High dose kitty

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klunk

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Hi again

Firstly, I would just like to say thanks for everyone who has helped us out so far. We are now hometesting Timmy and its alot more reassuring. We have also fully changed Timmy onto Wet low carb food and this went very well. He was previously having mainly wet m/d with just a small amount of the dried m/d for a bit of crunch so it wasnt that bad really changing him, dont think he actually noticed. We have since changed him onto regular canned food, as per the food guide list we were kindly pointed to. This gives alot more variety for Timmy plus its easier to get and easier on the purse. Luckily Timmy will eat anything so again this was fairly easy. Although he did seem to quite like the m/d stuff.

What I am mainly worried about is that when we first found out Timmy had diabetes the vet initially put him onto 3 units BID, but the next day he went into DKA and the vet increased the dose to 4 then 5 BID. He was on 5 BID for a couple of months and then we had another DKA scare and he spent a few days in hospital and they increased him to 6 units. From reading people posts on here I am concerned that this is a very high dosage and that because he went up to 5 units very quickly (within 2 days of him being diagnosed) I am wondering if this if too high but was concerned because of his ketone episodes at reducing his units. However, looking at his numbers I have become more convinced that he is on too high a dosage so have been slightly altering his units based on his numbers and today I have dropped him down to 2 units and have been testing regularly and his numbers seem to have been the most steady they have been since we have been testing him. However this is only the first day we have been on 2 units and he has only had 1 shot of it, he is due his next one in 2 hours.

I am just concerned that I might cause further issues by dropping it so low when he has been on alot higher previously and when he was on higher he has had 2 DKA episodes, but we werent hometesting then so can obviously keep more of an eye on it now to ensure its not rising too much. I will keep updating his spreadsheet and testing regularly. I have also tested his urine every time he been to litter box over last couple of days and his ketones have been negative, as thats my main worry.

Sorry for rambling on and hope that makes sense!!

Thanks :)
 
Re: Bit of advice please

Looking at yur SS I see little drop i the BGs over the course of the day. I would expect to see more of a drop with Caninsulin. Therefore, as you are questioning, the present dose may be too high and reducing the dose might be in order. Based on history reducing it to 2 units might be in order. Based o history, frequent urine testing for ketones and mini BG curves are on order quickly find out if the dose reduction is going in the right direction.
 
Re: Bit of advice please

So wonderful that you are hometesting. I think the reduction may be a good idea, but definitely keep up the ketone testing. And watch your numbers carefully.
 
Re: Bit of advice please

Sue, the poster gave a link to her BG spreadsheet and stated: "I have also tested his urine every time he been to litter box over last couple of days and his ketones have been negative, as thats my main worry."
 
Re: Bit of advice please

Thank you so much for your quick responses. I will keep on doing both and just hoping a reduction helps his numbers, I was just worried this would cause more issues with such a big drop. Thanks again for your help its very much appreciated :)
 
Re: Bit of advice please

Hello.

I would be so cautious myself after your experience with DKA- completely understandable..

I would also be careful about dropping the dose as I don't see a huge indication on your spread sheet that too much insulin is happening, and the drop back level of today is not making a dent.

Perhaps you would also post on the high dose group?
A kitty needs how much insulin a kitty needs and every cat is different.
How does your cat seem overall these days?

Please keep us posted
Kimmee
 
He seems perfectly fine, to be honest he hasnt changed much throughout.. We noticed a massive difference as soon as we started giving insulin. Regards eating, drinking, urinating etc. He also had slight neuropathy but this also cleared up after a week or so on insulin. The only time we have noticed a difference since the insulin is when he had the DKA but luckily because there was a massive difference we noticed it quickly and the vets were able to fix him. His ketones did go slightly higher to the pale pink a few days after his second hospital stay but it wasnt a bad episode and just getting plenty of fluids in him fixed this without hospitalization.

He is also normally an outdoor cat during the day but since this has happened we have been keeping him in, just not sure if he will come back on time for his injections, hes not good at checking his watch :) or what he could eat while he was out. So I assume he is not getting as much exercise as he used to do.

Thanks again for all your help :)
 
Good to hear :)
It is important to look at the whole cat, not just the spreadsheet, as you move forward into regulation.

paws crossed things continue to look good.
Kimmee
 
Hello
I'm Patti from the hi dose group and just happened to see your title of your thread. I think it's toooo early yet to say if your kitty really is a hi dose kitty or not. And I'm just coming into everything you have been thru = but it sounds like alot already! :(

I've used vetsulin in the past with 2 kitties - Merlin who WAS a hi dose kitty and had acromegaly - and now Boris who is a diabetic so I have a little experience with it. i must admit I've switched Boris over to Lantus tho.


Please forgive me - I'm sure this has all been gone over - do you know how the vetsulin works - you know that typically it drops the sugar within 2-4 hours with a slower drop after that for a few more hours and then a steady climb back up after that. I don't see any of that in your cat's BG's. I don't really see much difference in your numbers between giving 2 units and 6 units. However I don't see any drop at all in the numbers when giving the Vetsulin. THAT is unsual. It sounds like perhaps Kimmee and Larry and Sue have been helping you more already so I don't want to give you any advice on dosage now but If you don't mind - I'll just follow along for awhile and watch your SS. Looks like you're able to test fairly often and with being able to test his urine too so often - THAT is a huge help and gives all of us alot of information to work with too.

It sounds like you just recently switched over to all canned food if I've read things correctly. How long has he been on JUST canned food? Would it be alright if I ask a few other questions - and again forgive me if you've answered all these a million times before?

How old is Timmy?
How much does he weigh?
Has he lost weight at since being diagnosed or prior to diagnosis or have you noticed a weight gain or maybe no change at all?
Ever notice any breathing difficulties?
Do you laugh about the fact that he snores loudly?

These may sound silly to you but they are part of a picture that later may help as we see what Timmy does with his insulin needs.

I hope I can help if you need. I'll check back later but if you would like more help or info just pm me and I'll come back sooner!
Wishing you and Timmy all the best
 
Yeah I had read up about Caninsulin and thats what was worrying me because no matter what we seem to give him the numbers stay fairly consistent, Its very odd!! We did as Vet about switching insulins but they said they wouldnt consider this unless he ended up being on alot more insulin?? To answer your questions Timmy is just coming up to 11 years of age, he weighs erm well when he last went to vets about 3 weeks ago he was 4.5, not sure what that is in to be honest, think its Kg so would be around 10lb. He did lose a fair bit of weight before he was diagnosed which as soon as we started to give insulin went straight back on and he has been a consistent weight since. The vets say this is his ideal weight however to me he does still feel skinny and he always wants food. Its very difficult to free feed him because we also have 2 other cats, a dog and a rabbit (that likes to snack on cat food so I dont like to leave it out without supervision) running around the house which is pretty open plan. So to free feed him we would have to leave him in an upstairs room on his own which really stresses him out. So I tend to give him two main meals before shot time and then little meal snacks when possible.

Oh and he has been on all wet food now for two weeks. I am currently off work which is why I am able to test him so regularly, however I am going back next week so will be out of the house for majority of the day, Between around 7.30am - 6.30pm so am not going to be able to test as often :(

Thanks again for your time :)
 
Are you in Canada or Europe? If in Canada, we have lots of members there who might be able to steer you to a vet who was willing to work with different (better) insulins. You don't need a prescription to change insulin in Canada, but you do want a vet who will work with you. I know we have several Canadian members using Lantus.

If in Europe, more complicated. Vets there are very reluctant to prescribe other insulins and seem to only do it if Canninsulin completely fails. But there have been a couple members lately who have been working on getting ProZinc prescribed. Maybe they will chime in.
 
Why not print out the below info and take to your vet, saying you want to switch to a longer lasting insulin like Lantus or Levemir.
Vetsulin / Caninsulin ... same thing.
Lawsuit against Vetsulin Manufacturer
Vetsulin FDAs Warning December 15, 2009

I started using Caninsulin on my high dose cat and had horrible numbers. I switched to Lantus and noticed great improvements.

If you vet refuses to allow you to use a safer insulin for your cat, can you try a different vet?
Just curious, how high a dose does this vet expect you to get up to, before considering a safer insulin?
 
Yeah we are in the UK, I am not sure how high they expect the dosage to be. I have considered using a different Vet but I know the other one in my area that we have used before has the same views as my current vet because my mum also has a diabetic cat and uses the other vet. There are other vets but they are along way away and as I dont drive I would prefer a vet that's quite close just in case I need to get to them in an emergency. But if this is not working and they refuse to try another then this might be the only option.

Yesterday we gave Timmy 2u in the morning but and the numbers were steady around 250 all day up until we came to test him before his PM shot and he had risen to 378 so I had a panic and thought that 2u wasnt enough so gave him 4u again last night, checked a couple of times in the evening and he was back to his normal 250 range and then this morning he was around the same 250 so gave him 4u again and he has been around the same numbers as he was throughout today that he was yesterday when I only gave him 2 yesterday. Will test him again before his PM shot and see what that tells me.
 
Ok, you are panicking and raising and lowering the dose by 2 units at a time...this is NOT a rational approach and will not help you figure out what dose your cat needs. Changes need to be methodical, and if you raise a dose it should be by no more than 0.5 units at a time! you essentially doubled the dose, a very dangerous thing to do. Don't get me wrong, I understand why, but nonetheless you need to please not do that!

The old cutoff dose that we used to suggest was 6 units. If that wasn't enough insulin or it wasn't working well, time to switch. But now we have such better alternatives to caninsulin/vetsulin that I really don't think its worth that amount of wait time and frustration.

The petdiabetes wikipedia article lists all the insulins that are available; I believe that one of the ones most popular in the UK is being discontinued (insuvet????) but there are a few other options for you that I'd strongly urge you to talk with your vet about. hopefully one of our UK members can provide more specific info

Jen
 
Just checking back in on you and took another look at your SS this AM.

Like everyone has said - it would be wonderful to get on another insulin - Lantus or Levemir. I don't know how comfortable you are with "pushing" your vet for this insulin - but sometimes if you try to remember you are an advocate for your kitty just like for your child at the Dr - that sometimes helps. But still it can be overwhelming too. Gayle gave you links about the vetsulin to take with. And I don't know if you've been bringing all your numbers to the vet too to show how there is now difference between all the doses. Sometimes our vets really don't understand much about these insulins either. It's oftentimes up to us to teach them more about all of this - sad to say. I also know you are in the UK and having friends there with diabetic cats - I also know that it can be difficult to change your vets way of thinking. May I ask where in the UK you are? Maybe???? you might even be near one of my friend.

Right now tho you have the Vetsulin you are working with. I saw you gave 2 units this AM. You might think about increasing this evening to 2.5 units this evening and for the next couple days. You are welcome to see what others think. But after reading thru things here more and on the vetsulin forum - I have to agree with Kimmee - I think your cat needs more insulin - You've been on canned food for 2 weeks - and still no change in readings - so an increase would be good here I think -

But please if anyone else has any ideas - please say so!

Oh are you using short or long needles when injecting?
and could you please say if your cat snores or breathes funny?

Again - I hope some of this helps in some small way - I'll check back again later
xxx


edited to add - sorry I read your SS wrong - I thought you had given 2 units steadily - Klunk try to pick one dose for right now - it might be best to stay with 2units right now - my fault - I thought you had been giving that for a couple days.
 
Sometimes I use the long needles and sometime short one. I really have no preference. Some of my cats snore and some do not. Twigie, my Scottish Fold makes some none when breathing but she is brachycephalic (swished-in face).
 
Hi

Sorry I missed that in your first message, no Timmy does not have any issues with breathing and does not snore when he is asleep. We also use the longer needles to give insulin.

To be honest I am not sure the 2units is working although his blood sugar has stayed consistently around 230 - 250 while we have been giving him the 2 units. I have just tested his urine and we have ketones again, it was just at Traceand he is still alert and eating so I have been giving him alot of water to try and flush them out like the vet advised. I am just worried that I only gave him 2 units this morning and he is not due another shot for another 7 hours so am concerned that this is going to get worse, I am going to test his blood again shortly and hope he uses the litter tray again soon so I can test again.

Thanks again :)
 
Thanks for answering Klunk. That helps alot.

I can only imagine how nerve wracking this all is for you.

How about your next shot you go back to 2.5units. I know it's just a 0.5unit increase but it's best to go slow with increases. If you can stay on that dose for for a few "cycles" and keep testing both the urine and his blood - we will watch what he does. Considering he hasn't moved much with his numbers on any dose we might have to go quicker up on the doses.

In the meantime - we need to figure out how to get your cat on Lantus. I've put out some emails to friends to see how they got Lantus from their vets in England.

Would you mind telling me where you are in England?

I'll be checking back again on you and hope I can help
 
Hi.
I agree with Patti.

YOu have room for a this curve to go lower.
A realistic caninsulin curve could look like 280-300 reshots and 80-100 peaks.
That would be a great caninsulin curve.
You can see why others are discussing the longer lasting insulin when you think about that.
They have curves that can stay under 100 for the better part of the day and much lower preshots.
I know there are members who are using them in the UK, I hope they will be along soon to comment as well.

Kimmee
 
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