Introducing Andy (and his caretaker)

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Andy and Cale

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I suppose I should start with a brief history. My 17 year old Russian Blue "Andy" was recently diagnosed with diabetes, and poor kidney numbers. As a result he's now eating medicat low protein wet and dry food, to treat the kidneys, and receiving 3 ccs of Humilin N once a day for the diabetes. During the first month the Humulin N managed to bring Andy's numbers under control, altho' he was only tested on two separate occasions, 11 hours after injection. Last week, his test showed high BG levels, and my vet seemed to be somewhat at a loss as to why. I got the impression that she has limited experienced with diabetic cats, so I began my own research. It would seem the problem is twofold. Humulin N is usually only good for about a month once first used. This means I've been giving Andy shots for some time now that have done nothing aside from annoy him. More importantly, Humulin N seems to be the least favored insulin for use in cats, due to the peaks and valleys it creates in their blood glucose. Both of these facts would have been immensely useful to know in advance. :YMSIGH:

As a result of having found these forums, I have a better understanding of what I should be doing. In addition to home testing, starting him on Levemir twice daily seems to be the way to go. I debated between it, Lantus and PZI, but the longer shelf life and availability of Levemir has pushed me in it's direction. Beyond that, I'm still trying to gather all the answers I'll need. For example, I still have to figure out the what when and how to feed him. Is open feeding taboo? Is dry food off the table? etc. Luckily these forums seem to have a wealth of knowledge to draw upon. I am thankful to have stumbled upon them.
 
Welcome!

Good for you to have done your homework. Levemir is great insulin and certainly should work better than Humulin.

We urge you to feed wet lo carb - after you start home testing. Have you seen this website by a vet: www.catinfo.org. She explains why wet is best for every cat but especially for diabetics and has great tips for transitioning from dry to wet.

Lots of us free feed. It helps support the pancreas.
 
Levemir is a great insulin and I use it for both my cats.

Dry food is out, it's too high in carbs, and it's just kitty crack. Go with low carb wet food; refer to the ones on Binky's list and aim for under 10% carbs - many feed friskies and fancy feast pates as they are decent, low carb, and inexpensive. Keep a few cans of higher carb just in case Andy's BG go too low.

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

Many use an autofeeder to space out mini meals when you are not home or even overnite.
Petsafe 5-meal Auto Feeder

Home testing, pretty important. Easy to do and may save you a trip to the ER if Andy goes too low.
Any meter from the pharmacy is good. Many in the US get the Relion as it is good and has the most economical test strips.
My main meters are Bayer and backup is OneTouch.

There really are not that many vets who know a great deal about feline diabetes, so if you like your vet and are satisfied with other areas like meds and dental and the like, then so long as the vet is willing to work with you, just stay with your vet and the 2 of you can learn together.
 
Thanks for the information. :-D
I plan to stick with my vet, she's fresh out of school and taking over for my old vet, so a lack of experience will hopefully be balanced by a willingness to learn. I'm planning to meet with her as soon as I can to discuss his soon-to-be-new insulin regime, as well as whether or not he'd be able to handle a home made diet with his kidney issue. I've cut out dry food, after reading the above article. Andy prefers wet food, so it was easy enough. Tomorrow one of my friends will inherit the remaining half bag of dry food (I'm not one for waste) tho' I'll be sure to inform him of the benefits of an all wet diet for his cat.

Hopefully, he'll be eligible for a home made diet. I already pre-prepare and freeze 75% of my own meals, so adding his food to my Sunday cookathons should fit in without any incident. If all goes according to plan, I should see an improvement in his health, as well as a noticeable decrease in feeding costs as a bonus.
 
Are you still giving 3 units of N? You took away the dry so please, do not give 3 units of N. I would give no more than 1 unit and start hometesting ASAP. There are cats that actually went into remission just from removing the dry food. Also, N doesn't last so dosing once a day (s.i.d.) is not going to do it.

If you are still giving him 3 units of N and you have removed all dry food, that dose is probably too high now. Actually it was a high starting dose to begin with. Dry is so much higher in carbs and you've taken the carb amounts way down so please, if you are still shooting that N insulin, lower the dose down and get thee to a Walmart or Pharmacy and buy a meter, test strips, lancets and Ketositx for testing urine for ketones.
 
I took him off of N as soon as I realized it was not working to begin with, having expired a month prior. Add the fact it's one of the harsher insulins for Cats, and it was an easy call to make. He's on Levemir now, and his number's are already looking much better. Tonight's pre-shot numbers were 13.2 mmol/L, or 237.6.I'll test again before bed, but he's a fairly large cat on a fairly small amount, so I'm feeling much more relaxed now than I was when I first came here. He's on an approximate .5ccs at the moment, I'm waiting for my Novopen Junior to show up so that I can get more exact measures before I start my first blood glucose curve for him. So far, so good :cool:
 
There are actually many different commercial foods that cats with both kidney problems and diabetes can eat. You don't need low protein diet unless your cat is at the end stages of CRF, and usually by then you want to feed whatever the cat will eat. With early stage CRI and diabetes, you need a canned food that is low in carbs and phosphorus, and there are many to choose from. You also preferably want a food without byproducts.

Here's a link to great page that talks about what to look for in a commercial food for cats with kidney problems: http://www.felinecrf.org/which_foods.htm#other_commercial_foods

Here's some more reading on the low protein vs low phosphorus controversy: http://www.felinecrf.org/which_foods.htm

My cat Gabby was on a high protein, low phosphorus, no byproduct diet from the time she was diagnosed with CRI, and her kidney values stayed exactly the same in the 2 years I had left with her (she passed away from stomach cancer, completely unrelated to her CRI). Furthermore, a low protein diet in a senior cat can cause muscle wasting.

I'll post the nutrition list with updated values tomorrow when I have it in front of me. Basically what you're looking for is something with less than 10% carbs, and less than 250 mg/100kcal of phosphorus. Do not use the Janet & Binky charts for phosphorus content, because many of the values have changed since that was made.
 
Great to see a post from you and to know you stopped using the N. Sounds like things are going well for Andy :razz: Size really doesn't matter when it comes to cats and insulin. Some tiny kitties may need much more than a 20 lber. would but hometesting is going to help you there. Levemir is a good insulin and there is a lot of info and help on the ISG forums for Levemir.
 
Hi Cale,

Which I assume is your name ;-) I'm glad Andy is doing better. Levemir is a very good insulin. We would welcome you on the Levemir ISG section where you can learn what those of us who have used it extensively have to share. http://felinediabetes.com/FDMB/viewforum.php?f=10

Also just a detail I want to make sure you realize so you won't be confused about the terms used on FDMB for insulin doses. Insulin is dosed in Units, not ccs or mls. For example - there are 100U of insulin in 1 cc or ml of insulin. .5 ccs of insulin would be 50 Units!

It's getting late here and probably early where you are, unless it's Canada? We'll check in tomorrow. You're doing very good with the BG testing already. Tell us more about the Novopen Jr.! Most of us use the pens with a regular syringe, but if there's a child dosing pen which measures in half units that would be wonderful!
 
Thanks so much for the chart. I think he's been getting tired of the same food day in, day out. This should definitely help change up his diet. I've been looking at getting a grinder and making Andy's food myself. It's not financially viable right this moment, however, what with his initial diagnosis, start up costs, followed by my tuition, school books and Christmas all lumping on top of each other.

NovoPen Junior is precise and fast, plus the speed seems to make it relatively painless for Andy. It does indeed measures in 0.5 unit increments, as does the NovoPen 3 Demi. While it's not marked on the pen itself, there is an audible click in between each full unit. Cost wise, here in Canada the pens themselves are given free with your first purchase of insulin, tho' it did take about a month for them to get my Junior in. Pen needle tips themselves are priced about the same as needles.
http://www.novonordisk.com/diabetes/public/insulinpens/novopenjunior/default.asp
http://www.novonordisk.com/diabetes/public/insulinpens/novopen3/demi/default.asp
 
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