Introducing Scooter

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Hi Jeff,

Just had a quick gander at Scoot's spreadsheet.

I see you've nudged the dose up to 3.25IU Vetsulin and that Scoot's now spending part of his cycle in a range that's probably under the renal threshold (varies from cat to cat but is typically somewhere in the 200s). Is Scooter drinking and peeing any less since you tweaked the dose? Also have there been any changes in his appetite; in particular is he a little less hungry by any chance?

Also did you hear anything back from the vet about the possibility of switching your boy to a longer-acting insulin? Scooter's responding well to insulin, it's just that the Vetsulin doesn't last long enough. An L insulin should make a big difference.

What's Scoot's form like today? Improving, I hope. And I hope you're sleeping a bit better, too. :)

(((Scooter)))


Mogs
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@Critter Mom @Jeff Phillips, I just noticed we are still on the Welcome board and this thread is getting rather lengthy and we try not to discuss dosing etc. on this forum. I'm sure one of the moderators will be telling us to move our discussions and advice to either Health or the Vetsulin forums very soon. So Jeff, when you next post, can you start a new thread over on Health HERE or in THIS forum for Vetsulin users. We can take a link of this thread and plant it there so we keep continuity. :)
 
Critter Mom said:
Hi Jeff,

Just had a quick gander at Scoot's spreadsheet.

I see you've nudged the dose up to 3.25IU Vetsulin and that Scoot's now spending part of his cycle in a range that's probably under the renal threshold (varies from cat to cat but is typically somewhere in the 200s). Is Scooter drinking and peeing any less since you tweaked the dose? Also have there been any changes in his appetite; in particular is he a little less hungry by any chance?

Also did you hear anything back from the vet about the possibility of switching your boy to a longer-acting insulin? Scooter's responding well to insulin, it's just that the Vetsulin doesn't last long enough. An L insulin should make a big difference.

What's Scoot's form like today? Improving, I hope. And I hope you're sleeping a bit better, too. :)

(((Scooter)))


Mogs
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He is drinking around the same amount just not peeing it out. Yes I don't use the tech terms. Heehee.

His appetite is not huge at 400-600 level but when it drops he is really hungry. I feed him a snack at +5 to +6 of his protein food. I slso see him grazing some. I know that's not ideal for control.

What I noticed on the .25 increase is he stays below 200 longer but never drops below 150 like he did in November.

You were right that 4.5 was too high. You can see that at his new +1 and +2 levels, also the drop is not as quick and the spike after peak doesn't skyrocket. Its gradual.

Im taking Scooter in to the vet tomorrow at 9am for T4 level test and she said we could talk about maybe using prozinc. Not sure but what I read this is along the same lines as vetsulin.

All in all he stays in the middle of the floor out in the open, in the kitchen or under the Christmas tree. He normally hides behind the couch when he feels ill.


What are your thoughts?

He does need a longer lasting insulin to keep him below 200-250 longer. I have the spreadsheet printed out and updated to take with us tomorrow.

Scooter hates the vet. Lol

Jeff
 
MrWorfMen's Mom said:
@Critter Mom @Jeff Phillips, I just noticed we are still on the Welcome board and this thread is getting rather lengthy and we try not to discuss dosing etc. on this forum. I'm sure one of the moderators will be telling us to move our discussions and advice to either Health or the Vetsulin forums very soon. So Jeff, when you next post, can you start a new thread over on Health HERE or in THIS forum for Vetsulin users. We can take a link of this thread and plant it there so we keep continuity. :)
Click to expand...
Yes
Thanl you
 
Hi Jeff,

Jeff Phillips said:
she said we could talk about maybe using prozinc.
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If it were my cat in this situation I'd hold out for one of the depot insulins - Levemir or Lantus (unless your vet can provide indisputable clinical evidence to prove that L insulins are contraindicated for Scooter). If my current vet was unwilling to prescribe an L insulin I think I'd try to find a vet who was willing to work to provide a better treatment for my kitty's diabetic needs.

Prozinc is another in-out insulin like Vetsulin. The dose goes in, it gets used up within 12 hours, and another dose is given.

Prozinc is supposed to have longer duration in cats than Vetsulin but consider the speed with which Scooter's metabolism is eating through each dose of his current in-out insulin: it is pretty much completely G.O.N.E. by +8 (even though in an 'uncomplicated' cat it's supposed to give another - less powerful - spurt of BG-lowering effect between +7 and +10).

My concern would be that, while Prozinc may possibly provide a little bit better cover, in a cat whose metabolism is faster than average it would still be very likely to peter out well before the next dose was due during which time BG levels would skyrocket again. Also with Prozinc there could be wide swings in BG over the course of each cycle (as is the case currently with Scooter's response to Vetsulin).

Conversely with a depot insulin like Levemir or Lantus the 'tank' of insulin in the kitty's body would provide more continuous BG-lowering effect and therefore offer the best chance of the kitty having enough insulin available in the body to provide better regulation 24 hours a day - and smoother BG levels overall.

Prozinc could prove to be a 'less bad' treatment option than Vetsulin whereas one of the L insulins should, in theory, be an effective treatment option much better suited to Scooter's particular diabetic needs.

My two penn'orth.

@MrWorfMen's Mom - Your thoughts, Linda?


Mogs
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Jeff Phillips said:
You can see that at his new +1 and +2 levels, also the drop is not as quick and the spike after peak doesn't skyrocket. Its gradual.
Click to expand...

Jeff Phillips said:
All in all he stays in the middle of the floor out in the open, in the kitchen or under the Christmas tree. He normally hides behind the couch when he feels ill.
Click to expand...

This is very important information to draw the vet's attention to, Jeff; it's further evidence in support of a switch to a gentler-acting insulin which is less likely to produce wide fluctuations in BG levels throughout the course of the day.

The whole purpose of giving insulin treatment is to make Scooter feel better. Between your BG monitoring and your observations of Scoot's clinical signs you have been able to identify a direct correlation between less violent swings in BG levels and definite improvements in Scooter's quality of life. Your vet should very much take this into account in your discussions about Scooter's treatment needs going forward.


Mogs
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I had the opportunity to help another member who was using ProZinc for her cat and while it is somewhat gentler in it's action than Vetsulin and works wonderfully with some cats, it can and does produce wild fluctuations in others. I think with HyperT in the mix, which in your case with the HyperT preceding the diabetes, could be causing insulin resistance, it makes your situation similar to mine with my high dose IAA positive cat. You are better off using a longer lasting insulin with any insulin resistance situation so that there is definitely 12 hour coverage and that little backup depot to ensure duration as well as keeping readings on a more even keel. I vote Levemir or Lantus too. :)
 
MrWorfMen's Mom said:
ProZinc [...] can and does produce wild fluctuations
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Of the spreadsheets I've seen for kitties on Prozinc I've always been struck by the number of them who have such a response; so many seem to have high BG at preshot. Given that Scooter's BG heads for the stratosphere as soon as his insulin dose wears off. Based on the data from the AM cycle where the fur shot happened that sky-high level would appear to be where Scooter's BG baseline would be were he not receiving any insulin at all. I cannot see Prozinc being of that much benefit to Scooter. Most likely it would still leave him unregulated and at very high BG levels for part of the day, just not for quite so long; hardly the ideal insulin choice for him when there are more suitable options on offer.

Jeff - keeping fingers and paws crossed here that your vet will be open to prescribing a depot insulin today for Scoot. As discussed earlier in this thread, because it doesn't sting and many cats seem to have brighter mood and better energy when being treated with it, I think Levemir would be the one to go for as a first option for Scooter.

To aid your discussions with your vet I'm uploading the PDF of the Roomp-Rand published study on the treatment of diabetic cats with Lantus and Levemir. If you print out a copy and take it with you to Scooter's consult today it may help you in securing a prescription for one of these gentler, longer-acting insulins.


Mogs
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Critter Mom said:
Of the spreadsheets I've seen for kitties on Prozinc I've always been struck by the number of them who have such a response; so many seem to have high BG at preshot. Given that Scooter's BG heads for the stratosphere as soon as his insulin dose wears off. Based on the data from the AM cycle where the fur shot happened that sky-high level would appear to be where Scooter's BG baseline would be were he not receiving any insulin at all. I cannot see Prozinc being of that much benefit to Scooter. Most likely it would still leave him unregulated and at very high BG levels for part of the day, just not for quite so long; hardly the ideal insulin choice for him when there are more suitable options on offer.

Jeff - keeping fingers and paws crossed here that your vet will be open to prescribing a depot insulin today for Scoot. As discussed earlier in this thread, because it doesn't sting and many cats seem to have brighter mood and better energy when being treated with it, I think Levemir would be the one to go for as a first option for Scooter.

To aid your discussions with your vet I'm uploading the PDF of the Roomp-Rand published study on the treatment of diabetic cats with Lantus and Levemir. If you print out a copy and take it with you to Scooter's consult today it may help you in securing a prescription for one of these gentler, longer-acting insulins.


Mogs
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Thank you Mogs:) I started a new thread but haven't learned how to tag you yet. Its under health and labeled Scooters multiple endocrine issues.

Look forward to your continued guidance over there.

Hopefully my vat will see what we see and gives him something to better level out his levels. He is acting better but the roller coaster ride of his levels can't be good.

Jeff
 
Hi Jeff,

If you look at post #60 above (post number is on right hand side of screen below the text) you'll see I've included a handy clickable link to your new thread on Feline Health. We know where to find you! :D ;)


Mogs
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