Help a Jerusalem cat daddy in need

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Jerusalem-cat-daddies

Jerusalem-cat-daddies

Member Since 2013
Hello all,

My name is Erez and I am the proud father of a little diabetic lion by the name of Raus. We've been giving him Insulin for a month now, using the "start low go slow'" approach, and I'm quite frustrated. His condition seemed to be improving somewhat, but not that much, and than a week and a half ago it became worse again - he is constantly hungry even though we give him more than enough food, and drinks and urinates a lot.

We are currently giving him Humulin, because that what our vet prescribed, but I've just been told by another vet that using Humulin for a cat is very old fashion, and that we should switch to Lantus. In general, I don't feel I can trust my current vet. I tried talking to him once about my suspicion that Raus is suffering from the Somogyi effect, and he had no clue what thשא is or that there is such a possibility of an Insulin rebound.

So, the point of all this is...mainly that it would be nice to have someone tell me I'm sane, because I feel like I'm going insane after too many hours of ear prickling and listening to the cry of a constantly hungry cat. Second of all, what do you say about Humulin vs. Lantus? and would you switch to another vet if you were in my place, despite the costs involved?

Hope it's not too much for a first message!
 
Welcome to FDMB.

First, let me give you some glucose reference ranges used for decision making using a human glucometer:
ETA: updated to provide mmol/L and AlphaTrak estimates
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
You're sane ... or we're all crazy!

You may feed up to 50% more food for an unregulated diabetic because they aren't able to use all they consume. Spread it out into 2 or more meals per shot. Slow down the eating by mixing a couple tablespoons of water in the food and spreading food thinly across a wide plate.

Lantus lasts about 12 hours in the cat; Humulin lasts 6-8 hours. Lantus has a gentle onset and wears off slowly; Humulin drops the glucose like a rock and wears off quickly. The lowest point (nadir) between shots for Lantus is around 5-7 hours after the shot; for Humulin its about 3-4 hours after the shot. Best control with Lantus is 1 shot every 12 hours. For Humulin, you may need to give it every 8 hours.

See my signature link for Vet Interview Topics. Alternatively, if the vet is willing to learn, provide the vet with the 2010 AAHA Feline Diabetes Guidelines. (Near top of Feline Health forum.)

Jerusalem the country city? If yes, what cat foods have you been able to find there?
 
Hmm, I'm quite sure there is no country called Jerusalem. :+)

Jerusalem is the city, Israel is the country. We used to give him a kind of wet food called Techincal. Than they ran out of it a month ago, and we started giving him some italien wet food which he devours like a maniac. The name begins with m...I can't remember the name. They also sell Le Cat, and all kind of dry foods, but I stick to the wet ones.

Thanks for the tips and information!
 
Sorry! A bit short of sleep and did a lot of driving this weekend!

This may be a useful post on European/international cat foods foods.

Cat Info has a lot of information of feline nutrition as well as a recipe for making home made cat food if you determine that the available foods are too high carb. You can slightly improve the canned food by adding 1 ounce of plain meat or poultry to every 5 oz of cat food.
 
Hi Erez and sugarkitty Raus and welcome to the FDMB.

Lantus is a much better insulin for a cat than Humulin. The Lantus lasts longer with a cat's higher metabolism so keeps the blood glucose levels more under control. I would not use Humulin on any cat because it does not last long enough. You would likely need to dose Humulin 3 times a day and that often is not possible with most people's schedules and life responsibilities.

Food can have a big impact on the BG (blood glucose) numbers. We suggest <10% carbs. My foster cat Wink went from eating high carb dry food to eating low carb wet food and no longer needed insulin. He is a diet controlled kitty, OTJ which means off-the-juice, insulin being the juice.

Wet food is best, it keeps the kidneys healthier, lower in calories, high water content to keep your diabetic cat hydrated.

Avoid any canned food with grains like wheat, corn, soy; no vegetables like potatoes or peas, no fruits. Those should be low carb enough.
 
Thanks everyone for the replies, so...I think Lantus it is. I'll discuss it with my partner when he comes back from abroad this weekend, and keep you update after we did a new curve. I'll look into the food we have later today, when I'm at home.

It's amazing. I thought I read quite a lot, but there's still so much information. Well, at least I'm not short on reading material.
 
Yep, "Humulin" does not last that long. What "Humulon" are you using? Humulin is a family of insulins made by the EI Lilly company. Presently they make R, N and a combination of N and R.
 
Now, if you update your user control panel, profile tab, edit signature and put the SS link in your signature, it will be there in each of your posts. Please put the link from the "publish to the web" pop up window, not the direct link in the web address bar.
 
Jerusalem-cat-daddy said:
Done! And I even added a picture of Raus.
Click to expand...

What a pretty little lion! :YMHUG:

How are things going today? I also second the advice about switching to Lantus. If your vet isn't willing to work with you or read the research himself on why humulin is not an ideal choice of insulin for long-term management of feline diabetes, then go to the vet that suggested Lantus instead. You pay him to work for you and if your vet isn't willing to do his job, find someone else who will. ;-)
 
Hi good job on the spreadsheet but I am a little confused on the dates in the rows? They dont seem to be in order? see below..

06/08/13
18/08/13
13/08/13
29/07/13
 
Wendy&Tiggy said:
Hi good job on the spreadsheet but I am a little confused on the dates in the rows? They dont seem to be in order? see below..

06/08/13
18/08/13
13/08/13
29/07/13
Click to expand...

She did day, month, year.
 
I updated the glucose reference values above to provide mmol/L in case your vets use that.
 
I am british but its still not making sense - maybe I am slow today but it looks like row by row..

06/08/13 - 6th august
18/08/13 - 18th august
13/08/13 - 13th august
29/07/13 - 29th july
 
Wendy&Tiggy said:
I am british but its still not making sense - maybe I am slow today but it looks like row by row..
Click to expand...

Wendy, even though you're British, you're still right. ;-) :lol: I think the date formatting is off.

Erez, when you get a chance, can you please update your spreadsheet for us? :-D
 
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