Insulin increase from 5 - 8 units

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Shed74

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Dear All

I am new to this site but am find it very useful. My cat was diagnosed with diabeties last April and I spent several months with the vet trying to get his insulin levels correct by increasing his caninsulin by 1 unit each time (usually monthly) until we found his blood sugars at an acceptable level. He's been ticking along quite nicely.

I took him back to the vet in Dec for a blood test and the new vet called to say his blood sugars were high again and to increase his caninsulin from 5 units twice a day to 8 units twice a day. I said I was very uncomfortable to do this as its a big jump and id be happier to increase it to 6 units twice a day and after a month if his blood sugars are still high we could increase to 7. My cat is still on 6 units twice a day and had a glucose curve at the vets on Friday.

So what I want to know is, is an increase of 3 units acceptable? & is a glucose curve recommended even though the vet thinks he should be on a higher dose?

Also I feed him dry biscuits with half a pouch of whiskers for breakfast & 1 pouch of whiskers in the evening. Ive been reading on here about a low carb diet. My vet has never mentioned his diet & I would be interested to learn more about this and if whiskers pouches are acceptable and leave out the dry food, before I speak to my vet about it who will no doubt offer his expensive diet from the vets.

Many thanks for any help, I'll keep reading for further tips.
 
Yes, we would consider an increase of 3 units too much. We usually increase by .5 or less.

The best thing you can do for your cat is to test him at home, away from the stress of the vet's office (which can raise numbers much higher). Here is how we do it.

http://www.youtube.com/watch?v=_zE12-4fVn8

Once you know how the insulin is working, it will be much easier to figure out dosing.

You have read that we prefer wet low carb diets. But we wouldn't advise a change on the doses you are giving until you are hometesting. When we switched Oliver from dry to wet, he came down 100 points overnight. If we hadn't been hometesting and had given our usual amount, we would have sent him into a hypo.

I know it is hard to hear advice on the Internet that conflicts with your vet. All I can say is that we have a very successful protocol that works to get cats regulated and sometimes into remission.
 
Way too big an increase - over 50% :shock: -and a really bad insulin for a cat. Glad you found your way here!

Most vets don't seem to be very up to date on treating FD, you need to remember that they're like a GP and just know a little bit about lots of things. Here you have specialists :-D . Also the protocol (at least for lantus and levemir, not sure about PZI) is based on some very successful scientific studies by vets - 84% of cats in remission when they were put on the TR protocol on lantus or levemir within the first 6 months of diagnosis. Home testing is essential to follow this protocol, in fact home testing is essential to keep your cat safe when they're taking any insulin no matter what the protocol. Also you will feel much better being able to see where your cat is at...
 
Welcome! So glad you found us. Everyone here is extremely helpful.

I can't give advice on insulin, but can on food.

A low carb high protein diet is best for FD. If you take away the dry food that could help lower the high BG #s. Dry food is high in carbs. I don't know about the carb count in Whisker pouches.
Here is a link that will help you in finding food with the carb counts. It will also help you understand the diet & nutration needed for a feline.
http://www.felinediabetes.com/diabetic-cat-diets.htm

You are right about your vet trying to sell you a "vet diet". Don't buy it. You don't need it for a couple of reason. Depending on the food he might try to sell it might be higher in carbs then what your kitty really needs. Also, the price of food might be higher then some of the foods that are lower carb & better for your kitty.

What is you kitty's name?
Please keep us updated!
Jenn & Baxter
cat_pet_icon
 
goodluck,

i can't offer much advice as i am new to this, but that is a big jump, and when my vet wanted me to start increasing my kittys insulin willynilly, i came here, and discovered so much kindness, knowledge, experience, and patience so far.

something that helped me when i went cat food shopping http://binkyspage.tripod.com/CanFoodNew.html

my cat was only into eating the very saucy gravy filled foods, but he's pretty happy with wellness cat food for the past few days.

goodluck!
 
Welcome!

One trick someone here taught me is if your cat is used to gravy-style foods, you can mix warm water with the pate-style food to make a gravy. My kitty found that much more palatable than regular wet food and it can sit out longer without drying out.

Definitely the low carb food made a HUGE difference for my Scout, she's down from 2 units to 1 and doing great!

Lori
 
Shed74 said:
Dear All

I am new to this site but am find it very useful. My cat was diagnosed with diabeties last April and I spent several months with the vet trying to get his insulin levels correct by increasing his caninsulin by 1 unit each time (usually monthly) until we found his blood sugars at an acceptable level. He's been ticking along quite nicely.

I took him back to the vet in Dec for a blood test and the new vet called to say his blood sugars were high again and to increase his caninsulin from 5 units twice a day to 8 units twice a day. I said I was very uncomfortable to do this as its a big jump and id be happier to increase it to 6 units twice a day and after a month if his blood sugars are still high we could increase to 7. My cat is still on 6 units twice a day and had a glucose curve at the vets on Friday.

So what I want to know is, is an increase of 3 units acceptable? & is a glucose curve recommended even though the vet thinks he should be on a higher dose?

Also I feed him dry biscuits with half a pouch of whiskers for breakfast & 1 pouch of whiskers in the evening. Ive been reading on here about a low carb diet. My vet has never mentioned his diet & I would be interested to learn more about this and if whiskers pouches are acceptable and leave out the dry food, before I speak to my vet about it who will no doubt offer his expensive diet from the vets.

Many thanks for any help, I'll keep reading for further tips.
Click to expand...

First off, NOBODY increases their cat's dose by 3units twice a day, and that includes cats on very high doses like 30u or even 70units twice a day. The very MOST increases done are 2units twice a day. Do NOT increase by that amount.

At such a high dose, I am hoping that you are home testing, but if not, it's easy to do and anyone around this site can help you get started. People are using just an ordinary blood glucose meter from the pharmacy, like Relion if you are in the US as it's quite inexpensive and the test strips for these meters are also very inexpensive. While you are at the pharmacy, get the meter, test strips and lancets for the meter, and also a box of KETOSTIX to test the urine for ketones.
Don't worry about any sort of excuses your vet may give you why it's bad or not necessary to do, because my two cats pretty much sleep through the little poke on their ear tip to get the drop of blood to test. ALL human diabetics test their own BG numbers, so why would someone say it's not needed to test our cats? Testing is very important, but it will become even more important, vital, once you switch to decent wet low carb food appropriate for diabetic cats.

Please do NOT change the food before you are testing and lowering the dose. You cat may be safe now on the higher dose because you are feeding dry food and foods with GRAVIES. I am sure your cat LOVES the gravy foods, but they are contributing to the high dose needed.

Don't bother buying the lousy vet RX food; it's expensive and not as good as the cheaper brands you can get at the store. Many people feed their cats Friskies or Fancy Feast, or even Sophisticat or 9Lives foods - they are wet, and low carb.... stick to the pates and no gravies or grilled varieties.

So once you are hometesting, you don't need your vet's approval, and you can see what kind of numbers your cat is getting on the 6 or 7u dose, people here can help you with a plan to lower the dose and then change the food. Many cats, once fed the proper diet, become DIET CONTROLLED and do not need insulin, but in order to know for sure, testing at home, while your cat is relaxed in the cat's home, is the way to go.

Curves done at the vet office give untrue readings due to stress. My own two cats test differently at home than at the vet.... one has much higher numbers and the other has a tendency of having lower numbers at the vet office. Once they are back home and I test after about 30min, they have returned to their true BG numbers. Vet curves just cost you money for useless data, so keep your money in your pocket and test at home.
 
I echo what the others have said - a 3 unit increase is too much, you are absolutely right. If I were you I would ask to see a different vet in the practice who may - you never know - have better experience of dealing with FD. The sad fact is that not many vets are anywhere near as clued-up as they should be. But whatever they say, take any increase slowly, that's for sure.

Where are you, by the way?

Diana (Surrey, UK)
 
Sorry, I left out some very important info in my earlier reply...

My two cats have an insulin resistance condition called Acromegaly, and one also is positive for IAA, so they are a bit difference from the usual diabetic cat ... they have diabetes because they have acromegaly and not any issues with their pancreas, whereas the usual diabetic has some pancreas issues and with a little help from insulin, their pancreas may heal up and take back the duties involving insulin...these cats may get better and no longer need insulin, but cats with acromegaly are diabetic due to a growth hormone issue and will be diabetic for life.

I was referring to the doses of acromegalic cats when I mentioned high doses like 30units or 70units twice a day. Even they would increase a dose like 30units up to 32units, but only if their tests showed high BG all 12hours. Your subject caught my eye because few typical diabetic cats need 5units a day and likely none would need 8units so I was worried for your cat.

One more thing I would like to mention.... Caninsulin is not the best insulin for cats as it does not last for the full 12hours. It's OK for dogs, as in the name CANinsulin for canine, but not so good for cats.
Once you see what kind of BG numbers you are getting with a lower dose and better food, it may not matter because some cats do OK on caninsulin. If you do find that it's not lasting long enough, per your BG test numbers, you can talk to your vet about switching to Lantus or Levemir, as they are more longlasting, or even a different vet insulin like PZI.

I bet once you are testing, and feeding low carb foods, your cat may not even need half of that 5unit dose!
 
May I ask what syringes you are using? Are you using the ones made for Caninsulin (called U40 syringes) or are you using the ones you buy at a pharmacy- the kind humans use (called U100 syringes). The reason I ask is if you are using the U40 ones, then yes, a 3u increase is dangerous. But if you are using the other syringes, there's a conversion factor involved, and it would be a much smaller increase. So, before I have a heart attack, could you check on that? ;-)

Thanks.
 
I have a PhD in (human) nutrition and I say this just to let you know that I do not take expertise lightly and I value education.

That said, DO NOT TRUST YOUR VET when it comes to insulin doses or the chronic treatment of this or any other chronic disease.

Most vets simply do not have the expertise to be true experts in all diseases in all animals--as human doctors don't and that's why human doctors specialize.

I recently saved a diabetic cat from the shelter and the vet increased his dose of Lantus from 0.5 to 2.5 units in 3 days--against my request--and he insisted it was still too low. I insisted on taking him home--and had to sign a waiver that I was doing so 'against medical advice'...as if I were the one harming the cat, not them--well as I suspected, one hour after I got home and +5 after his 2.5U dose of insulin he was hypo--39. The reason the vet kept jacking up the dose was because they weren't taking glucose readings much and so they'd send him into hypo then get a rebound super high number--then assume that this was because the insulin was not working--it was but his body was on a rollercoaster of hormones trying to counteract the constant overdosing. My cat has now been on 0.25 units for the past month and doing great---never a high number anymore.

LESS IS MORE. And for any disease your cat gets, always google and find one o these specialist groups and join. I promise you, the people (who include some vets and vet techs) on this board know more than most vets. My cat who lived to 20 had heart disease, kidney disease and diabetes (Db for 5 years) and I ALWAYS questioned the vet about meds diet changes, etc. and often went against what they said (not easy) but it was always the right thing to do. Won't go into details, but you are dealing with a vet who clearly has NO CLUE. So start learning up on this board and you may even want to dial your kitty back down gradually, you must start testing, It's not hard just takes a little practice.

good luck
 
I agree that you shouldn't increase by that much ... It's excessive.

You really need to hometest and complete a curve at home. Your kitty will be less stressed and the results will be more accurate.

Are you UK based? (If so, which county)

Please don't increase the dosage without hometesting!
 
Thank you so much everyone, I now feel much more confident in tackling the vet and my cats diabeties.

A few questions to answer from above & some info about my cat, my cat is called Cefor, he's 12 years old, cross between a british blue & tabby but he looks exactly like abritidh blue & he weighs 8 kilos, not fat just a big cat, as british blues are. I have been treating him for diabeties since April 2011. I am using the caninsulin 40U needles so thats why I was very concerned with such a high increase. I live in the UK in Hampshire so would really benefit from some wet food choices from the UK supermarket/pet shop.

Ive just spoken to my vet about his curve resulst taken on Friday. Surprise surprise, Cefors levels are quite low so the vet has asked me to put him back to 5 units twice a day. I said I was happier to decrease his doseage and that id found an amazing forum and was getting some good advice, although its important to still work with a vet I want to try and manage Cefors diabeties better with diet & home testing. He agreed and said it was good I was getting more info about his condition.

The vet said he'll call me back with some prices of a glucose test kit & diabetic diet food. I just want some prices from them so I can compare them to other places. He said I could claim for the test kit through my insurance, Cefor is only insured for the first year of treatment so if I can claim for that it'll be better than buying from the pharmacy. I'll give my insurance a call to make sure.

I also have a second cat so I would need to change his diet as they often swap bowls halfway through eating and although they both go mad for eating at breakfast & tea time they only eat a small amount and go back through the day for a top up. So I dont really want to buy the expensive vet food as id have to buy it for both of my cats. Benson (the sencond cat) is not diabetic but im happy to have them on the same diet. I am very luckly that they are not fussy & will eat anything I give them so no problem there.

I'll keep reading and getting advice on here and once I am armed with my test kit I can monitor him and reduce his insulin as required.

Thanks again
Cheryl :razz:
 
Hi Cheryl, sounds like you're making really good progress, well done!

This has to be rather quick I'm afraid, but just briefly - ref food, any Whiskas or Felix meat in JELLY is absolutely fine and of course all supermarkets have the boxes with various flavours. Go for whatever you like - the poultry selection is a good bet - just make sure it's in jelly, not gravy. At the moment Sainsburys has a special offer on Whiskas pouches - two boxes of 12 pouches for £5. I stock up when they're that price! Actually any other pouch or tinned food is fine, including supermarket own brand etc, it's just the jelly bit to watch for (much higher carb content in gravy).

Yes, you should be able to claim for the glucometer and supplies (strips and lancets) through your insurance. It will be interesting to see what prices your vet gives you - I doubt if they will be bargains! Most of us have bought these things on ebay so look there for 'glucometer' (try 'One Touch Ultra' and see what comes up). Quite often you will see kits being sold which include 25 or so strips and lancets, which will get you off to a good start.

I wonder where in Hampshire you are? I grew up on the south coast and Isle of Wight, and now live in Surrey - it's a small world!

Good luck
Diana
 
There is a great deal of knowledge and expertise within the FDMB community Cheryl. It is hard sometimes to accept that a lay person can be more knowledgeable than a veterinary practitioner but this can be the case. This is not a criticism of those who work within veterinary practice, far from it. It would be unreasonable to expect them to be experts in all areas of veterinary practice. With experience comes knowledge and that experience and knowledge is freely shared here.

I wouldn't recommend specialist food from the vet. It will make a big hole in your wallet and Cefor probably won't like it. When our Sweepy tried it, it gave her wind and she only ate when she was really hungry. Diana's recommendations are really good. You might also want to try Butchers Classic Cat Food. This is available either from Sainsburys or ASDA. It was recommended to me when Sweepy was diagnosed. My current kitties (Phoebe, Mr. Jess, Pepper and Chilli Billy) still love their daily meal of Butchers. It also has an added bonus of being really cheap.

Like Diana, I am wondering where you are in Hants. I was born in Gosport and lived in Cosham until the family moved to Essex when I was thirteen.

Please keep in touch with us and let us know how Cefor is getting on

Best wishes
 
You will be much better off to get your home testing meter, strips and lancets at the pharmacy and pass on the vet's 'special' food. Go with the low carb wet foods that have been suggested.

You may also want to tell your vet that you want to switch to Lantus insulin. More and more people are using Lantus for their animals, as caninsulin is not long lasting so you will find the it barely lasts 9hours, where as Lantus and Lev last the full 12hours for cycles.
 
Gayle, I'm pretty certain that lantus is hard to get in the UK. In fact, UK'ers don't have nearly as many options as we do here in NAmerica.
 
I do know it's hard, but I know of one acro owner in UK whose vet allowed her to get Lantus because Dr. Mark E Peterson (in NY) said it was good. Maybe a mention of this NY vet's name could be helpful?
 
Sorry to be late to join in..... I spent ages writing to you and then the pooter ate it!

Simon and Dianna have covered most of the basics. I would only add to get a box of glucose powder (about£1) for use in hypo.

We live in Hastings E Sussex
I will send you a PM with my tel no

#Mary
 
Thanks everyone, this is so helpful & I feel so much more confident that I can control Cefors diabeties at home and hopefully reduce his insulin. I just thought id have to work with the vet and assumed he was correct until the massive increase in insulin he suggested, thank god I used my instinct and went against what he said, which was when I thought is better look for further help.

Vets are good but like some of you say, they cant specialise in all areas and as everyone on here has a cat with diabeties and has sought further help then I can take this knowledge and work with the vet and reduce my costs and more importantly have a positive effect on Cefors health.

Such a small world, I am a born & breed Gosport girl. I grew up in Elson, moved around Gosport a bit and have settled back in Elson.

I have found some much cheaper glucose tests on ebay and theres no way i'll buy the expensive vets food especially as id have to buy it for both cats. I'll stick to Whiskers & give Butchers a try, all wet foods and no gravy.

Thankfully Cefor has been insured for the first year so all the costs from the vet I have claimed back but after April he wont be insured and as much as I need to work with my vet for his insulin, I now have so much more knowledge & I wont have to take him to the vets as often as they have been advising for unneccessary and expensive blood tests/curves, which all make him grumpy, quite understandably!!

Many thanks
Cheryl
 
Cheryl, I take my hat off to you - you've got such a good handle on this already. I can see that you've taken on board everything we've said which is great as there's a lot to take in all at once. Carry on as you are and you'll be the one giving advice soon!

Keep coming back here with any other questions and progress reports. There are people on this board almost 24/7, all wanting to help. The advice you'll get is pretty much the same wherever in the world it comes from, plus there are, as you've seen, a few of us here in the UK who can give you additional "local" suggestions.

I'm not sure if any of us are close to Gosport (although I do know the area - I started my working life on the Portsmouth News) but you can be sure that if you do have any questions we will all do our best to give you a bit of moral support!

Good luck,
Diana
 
Thanks Diana, the information is amazing and so valuable. Im so pleased I can be more positive about treating Cefor & I no longer feel alone.

I did laugh when I read your email as I also used to work for Portsmouth News!!! I was there between April 1995 & Dec 2000, starting off as a Production Assistant in Contracts Dept then moving into the Finance office. Very small world!!

Take care & thanks again for all the advise.
Cheryl
 
The problem with most vets is that they probably have only 2 or 3 diabetics on their books, and very few vets have 24/7 experience. I know some vets have tried to rubbish advice from the internet, but all the posters here have experience of living with feline diabetes. I spent 10 years as a cat carer as we had three diabetics (one after another) and many people have had more than one diabetic. Now who was it who had SIX.? The cats would all jump up on the workbench and sit in line for ear-pricks, jabs and breakfast. Now I would respect her advice over any vet!

After I started to home test, I would do a curve and take the results into the vets. As a result we saw the vet about once a year.

Any help you need, JUST ASK

Mary
 
Before choosing a glucometer, check online and see how big a blood drop is needed.

0.3 microliter is the best, 0.5 is pretty good, 1.0 is horrible and hard to get a drop that big while kitty is patiently waiting.

Also - check for "sipping action" test strips or "approved for alternate site testing" These are easier to use with cats when we get a tiny blood sample from the ear.

The glucometers that have "TRUE..." in the name tend to be not great - giving lots of ERRORs which means wasted test strips.

I like the Maxima AST, many use the Walmart Relion Ultima as inexpensive brands. There are other good glucometers but I stopped looking when I found the Maxima AST.
 
We don't have Walmart here and I'm not sure what the UK equivalent would be - Boots or Superdrug perhaps. Both will have their own-brand meters, but I don't know anything about them I'm afraid and I doubt if other UKers do.

I think most of us here have used the One Touch Ultra with good consistent success, but don't buy it full-price, look on ebay. Ask us if you're not sure. However, as your insurance is going to pay for this, it's possible that they'd prefer an invoice from a pharmacy. You may like to check that out with them.

[I was at The News several years before you, and not in those departments. I did my training (three years) as a journalist both there and in Ryde, on the Isle of Wight, before I moved to London. These days I've put all that behind me and re-trained as an art teacher!]

Diana
 
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