitis that caused the insulin not to work properly however he showed no sign of pancreatitis until a week after changing the insulin so did the insulin cause the pancreatitis I don't know. We've just done a bg for Harry and its currently 23.4 he's had 2 i/u of caninsulin along with his other meds and his 1 satchet of royal canin gastro intestinal moderate calorie wet food. According to their website the carbs are 26% per 100g dry matter. I did challenge the vet on this and she said its because of his pancreatitis he has to have low fat and therefore the carbs are higher. Protein is about 40%. We are going to do his bg again at about 9.30 and then again at 11.30 tonight to see what happens but for now:-

These are the figures from Harry's curve done on Saturday
Time mmol/Lt
08:00 18.4
09:00 18
10:00 17.6
11:00 15.8
12:00 18.4
13:00 20.4
14:00 22.1
15:00 24.6
16:00 24.4
17:00 24.2
18:00 24.3
19:00 24.3
20:00 24
21:00 23

The vet is currently stating that the insulin is not the problem its the pancreatitis so she won't entertain changing insulin and there isn't anything else its the only one licensed in the uk as Insuvet is no longer available. Unfortunately we live in Fort William (Highlands of Scotland) and the next vet to us is about 1.5 hours drive in one direction or 2 hours in the other direction so unless we really have to its not really an option to change. Its time like this I wish I still lived in Surrey as there was much more choice but the way of life up here is great so wouldn't change it most of the time.

Anyway I think I covered everything but if I missed anyones question please let me know and I'll answer as best I can. Once again thank you all for your help with this.

Janet
 
It is true that pancreatitis can wreak havoc with the bg numbers. However, it doesn't change the action of Caninsulin - steep drop, short - medium duration, and climb again. The information on the package insert gives this information, so its right from the source.

This thread has quite a discussion about other insulins in the UK and some of the posts talk about what needs to be done by the vet to use another insulin. It might help if you are aware of all the hoops and sympathize with your vet, but stand up for your cat.

viewtopic.php?f=22&t=11312
 
Janet, can you post a link to where you're getting the nutrition values for the Royal Canin? I couldn't find it.

Here's a link to the Non-US cat food nutrition charts. what is the percentage of fat that your vet wants to stay under? There are several commercial options that are low carb that may also have low enough fat.

http://binkyspage.tripod.com/nonusfd.html
 
Janet, it's good to see you sounding a bit calmer but carry on posting here as much as you need to, maybe someone will say something new to help.

Well done for doing such a detailed curve. Every two hours would be fine actually. All you need to add really is when insulin was given, and how much - and then the following readings should say + 2hrs, + 4 hrs etc - that helps us to see at a glance how the insulin is working in a particular cat (it can vary a lot).

It may be fair enough to keep Harry on a prescription diet food if he has an acute condition, but I would still switch him to a wet food in jelly when you feel he's on the mend, as a lower-carb food will help his BGs, which are clearly too high for him to feel comfortable.

As far as the insulin debate is concerned - this is a toughie and the ball really is in your court. I sympathise enormously if your vet is the only one in your area and is adamant that Caninsulin is the only insulin available, but I really don't think this is the case and I agree with Just-as-Appy below who says it all really. Vets are like GPs - they are not all trained in specialist areas and FD is a specialist area with developments that most are sadly unaware of. It's up to us as our pets' caretakers to research what we can and speak on their behalf. Some of us are able to do that and others not; it is your call. Bear in mind that while Caninsulin does have its fans, it is just not the optimal insulin for cats. It was developed for dogs, who process insulin in a different way.

You're doing really well and we have all been in a similar place to where you are now, so please take heart. FD is an ongoing learning experience for us all.

Diana
 
http://www.royalcanin.co.uk/vet/clinica ... l_wet.aspx

Heres the link if you click on the product information it opens a pdf document which shows the values per 100g dry matter perhaps I'm reading it all wrong it wouldn't surprise me to be honest. The vet hasn't actually said what fat they want to keep him below but this food says 2.6% on the box but then Harry is supposed to have 2.5 satchets a day I think it is.

I will definately have a look at the links supplied I'm trying to gather all the information I can to arm myself for the vet.

I'm off to do Harry's bg I'll be back in a moment with the result for you.
 
Ok readings so far tonight

19.30 23.4 fed and 2 i/u's
21.30 23.3 +2 think Harry may have eaten more food at about 9.00

These are the figures from Harry's curve done on Saturday
Time mmol/Lt
08:00 18.4 fed and 2i/us
09:00 18
10:00 17.6
11:00 15.8
12:00 18.4
13:00 20.4
14:00 22.1 fed only mouthful so he could have his potassium supplement
15:00 24.6
16:00 24.4
17:00 24.2
18:00 24.3
19:00 24.3
20:00 24 fed 2 i/us
21:00 23

I really am trying to do as much research as possible so any info that can be thrown my way I will certainly keep so that if we really aren't getting anywhere I can make a good case for them to change the insulin. My other half is fairly good with the science stuff and you always have to convince him scientifically so I've convinced him now just the vet to tackle really. It just seems such a coincedence that he got sick just after the insulin being changed.
 
Well done Janet, you might also like to tell the vet about this board which has members from all over the world with many many years' combined experience of caring for diabetic cats - some with simple FD, others with various and several other conditions. We are not vets, but there are some medically qualified people here, and above all we have hands-on, day-to-day experience of caring for cats with FD - something that most vets will never have. Vets don't like their judgements or advice being challenged, but with tact they can be educated in a subtle way!
Diana
 
Diana&Tom said:
Well done Janet, you might also like to tell the vet about this board which has members from all over the world with many many years' combined experience of caring for diabetic cats - some with simple FD, others with various and several other conditions. We are not vets, but there are some medically qualified people here, and above all we have hands-on, day-to-day experience of caring for cats with FD - something that most vets will never have. Vets don't like their judgements or advice being challenged, but with tact they can be educated in a subtle way!
Diana
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Thank you I think I was perhaps being a bit irrational earlier but I think because harry has been poorly since the beginning of August I've not been sleeping well worrying myself silly and perhaps spending far too long on the internet imagining he has all sorts of horrible things wrong.

I'm so glad I found you guys as you all really understand and are so happy to help even if its just to calm me down. :lol:

I will just keep reading and asking you guys for help now I've found you.
 
Just done another bg for harry and the results for tonight are as follows:-

19.30 23.4 fed and 2 i/u's
21.30 23.3 +2 think Harry may have eaten more food at about 9.00
23.30 21.6 +4

I suppose at least its going down and hasn't dropped as fast as Saturday unfortunately we aren't likely to do anymore tonight. I think we'll do another bg curve at the weekend and see what happens.
 
Hi Janet, Welcome.
Could you just simply write the
amps----#-----dose
+-------#
+--------#
pmps------#

this way it is real easy to understand...I'm not sure what all the other numbers are.
 
Lol, Lori, the first 4 numbers with the decimal point in the middle is 24 hour clock time (knew that 4 years in the USMC would come in handy one day). The next set of numbers are the UK BG values.
I can't convert them off the top of my head, but I read recently that 5-7 is "normal", so I just knew the 20.somethings were pretty high.

Carl
 
oh dear, well....do you know how to convert them for us americans?
thank you for clearing that up carl, i was totally confused! confused_cat
and you'll see that including what time it is will not be relevant here on the board as we cover a dozen time zones and well, it just does'nt really matter. the only numbers that matter are the number of hours since your shot...thus +6 or +9
thank you in advance if you know how to convert...
lori
 
The conversion is MULITPLY BY 18

2.2-5.5 is Green (2.2=40, 2.8=50)
5.6-11.1 is Blue
11.2-16.6 is Yellow
16.7-22.1 is Pink
22.2-27.7 is Red
27.8=500

Here are the numbers converted:
Today's results:
PMPS - 19.30 - 23.4 = 421.2 fed and 2 i/u's
+1 - 21.30 - 23.3 = 419.4 +2 think Harry may have eaten more food at about 9.00
+3 - 23.30 - 21.6 = 388.8 4

Saturday's Curve
AMPS - 08:00 - 18.4 = 331.2 fed and 2i/us
+1 - 09:00 - 18 = 324
+2 - 10:00 - 17.6 = 316.8
+3 - 11:00 - 15.8 = 284.4
+4 - 12:00 - 18.4 = 331.2
+5 - 13:00 - 20.4 = 367.2
+6 - 14:00 - 22.1 = 397.8 fed only mouthful so he could have his potassium supplement
+7 - 15:00 - 24.6 = 442.8
+8 - 16:00 - 24.4 = 439.2
+9 - 17:00 - 24.2 = 435.6
+10 - 18:00 - 24.3 = 437.4
+11 - 19:00 - 24.3 = 437.4
PMPS - 20:00 - 24 = 432 fed 2 i/us
+1 - 21:00 - 23 = 414
 
I just ran the numbers on that food, and by my count it is not low Fat at all...

Dry Matter Basis from here
40% Protein
15.4% Fat
26% Carbs

So, to convert to % energy, you need to multiply Protein and Carbs bo ~3.5kcal/gram, and Fat by ~8.5kcal/gram
140 Protein
131 Fat
91 Carbs

As a % of energy:
39% Protein
36% Fat
25% Carbs
 
Hi again Janet. Just to clear up how to list the BGs in the clearest possible way:

The actual clock time of the shot is not relevant. I think to use the 24 hour clock is confusing some people and you can either leave it out altogether or say 'am' or 'pm' if it helps you to look back on it. The important data is the BG number, and how long after insulin given. As an example:

8am - 15.7 ~ 2 units given
+2 ~ 13.1
+4 ~ 12.2
+6 ~ 11.1
+8 ~ 10.4
+10 ~ 11.8

and so on, and then when you give insulin again, state what dose you gave after the relevant reading. Does that make sense? If you have time, it also helps to add a simple note in brackets after each reading if Harry has eaten something, or thrown up, or is acting at all weird. Don't worry too much about this, but it can be helpful to see the overall picture.

Also - Americans use different numbers (multiply ours by 18) but again, I wouldn't worry about that too much just now, it can confuse the issue. This is an international board and we all try to talk in the 'language' of the person needing help.

Diana
 
Diana&Tom said:
Hi again Janet. Just to clear up how to list the BGs in the clearest possible way:

The actual clock time of the shot is not relevant. I think to use the 24 hour clock is confusing some people and you can either leave it out altogether or say 'am' or 'pm' if it helps you to look back on it. The important data is the BG number, and how long after insulin given. As an example:

8am - 15.7 ~ 2 units given
+2 ~ 13.1
+4 ~ 12.2
+6 ~ 11.1
+8 ~ 10.4
+10 ~ 11.8

and so on, and then when you give insulin again, state what dose you gave after the relevant reading. Does that make sense? If you have time, it also helps to add a simple note in brackets after each reading if Harry has eaten something, or thrown up, or is acting at all weird. Don't worry too much about this, but it can be helpful to see the overall picture.

Also - Americans use different numbers (multiply ours by 18) but again, I wouldn't worry about that too much just now, it can confuse the issue. This is an international board and we all try to talk in the 'language' of the person needing help.

Diana
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Hi Diana

I will try and remember must admit I was being a bit lazy last night and just copied the figures from an excel spreadsheet we'd used to do the curve for the vets. I will try and remember to give you as much information as I can without confusing things. I just want to do the best for my little man and you all seem to be a great source of information and so helpful. I was certainly in a bit of a state yesterday when I signed up but I just feel this has been going on too long and needs sorting but perhaps thats me being impatient as always. Its not helped by the fact that the vet won't admit that Caninsulin might not be right all they can say is its all thats on offer but that doesn't really help Harry. Hopefully the blood results will be back tomorrow and we can find out how his pancreas and potassium is doing.
Janet
 
Sam and S'mores said:
I just ran the numbers on that food, and by my count it is not low Fat at all...

Dry Matter Basis from here
40% Protein
15.4% Fat
26% Carbs

So, to convert to % energy, you need to multiply Protein and Carbs bo ~3.5kcal/gram, and Fat by ~8.5kcal/gram
140 Protein
131 Fat
91 Carbs

As a % of energy:
39% Protein
36% Fat
25% Carbs
Click to expand...

hmmmm thats not so good then. They'd convinced me that that really was the best food to treat his pancreatitis but perhaps it isn't. I know what I'll be spending the day doing now then and thats researching the best food for a cat with pancreatitis.

Anybody have any ideas where to start.
 
Janet, you seem to have a really good handle on everything which is good to see! I know you want the best for your little man - we all do - I just don't want you to worry about converting BG numbers etc when we can all see at a glance when the numbers need attention and you could be spending your time more productively - such as, as you say, researching a food that's good for cats with pancreatitis. I'm sure you've Googled that phrase - and come up with the usual pet food companies' prescription diets? Other people here may be able to give you good advice. I would suggest starting a new thread on this forum with your specific query in the message header, eg 'What to feed my cat with pancreatitis?'

Ref the Caninsulin - the vet only has to look at Harry's numbers to see that it's not doing much for him. This issue is certainly confused by the pancreatitis, but pretty much all of us here would advise a switch to another insulin if at all possible, simply because of the way Caninsulin works. You mentioned you used to live in Surrey - did you have a vet there who used to treat Harry who you could ring, just for a chat and another opinion? As we have said, not all vets have the same background and many are simply following their surgery's standard procedures which may have been put in place by an older/senior vet - or a medical sales rep! where i live there were/are differences in the two vets I have used within a mile of each other!

Diana
 
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I hadn't thought to start another thread how daft am I :lol:

I also hadn't thought of trying my old vet I really am going a bit daft really. I used to live in Horley and worked in Leatherhead. I was also considering contacting the vet school up here in Edinburgh to see if they could be of any assistance because although I don't really want to change vets at least if they could agree the insulin isn't right and he needs something else perhaps my vets would listen. I am a little concerened as they've said if his fructosamine is high when they get the results tomorrow they will up his insulin by half a iu I know his numbers are high now but I don't want him crashing out the bottom and then flying back up again. We'll definately be doing more blood glucose curves to try and prove that this one just isn't lasting long enough and needs to be changed as I think this may be my best attack.

Oh I do hate being so confrontational with people!
 
Small world... I pass through Leatherhead often on my way to Dorking, and I know people who live in Horley and work there sometimes too!

You are doing all the right things - try your old vet, try the vet school in Edinburgh and get some more solid advice to back up what you might say to your current vet. Harry's fructosamine is almost certainly going to be very high so the vet most probably will recommend that you up his insulin dose. You are right to be cautious but tiny increments are OK and in fact probably a good thing to try to get his BGs down. You are monitoring him very closely and really, he is very unlikely to hypo at the numbers you have been getting.

The other person you might try for local advice is (Steve and Jock) - Steve used to live in London but is now in Edinburgh. He is a very nice and knowledgeable chap and may have some more suggestions for you. I'm not sure of his current email address but you can send him a private message via this board. If you go here:

memberlist.php?mode=viewprofile&u=336

and then click on the link to the left where it says 'send private message', that will reach him.

Diana
 
Janet,

I feel for you. I was in your situation a few years ago with my boy Major.

First of all, Cannisulin is a very harsh insulin on cats. It is fast acting with short duration. If you are only giving Harry Cannisulin twice a day, Harry ends up with high BG through the most part of the day. Please show your current vet some supporting documents (see the following links) as to why you want to try Lantus or Levemir, which I know some UK vets are using to treat feline diabetes.

Supporting documents:
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

http://www.tillydiabetes.net/en_6_protocol2.htm

http://www.ncbi.nlm.nih.gov/pubmed/19592286

http://petdiabetes.wikia.com/wiki/Case:Jock

I will email you privately (I don't know if we can attached a PDF document with the post at FDMB) with an attachment of a paper by Univesity of Queensland which clearly states their preference of insulin to treat diabetic cats: choice #1 is Lantus (glargine) or Levemir (detemir), choice #2 is PZI. Lente is their 3rd choice which results in lower remission rates compared to longer acting insulin. Cannisulin has EVEN SHORTER duration than Lente. So please try to get Lantus or Levemir if you can. One of our old members (Steve and Jock) started using Levemir for his cat Jock in 2005. They live in the UK so I know you can get Levemir to treat diabetic cat in the UK. Steve set up a wetsite documenting Jock's case study using Levemir (http://petdiabetes.wikia.com/wiki/Case:Jock).

I used to live in London, UK. I had to change to a different vet (quite far away from where I used to live) in order to get the insulin (Insuvet PZI) I wanted to try for Major becasue my old vet refused to try anything new.

Janet , Cannisulin may be the only insulin licensed for veterinary use in the UK but vets in the UK can get a cascade prescription (they just need to fill out some paper work) to get you prescription for medicines which are intended for people. I had done it many, many times in the UK.

I know Insuvet PZI has been discontinued in the UK but I was able to get a bottle of Hypurin PZI from my previous UK vet in April. From the insert, Hypurin PZI seems to be intended for humans but some vets are using it for cats. If you can't get Lantus or Levemir then ask your vet if he can put Harry on Hypurin PZI. PZI is better than Cannisulin.

Are you checking Harry's urine keytone? I would highly recommend it.
 
Janet,

I found the article I wanted to email you on line. Here is the link:

http://www.uq.edu.au/ccah/docs/diabetesinfo/link2.pdf

This is the article that mentions Lantus (glargine) or Levemir (detemir) being the first choice insulin for control of feline diabetes. PZI is second. Lente is third.

I know from my experiences dealing with vets in the UK, if you can make a convincing argument and show them supporting documents then CREDIT them for any improvement you see in your cats (even though it was your suggestion), they will be more willing to try something new.

I really, really hope you can put Harry on Lantus, Levemir or PZI. My Major is here with me today because I was lucky enought to find a vet (one of the FDMB members recommended him to me. I am forever grateful for her help.) who was willing to switch Major from an insulin that was not doing anything for him to one that Major responded well.
 
Hi thanks for all those links I'll go through them later (being naughty again supposed to be working!)

I'm getting together as much information as I can for the vets re Canninsulin and all the alternatives and then we are doing more blood glucose curves to prove this isn't working long enough and then I will insist the vets follow the cascade procedure. Can I ask even if a cat has pancreatitis if he's on the right insulin you should still get a normal blood glucose curve even if the numbers are perhaps higher than they should be?

We haven't been testing his keytones as we have 2 cats, Harry and Katie they are brother and sister not that you'd know it to look at them, and they both use the same litter tray. When he was really poorly at the vets they tested his keytones and it was negative but the nurse said she could smell it so I don't understand what is going on there. I might see if the testing sticks we have do keytones we did have them to test his glucose but he refused to use the special tray at night when we separated the 2 cats.

Harry is currently on Royal Canin gastro intestinal moderate calorie wet food that the vet says he has to have because of his pancreatitis its low in fat although I'm not sure that is correct now. From what I could find it doesn't look as low as I'd like in carbs I think his whiskas tinned food is lower but thats too high in fat apparently. All in all I don't seem able to win on the food front at the moment. Perhaps I'd be better off switching him to raw like the dog eats.

Thanks

Janet
 
Harry and Katies Mum said:
Sam and S'mores said:
I just ran the numbers on that food, and by my count it is not low Fat at all...

Dry Matter Basis from here
40% Protein
15.4% Fat
26% Carbs

So, to convert to % energy, you need to multiply Protein and Carbs bo ~3.5kcal/gram, and Fat by ~8.5kcal/gram
140 Protein
131 Fat
91 Carbs

As a % of energy:
39% Protein
36% Fat
25% Carbs
Click to expand...

hmmmm thats not so good then. They'd convinced me that that really was the best food to treat his pancreatitis but perhaps it isn't. I know what I'll be spending the day doing now then and thats researching the best food for a cat with pancreatitis.

Anybody have any ideas where to start.
Click to expand...

Janet,

Have a look at this food which you can get in the UK:
http://naturesmenu.co.uk/products/Chick ... _for_Cats/

I switched Major to this food when he was dx diabetes then later with suspectd low grade pancreatitis. Major did well on this food but later he became allergic to chicken, turkey, beef and lamb so I had to switchhim to 100% raw rabbit diet.The neutritional consultant for this company was Dr. Nick Thompson, a holistic vet who also adovcates raw feeding. I consulted with him a few times while we were still in London.
 
Janet,

I have some more supporting documents for you to show your vet for your to ask for either Lantus or Levemir insulins:

Dosing Protocol for Cats on Lantus or Levemir Using Daily Home Monitoring of Blood Glucose
http://felinediabetes.com/Roomp_Rand_20 ... otocol.pdf

Intensive Blood Glucose Contol is Safe and effective in diabetic cats using home monitoring and treatment with Glargin (Lantus)
http://felinediabetes.com/Roomp_Rand_20 ... otocol.pdf

This article states Lantus and Levemir as the first choice insulin to treat feline diabetes, PZI being second then Lente. Cannisulin is not specifically mentioned in this article but it has an even shorter duration then Lente. When I first joined FDMB, one of the UK FDMB members told me that Cannisulin was initially intended to treat diabetes in dogs, hence the name. It is later used to treat feline diabetes but the results are not as good as PZI, Lantus or Levemir or even compared with Lente (both Lente and Cannisulin have shorter duration than PZI, Lantus and Levemir). Cannisulin may work work well for dogs but cats have higher metabolism than dogs; therefore, insulin with longer duration usually works better to treat feline diabetes.
http://www.uq.edu.au/ccah/docs/diabetesinfo/link1.pdf

Good luck!
 
Hi Harry's Mum :)

I have found that the best food for my old diabetic girl is Natures Menu and then Bozita Pate, both wet. I'm not sure how this may fit in with a pancreatic diet, but it really is good food - about 70% meat and no sugar. I have one last bottle of Insuvet PZI in the fridge then I don't know what I will do ...try convince my vet to prescribe Hypurine Bovine..

Good luck, I am in London.
 
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