Dosing and food Question-For YoYo

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Hala Darwish

Hala Darwish

Member Since 2021
Hello all,
I am new here, I shared the story of YoYo already on Facebook. I will brief you again.

YoYo is a rescue cat , 1+ years old. With Cerebellar Hypoplasia, Pancreatic Insufficiency and Diabetes. As I currently live outside the US , when diagnoses with diabetes which in his case is juvenile, he was started by the vet on an Insulin type not used in the US , it is a human Long acting insulin ( Insulatard, Onset of action is within 1½ hours, reaches a maximum effect within 4-12 hours and the entire time of duration is approximately 24 hours )
https://www.ema.europa.eu/en/documents/overview/insulatard-epar-summary-public_en.pdf

Within 3-4 months of his first DKA or when he was diagnoses, he went into remission for about 4 months. When we started the treatment and when in remission he had gained weight but he remains underweight for his age , he is now 2 kg. The vet asked me to increase his food quantity which I did but he does not eat much.

This past month, his BG started to climb again. I went back to giving insulin, I started with 0.5 unit twice per day, I went up to 1 unit twice per day, then he had a couple of hypoglycemia episodes by 4-5 hours post morning injection ( asymptomatic ones) , the lowest he got was 22mg/dl. I reduced the morning and night insulin doses to 0.25 , then his BG became in 100s to 150s in the evening so I skipped the night dose and made the morning dose a barely noticeable in the syringe volume. It has been a week now, his morning fasting BG is in the 200s , yesterday I skipped insulin all day. This morning his BG was 203 mg/dl. I use a human meter. I did not feel comfortable giving insulin. I leave to work all day and I do not free feed as I have another cat who is overweight and if I leave food he would eat it all.

I am only feeding him wet food, mostly Royal Canin Diabetic as I had already bought a stock and I am introducing Pate as recommended in this group. I only use dry food to sprinkle on food to make him eat a larger quantity. I sprinkle with Light weight Royal Canin dry food.

I would like to hear your opinion about the BG management, can I skip the insulin when it is in the 200s ?
Anything you suggest that can get him to gain some weight. I notice that when his Diabetes is controlled he eats very little, when his BG is not in control he has lavish appetite and eats everything and jumps on our food plates. I obviously understand that he is better off with a controlled BG but he also needs to gain some weight. Any suggestion is helpful.

I also would like to hear your opinion about the raw diet ? A vet told me about this, but I am not able to think of how to feed raw meats ? I did not do enough search about this. Let me know your thoughts.

Thank you.
 
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Hi @Hala Darwish And Yo Yo

1.,I have the pictures of your Insulatard. It's an NPH insulin,
and I have used it in 2006-2007 since it is a Nordic Danish NovoNordisk insulin. Prior to Lantus in 2007. See For NPH insulins here https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

2. You should set up a bg Spreadsheet and Your Signature, and link your Spreadsheet into your Signature.
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

3. Concerning raw food, of course that is doable, see Dr Vet Lisa Pierson's www.catinfo.org

4. And that's correct, no insulin if under 200.
 
Hi @Ann & Scatcats ,
Thank you this is helpful, Indeed Insulatard® is a suspension of isophane (NPH) insulin, but it is considered long acting as its duration of action is 24 hours
"Insulatard is a long-acting insulin. Onset of action is within 1½ hours, reaches a maximum effect within 4-12 hours and the entire time of duration is approximately 24 hours."
http://www.pharmaline.co.il/images/.../novonordisk/12102011/insulatardpenfilldr.pdf

In any case, at this stage I needed reassurance that it is okay to skip the insulin when he is the 200s . I started filling the spread sheet , I will complete it soon.
I will check the link on raw food. I think I will postpone this plan until I move back to the US in the summer, until then any suggestions for weight gain ?
 
Ann & Scatcats said:
@Hala Darwish I know CH kitties very well. But Yo Yo is the first diabetic CH kittie I've met.

Is he too wobbly too eat more, often and a lot?

I read through here https://lifewithchcats.com/ch-topics-tips/eating/ but don't know what fits Yo Yo's description?
Click to expand...


He is not too wobbly, he has a mild ataxia when walking and it becomes more noticeable if he is running or jumping. The tremor is more evident when he is scared or focusing or sniffing around. But I do notice that at times he likes to eat from his brother's more elevated bowl. I use a stainless sturdy and wide bowl for him but not elevated, I will try to elevate his bowl and will see if it will help. Thank you for the suggestion.
 
@Hala Darwish this kind of on legs elevated food table helps Yo Yo, there are several kinds on Chinese alibaba and when our image upload here doesn't work, I can't show you the specific one, it's the one on legs elevated but also tilted, item nr 47 https://www.alibaba.com/products/pets_feeder.html?IndexArea=product_en&page=1&viewtype=G

I think you can find similar around where you are.


When you have tried to fit something out for Yo Yo, make a thorough Design Drawing, with all correct measurements, of it how it should be and look for Yo Yo, and then you can go to a Wood handler and buy the wood pieces you need, and you can, unless you don't already know one or can do it by yourself, someone with Carpenter equipment and make it for Yo Yo yourself.
 
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I've also assessed your Spreadsheet. Good Call on lowering the Insulatard insulin there since ended up on Hypo 22.

It could be assess benifical if you could do a day curve, with the AMPS bg, the + 3 hrs, +6 hrs, + 9 hrs, and +12 hrs bg number tests.
So we see what YoYo is up to during the entire 12 hrs with his bg numbers.
 
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