Can someone please check my spreadsheet/notes? (Caninsulin)

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Lori&Scout

Member Since 2012
I'd like to ask anyone who feels comfortable reading curves to have a look at Nipper's spreadsheet and secondary monitoring info below and let me know if there's something I should be doing different, if you see any red flags, and if you think she might do better on Lantus (if her numbers don't improve in the next week, I will be pushing vet for that.)

I've not been doing a great job at getting a curve thus far because of schedule difficulties and ornery cat difficulties. My plan is to try to get a better curve tomorrow or Wednesday for you guys to examine - should I do every 2 hours? Is there a specific hour or hours that you'd like to see numbers for? (I was thinking +2 +4 +5 +6 +8 +10 to try to see when the nadir is) I might only get one shot at a curve this week.

5 Ps:

Purring: Not purring much. Not asking for attention and pets like she usually does... she comes to me and my boyfriend for about 10 minutes a day rather than the usual 2 hours +. She is happy for the attention during test time and when I sit with her, but she won't come to me when I call like she normally does. Sitting in her cardboard box with eyes half open most of the time, but she does walk around the house and jump onto the furniture when it suits her - moreso over the past couple days.
Peeing: Rivers. Often outside the box :sad: (she walks into the box then pees outside of it, and once she just peed on the wall next to it.) This is new this week. Drinking lots but I can't measure because she keeps dumping the bowl all over the kitchen floor. :-x
Preening: Yesterday was the first time since before her diagnosis that I saw her grooming. Not a full bath, just a post-meal face wash.
Playing: Won't play with laser pointer. Sometimes follows it with her eyes but usually not. She keeps moving her water bowl all over the kitchen and splashing the water out of it, which she never did before her diagnosis. Does that count as playing?
Pooing: Normal, albeit quite stinky. Had diarhhea prior to diagnosis but this has cleared up on its own.

I have not been checking for ketones as she normally will stop if anyone interrupts her but since she's going outside the box I may be able to check tomorrow. How often should I be checking with numbers like hers?

I changed her food on Friday from Purina DM wet to some German food on the low carb list that is supposed to be about 3%. It hasn't impacted her preshot readings. She also gets some chicken and freeze-dried treats.

I upped her insulin from 1U to 2U on Friday per vet's instructions. She weighs 11 lbs and is quite lean and muscular. Vet thinks she'll need 3-4U and wants to slowly increase it, but I want to get the green light from you guys as well as the vet before I go above 2.5.

Thanks in advance for any advice and opinions. I greatly appreciate the time and effort you all dedicate to our cats' wellbeing.

Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Food change can take some time, to see the results. The way I see it is its almost like detox. Some can flush out the gunk quickly, others may take some time so I wouldn't get discouraged with that.

As to the numbers, it looks like the lowest she has dropped is 220. Sometimes it can take a while to get a cat regulated, but I really do not recommend the caninsulin. Hidey was on vetsulin which is basically the same and his numbers wouldnt budge. I had him on it for a month since my vet asked to give it some time, after that month I DEMANDED prozinc and after a month on that with diet change he went into remission and I can happily say he has been OTJ and diet controlled for 9 months.

I would suggest switching insulin if that is an option, simply for the fact that caninsulin lasts about 8 hrs and its best to have a longer acting insulin (12 hrs) those are levemir, lantus, prozinc and PZI. I see you are in the UK and am not certain what is available. Ive seen posts about trials going for prozinc not sure how to find more info on that though.
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Hi Lori,

As Samantha said above, it can sometimes take a little while to see the effect of a diet change, so you may see more response over the next few days. (Incidentally, which German food are you feeding?)

If it can be shown that Caninsulin isn't working sufficiently well for Nipper then it may be possible to get your vet to prescribe a longer lasting insulin. There are 3 such insulins currently in the UK: Lantus, Levemir, and Hypurin PZI. (Note: Prozinc isn't generally available here yet, but may be soon because it's getting such good results on the Royal Veterinary College's remission trial).
Vets in the UK vary enormously in their attitudes to prescribing alternative insulins. Some vets actively encourage a change of insulin; some vets can be easily persuaded; and some vets doggedly refuse (some folks have had to change their vet in order to get a change of insulin).

Regarding getting vets to prescribe alternative insulins, some folks have sought help from a lovely vet (called Ruth) who's involved in the RVC's remission Trial. (Her first hand (and professional) experience of the benefits of longer lasting insulin has helped to persuade a reluctant vet...)

Eliz
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Thank you for the replies. The food is Miamor Pastete (4% carbs) which I found on the UK cat food list: https://docs.google.com/spreadsheet/ccc ... mWmc#gid=0

Thanks Elizabeth for your work on this list! Both cats like it and no one has had an upset tummy so far.

I'm not having a good day... Nipper is now peeing EVERYWHERE. Apparently she's been going behind the TV (near the litter box!) and my poor boyfriend came home yesterday to soaked floor and soaked rug. He cleaned everything, then she did it again! The litter box was spotless and accessible and THREE FEET AWAY. She's never had an issue with using her box before this week, apart from the occasional pee-over-side-of-box. I had to shut her in the kitchen overnight, and as far as I can tell she used her box at least once, no obvious accidents.

I need to get her regulated soon because I can't just lock her in the kitchen 24/7. Not sure what to do. I have two very clean litter boxes for two cats (I know I should have 3, but I have nowhere to put a third and they don't protest as long as they are clean). I could add a third if people think it might help. I just cant figure out why she's doing this, it seems like she's purposefully going next to the box, rather than an accident.

Anyway I just feel like crying and I'm so worried about her, and also very over cleaning up after cats all day long.

Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Maybe a slightly larger box - I use a cement mixing tray, some folks use large plastic sweater boxes with an entry cut into it.

Also, if you don't get the smell cleaned out, it is a marker for using the spot. For carpet, this may mean rolling it back, and treating any pad plus the back of the carpet with an enzyme product designed to break down the odor source. In the US, Bramton makes a product called Simple Solution that works very well. A large pet supply company may carry something similar where you are.

A urinary tract infection can cause urgency issues, as may diabetic neuropathy. That leaves the cat without enough time to get to the box. A vet check may help for the former. Methylcobalamin, a specific form of Vitamin B12, may help when combined with good glucose control.
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Thanks BJM... I am taking her back to the vet tomorrow morning. Now she is pawing at her mouth after eating hard treats and that points to mouth pain.

I'll also ask the vet about UTI possibility, but the peeing everywhere I think is more likely caused by some combo of high sugars, feeling poorly, neuropathy. Probably it was too painful or too much bother to get into the box and get turned around.

I'm definitely aware of the marking as Scout is a very naughty girl and pees on things when she thinks her box is too dirty and then continues to pee on them forevermore. I have an enzyme cleaner that helps somewhat. I've just never ever had this problem with Nipper and the last thing I need is Scout smelling where Nipper has gone and deciding to join the party. I'm at wit's end with this because I keep thinking that if this spirals out of control I'm going to have no choice but to move house!

I was hoping to get a decent curve today but with keeping Nipper shut in the kitchen and the fact that it took me like 8 tries to get blood for her AMPS I decided to wait until tomorrow. I really want to get her regulated ASAP. I'll speak to the vet about Lantus again tomorrow.

Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

BJM said:
A urinary tract infection can cause urgency issues, as may diabetic neuropathy. That leaves the cat without enough time to get to the box.

(((Lori))),

We all understand how stressful this is. But keep your chin up, sweetie: Chances are that this is just a short phase and will soon pass.
I second what BJ said above. And it may be that Nipper does indeed have a UTI that needs treating.

I do so sympathise about the 'peeing in the wrong places' problem...
My Bertie had high blood glucose numbers and neuropathy at diagnosis. It did take us quite a while to get the blood glucose numbers under control, and we certainly had problems with him weeing all over the place. It was as if he was incontinent (even though he didn't apparently have a UTI...).
He's always liked to sleep on my pillow, and I've twice woken up to find my hair soaked in cat pee because he'd peed in his sleep.... :-|
This was a relatively short phase though. When his numbers got a bit better all of this stopped (thankfully...)

Do please let us know how you get on at the vets.

Big reassuring hug to you,

Eliz

PS. The UK food list wasn't my work; it was (and still is) the work of lovely FDMB member, Juliet (AKA 'Dr Schrodinger') :smile:
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Ugh. Her PMPS is 29.1 (524) which I'm trying not to freak out about. She ate an hour ago so maybe that's why it's so high?

She's going to the vet tomorrow morning. I'm going to stay up with her tonight and try to do a curve, then maybe I can use the data to lobby for a switch to Lantus.

Thank you for the reassurance. I know she's feeling very poorly and normally very good about using her box so I'm sure you're right and it's temporary. She's using her box today so that's a start. It's just been one thing after another with both cats this year, we've moved twice and it has stressed them out a lot, Nipper has been sick a couple times, I have to travel for work quite often and I'm totally stressed out about leaving them.

Breathe, right?

Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Gave Nipper her first 3U injection last night, up from 2U. Numbers were still in the purples at +2 and +4 so I went to bed. This morning at +13 hours she was 13.2 (238) and very hungry. I assume she ate all her food earlier in the night. I only gave her 2U since she was still low from the 3U, and her numbers have steadily gone up since then, 17.9 (320) at +2.5 and 20.5 (370) at +4.5. She has eaten but still that's higher than her numbers normally are on 2U.

Soooo I guess this was a bounce. My question is what to shoot tonight. I was thinking to shoot 2.4 or 2.6U for a week, especially since I'm going to be out of town T-Th and my boyfriend has not got the hang of testing her yet. I have some 100U syringes and the conversion chart, so that should work.

Any thoughts?

Cheers,
Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Hi Lori

Splitting the difference may be good but am sure someone more experienced can advise. When are you going out of town. If you change to the different syringes please just double check here. When I did I almost went mad from the stress of it. I had two vets telling me different things about the dose and I became paranoid about getting it wrong. When you do go away I would fill an old syringe with coloured water (grape juice or something) so that your partner can has a visual reference to check against.

Did I miss what the vet said? Did nipper have a UTI?
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Sorry I should have updated my post :) Vet said she didn't have a fever or any bad teeth. Could be a UTI but unlikely as she doesn't have any other symptoms. She is going only in her box now but peeing over the edge instead of going in and turning around and then peeing. Hopefully that's just temporary. I'm going to try to get a sample to bring to vet just in case.

Nipper has shown a few signs of perking up... grooming a couple times and playing with a string when I dangled it. I'm hoping a 2.4U dose will keep her from bouncing too much this week. I'm sure my vet will not like me using the 100U syringes and going against her 3U advice. I have the conversion chart:

http://www.felinediabetes.com/insulin-conversions.htm

Just need to draw to 6 on the 100U syringe for 2.4U. I'll try it tonight and see how it goes. The 100U syringes have a shorter needle part so I don't even know if they are going to work.

Teaching my partner how to blood test, but it's so cold today that even with the rice-sock her ears didn't want to bleed for him. We'll try again later.

Cheers,
Lori
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

I use the shorter needle as otherwise, I tend to go through the tent and/or stab myself. Plus, longer needles, if 31 gauge, bend really easily.
 
Re: Can someone please check my spreadsheet/notes? (Caninsul

Has Nipper been tested for pancreatitis at all, Lori? Some of her clinical signs could possibly point to a GI system problem:

- playing with water
- pawing at mouth
- whiffy poops
- vomiting (culprit unknown)

Tanya's site has a very useful page on nausea symptoms and treatment.

Is Nipper pooping in the litter tray OK? What was the vomitus like? Clear foam / furball / contained food / other?

FWIW, Saoirse sometimes stands when she pees. I'm not sure what type of litter box you've got but I use this type. The high sides are great.

Also, Saoirse was very withdrawn when on Caninsulin. It might be worth checking her spreadsheet comments for some of the clinical signs that it wasn't agreeing with her. She was miserable for 9-10 hours out of every cycle and used to try to avoid injections (both problems resolved pretty much completely when she switched to Lantus). I used the clinical signs as well as the poor regulation / hypo risk to argue the case for the switch away from Caninsulin. The consult between our vet and Ruth from the RVC helped a lot, too.
 
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